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15-104145Demolition Ciof Federal Way Permit #: 15-104145- 00 - DE Community 8 Econ. Dev. Services 33325 8th Ave S Federal Way, WA 98003 FILE Inspection Request Line: 253 835-3050 Ph: (253) 835-2607 Fax: (253) 835-2609 p Q Project Name: MATHUR Project Address: 528 SW 294TH ST Project Description: Demolish single family residence. Parcel Number: 1196001750 Owner Contractor ALOK K MATHUR PAUL MONSEF SCOTT DONOGH HOMES ANJALI MATHUR MONSEF DONOGH DESIGN GROUP LLC SCOTTDH952NB (10/13/15) 528 SW 294TH ST 2806 NE SUNSET BLVD SUITE F 2806 NE SUNSET BLVD SUITE F FEDERAL WAY WA 98023 RENTON WA 98056 RENTON WA 98056 Additional Permit Information Demolition Valuation.............................................15000 PERMIT EXPIRES Wednesday, August 16, 2017 Permit Issued on Monday, August 17, 2015 1 hereby certify that the above information is correct and that the construction on the above described properly and the occupancy andth will be in accordance with the laws, rules and regulations of the Stat of Washington and the City of Federal Way. Owner or agent: Date: I fn Fxr1P- THIS CARD IS TO MAIN ON-SITE CITY OF Construction In ction Record Federal Way INSPECTION REQ TS: (253) 835-3050 PERMIT #: 15 -104145 -00 -DE Address: 528 SW 294TH ST Project: ALOK K MATHUR FEDERAL WAY, WA 98023-3540 Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card. Final - Building (4050) Approved By V-% Date $12*,( (S� Rough Electrical Approved Final Electrical Approved ERight of Way Approved By Date By Date By Date "�7 REANED _ OF AUG 17 2015 PERMIT APPLICATION Federal Way CITY OF FEDERAL WAY jjjjj CDS PERMIT NUMHER�— C 111 I�` (� TARGET DATE ---� SITE ADDRESS SUITE/UNIT d 528 SW 294th St, Federal Way, 98023 PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL N $ ACU RS9.6 119600-1750 TYPE OF PERMIT e BUILDING ❑ PLUMBING C MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT Mathur Residence PROJECT DESCRIPTION Demo Existing Residence Detailed description of work to be included on this permit only NAME PRIMARY PRONE PROPERTY OWNER Alok Mathur 425.931.3414 HAILING ADDRESS 528 SW 294th st aloc. c.mathur@boeing.com Fedeway WA zzp 98023 NAME PHONE Scott Donogh Homes, INC 206.612.8647 HAILING ADDRESS - E-MAIL CONTRACTOR 2806 NE Sunset Blvd Ste F alok.k.mathur@boeing.com CITY STATE ZIP FAL Renton WA 98056 WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE l NAME PRIMARY PHONE Monsef Donogh Design Group, LLC 206.612.8647 APPLICANT MAILING ADDRESS 2806 NE Sunset Blvd Ste F E-MAIL paul@monsefdesign.com CITY STATE ZIP FAX Renton WA 98056 NAME PRIMARY PHONE PROJECT CONTACT Paul Monsef 206.612.8647 MAILING ADDRESS 2806 NE Sunset Blvd Ste F B.MAM paul@monsefdesign.com (The individual to receive and respond to all correspondence CITY STATE ZIP FAX concerning this application) Renton WA 98056 I PROJECT FINANCING NAME Jamie Wilson El OWNER_FII(ANCED Required Value of $5,000 or more MAILING ADDRESS, CITY, STATE, ZIP I'BONE IRCw IB.2ZG95) Washington Federal 1253.941.3805 I certify under penalty of perjury that I am the property owner or authorised agent of the property owner. I certify that to the best of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorised by the issuance of a permit I understand that the issuance of this permit doesAmot remove the owner's responsibility for compHance with local, state, or federal laws regulating construction orenvfron t laws. I further agnea to ho less the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and of c , which may be made by any person, including the undersigned, and jLled against the city, but only where such ari o the reliance of the city, including its officers and employees, upon the accuracy of the information supplied pa his plication. SIGNATURE: . 