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HomeMy WebLinkAboutPermit D05-403 - DOAK HOMES - COTTAGE DEMOLITIONDOAK HOMES 11638 EAST MARGINAL WY S D05 -403 City G. Tukwila Department of Comn:irnity Development Q 1 ) 6300 Southcenter Boulevard, Suite #100 N = Tukwila, Washington 98188 Phone: 206- 431 -3670 190E Fax: 206- 431 -3665 Web site: ci. 03vila.wa.us DEVELOPMENT PERMIT Parcel No.: 0733000030 Address: 11640 EAST MARGINAL WY S TUKW Suite No: Permit Number: Issue Date: Permit Expires On: Steven M. Mullet, Maya Steve Lancaster, Director DOS -403 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: N 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 COTTAGE AND REMOVAL OF ALL DEBRIS AND SEPTIC TANK Value of Construction: $3,000.00 Fees Collected: $174.55 Type of Fire Protection: NONE 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 -403 Printed: 12 -08 -2005 Z �Z �W a � JU 00 W W J �. CO L W La U� = CY F .. W Z �_ r_ O 2 11— U� O N_ D W u. O iii Z co p O F 2 City G ``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 * *continued on next page ** Steve Lancaster, Director doc: IBC- Permit D05 -403 Printed: 12 -08 -2005 Z Q Z. '~ W u�D J U • UO N Q. W= J � CO LL W O J' U. Q` (1) Z H UJ Z H O Z H UJ �� •O N_, Q F- ' W W`: F-. U `. 111 Z O~ Z City G. Tukwila Steven M. Mullet, Mayor Departmeitt of Cot?ininy:ity Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: ci.tukwilama.us Permit Number: Issue Date: Permit Expires On Steve Lancaster-, Director D05 -403 12/08/2005 06/06/2006 Permit Center Authorized Signature: v i. Date: � D'Z I DS- I hereby certify that I have read and ar>'ti d this 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 pstr uction or the performance of work. I am authorized to sign and obtain this development permit. Signatu Print Name: 9'4pFzf'/ Dpiq-h-- 7p Date: 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 �Z ' W WD JU U00 w� (D L w La LL co) d = w Z� �- 0 w LLj �o U O N, o� =U LL O w Z U= O ~ Z doc: IBC- Permit D05 -403 Printed: 12 -08 - 2005 �... r City of Tula - wila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 PERMIT CONDITIONS z Parcel No.: 0733000030 Permit Number: DOS -403 z Address: 11640 EAST MARGINAL WY S TUKW Status: ISSUED i Suite No: Applied Date: 11/09/2005 D Tenant: DOAK HOMES Issue Date: 12/08/2005 0 O' C O co W J = 1: ** *BUILDING DEPARTMENT CONDITIONS * ** N ii.- 0 . 2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the Building Official. Q � 3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to start of any construction. These documents shall be maintained and made available until final inspection approval is � w = granted. ? t-- E- 0 4: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary z H w w sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other 0 excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of 0 co this requirement. o ww 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 U- 0 presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila W z N shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the Building Official from requiring the correction of errors in the construction documents and other data. 0 �. z 6: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * ** 7: The applicant must notify the City Utility Inspector at (206)433 -0179 upon commencement and completion of work at least 24 hours in advance. All inspection requests for utility work must also be made 24 hours in advance. * *continued on next page ** doc: Conditions D05 -403 Printed: 12 -08 -2005 City of Tukwila race Department of Community Development / 6300 Southcenter BL, Suite 100 ! Tukwila, WA 98188 1 (206) 431 -3670 I I hereby certify that I have read these conditions and will comply with them as outlined. All provisions of law and ordinances i 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. 