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HomeMy WebLinkAboutPermit D05-400 - DOAK HOMES - DEMOLITIONDOAK HOMES 11640 EAST MARGINAL WY S D05-400 , . , • `:. t, „.■ ; � Q lG) N JF 1908 City of Tu kwila DEVELOPMENT PERMIT Parcel No.: 0733000030 Address: 11640 EAST MARGINAL WY S TUKW Suite No: Tenant: Name: DOAK HOMES Address: 11640 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: Stever: M. Mullet, Mayor Steve Lancaster, Directot- DOS -400 12/08/2005 06/06/2006 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 Number: 0 Size (Inches): 0 Flood Control Zone: N Hauling: N Start Time: End Time: Land Altering: N Volumes: Cut 0 c.y. Fill 0 c.y. Landscape Irrigation: N Moving Oversize Load: N Start Time: End Time: Sanitary Side Sewer: N Sewer Main Extension: N Private: Public: Storm Drainage: N Street Use: N Profit: N Non - Profit: N Water Main Extension: N Private: Public: Water Meter: N doc: IBC-Permit D05-400 Printed: 12-08-2005 .• ,;,. ��.. �.4 .: .L.. �...:.... � �t..: ..._. �..:...:t.::- �.....«. U.`. �.' x. t: rv.: �: �..,.+. r.. w..: o-w' �bw.l. I, iNI' J, t: xa.. x: �. ve:. w...�:. r�tub:.ial..iw.:::'wa4++ iii.:.. i.+: w��wJJ.t'IJ�F:o[u' <:�.SSW.�r..: Ails' �:.: N.ss.�If..Lkii3rlwtS..��r'.....: ,�-:'y � +v:41«w w,:.! ».v Permit Number: Issue Date: Permit Expires On: Department of Community Developnnent 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: ci.tufivila.wa.its Z ;H Z �w QQ JU UO N o co LLJ J = (D L w O LL co = a �. w Z I_ 0 Z �- w w U 0 � o�_ w W u. 0 tll Z 0 O Z --N City oiL Tukwila Department of Commartity Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206- 431 -3670 Fax: 206 - 431 -3665 Web site: ci.tttkwila * *continued on next page ** Steven M. Mullet, Mayor Steve Lancaster, Director Z w m u� D J U 0 N 0 W= CO LL W O U- Q N _. _ d W a Z F- H O Z F—: 2= ' D O � W W: H LL O U U' O Z doc: IBC - Permit D05 -400 Printed: 12 -08 -2005 City G. Tukwila Department of Community Developnient 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206- 431 -3670 Fax: 206 - 431 -3665 Web site: ci. ukivila.wa.us Permit Number: Issue Date: Permit Expires On: Steven M. Mullet, Mayor Steve Lancaster, Director D05 -400 12/08/2005 06/06/2006 Permit Center Authorized Signature: Date: 1'2- 1.0 l� I hereby certify that I have read and tm ind his 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 I regulating construction or the performance of work. I am authorized to sign and obtain this development permit. Signature: �--� Q ) Date: Print Name: ' ejZVL 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. Z �W QQ� _3 L) UO U 0 wi J H CO LL W O I LL �D = �W Z ZO W UJ U� O N O H W W LL w Z U= O Z doc: IBC - Permit D05 -400 Printed: 12 -08 -2005 - �..�.� City of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 PERMIT CONDITIONS z Parcel No.: 0733000030 Permit Number DOS-400 Address: 11640 EAST MARGINAL WY S TUKW Status: ISSUED w a: W Suite No: Applied Date: 11/09/2005 D . Tenant: DOAK HOMES Issue Date: 12/08/2005 U O N o CO W J = 1: ** *BUILDING DEPARTMENT CONDITIONS * ** J LL O 2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the Building Official. Q LL 3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to = CY start of any construction. These documents shall be maintained and made available until final inspection approval is _ granted. Z H O 4: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary z H LU Uj sewer connections, and properly fill 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 0 cn this requirement. 0 1-- W UJ 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 O presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila tii Z co shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the v Building Official from requiring the correction of errors in the construction documents and other data. p f— 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 -400 Printed: 12 -08 -2005 lb J ,�tltUl ly �` I ..