17-103697 RECEIVED
PERMIT APPLICATION
CITY OF
AUG A'Ir 01 2017 7
PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
Federal Way
253-835-2607+FAX 253-835-2609+permitcenter(aitvoffederalway.com
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT NUMBER / - 7 03_6 4 ?- D
6666 �✓ TARGET DATE r"
SITE ADDRESS SUITE/UNIT#
20 yo S . 3 2-01" 5 . ' d c".t.( W
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL
lay,
r00 Q ' _ 1 0Y - '7 ,0/1J q-
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL DEMOLITION ❑ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT N w C. -P14-?
be.vo 1,NA --1 4k. on rade-.
PROJECT DESCRIPTION
Detailed description of work to D.000.4 bvi\a.:,01 I 0...eProx:wwk4 Z.2( oat, S,vr. nr-1. C.ont.rsl. 5 O(s
be included on this permit only 5 400 S.r o f p4A SAL .
•
NAME PRIMARY PHONE
PROPERTY OWNER oorwtot $J e YI //J�C C-
MAILING ADDRESS E-MAIL
CITY STATE ZIP x�
xAMaCGIlS-�-(4CAi Gt'a�ip r�lcre,sa;,.� (1i.�) 4$7- V,J 8
MAILING ADDRESS E-MAIL
CONTRACTOR /4P/ 7' £ fl Incr411.-- )Cy;US ,rte
CITY
OO CVI ki AL4L- WA- ci00 - qs1- -14Iq
WA STATE///COJITRACTOR'S LICENSE f EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME e.....01 PRIMARY PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT
(The individual to receive and MAILING ADDRESS EMAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING 0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
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 does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City o Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defense,
of such claim);w ich may be made by any person,including the undersigned,and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the dity as a part oft is application.
- /
SIGNATURE: DATE
PRINT NAME: // ) SS - � 'nJ lJ1 S
Bulletin#100-January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
c
COMMUNITY DEVELOPMENT DEPARTMENT
8th.A.
Avenue South
Federal
Way,WA 98003
CITY OF 253-835-2607;Fax 253-835-2609
www.oityoffederalway.com
Federal Way
DEMOLITION PERMIT REQUIREMENTS
A demolition permit is required to remove any structure on a subject property.Demolition of separate
structures may require separate permits.
❑ Address of Demolition: 2-020 3'- 32-04 bi--4lisr ft Fdeal (Arb 7l6v3
❑ Prior to submitting a demolition permit,the following items must be signed by the respective
agency or their approvals attached.Items not applicable to your project should be marked N/A.
n A ompleted Construction Permit Application form is also required.
.ASBESTOS ABATEMENT
(P • id- c f of Notii- C'if tfrom Puget Sound Clean Air Agency ,6�ELECTRICITY / _
�,'d c.T •f inspe 'on re .y A RA•cerdfied inspector) / i'�_ ?S3—p 0'452-
/ 4 / di " . � Psi j . .y spm.
��II��b t. nom- a. - •uget Sound Energy/Tacoma Power)
""'"'-'''-'•ederal Way Bui ding Me)
NATURAL GAS
/FUELSTORAGETANKSUnder grade tank(s)is/are present
CI Above grade tank(s)are present (VA
❑Tank(s)has been pumped or removed under South King Fire&Rescue (Puget Sound Energy)
permit prior to any dismantling or excavation
(South King Fire and Rescue) 7.7-Pu is S urce
.....-- 7/c3ih 7
(Lakehave tility District)
3.SEPTIC SYSTEM DECOMISSIONINGfiler-ER CFF g OW i
/ 8.WATER-Pr a e Well
GG (King County Environmental Services)
( ng County Environmental Services)
4.SANITARY SE R 7
L (Lakehaven Utility ctq)
c J Z ,4 ecr Lcl
I Please Note: Erosion control measures nus e- in place during the demolition and through
completion of the site clean-up.
.11111.7 (,"T.11f�Pr".
Bulletin#122—March 16,2017 Page 1 of 1 k:\Handouts\Demolition Permit Requirements
Approved Transaction Page 1 of 1
pscleanair.org
Puget Sound Clean Air Agency
Notification Case #: 201703362
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#AT0FFC550672
Transaction Date 07/11/17 •
Owner's Name NWCC Center Plaza LLC-Johanna Barnhart Phone (206)432-3105
Project Street Address 2020 5 320th St
City Federal Way Zip 98033
Contact Person Johanna Barnhart Phone (206)432-3105
Mailing Address 1402 East Pike St
Seattle,WA 98122
This project includes a demolition.
