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HomeMy WebLinkAboutPermit D05-398 - DOAK HOMES - DEMOLITIONDOAK HOMES 11638 EAST MARGINAL WY S D05 -398 Z it- w 00 W = J CO LL: w0 =• a w Z,.. E- o Z LU M ww Ili U co O �' • r f N �J 1908 DEVELOPMENT PERMIT Parcel No.: 0733000030 Address: 11638 EAST MARGINAL WY S TUKW Suite No: Permit Number: Issue Date: Permit Expires On: Steve Lancaster, Director- DOS -398 12/08/2005 06/06/2006 Tenant: Name: DOAK HOMES Address: 11638 EAST MARGINAL WY S, TUKWILA WA Owner: Name: CEDAR GROVER PROPERTIES LLC Address: PMB 262, 3213 W WHEELER ST Contact Person: Name: DARRYL DOAK SR Address: 11812 26 AV SW, BURIEN WA Contractor: Name: DOAK HOMES INC. Address: 11812 26 AV SW, SEATTLE, WA Contractor License No: DOAKHI *092NZ Phone: Phone: 206 - 246 -6587 Phone: 206 246 -6587 Expiration Date: 08/08/2007 DESCRIPTION OF WORK: DEMOLITION OF OLD HOUSE AND REMOVAL OF ALL DEBRIS AND SEPTIC TANK Value of Construction: $3,000.00 Fees Collected: $174.55 Type of Fire Protection: International Building Code Edition: 2003 Type of Construction: Occupancy per IBC: 0022 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Fire Loop Hydrant: N Flood Control Zone: N Hauling: N Land Altering: N Landscape Irrigation: N Moving Oversize Load: N Sanitary Side Sewer: N Sewer Main Extension: N Storm Drainage: N Street Use: N Water Main Extension: N Water Meter: N Number: 0 Size (Inches): 0 Start Time: End Time: Volumes: Cut 0 c.y. Fill 0 c.y. Start Time: End Time: Private: Public: Profit: N Non - Profit: N Private: Public: doc: IBC - Permit D05 -398 Printed: 12 -08 -2005 City 0. \ Tukwila Steven M. Mullet, Mayor Department of Connnrrnity Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: ci.tulnvilama.us Z �Z �w QQ 3 UO Cl) 0 CO Lu J = t` Dw w 0 LL Q �D = �w Z HO Z E-- w UJ � o U O N OH w w. ILL O . Z . W U= O Z City O.'Tukwila Department of Co mmimity Developmei :t 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: cOukwila.wa.us * *continued on next page ** Steven M. Mullet, Mayor Steve Lancaster, Director doc: IBC - Permit D05 -398 Printed: 12 -08 -2005 i Z '~ W UO N O J H N U WO J LL Q: CO �. _ d, H W Z H O Z iH U 13' U; �O — � H' `W W S U, tL O' LLi Z, U CO) O Z ILA, �J .... 1908 3 City 0. \ Tukwila Steven M. Mullet, Mayor Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: ci.tulnvila.wa.us Permit Number: Issue Date: Permit Expires On: Steve Lancaster, Directo,- DOS -398 12/08/2005 06/06/2006 Permit Center Authorized Signature: Date: �2� irli I hereby certify that I have read and Umind Jhis permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be complied with, whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws regulating construction or the performance of work. I am authorized to sign and obtain this development permit. Signature: �� /� Date: Print Name. D'qv2- floes <. - 3 - QL_ This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection. doc: IBC - Permit D05 -398 Printed: 12 -08 -2005 Z W WD 0 0 Co o to W J = H CO lL. wO 9 � LL j �CY =w Z r - O Z f- w w �5 U� O N o t-. w W. �U LL O t.. Z 0 =, O Z City of Cul�wlla f90 Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 PERMIT CONDITIONS z Parcel No.: 0733000030 Permit Number DOS -398 ;� w Address: 11638 EAST MARGINAL WY S TUKW Status: ISSUED 2 D Suite No: Applied Date: 11/09/2005 Tenant: DOAK HOMES Issue Date: 12/08/2005 v O C J) 0 J =. 1: ** *BUILDING DEPARTMENT CONDITIONS * ** N LL w 2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the Building Official. Q U. 3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to = d start of any construction. These documents shall be maintained and made available until final inspection approval is _ granted. Z F- 0 4: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary z F- UJ sewer connections, and properly flIl or otherwise protect all basements, cellars, septic tanks, wells, and other o excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of © co this requirement. 0 w H 5: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits LL 0 presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila w Z co shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the 0 Building Official from requiring the correction of errors in the construction documents and other data. 0 z 6: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * ** 7: Contractor shall notify Public Works Utility Inspector at (206)433 -0179 of commencement and completion of work at least 24 hours in advance. _" * *continued on next page ** doc: Conditions D05 -398 Printed: 12 -08 -2005 �}:r..,:.:. -^_. •,s: ..v. �,�.i.., . ,:. r..: u,,, i... re h' ius: u��: 1... �,.