� Cit of Tul, wila I 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: r Date: 12 -�,-5 Print Name: DnR -F doc: Conditions D05 -400 Printed: 12 -08 -2005 Z �~ W JU . U to o CO W J = F- Q U. w O LLQ .-d = w z �.- I- O Z R 2 LU 5 U 0, O N O F- W W F- u. 0 W Z U= O F " Z 7 CITY OF TUKWILA Community Development Department Public Works Department Permit Center 190 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 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 ** SITE LOCATION Site Address: l l 6 L Tenant Name: A), King Co Assessor's Tax No.: �'' 7 -3 n L Suite Number: Floor: New Tenant: ❑ .... Yes[�..No Mailing Address: / ,[ 2" -- 2 C,z�4 f, ce i elz.' City State Zip E -Mail Address: Fax Number: -. e6K a� 4 /6--,'99/ GENERAL';.CONTRACTOR INFORMATION = (Mechanical Contractor information On back page)', Company Name: yJ_V25 4K J P S »G , Mailing Address: .777 /�-v S', cJ �i - -.ti'r✓ �E�/� �/�l�_ C C'e// iR� Contact Person: / / / 3 Day Telephone: el 6 — &1, : E -Mail Address: Fax Number: - 7 e 6 e), 9V Contractor Registration Number: M 2iV Z Expiration Date: d 0 a '7 * *An original or notarized copy of current Washington State Contractor License must be presented at tie tine of permit issuance ** ARCHITECT OF RECORD -All plans must be wet stamped by Are 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: "41 �y r A> c°Fr1 IVIC,, A N 72 4 , 55 , 14'ev eC11,0 //VC Mailing A Contact P E -Mail A City State Zip C e,, c.)e e Day Telephoney '�/ - /0 �'� /Y Fax Number: 4 1 -Z 5 ~ yl� S q: %\pc miu pluskice ehangestpenmit application (7 -2004) Revised: 6.1.05 bb Pap l _. ��. ��... �.._......_,.,.,•:.,._..:.,,.:...,. �...: .:.....�..,_ >aw a+�.r .... ire I' Z �Z W 2 U UQ N CO W J = F- Cl)W WO �QQ LL <C N� = �. W Z f- H O Z H W w U ON o ff W H� - z iii CO U O Z 'BUIL,'ERl1(� 'ION 206 - 431 -3670 Valuation of Project (contractor's bid price): �� OC20 _ Existing Building V luation: Scope of Work (please provide detailed information): ' Will there be new rack storage? ❑ ..Yes JR'. If "yes ", see Handout No. for requirements. Provide Al! Building Areas in Square Footage Below Addition to Type of Type of Interior. Existing 'Construction, Occupancy per_ Existing Remodel Structure New per IBC IBC 2 .. Floor rd floors `. thru Basement Accessory. Structure* Attached Garage Detached Garage 'Attached Carport Detached-Cu port 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 ;314 No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑.. Sprinklers ❑ ..Automatic Fire Alarm '®.None ❑ . Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? []..Yes ❑ ..No If' yes ", attach list of mater ials and storage locations on a separate 8 -112 x 11 paper indicating quantities and Material Safety Data Sheets. gA\permits plus%kc changes\permit application (7.2004) Revised 6 Page 2 bh r , i� Z Z tY 2 UO CO 0 J = I— WLL W }} �J LL a =W ZF F_ O W �5 U� CO � H W HC �O ll.l Z CO P _ O Z Mill PUBLIC W( RKS* ERM T IN TION 2064 '0179` Y a a 1 Scope of Work (please provide detailed information): , Call before you Dig: 1- 800 - 424 -5555 Please refer to Public Works Bulletin 01 for fees and estimate sheet. Water District ❑ ...Tukwila El ... Water District # 125 El.. Highline ❑ ...Renton :; ❑ ...Water Availability Provided Sewer District ❑ ...Tukwila ❑ ... ValVue ❑ .. Renton ❑ ...Seattle ❑ ...Sewer Use Certificate ❑ ... Sewer Availability Provided El.. 