1 Signature: Date: Print Name: i doc: Conditions D05 -403 Printed: 12 -08 -2005 Z Q H Z 2 D UO CO 0 W J F W U. W O LL Q cl) �W ? �_- H O w ~ W 2 5 U� O N CI E- 2V H� tL O. .. Z. W U =: O Z f tu' w CITY OF TUKWILA'. Community Development Department Public Works Department Permit Center I 1906 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 i 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: Tenant Name: ,)d Property Owners Name: 1-) Mailing G' King Co Assessor's Tax No.: S Suite Number: Floor: New Tenant: ❑ .... Yes[�..No E -Mail Address: City Slate Zip Fax Number: 2 , 6 6' v� y9- -,5 'GENERAL-',.CONTRACTOR INFORMATION -:(Mechanical Contractor information on back page) Company Name: S »C Mailing Address: 777 AU -e City eeZI 2oe7 j a ! --22 C Contact Person: Day Telephone: E -Mail Address: N 9' Fax Number: -? U' C= Vx Contractor Registration Number: 51 0�}/�l�.T' M21V7_ Expiration Date: * *An original or notarized copy of current Washington State Contractor License must be presented at & 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 -.All plans must be wet stamped by Engineer of Record Company Name: J� f / //3�f �Nr r'/l�t //U�i Aw G Ati'���. &f 0 eell'o�G 1 /uC Mailing Address: �� �X 5 �� �.c'ar?i�in7 t/ i �' fir /� C / 9 JZ City State Zip Contact Person: TI /Yl y C. / �y e'.2 Day Telephone' - - '� �'3 E -Mail Address: k Fax Number: /� gMpe mite phuUce ehanges\pennit application (7 -2004) Revised: 6-8-05 Page 1 bh Z ~ W !r � UO CO WZ F- U) W WO LLQ co = ~W Z I— I— O Z F- LU W U CO O H W H- H U. O w Z U= O Z '$UILriI�TtI� R�VI+iT' ORMATION 206 -431 3670 :3. Valuation of Project (contractor's bid price): $ Existing Building Valuation: S Scope of Work please provide detailed information): i / /Are" , G o et Will there be new rack storage? ❑ ..Yes J� 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 X. No If "yes ", explain: FIRE PROTECTIONIHAZARDOUS MATERIALS: ❑..Sprinklers ❑ ..Automatic Fire Alarm one 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 I I paper indicating quantities and Material Safety Data Sheets. q:Upermits plWkc changes\permit application (7 -2004) Revised 6-M5 Page 2 bh Z z �W JU U CO 0 W_ H �LL WO 9 -1 LL CO d = W H Z� l— O Z I-- LIJ �5 U O- 0 1— W H FF_ LL Z 111 U= O Z Existing Interior Remodel :Addition to Existing Structure New Type of Construction er IBC ' Type of Occupancy per. IBC 1 :`.Floor. 2 : Floor 3' ..Floor. ' Floors thru Basement Accessory Structure* Attached Garage Detached Garage , Attached Carport Detached Carport Covcred.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 X. No If "yes ", explain: FIRE PROTECTIONIHAZARDOUS MATERIALS: ❑..Sprinklers ❑ ..Automatic Fire Alarm one 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 I I paper indicating quantities and Material Safety Data Sheets. q:Upermits plWkc changes\permit application (7 -2004) Revised 6-M5 Page 2 bh Z z �W JU U CO 0 W_ H �LL WO 9 -1 LL CO d = W H Z� l— O Z I-- LIJ �5 U O- 0 1— W H FF_ LL Z 111 U= O Z 1, Y 1 r1 t. t . + I . i s. is P B]LIC WdA k9. VERMIT INF Tt 2 . 6 ' * Q179: ' , + x Scope of Work (please provide detailed information): Call before you Dig: 1- 800 - 424 -5555 Please refer to Public Works Bulletin #1 rotr fees and estimate sheet. Water District ❑ ...Tukwila El ... Water District # 125 [1.. Highline ❑ ...Renton ❑ ... Water Availability Provided Sewer District ❑ ...Tukwila E] ... ValVue ❑ .. Renton ❑ ...Seattle ❑ ...Sewer Use Certificate F1 ... 