04/01 /2015 PRINT NAME: P O f Bulletin #100 —January 1, 201 Page 1 of 3 kAHandoutsTertnit Application GENERAL INFORMATION CRITICAL ARE�AAS�/ OR PROPERTY% WATER PURVEYOR PURVEYOR VALUE FMST�II.R.�GIIMPROVEMENTS # of Stories Additional Information Ew a EOOFF EXISTING/PREVIOUS USE LOT SIZE (In Sgmm Feat( VALUE OFXECH.ANI AL WORK PROPOSED fuzz SUPPRESSIOII SYSTEM? MECHANICAL PERMIT � j CV0 �j ❑ Ye No ❑Yes No is COMMER IAL — REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in oars Feet Occupancy Group(s)a Construction N of Additional Information TOTAL SUELMOG Indicate how many of each type of fix:VZe to be installed or relocated as f thisproject- Do rot includ existinq fExtures to remain. AIR HANDLING UNITS FANS GAS PIPE: OUTLETS OTHER (Describe) —�^ AIR CONDITIONER PRO.IECr AREA ONLY FIREPLACE: INSERTS C� HOODS;c�:,;,::<<a; / BOILERS Z FURNACES HOT WATER TANKS c i �C COMPRESSORS d GAS LOG SETS _L REFRIGERATION SY T DUCTING GAS PIPING WOODSTOVES V.A1,USOFPLLLif-OXG VVOWf PLUMBING PERMIT Is -I Z51:� Indicate how maLty of each t2ee 2L ix re to be uistalled or relocated as P a f this o •ect. Do not inchtde existing'fixtures to remain, BAT]iTUBS i�rTu:,;Sna�.•,.com*�; ].AVS 14. 4 S: -.k::: TOT! . S WATER PIPING j_ DISHWASHERS TRAI1NWAT N. R SYtiT:";R•1., d. L' NALS OTHER (Describe) DRAINS SHOWERS ACUUM BREAKERS L DRINKING FOUNTAINS � SINKS _ ,••� .tip WATER HEATERS (Ei--) ,.t HOSE HIBBS S'l'tiPS�� WASHING: MACHINES TOTAL FEKTURES GENERAL INFORMATION CRITICAL ARE�AAS�/ OR PROPERTY% WATER PURVEYOR PURVEYOR VALUE FMST�II.R.�GIIMPROVEMENTS # of Stories Additional Information Ew a EOOFF EXISTING/PREVIOUS USE LOT SIZE (In Sgmm Feat( 8XI81I FIRE SPRI SYSTM? PROPOSED fuzz SUPPRESSIOII SYSTEM? ADD � j CV0 �j ❑ Ye No ❑Yes No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISY&G PROPOSED TOTAL FOR OFFICE USE _. ..._._. _._._. _.. ... BASEMENT FIRST FLOOR (or Mobile Home) SECOND FLOOR Z 'Z10 COVERED ENTRY DECK GARAGE ZCARPORT ❑ OTHER (describe) Area Totals t,aa —REW HOA S OIILYa' ESTIMATED SELLING P E $ # OF BEDROOMS COMMERCIAL NEW/ADDITION AREA DFSCRI ON Area I. Square. Feat Occupancy Gron �s icy Pa) Construction # of Stories Additional Information Ew a ADD COMMER IAL — REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in oars Feet Occupancy Group(s)a Construction N of Additional Information TOTAL SUELMOG .. TENANT AREA ONLY PRO.IECr AREA ONLY Bulletin #100 —January I, 2013 Page 2 of 3 kA HandoutAPerrnit Application COMMUNITY & ECONOMIC DEVELOPMENT DEPARTMENT 33325 8`h Avenue South Federal Way, WA 98003-6325 CITY OF 253-835-2607; Fax 253-835-2609 it Wa r www.citvoffederalway.com Fedelco" DEMOLITION PERMIT REQUIREMENTS A demolition permit is required to remove any structure or structures on a subject property. Check with the City's Planning Division to see if the proposal exceeds thresholds that trigger an environmental review. An environmental review and submittal of an environmental checklist may be required, which will extend the time period before a demolition permit can be issued. ❑ Prior to submitting a demolition permit, the following items (as applicable) must be signed by the respective agency (see attached Demolition Permit Contact List). NoTE TO APPLICANT. Utilities shall be disconnected and services performed, if applicable, prior to issuance ofmolition p rmit. All applicable items below are to be signed and dated by the respective agency representatives. 