`.:+...: aw. x: �. �, c. a:::, u': �:>:'.'.. :::..:...i...�.�w..:w..w._:sii_ r _ ..:.... ....::..�:.+:�.t:w.,,w._..s.s.. City of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 I hereby certify that I have read these conditions and will comply with them as outlined. All provisions of law and ordinances governing this work will be complied with, whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provision of any other work or local laws regulating construction or the performance of work. Signature: y" Date: /2- - (9 s Print Name: .i i z = Z D U U CO 0 CO W J � cn u- w O. U- ¢ CO �. Y O �_ z F- f- O z f- w U :O W W . H u. O .. Z W U CO) H _ Z doc: Conditions D05 -398 Printed: 12 -08 -2005 J �v+tu. w CITY OF TUKWILA Community Development partment Public Works Department N Permit Center tsoe 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 Building Penrt ~ .lo. Mechanical Permit No. Public Works Permit No. . Project No. For o tce use onl Applications and plans must be complete in order to be accepted for plan review. Applications will not be accepted through the mail or by fax. / * *Please Print ** -,I SITE LOCATION King Co Assessor's Tax No.: CXZI)Q_�Z 5 Site Address f b 3?r _ f 80a 10 & S `,.RgL Suite Number: Floor: Name: Mailing Address: oe Day Telephone: .7% y 6 -- e :L`�rZ— City State Zip E -Mail Address: Fax Number: GENERAL ,CONTRACTOR INFORMATION - (Mechanical Contractor information on back page) Company Name: S !/�C , Mailing Address: 1,L� /,a - 6 777 /9 -e _S': CJ . , �. ,� , K ;z- Q�p' /GI \ ` City c' e 2 O t• j 1 ala Contact Person: �%J ?2 y/ /v < <���4 /� �i- , Day Telephone: ?off; A, V 6 - e, 51F�7 E -Mail Address: Number: 2 U H Contractor Registration Number: )) &I. k M2AIZ Expiration Date: d � 4 a 0 0 7 * *An original or notarized copy of current Washington State Contractor License must be presented at the tirde of permit issuance ** ARCHITECT OF, RECORD - All plans must be wet stamped by Architect of Record Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: ENGINEER. OF RECORD - All plans must be. wet stamped by Engineer of Record Company Name: - - f / �t /� �v g r �F��.rrG A �U ,�,e� 5' r�r r y P��ii� / /u C Mailing Address: 90/ oZ 5 ql� LL, cn���n� l le ) ' ej r - 72 City state Zip Contact Person: Day Telephone f)` '�§_- 4 196 -- /0 9_3 E -Mail Address: Fax Number: 5 e- lj� 5 / Q F;3 q:\\permits plus\ice changes\permit application (7 -2004) Revised: 6-8-05 bh Page t Z ~ W JU UO D W = H Cl) LL WO 9_j LL- Q to D = �W Z H Z� W W U O- 0 E- W �O W Z U= I= � z SAS M ��•MLwY,I/{�4W:iMltj'1yY14 �air1N1:iiRKi.J4c M::.4ir.v'�.At�i. Z ~ W JU UO D W = H Cl) LL WO 9_j LL- Q to D = �W Z H Z� W W U O- 0 E- W �O W Z U= I= � z BUINp ., T rr �RNt.. ION -206 431 -3670 Valuation of Project (contractor's bid price): $ Scope of Work (please provide detailed information A �. 1 It Existing Building Valuation: $ C Will there be new rack storage? ❑ -.Yes 'No If "yes ", see Handout No. for requirements. Provide All Building Areas in Square Footage Below PLANNING DIVISION: Single- family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq ft): Floor area of principal dwelling: Floor area for accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Compact: Handicap: Will there be a change in use? ❑ ....Yes Pill' No If "yes ", explain: FIRE PROTECTIONMAZARDOUS MATERIALS: ❑.. Sprinklers ❑ ..Automatic Fire Alarm None El. Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ .. Yes ❑ .. No If ' yes ", attach list of materials and storage locations on a separate 8 -112 x l l paper indicating quantities and Material Safety Data Sheets. q:\ \permits plwicc changes\permit application (7-2004) Revised 6.8.05 Page 2 bh O I' Z �z '~ W UO UD W = CO LL W } O UQ UD = F- W Z F- F- O Z F- W 25 U O� 0 F- W F=- FU-- LL. F- U.I Z U= O H F- Z Existin Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC J` Floor {�Q 2 Floor 3` . Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck PLANNING DIVISION: Single- family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq ft): Floor area of principal dwelling: Floor area for accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Compact: Handicap: Will there be a change in use? ❑ ....Yes Pill' No If "yes ", explain: FIRE PROTECTIONMAZARDOUS MATERIALS: ❑.. Sprinklers ❑ ..Automatic Fire Alarm None El. Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ .. Yes ❑ .. No If ' yes ", attach list of materials and storage locations on a separate 8 -112 x l l paper indicating quantities and Material Safety Data Sheets. q:\ \permits plwicc changes\permit application (7-2004) Revised 6.8.05 Page 2 bh O I' Z �z '~ W UO UD W = CO LL W } O UQ UD = F- W Z F- F- O Z F- W 25 U O� 0 F- W F=- FU-- LL. F- U.I Z U= O H F- Z f { a �• `: "PUBLIC .WORKSTERMIT IN ATION - 206 433 „0179 � 1 Scope of Work (please provide detailed information): Call before you Dig: 1- 800 - 424 -5555 Please refer to Public Works Bulletin #1 for fees and estimate sheet. Water District ❑ ... Tukwila ❑... Water District # 125 ❑ .. Highline ❑ ...Renton ❑ ... Water Availability Provided Sewer District ❑ ...Tukwila ❑ ... ValVue ❑ .. Renton ❑ ...Seattle ❑ ...Sewer Use Certificate ❑ ... Sewer Availability Provided ❑ .. Approved Septic Plans Provided ❑ ...Septic System - For onsite septic system, provide 2 copies of a current septic design approval by King County Health Department. Submitted with Application (mark boxes which apply): ❑ ...Civil Plans (Maximum Paper Size — 22” x 34 ") ❑ ... Technical Information Report (Storm Drainage) El.. Geotechnical Report ❑ ... Traffic Impact Analysis ❑ ... Bond ❑ .. Insurance ❑.. Easement(s) El.. Maintenance Agreement(s) ❑ ... Hold Harmless Proposed Activities (mark boxes that a ❑...Right -of -way Use - Nonprofit for less than 72 hours ;f, ❑ ...Right -of -way Use - No Disturbance ❑ ... Construction /Excavation/Fill - Right -of -way ,.,,. . Non Right -of -way _ (A... Total Cut cubic yards ff ..Total Fill cubic yards ❑ .. Right -of -way Use - Profit for less than 72 hours ❑ .. Right -of -way Use — Potential Disturbance ❑ .. Work in Flood Zone ❑ .. Storm Drainage ❑ ...Sanitary Side Sewer ❑ .. Abandon Septic Tank ❑ ...Cap or Remove Utilities El.. Curb Cut []...Frontage Improvements ❑ .. Pavement Cut ::.' ❑ ...Traffic Control El.. Looped Fire Line ❑ ...Backflow Prevention - Fire Protection " ;': Irrigation >_ Domestic Water " ..Permanent Water Meter Size... WO# 0—Temporary Water Meter Size.. WO# I ~' ❑ ...Water Only Meter Size............ WO# ❑ ...Sewer Main Extension Public Private ❑ ... Water Main Extension .............Public Private �f ❑ .. Grease Interceptor ❑ .. Channelization ❑ .. Trench Excavation El.. Utility Undergrounding ❑ ...Deduct Water Meter Size " FINANCE INFORMATION Fire Line Size at Property Line Number of Public Fire Hydrant(s) ❑ ...Water ❑ ...Sewer ❑ ...Sewage Treatment Month Service Billing to: Name: Mailing Address: City State Zip Water Meter Refund/Billing: Name: Day Telephone: Mailing Address: City State Zip gMpermits pluslice changeslpermit application (7 -2004) Revised: 6 -tl•os bh Day Telephone: Page 3 I f I l Z iH Z �W �0 0 O W= H NU WO LL Q CO Z CY �W Z H HO Z H LU5 U ON C1 1— W W H H U— O W Z U= O Z r MECIIANICAL.PERMIT INF ATION - 206- 431 -3670 MECHANICAL ` i C OR INFORMATION Company Name: // P' 0 e llP/a-�i �c Mailing Address: 00 Z i LSE r, Contact Person: K E -Mail Address: Contractor Registration Number: F T & — .Z * *An original or notarized copy of curren Washington State Contractor n U Valuation of Project (contractor's bid price): Scope of Work ( provid detailed informatio City State Zip Day Telep one Fax N ber: Expiration Date: /J 2 eS ;Ah ust be presented at the time of permit issuance ** e Use: Residential: New ... Replacement... Commercial: New .... ❑ Replace; Fuel Tyne Electric ..... ❑ Gas... ; � _ Indicate type of mechanical work being installed anXthe quantity Unit Type: Q ty Unit Type: Qty Unit e: Qty Boiler /Com ressor: Q Furnace <IOOK BTU Air Handling nit >10,000 Fire Da per 0 -3 HP/ 100,000 BTU CFM Furnace >IOOK BTU Evaporat9f Cooler Diffuser 3 -15 HP /500,000 BTU Floor Furnace Ventil on Fan Connected Thermostat j 15 -30 HP /1,000,000 BTU to Si le Duct Suspended /Wall /Floor ilation System / Wood /Gas Stov r 30 -50 HP /1,750,000 BTU Mounted Heater Appliance Vent Hood and Duct Water Heater 50+ HP /1,750,000 BTU Repair or Addition to Incinerator - Domestic Emergency Heat/Refrig/Cooling Z Generator System I Air Handling Unit Incinerator — Comm/Ind Other Mechanical <10,000 CFM Equipment PERMIT APPLICATIONNOTES. - Applicable to all permits in this applica 'on Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This f gure will be reviewed and is subject to possible revision by the Permit Center to comply with current fee schedules. Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation. The Building Official may grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition). I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING O"E� OR THO IZED AGENT: Signature: r r Date: M �/� — 0 5 - 0 � / ce/ - ;2,c; , C 3 -7,Z - ,: Print Name Day y ( - /J.9.�� j" Day Telephone: ;2 O 6 Mailing Address: G �4 -�9t� 6 01 qt4 of /?l 10'o 9rF/ - City State Zip Date Application Accepted: Date Application Expires: Staff Initials: gMpermits plus \icc changes \permit application (7 -2004) Revised. 6.8.05 Page 4 bh f �1 Z iH Z �W JU 0 D = W H (0 W WO LLQ = �W Z t O Z F- w �5 U� O� oI.- WW F H U. F- W Z U C0 H O H Z i i j i i W O 2 w� ? 1 i M,,'•• 908 �IY C i fy of lij kwih a Steven M. Mullet, Mayor Department of Community Development Steve Lancaster, Director 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 SET RECEIPT Copy Reprinted on 12 -08 -2005 at 12:06:32 12/08/2005 RECEIPT NO: R05 -01756 Initials: BLH Payment Date: 12/08/2005 User ID: ADMIN Total Payment:628.00 Payee: DOAK HOMES, INC. ACCOUNT ITEM LIST: Description Account Code Current Pmts ------------------------ - - - - -- ---------- - - - - -- ------ - - - - -- BUILDING - NONRES 000/322.100 601.00 STATE BUILDING SURCHARGE 000/386.904 27.00 TOTAL: 628.00 Z �_- Z �W JU UO (0 13 co =: J H N IL w 0 LL Q cf' a =w F— 0 Z !— w W U� O CO. W W, 1:U LL O ul Z co O ~' Z i N)'74 2/09 9716 TMAL 62B 01) SET NAME: DOAK HOMES DEMOS SET ID: 1234 SET, TRANSAC'T'IONS: Set Member Amount ---- - - - - -- DA5;3'98f ------ - - -� -- 107.56 D05 -399 107.56 D05 -400 107.56 D05 -401 107.56 D05 -402 90.20 D05 -403 107.56 TOTAL: 628.00 TRANSACTION LIST: Type Method Description Amount - - - - -- ------ - - - - -- ---- - - - - -- Payment -- - - - - -- --------------------- check 5095 628.00 TOTAL: 628-00 ACCOUNT ITEM LIST: Description Account Code Current Pmts ------------------------ - - - - -- ---------- - - - - -- ------ - - - - -- BUILDING - NONRES 000/322.100 601.00 STATE BUILDING SURCHARGE 000/386.904 27.00 TOTAL: 628.00 Z �_- Z �W JU UO (0 13 co =: J H N IL w 0 LL Q cf' a =w F— 0 Z !— w W U� O CO. W W, 1:U LL O ul Z co O ~' Z i N)'74 2/09 9716 TMAL 62B 01) 00 �... City of Tukwila toe 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 (206) 431-3670 RECEIPT Parcel No.: 0733000025 Permit Number: DOS-398 Address: 11620 EAST MARGINAL WY S TUKW Status: PENDING Suite No: Applied Date: 11/09/2005 Applicant: DOAK HOMES Issue Date: Receipt No.: R05-01634 Payment Amount: 66.99 Initials: BLH Payment Date: 11/09/2005 01:46 PM User ID: ADMIN Balance: $107.56 Payee: DOAK HOMES INC TRANSACTION LIST: Type Method Description Amount ---------- -------- ------------------------ --- ------------- Payment Check 5083 66.99 ACCOUNT ITEM LIST: Description Account Code Current Pmts ------------------------------ ---------------- ------ - - - - -- PLAN CHECK NONRES 000/345.830 66.99 Total: 66.99 I'l /09 TOTAL 9 6 6 doc: Receipt Printed: 11-09-2005 I Z Z W 0 0 CA C3 cr) LU W 3: U— LL J 0, LL Cj) C3 W z 0 z �- W Lu, 5 co, 0 W W . LL Z co P 0 Z' INSPECTION RECORD ' J Retain a copy with permit INSPECTION NO. PER O. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 ( 0 43 -3670 Project Type of Inspection: 7 Address: Date Called: Special Instructions: Date Wanted: p.m Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: v.. t- Ins Date: $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. receipt No.: Date: �i z Z �W JU U O N 0 (0 UJI W = WO 2r L? co d = W z _ Z F- t•- O z F- W U� O N 0 H WW H U. 111 z U= O z INSPECTION RECORD -- Retain a copy with permit 1 a� INSPECTION NO. P MI NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (00 )431 -3670 Pr o'e :� � Type of Insp e.4tion: ress: Date Iled �� Spe iallnstructionsl teWanted: (3 t D a.m. gy Reque i Phone NO �0 r V Approved per applicable codes. Corrections required prior to approval. COMMENTS: E: /Jrnpe qor: Date: rai 8d 0 REINSPECTION EE REQUIRED Prior to inspection, fee must be t 630 0 Southcenter Blvd., Suite 00. Call to sechedule reinspection. Rb&glpt No.: Date: Z '~ W �U UO CO) co W J � �tL W LL Q U� 2 f.. W Z 2 F- WO W U� N 0 F- WW H� LLl Z U =. OH Z INSPECTION RECORD j 2 Retain a copy with permit y'�ti' INSPECTION NO. PERMIT NO. 1 CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 y. f� 4 Y I. k 1 i r I ' t i I I I, F i i' i P�Ject: T pe of inspection: r , Address: � � Date Called: 3K Lb Special Instructions: Date Wanted: a:r O(,Q p.m. Re uester: Phone No: ZJ Inspector: c-,pc i J Date: rl � Receipt No.: I Date: $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. 