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) ❑ .. Geotechnical Report ❑ ...Traffic Impact Analysis ❑ ...Bond ❑ .. Insurance [:1.. Easement(s) ❑ .. Maintenance Agreement(s) ❑ ... Hold Harmless Proposed Activities (mark boxes that a ❑ ...Right -of -way Use - Nonprofit for less than 72 hours ❑ ...Right -of -way Use - No Disturbance ❑ ...Construction/Excavation/Fill - Right -of -way Non Right -of -way _ [...Total Cut -5 - _ cubic yards ...Total Fill �S:b 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 ❑ .. Curb Cut []...Frontage Improvements ❑ .. Pavement Cut ❑ ...Traffic Control ❑ .. Looped Fire Line ❑ ...Backflow Prevention - Fire Protection " Irrigation " Domestic Water " ❑ ...Permanent Water Meter Size... 19 WO# ❑ ...Temporary Water Meter Size.. WO# ... Water Only Meter Size............ WO# ❑ ... Sewer Main Extension ............Public Private ❑ ... Water Main Extension .............Public Private ❑ .. Grease Interceptor ❑ .. Channelization ❑ .. Trench Excavation ❑ .. Utility Undergrounding ❑ ...Deduct Water Meter Size ........ " FINANCE INFORMATION Fire Line Size at Property Line Number of Public Fire Hydrant(s) ❑ ...Water ❑ ...Sewer ❑ ...Sewage Treatment Months Service Billing to: Name: Day Telephone: Mailing Address: City state zip Water Meter Refund/Billine: Name: Day Telephone: Mailing City State "Lip q:%Npermits plus%iec ehangeApermit application (7- 2004) Revised: 6-1145 bh Page 3 f 1 I Z Z �W QQ JU UO CO W J H CO LL W O LL T C1 = W Z F-- F- O Z H W W U� O CO o l— WW ~ I ti O !L Z U U) F- 2. O F ' Z CHANICAL PERMIT INFORMATION -- -206 * 31 3670 MECHANICAL CONTRACTOR INFORMATION Company Name: yF'�' ) f A, e Jle "Wi Mailing Address: Contact Person: - E -Mail Address: 0/ J9 i2 C CWe- %�`fcy'Iil i 2Z Day Fax Contractor Registration Number: HkkIVA * *An original or notarized copy of current Valuation of Project (contractor's bid price): $, Scope of Work (please provide detailed i g S tate Contractor License 7 t � fU NC State Zip R - ?Zza-:? / /' m r: �� ° 5'3 Z —,V �' 4 r9 .ton Date: /0 be presented at the time of permit issuance ** Use: Residential: New... Replacement... ❑ Commercial: New .... E] Replace t..... Fuel Type Electric.....❑ Gas... ther: Indicate type of mechanical work being installedAnd the quantity below: Unit Type:' Unit T e . Qty. Un't Type- Qty Boiler/Compressor: Q Furnace <100K BTU Air Hand ng Unit >10,000 Fire mper 0 - 3 HP/ 100,000 BTU CFM Furnace>100K BTU Eva razor Cooler Diffuse 3 -15 HP /500,000 BTU Floor Furnace VeAtilation Fan Connected Thermos t 15 -30 HP/ 1,000,000 BTU Sin le Duct Suspended /Wall /Floor entilation System Wood /Gas tove r 30 -50 HP /1,750,000 BTU Mounted Heater /r I 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 <10,000 CFM Equipment PERMIT APPLICATION NOTES Applicable to all permits 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). 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 Or R O TH IZED ENT: Signature: G Date: Print Name: i��'' ( 1 j- Day Telephone: 2 Mailing Address: I /!2 - -a 6ZZ ) �' C•c> 9, W Z/ City State Zip Date Application Accepted: Date Application Expires: Staff Init q.