Demolition Start Date 07/24/17 Completion Date 08/24/17
Demolition will be completed by a demolition contractor
Demo Contractor Construction Group Intl LLC Contractor Job* D17232
Contact Mark Marcell Phone
(425)487-2618
Mailing Address 19407 144th Ave NE Bldg D
Woodinville,WA 98072
(1)I certify that the Information I have provided Is to the best of my knowledge true and accurate.
(2)I understand that I must file an Amendment to this Notification If:
• The type of project has changed.The project types are asbestos and demolition.
• The quantity of friable asbestos to be removed meets a larger project category.
• The project's start or completion date has changed.
(3) I understand one Notification must be filed for each structure. The only exception is for
a single-family residence that includes multiple ancillary structures, such as a detached
garage or other outbuildings having the same street address. If there is no street address, I
have used a building number.
(4) I understand the fees for this Notification are nonrefundable.
View History Lou Out
If you have questions,contact us at asbestos@psdeanair.org or 206.689.4058.
•
Mins://secure.nscleanair.ore/Asbestos/Anoroved.asnx 7/11/2017
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VI
Contents
Executive Summary 1
Introduction 1
Methodology and Scope of Work 1
Site Characterization 2
Findings 2
Conclusions&Recommendations 2
Limitations 2
APPENDIX A: Asbestos Sample Inventory
APPENDIX B: Laboratory Reports and Chain of Custody
Forms
APPENDIX C: General Asbestos Abatement
Requirements
APPENDIX D: Glossary of Terms
APPENDIX E: Accreditation
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Limited Asbestos Survey of Fire Damaged Materials(06/14/77)
Commercial Property-2020 S 320dh St Federal Way, WA 1 of 3
•
Executive Summary
Forensic Analytical Consulting Services, Inc. (FACS)was retained by American Technologies, Inc. (ATI)
to perform a limited inspection for fire damaged asbestos-containing materials (ACM)at the commercial
property located at 2020 S. 320th St. in Federal Way, Washington. FACS conducted the initial site visit
and bulk asbestos sampling on May 22, 2017 and a second site visit with additional bulk asbestos
sampling on June 8, 2017. The survey was limited to readily accessible suspect materials and debris
resulting from the catastrophic fire which occurred on May 19, 2017. The fire resulted in the majority of
the building being burned to the ground. Results of sampling indicated that asbestos was detected in
two of the building materials sampled during the inspection. A more detailed discussion of findings and
conclusions is provided below.
Introduction
FACS conducted a limited inspection for ACM at the commercial property located at 2020 S. 320th St. in
Federal Way, Washington. AHERA-Accredited Inspector Ryan Anderson of Rose Environmental
conducted the first site visit on May 22, 2017 and the second site visit on June 8, 2017 at the request
and direction of Nathan Kazlauskas of ATI. The limited asbestos survey consisted of a visual and tactile
inspection and sampling of suspect ACM throughout accessible areas of the building and debris resulting
from the catastrophic fire event on May 19, 2017. The purpose of the survey was to identify asbestos in
materials prior to demolition of the building and provide recommendations for safe handling of these
materials during the project.
Methodology and Scope of Work
FACS's inspection was limited to the accessible materials and debris within the fire damaged construction
debris which will be impacted by the demolition of the building.
Materials suspected of containing asbestos were sampled in accordance with the federal EPA AHERA
protocols(40 CFR 763 Subpart E). Materials determined by the inspector to be non-suspect, such as wood,
metal,glass, and fiberglass insulation, were not sampled. Additional suspect building materials may be
present in areas that were inaccessible, unsafe to inspect, or obscured from view during the inspection
process.
Suspect materials were grouped and classified as homogeneous materials based on their appearance,
usage, and age of the building. Representative samples of each homogeneous material were collected for
laboratory analysis.