0 Z =H W W� JU UO W= S2 LL W o u_ = W f- _ Z f- Z C) WW U 0 1-- WW 11 -- U 0 W Z co O ~' Z F1 Approved per applicable codes. R Corrections required prior to approval. - Dec 08 05 09:52a American Environmental Cc 206 522 4099 p.l Af P.U. gOx 81005 Seattle, WA 98108 - 1005 Environmental Construction LLC Phone: (206) 2 67 -0746 JA Asbestos - Lead - Mold - Demolition Fax: (206) 2 E7 -0753 December 8, 2005 z Telly & Darryl Doak z Doak Homes Inc g. 11812 26 Ave SW Burien, WA 98146 0 CO ' Via Us Mail CO) - -- Wo Letter of Completion - -- (AEC Job # 5495) U- a c CY Re: Asbestos Abatement Services at: 11620, 11638, 11640 E, Marginal Way S., Seattle _ z rr-- F F- O z t—. This is to certify mat American Environmental Construction LLC has removed all of the asbestos containing materials from the above referenced address per the Asbestos o Surrey conducted by Asbesto -Test Inc., dated November 10, 2005 and our Proposal & w Contract dated November 18, 2005. U- Clearance Air Monitoring (Sample Type = CL) as reported on the attached Air Sample Data z co Sheet indicates that the airborne asbestos level is below the EPA established standard of .01 fibers /cubic centimeter for clean air after an abatement project. Accordingly, the work 0 1 area is safe, in regard to asbestos exposure, for re- occupancy and /or demolition. z Please call me at 206 - 5234441 if you have any questions or comments regarding this Letter of Completion. Respectfully submitted, America Environmental Construction, LLC I�L ra Bellows – Ad niiniitr4ve As istant It r V 1 '1 , 1 I r .1I,l1'v'Jl ♦ —0. (�r v l 1 - 1 1- ♦` 1 \A11,1, 1111 ri' 1 1 V C! A \J V r� y y y t- L ✓cV. , ..jv) 4: 7r. r',�l ❑IL L/6WA;,jNl :I \V '1 V ♦I N American rnvironmenlel : ' `r Sample Vata .Meet cage: it Job Location. Z16 �., /I� ild 1 12",Ae � u q I tar s Job#: 51 5r Samp e � 1 - // ,, , � Decon: "'"-"` Date: f . c) `7 .,� Time. Environment . � - S .R Rate: Steil -da Cou nt. Ml=scope F Area: Blank Ce 4settes: r Minutes ■ _ Sam ple ID: .. Loca Type: -Z, WorkActivlly' �M i A -- lion %•r, Observations t A d A V 0 ....�... Q Worker: d nment: Time: Start 1 �g Hate: Steps - Firers Fibers = r ... #: Tune: End &7 5 Rats: End Z. LRers lfeld !cc �. "nutes Average Z - _ M Ij'a Location: z - 1 r ti Ype: C( Work ftttvity: Mel voC erorection �2, Observati , Decon: Wcrker.. - - SS# Cert#: Envimnment 71 Start Stab: S ! Z Pump : �j I 1 mw: End / Retw. End I ? Liters de)d Ma �efmp {e In: Samp Typ C C Protection: !4-2, Decon: - _— ErMronment Pump m1wites = b o o Average 111 Zo LocaWn: (d �S L Work A Observations: Worker. -------- - -----' 71me: start - Tent: En c,...__,� Minute - • U CAD C� j L, ssit Cart# Rate: Start Fibers Fibers Ride: End ! L _ r Liters t1i Id /cc Average I Z l �6�, � loo : Coo, c - arti"09 7me P • Im Abatemfit • celing '� CL - Cleers:us • Inside Area N - HEPA Exhaust 0 - Ouhpda Area EL • Field Blank r•rn,��e M - Hal Mask A PR F - Ful Pur Mask APR PAPR CA - Conifnuous FlowAAr PA - Possure D*f"ndAk 0.3 Dew wi 6hcwer H - HEPA Vawum D - Dscon w/o Shower G - Glow+beg ME Wni Dflosure FE - Full !'ndusurb Pr - N L a z �z �w _U U0 ul U J F- (0 U_ w 0 U_ U� = a �w z E- F- O w ~ w U� U) o1- wW �U U O W z co H� Z Sanrpin Y Ype: Work Activity -j, ilk -„ Protwbn: /�- Observati / 1''n . ll ---- -� ./yj J Decon: "'"-"` Worker su. Environment rant:: Start �- J ? z Rate: Steil Pump fit: 1 Tung: End �;_� Rate: tad Man Fibers Liters !i'HCid /cc Minutes ■ Average g c - arti"09 7me P • Im Abatemfit • celing '� CL - Cleers:us • Inside Area N - HEPA Exhaust 0 - Ouhpda Area EL • Field Blank r•rn,��e M - Hal Mask A PR F - Ful Pur Mask APR PAPR CA - Conifnuous FlowAAr PA - Possure D*f"ndAk 0.3 Dew wi 6hcwer H - HEPA Vawum D - Dscon w/o Shower G - Glow+beg ME Wni Dflosure FE - Full !'ndusurb Pr - N L a z �z �w _U U0 ul U J F- (0 U_ w 0 U_ U� = a �w z E- F- O w ~ w U� U) o1- wW �U U O W z co H� Z ueo Uu ua Ua:a , 4a mmerican tnvironmentai L.o GUb oer_ 9•ubtj P,5 r - \N. • LVVi 'f.11liq IYtL LA0VNAIVI1%1LJ ii1V I%V. JjIL I. L Amerloa Environmental "ir S am ple Data Sheet Of Job i ocation I1440 t" MAf4iNfill Job fit: �! S ampled Ry: 6bd6: �'A 1 � Date: 17 7- 0 +r ime: -wank Count: Microsco Field Arcs: Bla Cassettes: Location: ,�Qt1$C ,r w 0 Typa. P 6 Work Activity: 0 Observations: 1 � N 1 •� r G IT 7n: Worker. S S P Gent#: T7me ' g " : Start Rate: Slad /G V ronmsnt: End Rate: End Time: f p Fibers Fibers Liters /tF:►d Ica e� Minutes Average jp • ~ plD:�r Sample Type: A17c-i Protection Oecon: Ernrironrnent:____ Pump #: I Locetfon: Works Act :� Qbsecvatiorts: Woker; . Tine: St art Time: End 7 Minutes a ss*: cero�: Rote: Start 4 Fibers Fibers Rate: End 1 p Liters !field /CC Average / (� p le I Location. 