17-103488 —_
PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
CITY OF ,. , . -•_' 253-835-2607+FAX 253-835-2609+;;:,-;it._r;;:; ..........
Federal Way
PERMIT NUMBER ) — o 5 9 V — Y TARGET DATE -712,01 /7
SITE ADDRESS SUITE/UNIT#
31408 8TH AVE. SOUTH FEDERAL WAY, WA. 98003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL S
RS7.2 8588000160
I/ (401) _
TYPE OF PERMIT X BUILDING 0 PLUMBING❑ MECHANICAL DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT DINA GRIG AFH RESIDENCE
DEMOLITION OF AN 1 XTSTING RESIDENCE A
PROJECT DESCRIPTION -
Detailed description of work to
be included on this permit only
DINA GRIB PRIMARY PHONE
206 351 3464
PROPERTY OWNER MAILING ADDRESS E-MAIL
35927 30TH AVE S. dinagrib@hotmail.com
FEDERAL WAY STATE ZIP
WA
NAME PHONE
Wne, l.5 Coi r((.Dv
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE M EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE/
NAME PRIMARY PHONE
KENT VICARY 425 443 9387
APPLICANT MAILING ADDRESS E-MAIL
16225 SE 42ND PLACE
CITY STATE ZIP FAX
BELLEVUE WA 98006
NAME PRIMARY PHONE
PROJECT CONTACT KENT VICARY 425 443 9387
(Me individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 16225 SE 42ND PLACE kentvicary@yahoo.com
concerning this application) CITY STATE ZIP FAX
BELLEVUE WA. 98006
NAME
PROJECT FINANCING OWNER X 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 authorized 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 authorized 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 of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defense of such claim),which 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 city as a part of this application.
SIGNATURE:
DATE 7 / 17 / 2017
PRINT NAME: Dina Grib
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
COMMUNITY DEVELOPMENT DEPARTMENT
e8th Avenue South
AA.
Federal
Way,WA 98003
CITY OF 253-835-2607;Fax 253-835-2609
Federal Way www.cityoffederalway.com
DEMOLITION PERMIT REQUIREMENTS
A demolition permit is required to remove any structure on a subject property. Demolition of separate
structures may require separate permits.
j"t Address of Demolition: 3/ e108. V ` $ rVe/ 0// /(4 4/19( 0e0
❑ 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.
0 A completed Construction Permit Application form is also required.
e .ASBESTOS ABATEMENT
(Provide copy of"Notce ofIntentfro uget Sound Clean Air Agency 5. ELECTRICITY
and copy of inspection report by ERA-certified inspector)
C jti� i ` hof �'-
(City of Federal Way Buil ing Official) (Puget Sound En rgy/Tacoma Power)
2. FUEL STORAGE TANKS 6. N URAL GAS
❑ Under grade tank(s)is/are present
❑Above grade tank(s)are present / 5 r:� / e a
❑Tank(s)has been pumped or removed under South King Fire& 'Puget Sound Energy)
Rescue permit prior to any dismantle or excavation
, A .
(South Ki Fire and Rescue) 7.WATER- Public Source, GI,L,,,s,iJ
t ._ • � _ ............... G -I 1I7
(Lakehaven Utility District)
3.SEPTIC SYSTEM DECOMISSIONINGJ
IS
n- 8.WATER- Private Well
(King County Envir nmental Services)
iA1
(King Coun nvironmental Services)
4.
2ISE
ER 01 w P'
— 7/2_Di/ 7
(Lakehaven Utility District)
❑ 76: 64-tiA- a-, •ol measures must be inplace duringthe demolition and through
9
(ape C n-up.