Samples were collected in a manner to minimize release of the material into the surroundings. Material
type, sample number, sample location and other pertinent information were recorded at the time of
sampling. Each sample was placed in a sample container labeled with a unique sample number, sealed,
and submitted to the Forensic Analytical Laboratory, Inc. (FALI), a NVLAP(National Voluntary Lab
Accreditation Program)accredited laboratory, for analysis following appropriate chain of custody
procedures. Samples were analyzed in accordance with EPA Method 600/R-93-116, using polarized light
microscopy(PLM)with dispersion staining and using visual area estimation to determine percent asbestos
content. This method allows for the identification of the primary type(s)of asbestos used in building
materials. The lower limit of detection for this method is one percent. Samples containing less than one
percent asbestos by PLM with visual area estimation are reported as Trace.
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Limited Asbestos Survey of Fire Damaged Materials(06/14/77) 2 of 3
Commercial Property-2020 S 32e St Federal Way, WA
Site Characterization
• The subject property was a single-story multi-tenant retail commercial structure. Interior materials
included drywall, ceiling tile and concrete. Exterior materials included wood siding and brick with terra
cotta roofing tiles and composition roofing. Due to the severity of the fire damage, other building
materials may be present at the site that were inaccessible and/or indistinguishable at the time of the
inspection.
Findings
Asbestos was detected in two identifiable materials sampled during this inspection:
• Black roofing mastic/binders on associated asphaltic roofing materials-This material was
located throughout the roof and currently throughout fire damaged construction debris.
• Black mastic on metal flashing -This material was located throughout metal roof flashing and
is currently located throughout fire damaged construction debris.
A detailed summary of asbestos sampling results is provided in Appendix A. Laboratory reports are provided
in Appendix B.
Conclusions & Recommendations
Local, State, and Federal regulatory agencies define asbestos-containing materials (ACM)as those that
contain greater than 1% asbestos. Asbestos was detected at concentration>1% in two materials
sampled during this inspection.
All of the ACM identified in this survey must be removed in accordance with all Federal, State, and Local
regulations by a licensed asbestos abatement contractor prior to renovation or demolition activities that will
impact them. If any additional suspect materials, are encountered during the course of demolition,
renovation, remodeling, or maintenance work that are not reflected in this survey, such material(s)shall not
be disturbed until further sampling can determine whether or not it is asbestos containing.Alternatively,
these materials may be assumed to be ACM and removed by a licensed asbestos abatement contractor. For
detailed regulatory requirements in specific situations, FACS should be consulted, or the applicable
regulations should be examined.
Due to the condition of the building following the catastrophic fire event, FACS recommends all asphaltic
roofing materials and fire damaged debris in and around the structure be removed and disposed of as ACM
and/or asbestos contaminated waste. Any water used in this process should also be captured and filtered
prior to disposal. See Appendix C for general asbestos abatement requirements.
Limitations
This investigation is limited to the conditions and practices observed and information made available to
FACS.The methods, conclusions, and recommendations provided are based on FACS'judgment,
experience and the standard of practice for professional service. They are subject to the limitations and
variability inherent in the methodology employed. As with all environmental investigations, this
investigation is limited to the defined scope and does not purport to set forth all hazards, nor indicate that
other hazards do not exist.
www forensicanalytical corn Forensic Analytical Consulting Services
Limited Asbestos Survey of Fire Damaged Materials(06/14/17)
Commercial Property-2020 S. 32dh St Federal Way, WA 3 of 3
The regulated building materials and conditions presented in this report represent those observed on the
• dates we conducted the sampling. This sampling is intended for the exclusive use of ATI for specific
application to the referenced property. This assessment does not replace, nor can be used as,
professionally developed construction or demolition plans, specifications, or bidding documents. This
report is not a legal opinion.
Please do not hesitate to contact our office at 503-595-1001 if you have any additional questions or
concerns. Thank you for the opportunity to assist ATI in promoting a more healthful environment.