4 V V /�`/} N o �© l - iri PSG A A the d t,,ll ✓p�OIC, 1 o11. ASBE S ABATEME T 4 , py of ov I form a� sto survey from Puget Sound Clean Air Agency p o 2 1 ,/ %� _ 2. GAS SUPPLY (Gas to be shut off, me r oved and final bill paid) (Puget S and Energy) 3. SEPTIC SYSTEM (Tank to be removed or tank to be drained and filled) ing County Environmental Services) 4. ANITARY SEWER (Check applicable box) wer line capped at prop" line o Existing sgwer Iiyle to,PeYffain and be used by propoped new structure, (Lakehaven Utility District) S.GARBAGE (All household r e isposed off and final bill paid) aste Management/other Company) ❑ Completed Construction Permit Application form 6. ELECTRICITY i (Electricity to be shutoff nd meter removed) A.IR - T� (Puget Sound Energy) 7. FUEL STORAGE TANKS (Above or below grade fuel tanks, have been pumped or removed under Fire DepijIt ent permit prior to any dismantle/excavation) / A (South King Fire and Rescue) /1�1NATER - Public Source (Check applicable box) lMeter to be removed and final utility bill paid X'Meter to remain and be protected d Sup,ej'SU", (Water r)) ****** OR ****** 9. WATER - Private Well (Check applicable box) ❑ Private well filled and capped a Private well o bq uspd for other purposes (King County Environmental Services) ❑ Provide the following fees: 1. Demolition Permit Fee Based on valuation. See table on pg 4 of the construction permit application. 2. Automation Fee $20.00 3. WA State Surcharge $4.50 Bulletin # 122 — February 14, 2013 Page 1 of 1 k:\Handouts\Demolition Permit Requirements • Grace Skidmore From: Paul Monsef <paul@monsefdesign.com> Sent: Tuesday, April 07, 2015 2:51 PM To: Permit Center Subject: RE: permit: 825 S 294th St Single -Family Notification Case #: 201501339 • This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)). Fee Amount Paid $65.00 Credit Card Transaction # APOFBD7FECBF Transaction Date 04/07/15 Owner's Name alok mathur Phone (425) 931-3414 Project Street Address 528 sw 294th st City federal way Zip 98023 Contact Person Paul monsef Phone (206) 612-8647 Mailing Address This project includes a demolition. Demolition Start Date 04/27/15 Completion Date 05/27/15 Demolition will be completed by the home owner I certify that: (1) This is a single-family residence project. The structure is used by one family who owns the property as their domicile. (2) The information I have provided is to the best of my knowledge accurate and complete. (3) 1 understand the fee for this Notification is nonrefundable. Create Another Notification If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. Thanks, Paul Monsef 206.612.8647 1 pawl@monsefdesign.com www.donoghhomes.net Member I Monsef Donogh Design Group, LLC • • General Manager I Scott Donogh Homes, Inc Monsef Construction Services, LLC Sent from my Mobile Device, so please excuse the spelling, grammar and brevity... From: Permit Center Sent: 4/3/2015 8:59 AM To: Paul Monsef; Permit Center Subject: RE: permit: 825 S 294th St The address referenced is not in our database or listed as an address in Federal Way Could you provide us with a parcel # so we can confirm From: Paul Monsef fmailto:paul(&monsefdesign.com] Sent: Friday, April 03, 2015 8:48 AM To: Permit Center Subject: permit: 825 S 294th St I hope to swing in and submit for a building permit for the above listed address. Is it just a drop in? or do I need an appointment? Paul Monsef 206.612.8647 j paul@monsefdesian.com 149oN5EF j 0OM0GH k0MfS Scott Donogh Homes, Inc I donoghhomes.net Monsef Donogh Design Group LLC I monsefdesign.com