kd�� /
(Applicant)
Zi'/r2-1 –e":____---2---- n, 'moo I ,S o 7- -----�"
Bu.. ,.. — ..._, ._,____ Page 1 of 1 k:\Handouts\Demolition Permit Requirements
LAKEHAYEN UTILITY DISTRICT
� ... "" H CASH RECEIPT
Receipt No: 36595
Receipt Amt: $210.00
Received By: bnelson
Received On: 1-6/1 )17-17). PM
Method of Payment I CREDIT CARD
Check No. r�
Received From: 'DINA GRIB
Receipt Type: I MISC PAYMENT
InvoiceNo: 0
Description Line Notes Wtr Amt Swr Amt Water Applications Sewer Permits Projects
Permit DISCONNECT SEWER PERMIT 1---17.17.1-73= 28152
Cats (a k-c. 11 u veivl
fbr (nip-00-i oh -thofl-
Sew 67, has l'ezn Cap pe
7/17/17,8:57 AM
WL Construction LLC
US
v.v.lysyuk@gmail.com
INVOICE
BILL TO INVOICE# 1013
Dina Grib DATE 07/12/2017
DUE DATE 07/27/2017
TERMS Net 15
ACTIVITY QTY RATE AMOUNT
House Demolition 1 1,600.00 1,600.00
Labor
Tax 1,600 0.096 153.60
BALANCE DUE $1,753.60
https://connect.intuit.com/portal/module/pdfDoc/template/printframe.html Page 1 of 2
••000 AT&T 7:49 AM * :61% MD
StrOYka Marc,*Asbestos 8
Saturday 9:05 AM
Thanks Dina, will you able to
forward me a copy of the
report, I still need it
Saturday 3:43 PM
We will charge $1650.00 for
kitchen vinyl removal,
including proper
permits, labor, disposal and
clearance paperwork for
demolition purpose.
7/13/2017 Mail-DINAGRIB@hotmail.com
3140,8 8th Ave S Federal Way 98003
Heinzle, Ellen <Ellen.Heinzle@pse.com>
Thu 7/13/2017 8:38 AM
dinagrib@hotmail.com <dinagrib@hotmail corn>;
Hello Dina,
Per our conversation this morning the gas line was disconnected on Monday 7/10/2017.
I have confirmed with our dispatch this morning that a technician is on the way to remove the electric line so that will be
done today.
If you need anything else please give us a call.
Thank you and have a great day
Ellen Heinzle
Customer Construction Services
Puget Sound Energy
888-321-7779
www.pse.com
https://outlook.live.com/owa/?path=/mail/inbox/rp 1/1
Approved Transaction Page 1 of 1
pscleanair.org
Puget Sound Clean A=r Agency
Single-Family Notification Case #: 201703245
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 #AROFEAA9CB4A
Transaction Date 07/05/17
Owner's Name Dina Grib Phone (206) 351-3464
Project Street Address 31408 8th Ave S
City Federal Way Zip 98003
Contact Person Dina Grib Phone (206) 351-3464
Mailing Address 35927 30th Ave S
Federal Way,WA 98003
This project includes a demolition.
Demolition Start Date 07/15/17 Completion Date 07/25/17
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) I 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.
https://secure.pscleanair.org/Asbestos/Approved.aspx 7/5/2017
AAA Faith Services
Limited Good Faith Asbestos Survey
l
1
Site:
31408 8th Ave S,
Federal Way, Wa 98003
Prepared for:
Deena Grib
Prepared by:
Roxanne Bradshaw
AHERA Building Inspector
Cert. #158156 Exp. 7/20/2017
AAA Faith Services #: 17-038
Date Prepared: 7/13/2017
2328 Tacoma Ave S, Tacoma, WA 98402
Office: 253-779-9872, Cell: 206-354-8995, Fax: 253-274-5040
On71512017 I, Roxanne Bradshaw of AAA Faith Services performed a "limited good faith" asbestos
survey of the of a single family mobile home located at 31408 8th Ave S, Federal Way, WA 98003.
Purpose: Identify asbestos and non-asbestos materials scheduled for demolition
Exterior: Single story, wood siding, rolled out roofing w/seam sealant, metal windows, no putty.
Interior: 3 bedroom, 2 bath, kitchen, living room, family room,
Field inspection, data collection, and report were based on the following scope of work:
Asbestos Containing Materials (ACM)
Bulk sampling of suspect ACM.
Analysis of suspect ACM by NVLAP accredited laboratory.
Identify ACM to be removed prior to demolition or renovation.
The survey was based on "visible and accessible materials" and although reasonable effort was
made to locate and test suspect materials, some suspect materials may remain hidden in walls or
below floor underlayment or other areas until demolition or renovation work makes them accessible.
Materials uncovered during the course of demolition, renovation, or maintenance activities that are
not identified in this report must be presumed to contain asbestos or other hazardous materials until
proper analysis proves otherwise.
Sampling of suspect asbestos-containing materials were conducted as prescribed in Title 40 Code of
Regulations (40 CFR) 763.86.. Also, the owner is meeting the "Good Faith" inspection requirement
defined in WAC 296-62-07721 (Hazcom to Employees). In addition 40 CFR, subpart M, Section
61.141, establishes the allowable limit of asbestos in building materials at 1% by weight. Materials
more than 1% are regulated and must be handled in accordance with all federal, state and local
regulations.