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) ❑ .. Geotechnical Report ❑ ... Traffic Impact Analysis ❑ ...Bond ❑ .. Insurance ❑ .. Easement(s) ❑ .. Maintenance Agreement(s) ❑ ... Hold Harmless Proposed Activities (mark box that a ❑ ...Right -of -way Use - Nonprofit for less than 72 hours ❑ .. Right -of -way Use - Profit for less than 72 hours ❑ ...Right -of -way Use - No Disturbance ❑ .. Right -of -way Use — Potential Disturbance ❑ ...Construction/Excavation/Fill - Right -of -way Non Right -of -way [...Total Cut cubic yards Fl.. Work in Flood Zone ...Total Fill cubic yards ❑ .. Storm Drainage ❑ ...Sanitary Side Sewer ❑ .. Abandon Septic Tank ❑ .. Grease Interceptor ❑ ...Cap or Remove Utilities ❑ .. Curb Cut El.. Channelization ❑ ...Frontage Improvements El.. Pavement Cut ❑ .. Trench Excavation ❑ ...Tratlic Control El.. Looped Fire Line ❑ .. Utility Undergrounding ❑ ...Backflow Prevention - Fire Protection " Irrigation " Domestic Water " ❑ ...Permanent Water Meter Size... WO# ❑ ...Temporary Water Meter Size.. WO# ❑ ... Water Only Meter Size............ WO# ❑ ...Deduct Water Meter Size " ❑ ...Sewer Main Extension ............ Public Private ❑ ... Water Main Extension ............. Public Private FINANCE INFORMATION Fire Line Size at Property Line Number of Public Fire Hydrant(s) ❑ ... Water ❑ ...Sewer ❑ ...Sewage Treatment Monthly Service Billing to: Name: Mailing Address: Water Meter Refund/Billing: Name: Day Telephone: City State Zip Day Telephone: Mailing Address: State - � Zi P q:ltpertniu phuYicc changeslp=it application (7.2004) Revised: 6.1-05 bh Page 3 I 4 Z Z �W QQ 3 UO N J CO LL WO }} �J LL Q to n = �W Z F— F— O Z F— �5 U� ON o F- WW H LL Z llJ U= O Z I'MtCHANICAL PERMIT INFORMATION -,206- 431 -3670 - MECHANICAL INFORMATION Qty Unit T e: Qty lC�ONTRA-`CTO Company Name: /y Pte' Qty Boiler/Compressor: Mailing Address: Air Handling it >I0,000 Contact Person: k City Day Telep ne: State Zip E -Mail Address: Fax Nu er: �� _ 5_3 /�'—J7 d Contractor Registration Number: T Expi tion Date: /0 2 �� * *An original or notarized copy of current Washin ton State Contractor License St be presented at the time of permit issuance ** Valuation of Project (contractor's bid price): � J 6 e i Scope of Work (please provid detailed information): 3 -15 HP /500,000 BTU Floor Furnace mv ti Ventil on Fan Connected Use: Residential: New ... X� Replacement..... Commercial: New .... ❑ Replacement .... ❑ Fuel Type Electric ..... ❑ Gas... Ot r: Indicate type of mechanical work being installed an he quantity below: Unit Type. Qty Unit T e: Qty Unit T e: Qty Boiler/Compressor: Qty Furnace<100K BTU Air Handling it >I0,000 Fire Damp r 0 -3 HP/ 100,000 BTU CFM Fumace >100K BTU Eva rat 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 V tilation System Wood/Gas Stove f 30 -50 HP 11,750,000 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 Generator System Air Handling Unit Incinerator — Comm/Ind Other Mechanical <I0,000 CFM Equipment PERMIT APPLICATION NOTES - Applicable to all perm><ts in this application Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure 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). 1 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 OWNE R A THO ED AGENT: Signature: Date: -U Print Name ee c/ /),9.4A : Day Telephone: 2 Mailing Address: / /i�/ Z =,2 l i�ZL9f' �' to) u el pill 10 P, City State Zip Date Application Accepted: Date Application Expires: Staff Initials: S q:\ \permits plus \ice ahanges\permit application (7.2004) — Revised. 6.8.05 Page 4 bh i Z {�- Z �W QQ JU 0 W = CO U_ WO LLQ rn � = �W Z H H O Z F- W W U� ON o�_ WW LL O Z W U CO P _ O Z I" A. V �l Steven N1. Nlullet, Nlavor O Z 0 Department of Community Development Steve Lancaster, Director u 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 1908 Fax: 206 - 431 -3665 SET RECEIPT Copy Reprinted on 12 -08 -2005 at 12 :06:32 RECEIPT NO: R05 -01756 Initials: BLH User ID: ADMIN Payee: DOAK HOMES, INC. 12/08/2005 Payment Date: 12/08/2005 Total Payment:628.00 SET ID: 1234 SET NAME: DOAK HOMES DEMOS SET TRANSACTIONS: Set Member Amount D05 -398 107.56 D05 -399 107.56 RS''4O:Q 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 