Monsef Construction Services, LLC JL q1EWER SERVICE CONNECTION P*IT SERVICE NO. 15587 STATUS APPLICATION PERMIT NO. 2732 5 APPLICATION DATE „ 4/81/2015 SUPERSEDES _067 STUB SIZE STUB INSTALL DATE STUB TYPE GRAVITY STUB INSTALLED BY ISSUED DATE STUB MATERIAL �� ROUTE 0230; SERVICE House # Street Name Suite ADDRESS 528 SW 294TH ST�r LOT#(S) 1271,-30 BLOCK#(S) 18 PLATBSP/BLA TAX PARCEL NO. OWNER JALOK MATHUR BILLING ADDRESS House # Street Name 528 _. S W 294TH S� CONTRACTOR AUTHORIZED CONTRACTOR CLASSIFICATION Suite SCOTT DONOGH HOMES - PAUL MONSEF PHONE ,(206). 612-8647 ext. I PHONE _ .......�� _,... _...... ., ext NUMBER OF UNITS _ V SIC ERU CREDITS TREATMENT PLANT ����PUMP S� TATIONS !" SEWER ULID 297_,,, .r. SVC TYPE DISCONNECT TMP SWR SVC ❑ PRIVATE PUMP ❑ CHK VALVE REQ ❑ GRINDER PUMP MAKE 'GRINDER PUMP MODEL SPECIAL CONDITIONS HOUSE, BEING,DEMOLISHED , AN FICATION TO SEWER SYSTEM MUST HAVE APPROVAL OF THE D STR CT ** Issued by -- ................................................... Issued Date ....�.��1.. .. ... Permits not valid unless signed by District representative Permit valid ./�............................... for six (6) months. IF BOX IS CHECKED: A connection is being made to a pressure sewer system AND a private grinder pump system is being �•�1 installed. The pressure sewer system is designed for installation of a pump, model number ONLY. Inspector's Report ........ ..s^�...... _ ..........-.7..�. j. . ..................................................................................... This permit is granted subject to the conditions set forth on the reverse side of the permit. CAUTION -................................. .............. If applicable, existing on-site sewage disposal systems, septic tanks, holding tanks, or cesspools, shall be abandoned in accordance with the approved standards and regulations of the King County Health Department, Environmental Health Services * PIPE BEDDING SHALL BE 5/8 MINUS CRUSHED ROCK BUILDINGS/STRUCTURES PROHIBITED ON SEWER EASEMENTS JOB SITE COPY * NO GLUE JOINTS - RUBBER GASKETED ONLY * DEWATER DITCH BEFORE INSPECTION * DISTRI BACKFILL , FOR INSPECTION AT: (253) 94531 24 HOUR NOTICE REQUIRED A -T ASBESTO-TEST, INC. ASBESTOS SURVEY 528 SW 2941H-- ST., FEDERAL WAY, WA 98023 Page I of S #280741 August 8, 2008 Alok Mathur 33501 1 Ph Pl. SW Federal Way, WA 98023 Ph: 425-931-3414; 253-661-1259 Alok.k.mathurCa),boeing.com On July 31, 2008 Asbesto-Test personnel conducted an Asbestos survey (per U.S.E.P.A./A.H.E.R.A. guidelines as designated and specified by Puget Sound Clean Air Agency and Washington State) of the house 6) 528 SW 294`h St., Federal Way, King County, Washington 98023. This survey purpose is to identify any Asbestos Containing Materials that may be present and will require professional removal prior to renovation or demolition. NARRATIVE OF FINDINGS BASIC CONSTRUCTION: The structure is one story wood frame on a daylight basement. The siding is wood. The torch down roofing and siding vapor barrier materials were sampled. INTERIOR CONSTRUCTION, FINISHES, AND FLOORINGS: The interior is drywall and wood. The drywall/taping material was sampled. The vinyl flooring with relating backings and mastics were sampled per each located homogenous area. The mastic materials were sampled where applicable. INSULATION: The insulation materials were sampled. CONTINUE TO PAGE 2 1429 Ave. D. PMB #187, Snohomish, WA 98290 ph: 425-489-4040, c 206-914-5500 fax: 775-665-0420 page: 206-540-2401 web: www.asbestotest.com e mail : asbestotest(a-),msn.com 0 • Page 2 of 5 August 8, 2008 