\ \permits plus%ice changes \pumit application (7.2004) noised 6.8.05 Page 4 bh i h Z }_— Z �W QQ JU UO to J = t— LL WO 9_J LL < 2 t.W ZP ZO UJ �p U O� W H� LL O W Z U= O Z LA, ....... ....... Steven M. Mullet, Ma or Q T X q Department of Coninnuzity Development Steve Lancaster, Director 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206-431-3670 190 Fax: 206-431-3665 SET RECEIPT Copy Reprinted on 12-08-2005 at 12:06:32 12/08/2005 RECEIPT NO: ROS-01756 Initials: BLH Payment Date: 12/08/2005 User ID: ADMIN Total Payment:628.00 Payee: DOAK HOMES, INC. SET ID: 1234 SET NAME: DOAK HOMES DEMOS SET TRANSACTIONS: Set member AmoU•lt ---------- ------------ D05-398 107.56 D05-399 107i'56 D05-400 107 D05-401 107-.56 D05-402 90.20 J b 107.56 MOND# 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 - - - - - - - - - - - - - - - - - - - - 71 - - - - - - - - - - - - - - - - - - - - - - - - - ------ - - - - -- BUILDING - NONRES 000/322.100 601.00 STATE BUILDING SURCHARGE 000/386.904 27.00 TOTAL: 628.00 z Z Uj �v 00 cf) 0. C0 W W:c H. LL w 0 LL U) —, CY 0 z �- W U J L) CO) 0 — = U 0 --z W COX L) H 0 z 1 City of Tukwila Igoe f 6300 Southcenter BI-, Suite 100 / Tukwila, WA 98188 J (206) 431 -3670 ACCOUNT ITEM LIST: Description Account Code Current Pmts ------------------------ - - - - -- ---------- - - - - -- ------ - - - - -- PLAN CHECK - NONRES 000/345.830 66.99 Total: 66.99 doc: Receipt Printed: 11 -09 -2005 i �4 Z RECEIPT W. � 2 Parcel No.: 0733000025 Permit Number: D05 -403 L) o Address: 11620 EAST MARGINAL WY S TUKW Status: PENDING Cl) o Suite No: Applied Date: 11/09/2005 w = Applicant: DOAK HOMES Issue Date: N f- WO� �J Receipt No.: R05 -01639 Payment Amount: 66.99 u- CI Initials: BLH Payment Date: 11/09/2005 01:49 PM _ User ID: ADMIN Balance: $107.56 ? F-- F- O z E-- W Payee: DOAK HOMES INC co C1 f- = w' TRANSACTION LIST: L) Type Method Description Amount tL ~O ---- - - - - -- -- - - - - -- --------------------- Payment Check 5083 - - - - -- ------ - - - - -- 66.99 Z WOO = H O I— z ACCOUNT ITEM LIST: Description Account Code Current Pmts ------------------------ - - - - -- ---------- - - - - -- ------ - - - - -- PLAN CHECK - NONRES 000/345.830 66.99 Total: 66.99 doc: Receipt Printed: 11 -09 -2005 i �4 INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 aff ect: Type of Inspection A d e t ss: Date Called: fe Special Instructions: Date Wanted•rri) Requ ster: Phone No: Q � aU — f31— ❑ Approved per applicable codes. Corrections required prior to approval. i. i td r ' i-� i i l .. . I I i i s COMMENTS: Inspector: Date: Receipt No.: Dater $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. z JU UO CO J H N LL L O LL v7 d zX zO W U� Cl) 0 H l!] W H� LL O Z. U= O F- Z Inspector: Date: Receipt No.: Dater $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. z JU UO CO J H N LL L O LL v7 d zX zO W U� Cl) 0 H l!] W H� LL O Z. U= O F- Z INSPECTION RECORD Retain a copy with permit INSPECTION N0. y. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 PERfyS) n /,� Project: ` ce Type of Inspection: Address ! Date Called: Special Instructions: Date Wanted: a.m. Requester: Phone No: u paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. Receipt No.: 1 55e 7— : Z � W� J U, (j 0 . N 0 C0 W J = S2 U- WO -3 u_ ?. co = �W Z O W W U� O � OH WW F- H LL' O .Z W N O Z � INSPECTION RECORD Retain a copy with permit INSPECTION NO. P T 0* CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 206)431 -3670 `I.,[.lApproved per applicable codes. � Corrections required prior to approval. COMMENTS: Rr t: Type T spection: , - �' 111.7 A dV ress: Date C Iled: Spetial instructions: D to Wanted: a. m. (�� m Requettq'r` Phone No: 2-0 -- 2-- --a o Inspe or: Date: [�A i00 REINSPECT10 FEE REQUIRED Prior to inspection, fee must be pa at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. eceipt