5 E' / 1 6 Sample Type: 7 ftric AcW4: 122 0 iq '._._5.1 Protection: Observations: i Decon: Worker j4d Y RN 4 J f AgA dO S5 ( Cart*: O 5S 2 / Environment Time: Start 0 z Rate: Start Z, Titus Ertd Rate: End Fibem Fibers Pump #' �_3 _�� _ Liters Meld !cc Mttwtes = Averag Sample ID: LI Location: g(j_c1 7— Sample Type: jgUh Work Activity: . r ,.� �,q rte. .; �• c_� i r V Protection: % Observations: DeCOrt: ---• Worker SS O: — - Cert'k Environment: Start �; f Rob: Slant Pump #: 50 7, Fibe,•a Fibers Time. End Z_ Rata: End titers !field rcx j Minutes x Average 1 l INNER VI • Btealhft Zono P - PmAbsterwit SYtRoN&= rn dwAT1QN UWACKMr CL - GhRiMm M -Hall Mesk APR D.S. Devon w i s ww H . F EPAVncrnm 1 Ame' 14 I - HEaA Exbsuat F - Fuli Floe Mask APR 0 - Neon wio Shover G - abvebag 4 - Outride Arts RL • N1 d Blank PAPR ME - Mini Eneiowre CA - Continuous Fb*Ak FE - Fuh Endosum PA - Pmmrn DemanO Air y�i%- 'i.; :. x... .. r....t. ^.'.44�. ,. ^x (c� e�, kie•..'� '.vr.T•:i �s ",r'�• ^ • ';5t �'"45U.w ?.;.i.i>;kY"4.:rS: xEri t'd^:�id�:4.�I�\;tia i�ira' »rtF�• �.au+i4.::wdw�% acct.: dig. yet. a.�.,a.: "..i,;..nu:: z i� '~ w UQ CO w= to LL w0 }} �J U_ � = W z� ZO W5 U rn o t— w w LLZ U(0 P H z n Dec 08 05 09:53a American Environmental Co 206 522 4099 P.4 �.. I 54 ASN 4 ASBESTOS WASTE SHIPMENT "PORT FORIM PLEASE PRINT OR TYPE! If you have questions, cone your local DEQ Regional Office itt Po tiand a: (;03) 224- a 5364, Salem at (503) 378 -8240 ext •272, Medford at (541) 776 -6010 M 235, or Bend at ;541) 388.6146 ext. 226, OR call (800) 452 1 -4011 for the location of your local regional DEQ office. WASTE GENERATOR: (Cunuactor, Facility, or Op:rator) I t I • Asbestos removal site name and address: Doak Formes -Darryl Doak 16 20. 1 11640 E.Mar -g n Way South Seattle WA King 9 8168 - Street City/State County Zip Ccntact person: Darryl Doak Phone. 2 06.246. 658 7 2. Operator's name and address: Arnerican Enviranmentai Construction LLC Phone: 206 - 267 -0746 7417 - A Avenue South. Seattle. WA - Kino 96198 Street C ity /S tan County "Lip 3. Waste disposal site: Northern Wasco County Landfill Phone: 541- 993 -CC89 2550 Steel Road The Dalles, OR Wasco - 97058 Street w Cityistatt County Z,p 4. Describe asbestos materials: -YkT. _ MRS 7 I L ;C Mbf p, y __ S. Containers: 'dumber: /9 AaS r,,r'4,45 _• 75616s Type: 6. Total quantity (cubicyards): Z Vd5 - 7. OPERATOR'S CERTIFICATION: I hereby dee!are that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packaged, marked and labeled, and are in all respects in preper'condition for transport according to all government regulations, All movement of this asbestus- containing material is recorded on this Waste Shipment Reco.d Form. Name: _Z Signature: Company: American Environmental Constructio Date: / U'" O - 1 1 -- 0 5 _ TRANSPORTER(S): S. Transporter k 1: (Acknowledgment of receipt of materials; Agent: _. Company: D&B Trucking Address: 1 1905 East Lincoln Ave.. Tacoma, WA 93421 Phone: 25 - 333 -3860 r �_ Signature: Date: 9. ' ransporter rr2: (Acknowledgment orrc of materials) Agent: oaver _ Company: NTSI I D&B Trucking Address. East Lincoln Ave.. Tacoma, %VA 98421 Phone: x„5'3.363 -3860 Signature: Date: DISPOSAL: (Certification of rertipt'of asbestos materials covered by this manliest, except as noted in item 11 below.! 10 Waste Disposal Site: No-thern Wasco Co unty Landfill !game and Tide. Date: Signature. _ Phone: 11. DISCREPANCY SPACE: (Add attachments us nccdcd) (Revis:d bm.')) I Z Z W JU UO N J = F— NW W 0 F O �J LL Q c = W Z H H O W �5 U ON o E- W H� LL O Z W U= O Z Dec 08 05 09t52a Y agency Case'da. 200503701 American Environmental Co 206 4099 PUG-PT SGUi`dD CLEAN Af. AGENCY ' 10 Union Street, Suite 500 Seattle, WA 98101 - :03 v^vw.ascleanair.org P . -. Date Ra.cived cnry Ut.: One � � + Jgtnc1 Ute 0,,/y i a 'NOTICE O F INTE ....