CB280741 Asbesto-Test, Inc. 425-489-4040 528 SW 290' St., Federal Way, King County, Washinvon 98023 ELECTRICAL SYSTEM: The electrical wiring insulation did not appear to be of the kind to be ACM. The power may have been "on" at the time of the survey, thus sampling was not safe. Any suspect electrical wiring insulation or any suspect TSI (Thermal System Insulation) found in, around, or behind any located fuse or breaker boxes should be considered to be ACM (Asbestos Containing Material), unless determined otherwise by laboratory analysis. HEATING AND VENTILATION SYSTEM: There is baseboard electric heating in the structure. There was no visible suspect ACM located associated with the electric heating unit. Note: It was not possible to dismantle the electric heating units to locate and/or evaluate any additional suspect A CM which may be concealed, inside the units, or associated in hidden areas. It is our opinion any further handling of the heating units should be coordinated by the project manager and/or abatement contractor. If any additional relating suspect materials are located prior to and/or during any demolition or renovation, any and all additional related suspect materials should be considered to be ACM (Asbestos Containing Material), unless determined to be otherwise by laboratory analysis. Misc.: None. ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY: None. # of structures included in survey: one house Requested by: Alok Mathur Carl Dykstra Inspector, certified A.H.E.R.A. accred.# 1029787 (Expires 6/18/09) continue to page 3 Page 3 of 5 August 8, 2008 CB280741 Asbesto-Test, Inc. 425-489-4040 528 SW 294`hS_t., Federal Way, King County, Washington 98023 Any and all materials identified as ACM or PACM in this report (and/or additional materials associated with the structure that may be discovered and later identified as ACM or PACM), must be professionally abated prior to demolition. ASSESSMENT AND QUANTIFICATION OF ACM FOR ABATEMENT PURPOSES AND/OR PRICING FOR REMOVAL SHOULD BE DETERMINED BY ON SITE EVALUATION, AS LISTED QUANTITIES ARE NOT GUARANTEED AND ARE AN APPROXIMATION ONLY. SAMPLE 1 IS ASBESTOS CONTAINING MATERIAL ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL 1.0) torch down/built up roofing NAD cellulose, tar, (tar & gravel surface) fiberglass, non-fibrous materials 1.1) ROOFING FELT yes // chrysotile // 2-5% non-fibrous materials, ACM tar, cellulose, fiberglass Note: The asbestos is in the bottom layer of roofing felt material. THE ROOFING FELT IS NON -FRIABLE -1700 SQ. FT. NOTE: Any additional colors or kinds of vinyl flooring and/or tile with any relating mastics/backings that were not discovered in this survey and may later be located in this structure are also presumed to contain asbestos unless tested otherwise by laboratory analysis THERE WAS NO ASBESTOS DETECTED IN ANY OF THE REMAINING SAMPLES 2.0 sheet vinyl flooring NAD non-fibrous materials, kitchen — color: gray cellulose 2.1 mastic NAD adhesive 3.0 sheet vinyl flooring NAD non-fibrous materials, hall bathroom — color: off white cellulose 3.1 mastic NAD adhesive 4.0 sheet vinyl flooring NAD non-fibrous materials, master bathroom — color: cream & beige pattern cellulose, fiberglass 4.1 mastic NAD adhesive 5.0 insulating material NAD non-fibrous materials, on underside of kitchen sink cellulose, polymers continue to page 4 A -T • 0 Page 4 of 5 August 8, 2008 CB280741 Asbesto-Test, Inc. 425-489-4040 528 SW 290 St., Federal Way, King County, Washington 98023 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL 6.0 laminant mastic NAD