H �E... W JU UO CO) D J H Cl) LL WO L L to = W. z t- 0 Z F— U� 0— 93 H W LL 0 tll Z' U =; O z i s City of Tukwila Ins 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 (206) 431 -3670 z RECEIPT W Parcel No.: 0733000025 Permit Number: DOS -400 v O Address: 11620 EAST MARGINAL WY S TUKW Status: PENDING CO D Suite No: Applied Date: 11/09/2005 w = Applicant: DOAK HOMES Issue Date: N LL W o Receipt No,: ROS -01636 Payment Amount: 66.99 co z Initials: BLH Payment Date: 11/09/2005 01:47 PM Z User ID: ADMIN Balance: $107.56 O z r✓. w Payee: DOAK HOMES INC U O Co. o t-- Ww TRANSACTION LIST: H v Type Method Description Amount 0 ---- - - - - -- -- - - - - -- --------------------- - - - - -- ------ - - - - -- Z Payment Check 5083 66.99 U N Z ACCOUNT ITEM LIST: Description Account Code Current Pmts ------------------------ - - - - -- ---------- - - - - -- ------ - - - - -- PLAN CHECK - NONRES 000/35.830 66.99 Total: 66.99 9:i.eil. ,1-1 X09 "1'1.1:; TOTAL 390.6c; doc: Receipt Printed: 11 -09 -2005 INSPECTION RECORD Retain a copy with permit INSPECTION N0. PERMIT ' CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Project: Type of Inspection: Address: Date Called: Special Instructions: Date Wanted: p.m. Requester: Phone No: I i Y' proved per applicable codes. Corrections required prior to approval. El . COMMENTS: y. Inspector Date: $ .00 REINSPECTION F E REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. receipt No.: Date: � 1 4 Z W QQ � JU 0 CO W = �U_ W O. J ILL ?. � �W Z H 1-- O Z I_ W W 5 U� O CO O F- WW IL ~ h W Z U =. O ~. Z INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION I 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 I I � Rr ject: T pe of Inspection: �t7 ( - S� �, ❑ Approved per applicable codes. f I I I i i P i Receipt No.: Date: Corrections required prior to approval.' ' COMMENTS: Inspector: $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. r Z SZ Q �W W� .J U UO ND CO LLJ J 3: �U- W O. U. N = W H ? I-- ZO W co U� 0 H WW L Z ll.l U= O Z 4� Address: , tv Date Called: 319 1 Ce Special Instructions: I Date Wanted: m aj 1 C1 ( 0 (-F P.M. Requester: . Phone No: aOL. - q3t ❑ Approved per applicable codes. f I I I i i P i Receipt No.: Date: Corrections required prior to approval.' ' COMMENTS: Inspector: $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. r Z SZ Q �W W� .J U UO ND CO LLJ J 3: �U- W O. U. N = W H ? I-- ZO W co U� 0 H WW L Z ll.l U= O Z INSPECTION RECORD Retain a copy with permit INSPECTION NO. U (206)4311 0. a, CITY OF TUKWILA BUILDING DIVISION' 6300 Southcenter Blvd., #100, Tukwila, WA 98188 -3670 Pr 6P t: Type o nspection: Address: Le Date Called: } Special I structions: to Wanted: a.m. •m Requester: Pho a _• Approved per applicable codes. Corrections required prior to approval. M M ENTS: ., Insp c r: CAI/C, 8.00 REINSPECTIO FEE RE( aid at 6300 Southcenter Blvd., Receipt No.: I l� - tip / I. Prior to inspection, fee must be 100. Call to sechedule reinspection. !i , ti Z Z fY W Q � JU UO N co W W = C* LL WO LL N� = �W Z 2 t— H O W W W U� O- o�- W W` H� O W Z U N P _ O Z Dec 0© 05 09:52a American Environmental Cc 206 522 4099 P.1 AM AIA P.O. Box 81005 M"WHi7fCAN Seattle, WA 98108 - 1005 Alo Environmental Construction LLC Phone: (206) 267 -074et Asbestos - Lead - Mold - Demolition Fax: (206) 2E7 -0753 December 8, 2005 Telly & Darryl Doak ' Doak Homes Inc I 11812 26 Ave SW Burien, WA 98146 Via Us Mail - -- Letter of Completion - -- _ (AEC Job # 5495) Re: Asbestos Abatement Services at: 11620, 11638, 11640 E. Marginal Way S., Seattle I f , This is to certify that American Environmental Construction LLC has removed all of the asbestos containing materials from the above referenced address per the Asbestos Survey conducted by Asbesto -Test Inc., dated November 10, 2005 and our Proposal & Contract