�rrrrrrrr� ��� .u.rrrwrr�rrrr - A. Prniect TvncL 1.13 Friable Ash"tnt Reingyal 2. ❑ F r iahle As Removal & . 121 M tinn 3,_ 5f Derr+nlition Only - -- Property Owner: D oak Home In c _�� r M Phone: 05 .24b.658 7 ✓.2i!inG Ad :-�s: 11812 26th Ave SW ( city: Burien l State W A i�6 1 •. - l.. Asbellas 1' a. !•nLY I LC:dltl, r, Mix w•1-T,uA; Fell Ot NSIW 4A,2 M Jd . Contractor A merican Environ Cc- istructlon LLC ` Ownericco ,jo Ass elin _ B � ` r :.OrntraC.Or i ti ilin2 Add ress: P - 0 B o x 51005 F1:Gric: (CCU 523_4 lob No.' City: Seattle 1 Stott: WA Zip: 9818$ -iaOS Fa (20W 522 - + 5495 0. Sire ,1 + Address: 11620 11653, 11 East " o la rginal Way South ci Seattl ;�_ 98.68 + Site "Vlanar_.cr: Darryl Doak Local Phone: 206.372.22$0 • � �00 seestos Sun e�- o r ( T ( �o. u; Datc of Asbestos Was Friable Asbestos Identified? �e.s - -1410 1 .flat \1 Presumed I stril rcS: li - 85 'I Wes Nonfriable Asbestos Identified? I&CS CINO A1•lE:..a Buildia Certification �: 4110ch a copy' of t/te ;uive>> when firiahle zsnc x (nrprctor, Carl Dy'est a Ex , Date. 101684 - -C has not beer, :dentlfizd. I ki A NEn^.4 ou nvy r r required bdfore a dew+olulorr pnje _ _ F. Demolition Start ,,. �� �- p� ' e f t�� - er' No. of -� . U Fire LLisi Fire D;Ppt,) I Intormado_n: i Date, 1 BID (a.� Structures: 3 �2. ❑ Ordered Derno!kicr, (atta h coot of �rdef �Dento - err ditmonrnon cowractor'i nradrrrnddreuson ba.k. W ili nortfriable asbestos be Ist)t in place during demo?? U Yes 1V No 1 Con; r;tctor: Garry! Dcak If yes, list typo and :ity, Note disposal mq.tirements in St:p 6 (on back). I C. Friable Asbestos t i - Work Days: iA -Z" W Th it Sa Su i _ Prniect Information: Start Date: Completion Date: Hours: Will all friable asbestos ❑ N'es Total oiv. io be Iternoved: Linear Ft. S uarc Ft. rtateria!s be removed? ❑ No ❑ iladvrtFe trsulalion LJ Due insulation Ll P(pe Insuladon U i=irgroofing oaints LJ Plaster Ll T extured Coatings U 803rd = Pipe LJ Friable Floating LJ Friatrle Roofine Material Other: I H. Asftt:stostDernofition Project Categories) (yoti11=h1gn Period Project Demolition 1. iln ;I,:- Fnrnily Residence (owner- occupied;: Fe Sureh>trr A. ❑ Asbestos Removal Project Only A. Mor Notice A. $25 ! B. 0 Demolition Project (with or without asbcstos removal project) B. 10 Days'' !3. $50 •.'Asbestc, re_mo%ul_can begin upon notification'. demolition must wai: 10 cb �1'r te. l0he single ;crnrly residence is owned by o n e family who: hat been or,-Pill be using the residence as their domici.'e, rho cbcrv: bavis !: I or 18 May be checked If this is not air owner - occupied residence, one Qf the categories llsled below ntuv be used instead a` single !i2niily residence does nvt lncludu renlal Toverrt! nnrdtl- famif•; uni.s, or any mixed -use buildin -� _ - . - . � .... . .�, i 2. ' All Other Demolitions (with no Asbestos removal or Nonfriable Asbestos lU Gays + oily or less th 10 linear feet and /cr 4 8 square feet of friable Asbestos) ' •- ,_,,.,�,.1 lcrialrlc ,asbestos Projects (other than Sin F' amiiv Residence): Asbestos D emo '? ! 0 - 259 linear feet wed /or �t 48 • 159 square feet of asb estos I Prior Notice 10 D :.vs S 100 i 4. ' J 260 - 999 linenr feet and /or 1_60 _- 4_.999 square feet of csbestos 1' S >1.000 linear feet and/or 55.000 s uare feet of asbestos 10 Days_ I l0 Days I 5200 -- S M S F116 Sinn 6. LJ Emergency Asbestos Projector LJ Emergency 0einolition Project lsinaic.. mov ttes+acnwz are exem from crtm ercv fee: however_pr "ray ate"" must araride a Prior Notice unttc emerLency_ tequra j SSG = ruergency Fee I it 1. l ccrttiy ( at t »e �rfarmsumti con:^ n�1�n tkis neuticxion 6: svp(`iCMVntol dzw u, to t.Se bmt cf m} 0,owled9c, zC:ura ;e \k cam�lete. Age .yx'sti C}ttl ,ol Arn_ erican Environ Construct L.LG 1 ;- 23.0 _ t $ik'��Vltrre lietrlflnunp Dole ter oed / r' r Niger S\.,nd t:leaa Ai. nicest• =omi No. (6.160 (ttaviscd 2051 TS R EC E I VE D _.. r DE 02 ME Z =Z W QQ JU UO J U- W 0 U- El CO d = W H Z H 1- O WW 25 D ON 0 WW H� W Z ltj U= O Z Iles 08 05 09:52a American Environmental Co 206 522 4059 p -2 L Job Number 5455 -1 Labor and Industries u NO TICE OF Industrial Hygiene Compliance y ASBESTOS ABATEMENT (Regional addresses and phone numbers on page 2) , Today's Date No vember 28, 200 PROJECT T141S NOTICE NIUST BE RECEIVED NO LATER THAN 10 CALENDAR DAYS PRIOR TO THE START DATE COMPLETE ALL APPLICABLE BOXES - INCOMPLE'T'E OR ILLEGIBLE NOTICES. WILL NOT BE ACCEPTED MAIL OR FAX TO THE