No.: I Date: Z ;� W � W Q� JU UO CO) 0 �LL WO LLQ cf) = W Z F— z ° W U� N. 01-- LU W LL 111 Z U= O Z Dec 08 05 09:52a American Environmental Cc 206 522 4099 p.1 Y P Box 81005 9 Seattle, WA 98108 - 1005 ' doE nvironmental Construction LLC Phone: (206) 267 Asbestos - Lead - Mold - Demolition Fax: (206) 267 -0753 a December 8, 2005 r �•.. Z Telly & Darryl Doak Z $ Doak Homes Inc 1% 11812 26 Ave SW D Burien, WA 98146 U 0 i CO i Via Us Mail f W 1 - -- Letter of Completion - -- W O I (AEC Job # 5495) J U. Q co 4 = d Re: Asbestos Abatement Services at: 11620, 11638, 11640 E. Marginal Way S., Seattle Z X - F-- o w W l i. This is to certify that American Environmental Construction LLC has removed all of the 0 � asbestos containing materials from the above referenced address per the Asbestos o -- Survey conducted by Asbesto -Test Inc., dated November 10, 2005 and our Proposal & i W Contract dated November 18, 2005. �.. o. Clearance Air Monitoring (Sample Type = CL) as reported on the attached Air Sample Data tie Z 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 o area is safe, in regard to asbestos exposure, for re- occupancy and /or demolition. j Z Please call me at 206 - 523.441 if you have any questions or comments regarding this Letter of Completion. i j Respectfully submitted, America? Environmental Construction, LLC I�L,?bra Bellows — Ad inistr� ve As istant RECEIVED CITY OF TUKWILA DEC 0 7 2005 PERMIT CENTER Wow NOW I i Dec De 05 09:55a American Environmental Co 206 522 �LV f aUV7 4:7r lli NVL L1�5GVOh,;v111 :J :111, 4099 0. • - American Envirenmenial "ve Sam Uata Meet cage. 12t '� _ • ,�:,Y„ Work Activity: O A )E - Me l ejA � Observations: J ob Laca tlon: �1r!,z���.l�i.�r�f /fG �a X' , /w� S ,bb X: Sampled By: , J�S_C A Da %: f 2 - '7 - G �" 'rime - da nk Count: Microscope FwH Area: Blank Ca ssettes : Y Pump* Thief: End �� Minutes c Rabe: End j z, � Sam ple ID: •' 5 L oca tion: 3 .3_..�......�1.b•J `� 1 _ Type: WorkActivily: A fir' Observations: — ;ion: Q ,....,. Worker. �Q r 8Sr[: Cent# d'Z! q Tune: Sta t� Bate: Start •Z, ❑ nment: = c-- #: Tim e: ttirrd r~ 1z ; 55 Rat E n d Liters Fibers Fivers ltierd !ec 1` Mutes _ Average Z ra 'Ypo: CL r'rotect . Demn: Environment Pump #.- 501 Location: O L6 E /Z Work AL Observati ) Q Worker. Tim ��L:�' . li En d l ' L�/ Minutes = qwj� SS*: Gert#: Rate: Start / Z Fibers Fibers Rat End Liters O d 1^.c A verage � '7_,' {e t41Ji: �/ r - ; Location: c;E p e r .,P CM t 1/A r Sam Type: Work Activity: O A )E - Me l ejA Protection: % Observations: Worker. Racon:.�— Worker: ..-- .-- ..- .. ----- SS#: Cart#: — ErwMrorrment: 71c11e: Sta 12.' Rab: Start / y Rate; End liters Pump* Thief: End �� Minutes c Rabe: End j z, � Fibers F'iber>~ Liters A id /cc /ZLf `� <:�e yo Average r 7- (� L &uttpt+s '5495 Sarrrple Type: A ?- F A tcatiun: r'Of�'�" S Work Activity : Ck r .,P CM t 1/A ' l Protection: i01Q„6 alt_Dk .VAL__.�fN.�l - Me l ejA - -- - - Worker. Environment Time. S'tatt �:.?� 7 Rate: S 0 Pam fit: 1 p � T imw End LL _ r y Rate; End liters fibers Fibers Ifletd ter. Minutes = Average - Brnaftng Zone P - Pre Abatrmant . - Celing '� CL • Clears= ~ t f - Inside Area H • MEPA Exhauk 0 - OulstJe Ares dL - Fiek! Blank M • HaKMaskAGR F • Fu9 F;ce h%sk APR PAPR CA • CoAlinuaua Flow A]r FA - NrossureD*mandAk 0.$- pecan wi Shower H - HfiPA Vaarun► p - pawn wfo shower G - Giowe* 1E - FAni SAticsurs- FE - Ful! rrndusure , IjL� 7 q'lcd �� -, NL Y 9 z Z _5U UO ND CO -_ Nw w 9J U- Q ND 2 ZO 0o U o� w H0 u. O z CO 0 z Dec Oa 05 09:54a American Environmental Cc 206 522 4099 p.5 .0 ��• • Lvvi ' "L1Al lift. LAOVINAIV111CJ ON RV. jjI1 1. L American Environmental , " Sam D ata Sheet .' ���• ��.