dated November 18, 2005. Clearance Air Monitoring (Sample Type = CL) as reported on the attached Air Sample Data 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 area is safe, in regard to asbestos exposure, for re- occupancy and/or demolition. Please call me at 206 - 523 -4441 if you have any questions or comments regarding this Letter of Completion. Respectfully submitted, America? Environmental Construction, LLC 1 Labra Bellows — Ad inistr^ ve As istant CITY OF RECEIVED DEC 0 7 2005 PERMIT CENTER z �w QQ A0 00 CO 0 C0 W J = C/) LL w U- j. co =) =w z� �0 z�- w w U0 co 0 �- w F-- �0 w z U= O z r �..n IIIII t..1 •vVll % -- --♦1 VII-11 .3: 11%,_A ...V r..VV .J t-L— LNGVrh:JAltJ ;I\� nt'• American Environmental : "r Sam Uata Sl eet Job Locatio L Jbb il` ' 1.. � � - 11 L��.1(� .�� �� , /wr Sampled 8y: 2�—�jzcR— Date: Time: -- -Ala Cou Mlcroscope Field Area: Blank C 6 ample ID: Loca Type: -Z WorkActivily' g grj A OA ! 4 4Y lion :��, Observations: i f a r A VAC .__.._ C) I ,._,. Worker: Cra rl !? � e, SSO: 0 t;e �"� r Ti Gy Man t , me: Start ! ! g Hate: St - Z �' Ttme: End r Rate: End FilxErs Fibers T �-- , _ 2- Liters llefd /a * �- Mnutes r Average Z LO Ip, N ype;__ C( rrareellon• --- - Decon: EnvilmnavritiL Pump #: 501. Location: / Wo Activity:�� Observation Worker. Ti Start f ire: End f Minutes S$*. C er* _ Rate: Start ! Z Fibers Fibers Rat End f Z Liters ���d li c Average �,_,, 0 �� ,.am ple Location: eXj - Sample Type: Work Activny. tj Protection: % Oborvatl Decon: -� Worker. -- --.- -- SS*: Envfromnent _ _ lime: Start r���'8 Rate: Stirs f 'Z _ Fibers Fibers Pump Tmt: - �� Rabe End _� _ Liters Ai ld /cc Minutes o Average / Z J�� `� t Stimpl� U425 - 2 ►- '' - ra N4 - -u / I Sample T Work Activity: J M A --M _ Prom ion: ` O� - (j am._ _ldJ 1- - 7 4 rnpi- h i ----- Odeon: Worker. SSX: C srt� : --- .�. t~ttvlranmenr Time: Start �- �? � Rate: Start Pu m #t: 1 p Time -End i q mate: End Fl Firs _ Litery lt'►e{d r'cc Minutes = Average_ c - arrskhing Zone P - Pm Abi;Wwiat . - celling I i CL - Clearll= �i'� • Inside Area H • HEPA Exhaust 0 - Outs,da Area eL - Field Blank bYEd N - Half MaskAPA F - Fui m Mask APR PAPR G - Conlinuous FWwAir PA - PresaureD*mandAk q.S than wi Shower H - WPA Vacuum D - DwAn w/o Shower G - Giow+b" ME - L&H Enclosure FE - Full frnciuz;n - . U A, N L r i Z '~ W � 1U UO CO J = I CO W w U. a rn =) = a �W z W W UC3 ON 0 F_ w FU �O . Z W CO l= �„ Z Ueo L IU Un UU:048 mmerican t_nvlronrnenzal L.o cub t)e.e 9•Uby p. b • ►�. LvV. - r.jc��n IvrL LAOVAA1V1 %iL,) ,n4 Isv. JJIL t American Environmental "I Sampie Vat% She et J ob Location:`, �� � � �' M A F4 N , il r t Ja Sampled Ry: Date: /Z-0 U 'r ime: __.. -lank Count: Microsco Field Area: Bla Cassettes: !D: 5z1q �� Lo�ition; .0 ULL & C) Type. p � Work Activtkyy: U ectier: Y Observations: JJ141V 0 14 Dn: Worker. SS# V VM ranment•�i Time: Sleet 9 Rate: b /U E. Fibam Fibers Time: End Rate: End � r,,, ip #: � � - -- '...�� ! � Liters &1d I= T- Minutes = Average j p A !D: Sample Type: 1r � Protection Decon: Enviranr. tent: _ Pump #:__J O1_ locat ,tJSrE Work Act ivity: ,r,�zF Obswations: t ���• Worker, - Time: Start 7 Tim e: End l Utinutes a 8S#: Rote: Start / C3 Rate: End 1 Average /0 Cert#: Certit Fibers Fivers Liters /field let ' p !e ID;/ location. Samaie Type: f 7 y4brk Aot'ritty: p �� r� ►� �9 F= �.� w 1c► z Protection: _ Observatb l� ) � 1 C I oA z a Decon: ---"' Worker J4d N'i A 1 I A9A pb SS* L Gert#: 0 e 55 Z / Environment: Time: Start �' �� Rate: Start Z, Pump:O! _ _3 Tim e: �d ��� Role: End , Liters Meld Fi bers cc Minutes= A ve r ag e Z Sample ID:5c L ocation: (jc jS - Le C),j Sample Ty �4,eF Work Activity: - M Protection: % O bservationa ;�)F�f /'YJ�o S _ Decon: - Wo SSW: ---- ---- -- Cert* Environment: fie: Start / Rate: Start �+ Fump , #: 0 T ime; End Ftatr: End Z •• 5 Liters Fibers Fibers Ifieki /cc Minutes Average i p . 