Respectfully, Reviewed by,
FORENSIC ANALYTICAL FORENSIC ANALYTICAL
• r\t'itA
Robin Sharpe-Yablonka Michael S. Andrew, MS, CIH, CSP, LEED AP
Senior Project Manager
ar. icw na, '{
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Kagr_n ` \IYpAOP--ASV
www forensicanalytical.com Forensic Analytical Consulting Seivices
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A..endix A
Sample Material Description Sample Location Material Location Asbestos%and Type Quantity
Number
Throughout Asphaltic Roofing
522-1 Roof Mastic/Binders, NE Roof Materials and Suspected Mastic/Binders-19% Not
Black Throughout Fire Damaged Chrysotile Quantified
Construction Debris
522-2 Drywall and Joint SE -- ND --
Compound
Metal Flashing w/Brown
Paint—ND
Metal Flashing(w/Brown Throughout Roof Flashing
522-3 Metal Roof (w/
r want NE Roof Materials and Suspected Mastic,Black-3% Not
andPaiMastic,aoBlack Throughout Fire Damaged Chrysotile Quantified
Construction Debris
Roof Underlayment-ND
522-4 Asphaltic Roofing,Black NE Roof — ND --
522-5 Acoustic Ceiling Tile SE Ceiling — ND —
522-6 Drywall and Joint ESE -- ND —
Compound
522-7 Asphaltic Roofing,Black Within Fire Damaged -- ND —
Construction Debris
522-8 Terra Cotta Roof Shingle Within Fire Damaged -- ND --
g Construction Debris
Ceramic Tile,Dark Red and NE Restaurant Space,
68-1 __Grout Bathroom ND —
68-2 Roofy PPenetration Sealant, NE Restaurant Space -- ND --
Throughout Asphaltic Roofing Asphaltic Roofing-ND
58-3 and
Roofing,Black NE Restaurant Space Materials and Suspected Not
and Underlayment Roof Throughout Fire Damaged Mastic/Binders-2% Quantified
Construction Debris Chrysotile
Resilient Flooring Material, NE Restaurant Space,
68-4 Off-White near NE Entrance - ND —
www forensic-analytical com Forensic Analytical Consulting Services
•
A.•endixA
Sample Material Description Sample Location Material Location Asbestos%and Type Quantity
Number
68-5 •
Ceramic Floor Tile,Cream SE Suite Space — ND -
and Grout
68-6 Window Glazing,Black SE Suite,Exterior _ ND Window --
68-7 Debris,Black,Dark Grey, NE Space - ND --
and White
68-8 Debris,Black,Dark Grey, South/Central Space — ND --
and White
68-9 Debris,Black,Dark Grey, West/Central Space -- ND —
and White
Nob:
ND=None Detected
Samples in bold indicate samples that tested positive for asbestos
i vi vw forensicana/ytica/cornForensic Analytical Consulting services
Appendix B
Appendix B
Laboratory Report and Chain of Custody Forms.
www foreiisicana/ytica/corn Forensic Analytical Consulting Services
May 23, 2017
IN .
LABS
INDUSTRIAL
Martin Rose HYGIENE
Rose Environmental SERVICES
2208 Market St. #207 Laboratory I Management I Training
Seattle, WA 98107
RE: Bulk Asbestos Fiber Analysis; NVL Batch#1709131.00
Client Project: 09 Fedway ACM
Location: Federal Way
Dear Mr. Rose,
Enclosed please find test results for the 8 sample(s) submitted to our laboratory for analysis on
5/22/2017.
Examination of these samples was conducted for the presence of identifiable asbestos fibers using
polarized light microscopy (PLM) with dispersion staining in accordance with both EPA 600/M4-82-020,
Interim Method for the Determination of Asbestos in Bulk Insulation Samples and EPA 600/R-93/116
Method for the Determination of Asbestos in Bulk Building Materials.
For samples containing more than one separable layer of materials, the report will include findings for
each layer (labeled Layer 1 and Layer 2, etc. for each individual layer). The asbestos concentration in
the sample is determined by calibrated visual estimation.
For those samples with asbestos concentrations between 1 and 10 percent based on visual estimation,
the EPA recommends a procedure known as point counting (NESHAPS, 40 CFR Part 61). Point
counting is a statistically more accurate means of quantification for samples with low concentrations of
asbestos.
The detection limit for the calibrated visual estimation is <1%, 400 point counts is 0.25% and 1000 point
counts is 0.1%
Samples are archived for two weeks following analysis. Samples that are not retrieved by the client are
discarded after two weeks.
Thank you for using our laboratory services. Please do not hesitate to call if there is anything further we
can assist you with.
Sincerely,
_
Nick Ly, Technical Director
KwitapNVL Laboratories, Inc.
1.888.NVL.LABS Enc.: Sample Results
1.888.(685.5227) Lab Code:102063.0 4708 Aurora Ave N, Seattle,WA 98103
www.nvllabs.com p 206.547.0100 I f 206.634.1936
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