adhesive, cellulose kitchen countertop 7.0 drywall walls 7.1 drywall taping compounds SAMPLED PER AHERA PROTOCOL 7.2 surface paint homogenous throughout 8.0 drywall ceilings 8.1 drywall taping compounds SAMPLED PER AHERA PROTOCOL 8.2 surface paint homogenous throughout 9.0 textured paint material except bathrooms & kitchen sample 1 9.1 textured paint material sample 2 9.2 textured paint material sample 3 9.3 textured paint material sample 4 9.4 textured paint material sample 5 10.0 masonry splash tile 10.1 mortar/mastic 11.0 insulation 12.0 siding vapor barrier material beneath wood siding exterior NAD non-fibrous materials paint, gypsum NAD non-fibrous materials, cellulose, fiberglass NAD paint, cellulose NAD non-fibrous materials paint, gypsum NAD non-fibrous materials, cellulose, fiberglass NAD paint, cellulose 12NEVE paint, cellulose, non-fibrous materials NAD paint, cellulose, non-fibrous materials NAD paint, cellulose, non-fibrous materials NAD paint, cellulose, non-fibrous materials NAD paint, cellulose, non-fibrous materials NAD non-fibrous materials NAD non-fibrous materials, cellulose NAD fiberglass, cellulose NAD tar, cellulose continue to page 5 0 0 Page 5 of 5 August 8, 2008 CB280741 Asbesto-Test, Inc. 425-489-4040 528 SW 290 St., Federal Way, King County, Washington 98023 Some sample analyses listed may be a representative analysis of individual and separate samplings and analysis of homogenous materials, as prescribed by A. H. E. R.A. protocol. Samples taken are listed with their corresponding analyses. Ifasbestos is detected, those samples containing asbestos are listedfirst and noted with the initials "ACM". If, during demolition or renovation, any additional hidden or covered suspect materials similar to those identified in the survey are located [may include but not limited to: sheet vinyl flooring, the flooring, wall or ceiling texturings or paints, concrete siding or skirting, cement pipes, cement wallboard, electrical cloth, electrical wiring insulation, thermal paper, wallboard, joint compounds, vinyl wall coverings, spackling compounds, or any other suspect TSI (Thermal System Insulation)], they should be treated as Asbestos Containing Materials unless determined to be non -asbestos by laboratory analysis. Note: Asbesto-Test, Inc. does not guarantee approximations of quantities of ACM, which may be listed with the analyses. It is therefore recommended professional abatement price and/or disposal quotes be obtained by inquiring as to fees per area of specific ACM material (i.e. square or linear foot, etc.), or by on site assessment. Any and all materials identified as ACM and/or PACM in this report must be abated prior to disturbance, renovation, or demolition. Analytical test method: USEPA 600/R93/116** (PLM); WAC 296-62-07753 App. J Kev: ACM signifies "Asbestos Containing Material" PACM signifies "Presumed Asbestos Containing Material" CAB signifies "Concrete Asbestos Board" < signifies "less than" TSI signifies "Thermal System Insulation" HVAC signifies "Heating Ventilating Air -Conditioning" NAD signifies "No Asbestos Detected" **One percent is the USEPA regulatory limit for asbestos in bulk samples. PLM has been known to miss asbestos in small percentages of some samples, which contain asbestos, thus negative PLM results cannot be guaranteed. Floor tiles and wipes should be tested with SEM or TEM, to insure analytical accuracy when reported in small percentages. Asbesto-Test, Inc. claims responsibility for sample content only. END OF REPORT ArLynn Hammond, Pres. Analytical Chemist, B.Sc. AIHA proficient CD