6roathing Zono P • Pie Ababi met - CorrnD GL• - Gtearrrnce Imide Area H �- HEPAINhoust 0 - OuteldeAne RL - Field Blank M - Hall Mask APR F - Full Fxe Mask APR PAPR CA - Codriums Fk Air PA - Palau r* Oern %1 Air D.S. Decon wi ftv~ H - NEnAVncjmi D - Down woo Shower G - GiovstW ME -Mint 1 5 11* 64ire FE • Kul! Endoswr A z `~ w 10 UO Wr CO I WO LL coa = W t- _ zF- z� �5 U� o� W 2 t— FF-- U- O tii z U (1) H F Z Dec 08 05 09:53a American Environmental Cc 206 522 4099 P .4 A►.SN 4 ASBESTOS WASTE SHIPMENT REPORT FOR.A1 PLEASE PRINT OR'I'YPE! If you have questions, contact your local DEQ Regional Office in Po;tiand a: ( 229 - 5364, Salem at (503) 378.6240 ext •272, Medford at (541)1'6 -6010 e.XL 235, or Bend at ;5411388.6146 ext. 226, OR call (800) 4:2 -401 I for the location of your local regional DEQ office. WASTE GENERATOR: (Contractor, Fst:Jity. or Op :rator) r I. Asbestos removal site name and address Doak Hoines -Darryl Doak _ ` 116 20. 1 11640 E. Mg r_gina l Way aouth Seattle WA _ King 911168 Street GglState County Zip Ocntact person: Darryl Doak Phone: 2 06.2 46. 6587 2. Operator's nzme and addrtss: Environmental Construction LLC Phone: 206 - 267 -01'46 _ 7417 - din Avenue South Seattle, WA - King 98108 Street CityiStau County `Gip 3. Waste disposal site: Northern Wasco County Landfill Phone: 541- 993 -CC89 2550 Steel Road The Dallas, OR Wasco 97058 Street City /state _ County 'LAP 4. Describe asbestos materials � _ rYlAS• 7 C e"0,e ' 1�' S. �Clur Containars: Number :5, i a - 7Sd l h5 Type: 4 ; 6. Total quantity (cubic yards): 7. OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packaged, marked and iabeied, and are in all respe :ts in proper condition for transport according to all government regulations. All movement of this asbestos - containing material is recorded on this Wave Shipment Reco :d Form. Name: 1 2 AC - - Company: American Environmental Constructio Signature: eft Date: �: G 7 TRANSPORTER(S): S. Transporter #1: (Acknowledgment orreceipt of materials,' Agent: _• Company: D &B Trucking Address: 1905 East Lincoln Ave., Tacoma WA 91421. Phone: 25 3- 383 -3850 Signature: Date: 9. rransporter 0'. ( Acknowtedgment orreeeipt of materials) Agcnt: Dover _ Company: NTSI I D &B Trucking Address: 1905 East Lincoln Ave.. Tacoma, M 98421 Phone: �Q- 383-3W0 Signature: Date: DISPOSAL: (Certification of reccipl'of asbestos materials covered by this manifest, except as noted in item I 1 Wow.) In Waste Disposal Site: No-thern Ut Co unty Landfill 'came and Title: _ Date: Signature: _ _ Phone: 11. DISCREPANCY SPACE: (Add anachmcnts us nct:dcd) _. (Rcvi,.d 0103) i ••e••• :• ' ;.••. • , ,. f 4w118�i1+ " 1 ; ' iMY.YYtlWW( I •...• Mgau.rnR.w„ � Mwa"v aw.:.+.:.4 'WJ�.i.'.: Z }�— Z �W UO t] W= H N LL WO U _ N� �W Z 1— W 0 W U� ON Q H WW F=•- FU~^- W Z 111 U= O Z Dec 08 05 08!52a American Environmental Co 20S 522 4099 F.3 ..- d Agency Case tiro, t PUGET SOU?JD CI.L-AT M llate Rzctived�7 1l C ry AGENCY i 1 Goo503 / 0 i 10 Union Street, Suite 500 �'r�,,.�_,,•`n,. Seattle, WA 98101 -208 ; . : : _ : : :•Mr ." . anvw.pscleanair.org J!! rioene? UJ.: Only i + t 4gtne. Jte UnJy ar:t�ut 'NOTICE OF 1N ?5`T t L._... r rrrr.rrrrr�+r� rrswrirr�wr �. Pro'ieert Tyne: 1. ❑ Friable ,ksh"tns Removal Z. ❑ FritiMe AK ite Rern i - Molition 1 1 Qcmnik C>nlv� Property Owner: Doak Flames In � Phone- 206. 246.658 7 � t f ✓.ai; ins; ►dd :-ss: 11812 26th Ave SW Ci;v: 8urfen State MlF1 Zits: 98 ';6 I C. Asbestos I' .t,% I'MM t.L•AWF. . ,ur. ut trr,•avta tNt n i art . r ! Contractor; A merican Environ Co istru tlorl LL.0 � Ow ner /CEO: John ASs elin .�.._.�._...- ..____ I Contrzcto: l M nilin2 Address: P B OX 51005 Fl;onc: f206) 523!44 Job No. City: Seattle l State: WA ! Z ip : 9 81 08 -1005 Fax: (206) 522 -099 I 549•"'� �+w...�•.