RF.,.Gr ZONAL OFFICE - CIRCLE CHANGES ON AMENbED NOTICES Notice date: 11 / 28 i 05 Itti I d mended ❑ Site Work Hours Su Mo Tu We Th Fr Sa Start date: 12 /0710S On Ole Q Off Hold ❑ 8:00 am a �� X t X X� X X Completion: 12 / 31 l 05 >~mecgencl' ❑ pm 4 :00 pm Project Dates and Wei& Hours must be Exact N CONTRACT ❑ Indoors Q O utdoors ❑ Fir eproofi ng PROPERTY OWNER Company Name ❑ Popcom ceiling Name a Neg. prey, enclosure American E nvironmental Construction LLC I ❑ CAB Doak Homes I - - Contrac r Certification Number Q Wet me-,hods Owner's Agent ❑ mini enclosure [j Critical barrier ❑ Other _ 1338 ❑ Nrlag. pipe insulation Darryl Doak RESPIRA PRO M Y ,, ❑ Mudded pipe ins. Company ^ ❑ Ducting/duct insulation ❑ Duct tape Doak Homes In d `43me E D Other Address ❑ PAPR . LA uralwll ows 11812 26th A SW hone Number City _ State ZIP +4 (206) $23 -4441 Burien WA Job Site C.A.S. Phone number t Jodn Asselin ' (206) 372 -228D ' I JOB SITE FACILITY Address Type 11620 E2stMlarglnall Wa South Residential Structure Building Name Room Age Size 40 Years nla City Seattle WA WA C Remodel ❑ Demolition [] Repair 0 Maintenance _ ZIP 4 County � 98I68 King QUAN71TY OF ASBESTOS TO BE: ❑✓ REMOVED ❑ ENCAPSULATED Quantity 310 square fe ❑ Indoors Q O utdoors ❑ Fir eproofi ng ❑ Boiler insulation CONTROL MEASURES ❑ Popcom ceiling (] Duct paper- a Neg. prey, enclosure ❑ Wrap & cut I ❑ CAB VAT ❑ G love bag Q Wet me-,hods 0 Sheet vinyl ❑ Roofing (] Asbestos paper ❑ Oter Quantity linear feet ❑ mini enclosure [j Critical barrier ❑ Other _ [i] HEPA vacuum Q M anua l m ethods Other Resulated Area ❑ Nrlag. pipe insulation ❑ Cement asbestos pipe RESPIRA PRO ❑ Air cell pipe insulation ❑ Mudded pipe ins. % mask APR I .. Type C continuous flow ❑ Ducting/duct insulation ❑ Duct tape ❑ Full face APR ❑ Type C pressure demand E D Other ❑ Other ❑ PAPR T O Other .� F413. 025 -COO notice of asbestos abatement project 11 -01 For clean copies go to http:/ /www.Ini,Nva.gov/fornts' Z ~ w D 0 to = W F- � WO Q� LLQ = W H Z F. H O Z h- WW U� ON o1-- WW LL Z l ti to Z W C11 v wo • MOr eD 00 _J J O O W d0 :NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT. PERMIT COORD COPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER D05 - 398 DATE: 11 -09 -05 PROJECT NAME DOAK HOMES SITE ADDRESS 11638 EAST MARGINAL WY S X Original Plan Submittal Response to Correction Letter # Response to Incomplete Letter # Revision # After Permit Issued DEPARTMENTS Buil'dir�g Division Pu Fire Prevention Structural ❑ Planning Division �Z Permit Coordinator ❑ DETERMINATION OF COMPLETENESS (Tues., Thurs.) DUE DATE: 1 1-10 -05 Complete ❑yJ Incomplete ❑ Not Applicable ❑ Comments: Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES/THURS ROU ING: Please Route Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE- 1 2-08-05 Approved ❑ Approved with Conditions ❑J Not Approved (attach comments) ❑ Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Oocumentshouting sllp.doc 2 -28.02 z LL QQ W UO N CO Uj �F- N LL w LL.? � = I— w _ ? I— ZO �o U rn o F- wW F-F- LL W U= O z m Look Up a Contractor, Electrician or Plumber License Detail Washington State Department of Labor and Industries General /Specialty Contractor A business registered as a construction contractor with L &I to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. License Information License DOAKHI *092NZ Licensee Name DOAK HOMES INC Licensee Type CONSTRUCTION CONTRACTOR U BI 601329337 Ind. Ins. Account Id 58243002 Business Type CORPORATION Address l 11812 26TH AVE SW Address 2 Impaired City SEATTLE County KING State WA Zip 98146 Phone 2062466587 Status ACTIVE Specialty t GENERAL Specialty 2 UNUSED Effective Date 8/9/1991 Expiration Date 8/8/2007 Suspend Date CBIC Separation Date 08/01/2001 Parent Company Previous License DOAKH* *10605 Next License 03 Associated License Business Owner Information Name Role Effective Date Expiration Date DOAK, DARRYL E SR 01/01/1980 DOAK, ESTRELLA M 01/01/1980 Account Bond Information Bond Bond Company Account Effective Expiration Cancel Impaired Bond Received Bond Name Number Date Date Date Date Amount Date Until #4 CBIC SC9910 08/01/2001 Cancelled $12,000.00 08/01/2001 03 CBIC I SC9910 1 08/01/2000 1 08/01/2001 $6,000.00 https:H fortress .wa.gov /lni/bbip /printer.aspx ?License= DOAKHI *092NZ Pagel of 3 12/08/2005 Z Z d �W W� _3 U 00 y0 co W J = F- �W W O La CO) 0 = a W Z_ H. 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