Notes and observations of bulk samples were recorded at the time of collection.
Homogeneous Material List tested for ACM:
Exterior:
17-038-1: Roof sealant, na.
17-038-2: Roof rolled, na.
Interior:
Kitchen:
17-038-3: Formica counter top, yellow, na.
17-038-4: Sheet vinyl floor, top layer, brown, na.
17-038-5: Sheet vinyl floor, bottom layer, 40% acm, yellow mastic, 2% acm,
2 lower layers off tan vinyl and gray paper baking, na.
17-038-6:Ceramic back splash, White w/calking and yellow mastic, na.
Living room:
17-038-7: Popcorn ceiling, na.
Entry to kitchen:
17-038-8: Popcorn ceiling, na.
Hallway::
17-038-9: Popcorn ceiling, na.
Family room:
17-038-10: Popcorn ceiling, na.
Bedrm 2:
17-038-11: Popcorn ceiling, na.
Entry to Kitchen:
17-038-12: GWB w/texture-2%acm &joint compound (JC) 2% acm.
Family Room:
17-038-13: GWB w/texture-2%acm &joint compound (JC) 2% acm.
Bedrm 2:
17-038-14: GWB w/texture-2%acm &joint compound (JC) 2% acm.
Family room:
17-038-15: Orange ceramic tile w/glue, fireplace, na.
Living Room:
17-038-16: Cloth wall paper, na.
Hallway:
17-038-17: Black cove base w/glue, cloth wall paper, yellow mastic, na. Wall texture, 2% acm.
Bathroom:
17-038-18: Brown formica w/brown mastic, na.
17-038-19: White Shower surround, na,
17-038-20: White sheet vinyl floor w/yellow mastic, na.
17-038-21: Paper backing w yellow glue under#20, na.
Bonus room (previous garage):
17-038-22: Black sheet vinyl under carpet, na,
Summary of ACM findings:
The following building materials must be removed prior to demolition or renovation: All GWB
w/texture and/or joint compound, and the sheet vinyl flooring in the kitchen. The ceiling joints
are also presumed to contain acm joint compound, and may be removed prior to demolition,
or during demolition if a negative exposure assessment is performed per WRD 23.30
and a asbestos supervisor or an Ahera inspector are performing air monitoring downwind
during the demolition. The operations are to be kept wet during the demo and load out, per
regulations.
Kitchen: 17-038-5: Sheet vinyl floor, bottom layer, 40% acm, yellow mastic, 2% acm,
Entry to Kitchen: 17-038-12: GWB w/texture-2%acm &joint compound (JC) 2% acm.
Family Room: 17-038-13: GWB w/texture-2%acm &joint compound (JC) 2% acm.
Bedrm 2: 17-038-14: GWB w/texture-2%acm &joint compound (JC) 2% acm
Hallway:17-038-17: Black cove base w/glue, cloth wall paper, yellow mastic, na. Wall texture,
2% acm.
Interior of home: 3 bedrm, 2 bath room, kitchen, family room, bonus room, dining area, living
room, hallway.
Required Action: Along with all asbestos identified in this report the GWB (drywall) with
texture is class 1 material and must be removed in a full containment w/ negative pressure, as
well as a decon unit w/a shower. The Asbestos identified above must be removed prior to
demolition or renovation. A Copy of this report must remain onsite for the duration of the
project. All records are to be kept in the job file after the project is completed.
During renovation and/or demolition if any other suspect material is uncovered, that is not included in
this report, work must cease until the material has been tested for Asbestos. Please see the links
below for instructions on the regulations and rules that govern both asbestos and demolition in
residential housing.
Regulations and Notifications:
Puget Sound Clean Air Agency Information for Asbestos:
http://www.pscleanair.orq/regulated/asbestos/
Labor and Industries Notification Information for Asbestos Contractors:
http://www.Ini.wa.gov/FormPub/Detail.asp?DociD=1717
Glossary of definitions:
ACM: Asbestos Containing Material
PACM: Presumed Asbestos Containing Material
AHERA: Asbestos Hazard Emergency Response Act
WISHA: The Washington Industrial Safety and Health Act
WRD: WISHA Regional Directive
HAZCOM: Hazardous Communications
Friable: Material that can be crumbled, pulverized, or reduced to powder by hand pressure or by the
forces expected to act upon the material in the course of the demolition or disposal.
Non-Friable: Material that cannot be crumbled, pulverized, or reduced to powder by hand pressure or
by the forces expected to act upon the material in the course of the demolition or disposal.
AHERA Certification
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