��rr err rr �- rrrrr,�rirw�+� �w� rr�r. --_ - -_ ___ ___ - _ __ _ _— - Bice Add ress : 11620, 11638, 1 East Ma rginal Wa South Seattle zip: 98_ , Vl narcr: 'Dar ryl Doak Local Phone: 206.372.2280 k.. ..>u� soestos Survey or to of Dam rf Asbestos 'Alas Friable Asbestos Identified? Yes No 7 "Intl Presumed Structures: 5 Surve:': 1i "L "135 - 1 Wes Nonfriable Asbestos Identified? S(i'�Ycs CJNc •;1lER,a Building Ct Rificatian z~: .r. Attach a ccpj of the ;urvev when iiiahle asec: xr r. (n3pector. Carl Dykstra Ex • Date; 101684516 - 2x hasnoibeer; identified. i .tn A SRA ivrvcy a required before nt! demcdatoe pro1r _ F. Demolition Start e! e No. of :. Training Firc t Fire Dfpt.) i lnformad ; Date: ' �� I Structures; 3 J 2 . Ordered Demo!:tior, ( at, "a.h covy of rde-' 1 I Demolition radar: damotmott cantratlor's etodingaldre sea bac ili nonfriable asbestos be left in place during demo? U Yes ta No 1 Contractor Clar Doak if yes, list type and qty. Note disposal req.timments in St:p IS (on back). '�r.r�r� rrrnw�rr r� �rr•� r•rr C'. Fri.ibte Asbestos I Work Days: if V W A W Sa 5u Pi'gjcct Information: tStan Date: Completion Date: Hours: Will all friable usbtstos Q 'I'ts �..I.ottaa:: Qi , to be iterr.•oved: Linear Ft. S gore Ft. r- _tcria!s be removed? Q No ! l.1 ilutleeirtrnace Insulation U Duc Insulation U r=ireproorrng U Paints Ll 1'Iastbr U T c.x tired Coatings i J Curn. -ni Eaard Ll 'Canoe Pipe Friable FlaorinR W Friatiie Roofing Mazerial Other: H. AshestosiDtmolition Project Cntegoriest Notincation Pericd Project t3etuoution i !. Sin- le•Frmily Residence (owner - occupied;: ce Sureharr i A. 0 Asbestos Removal Project Only A. ?rior Notice I A. $25 9. Demolition Project (with or without asbestos removal project) B. 10 Days'' S. $50 i •; Asbestc, removal can begin upon notiflcstion: demolition must wait 10 da } otc. /J' the slnbte;cmlfy residoncu is owned by one farnNv Wto.has been or,tvill be usi►rg the residence as their domicile, the above breves t !.-I or /B may bu citeckdgd If this is not an owner - occupied residence, one of the categories listed below must be used instead. Z single ' lanuh- resialence does not Include rental p roverty. mrrltd- famil•� uriila, or any mixed use budding. --^ All Other Demolitions twith no Asbestos removal or Nonfria ble Asbes 1 10 Days I uu1, or Icss than 10 linear f eet and /cr 48 square feat of friable Asbestas) Friable:. -ksbesros Pro_lects (other than Sin ire Family R esidence): Asbestas Demo - i= ' 0 . 259 linear feet snd /orZ 48 - 159 square feet of asb asto; I Prior Notice 10 Cans 5 ,o0 S100 ___ t i 4. 'ZI - 999 linear feet andlor 160 -4,999 sou.-re feet of asbestos 10 Uays_ 1 5200 S i 00 T ❑ %1.000 linear felt and/or ?5.000 s care Feet of asbestos i 10 Days -_ 5600 5100 �J 6. Emergenc Asbestos Project or LJ Emergency Demolition Project 15inat <• -nmly Kesiocn :rs arc exemo: if twn arner cerev ferw however. propmv aw- trs must at nide a Prier Noti N rt lten e IgLC.� ��� 55G niergeacy f ree 1, l cartlt. (n t! a �rtornuuon con :at c n chi► neufica :iaa d: sup ^tctnuntal data ts, to ttx Nat cf tn} kr.oulcdge, ac grate C Ago y M ii Am erican Environ Construct LI - _ ' ? -23 � f ( Sitindu :r� Rttradrnuntt �� ~^ Dore _ R.:r aea r r Puget S�.nd t :Iei� • \t: nl;eacr =am, No. P6.16p (Rar'sec 3/51 TS R E C E I V Z ~ W � D JU UO W H N U- WO E N = �W Z F- W O W U ON 0 F_, WW H� U- Z lLl c o O Z Dee Og 05 09:52a American Environmental Co 206 522 4099 p.2 C Job Number 5495 -1 f Labor and Industries NOTICE OF Industrial Hygiene Compliance y ASBESTOS ABATEMENT (Regional addresses and phone PROJECT on page 2) "" Today's Date November 28,20 THIS NOTICE MUST BE RECEIVED NO LATER THAN 10 CALENDAR DAYS PRIOR TO THE START DATE COMPLETE ALL APPLICABLE BOXES - MCOMPLETE OR ILLEGIBLE NOTICES WILL NOT BE ACCEPTED MAIL OR FAX TO THE RE OFFICE - CIRCLE CHANGES ON AMEibED NOTICES Notice date: 11 / 2s r' p5 Itti I �00 mended ❑ Site Work Ho ur s Su Mo Tu We Th Fr Sa t Start dare: 12 / 07105 On ole ff Hold rl 8:00 am — �� X X ; X X X �. tc - .--- — Completion: 12 / 31105 ( Emergency [j pnt 4 pm Project Dates and W ert Hours must be Exact U r CONTRACT P PROPERTY OWNER Company Name N Name American E nvironm en tal Construction LLC D Doak H omes Inc - - Contrac r Certification Number . Owner's Agent 1338 D D arryl Doak W C Company Doak Homes Ix _ �ryhie Name A Address _ A ura $all 1 11812 26th A S SW _ P hone Number C City S _ (206) 523.4441 B Burien W WA 9 8146�_� Job Site C.A.S. P Phone number _ _ QUANTITY OF ASBESTOS TO BE: ❑✓ REMOVED ❑ ENCAPSULATED Quantity 310 s quare feet ❑ Indoors Q O utdoors ❑ Fir ❑ B oiler insulation CONTROL MEASURES ❑ Popcorn ceiling ❑ Duct paper Neg. A res. en closure ❑ Wrap & cut i ❑ CAB ❑ VAT ❑ Glove bag Q Wet me-,hods Sheet vinyl ❑ Roofing ❑ Mini enclosure [] HEPA vacuum ❑ Asbestos paper ❑ Other Critical barriers Q m anua l m ethods Q uantity linear feet ❑ other _ eth _ Reeulated A rea ❑ 1'r1ag. pipe insulation ❑ Cement asbes pip RESPIRATORY P'ROTECT ❑ Air cell pipe insulation ❑ Mudded pipe ins. Q '!, mask. APR ❑ Type C contin flow ❑ Ducting/duct insulation ❑ Duct tape [] Full face APR ❑ Type C pressure demand ❑ Other ❑ Other ❑ PAPR ❑ Other F413.025 -COG notice cf asbestos abatement ,project 11-0 1 For clean copies go to http: / /Www.Ini.iva.gov/forrtts/ .,�.. : •.: ,,.:v._...:.«,..'.d::, i:'u:.,a::u "...,tic: �:i: <d�.:r,�:d::1;»�1:,�:Li+: .. .bi� �kti+'s,�:.bvz a5..a.lrai .�+ ' 'r e m z �z �W QQ JU UO W= H LL WO �Q to D 2 �W Z = t-- HO z H WW U ON OH WW �- u- 8 W (f) U O z F413.025 -COG notice cf asbestos abatement ,project 11-0 1 For clean copies go to http: / /Www.Ini.iva.gov/forrtts/ .,�.. : •.: ,,.:v._...:.«,..'.d::, i:'u:.,a::u "...,tic: �:i: <d�.:r,�:d::1;»�1:,�:Li+: .. .bi� �kti+'s,�:.bvz a5..a.lrai .�+ ' 'r e m z �z �W QQ JU UO W= H LL WO �Q to D 2 �W Z = t-- HO z H WW U ON OH WW �- u- 8 W (f) U O z l M 9 VIA w d ara v Mr • ommr eD 00 O O O O - .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 -400 PROJECT NAME DOAK HOMES SITE ADDRESS 11640 EAST MARGINAL WY S X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # After Permit Issued DATE: 11 -09 -05 z 1 w UO 0 �!x N U- WO U. � =W z I zo 5 U O �. o t- WW LL O w z U =. O z DEPARTMENTS Buikng ivision Public Wo ks (n k II -f-f- Fire Prevention Structural ❑ 4 M AT 11-1&-oV nning Division Permit Coordinator ❑ DETERMINATION OF COMPLETENESS (Tues., Thurs.) DUE DATE: 1 1-10-05 Complete ❑� 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 ROUT G: Please Route Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS DUE DATE: 12-08-05 Approved ❑ Approved with Conditions 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: Documents/routing slip.doc 2 -28 -02 a i Look Up a Contractor, Electriria,n 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 1 11812 26TH AVE SW Address 2 Cancel City SEATTLE County KING State WA Zip 98146 Phone 2062466587 Status ACTIVE Specialty I GENERAL Specialty 2 UNUSED Effective Date 8/9/1991 Expiration Date 8/8/2007 Suspend Date #4 Separation Date SC9910 Parent Company Cancelled Previous License DOAKH* *10605 Next License 08 /01/2001 Associated License Business Owner Information Name Role Effective Date Expiration Date DOAK, DARRYL E SR 01/01/1980 DOAK, ESTRELLA M 01/01/1980 Company 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 #3 CBIC SC9910 08/01/2000 08/01/2001 1 1 86,000.00 Pagel of 3 Z Z �W JU UO N 0 J = F- CO)U W O 5 U- Q N� = a �W Z 2 H H O Z E- W U� ON � f- W H �O ll l Z CO) O Z https:H fortress. wa. gov /lni/bbip /printer.aspx ?License= DOAKHI *092NZ 12/08/2005 v File: D05 -0400 35mm Drawing #1 is t 7 P-4 A: .1 Rai tin - p 16 [ G4F �t,!'S, , 4i. g . 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