__�� J Loca,io r�- 2r�, ilia $ kb I< 4,A( �a : 5 U� Sampled e'y. /ti CA _ Date: jZ -p 7° 0 5 _r ime: __.. wank Count: Bla Casszftes: Location: USG z Q Type: P✓ : Work Activity: Utz nctior• Y Observations' h G 7n: rker. Wo�� SSi: _ X ronme nt• Time: St art 9 Rate: Slant iC} Time: End r Rate: End d Ton Minutes = Averdge / Plf Cortt Fibers Fibers Liters field I= sample Type!: ,4 ,c--7 Protection Decon: Environment: Pump #: , 01 — Mkmscope Field Arta: Location: I A OS+E Work Activity: f� E"• 611 Observatiow ��- Worker. . Time: St - Tirne: land .'1 Minutes as A SS#: C ertg , Rate: Start Fibers Fibers Rate: End 1 p Liters /field 1= Average 1 U pie IQ; Location. / SampleType: 1 7 'MlorkActi ly: y32 oU,� �'1 %� .��. —/.cam ,� ,oi2 A �l Protection Observations: 1 ! ., A Decon: Worker Ad r ,q 1 r R u do Sg* Gerl:k: 0 7 SS z l Environment: Time: Start Ra Start 7 Time' End Rate: End � Fibers Fibers Pump # _ _3 �� • �_ Liters (!geld Ict Mlnutts = Averag Sample IDs 55 25 L ocation: vcl SE - _ L'( �,jj, Sample type: ,agF,L; Work ActhritSr: _ M 0 felt �_, 7" Protection: % O bservations: F jyf� e Decow ' Worker. SSO: Cert* 1 Environment: Time: S irate: Start >1� Fibers f=ibers Fump�: J �/ T ime E nd f �.'Sc�� Rat End lfield rcc Minutes M Average OVER u • Breathing Zond P - PmAbs - Cedlno CL - O"wice hoide Ante H 1 - HEPA fixhsust O • Outside Arse RL - FieW Dlank w•�pt.d M - Halt Mafk APR O.S. Deoon wi Shower H • }IVAVUL F - Full F*wMaskAPR 0 - Neon wio sho',ter G - Giovetwu PAPR ME KnI Ernelawre CA - Ocntlnuowt Fttwl Ak M • Ful! hndosurc PA - Pntfa ro Uertlarld Air N +�W R-•. UaM.•v+/.�`�tN. n »e.e�a. .w,rw wcw•.c�.e.. + +a.rwvm.� v..r�. �»weex +:.�•- >.r.....r...., .... ,.. •.yr.:w.. x ..rniww: vrrtrs'r.« Z w D 00 CO J = f— (0) LL w 7 LL = CO D = w Z F— Z� W 7. 5 U O- 0H W 3:U L —0 tai U= O Z Dec 08 05 09:53a American Environmental Co 205 522 4099 v.4 ` L._.. ASN 4 ASBESTOS WASTE SHIPMENTREPORT F'OR.II7 PLEASE PRINT OR TYPE! If you have questions, eonma your local DEQ R.egional Office in Portland at ( 229 - 5364, Sal= at (503) 378 -8240 ext •272, Medford at (541) 776 -6010 M 235, or Bend at (541) 388 - 6146 ext. 226, Olt call (800) 4`? -401; for the location of your local regional DEQ office. WASTE GENERATOR: (Cunuactor, Facility, or Op:ratar) i 1. Asbestos removal site name and address Doak Homes -Darryl Doak ' ? 162 . 1 11640 f i Margfn f Way Knuth Seattle WA King 95168 j Street 04 County Zip Contact person; Darryl Doak Phone: 206.246. . _._ 2. Operator's name and addrtw Arnerican Envirorimenta; Construction LLC Phone: 206- 267 -01'46 7417 - atn Avenue South Seattle, WA Kinq 98108 Street Citrislate - County Zip 3. Waste disposal site: Northern Wasco County Landfill Phone: 541- 993 -CC84 25W Steel Road _ The Dalles, OR Wasco 97058 Street Cityistate County Z;F 4. Describe asbestos materials; 'L°= -t 5. Containvs: Number: r a _; 7$6 / SS Type: S , 1 & ' . Ca ' J ' 6. Total quantity (cubic yards): V 0 ✓ 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 labeled, and are in all respe:ts in proper'condition for transport aczording to all government regulations. All movement of this asbestos- cortaining material is recorded on this Waste Shipment Record Form. Name: _Z Signature: Company: American Environment C onstructio n _-, Date: _ /,; = O ­ 1 G: _ TRANSPORTER(S): 8. Transporter f* 1:( Acluiowledgmentorreceiptofm atcrials; Agent: __. Company: D &B Trucking Address: 1905 East Lincoln Ave., Tacoma, WA 99421 Phone: 25 3- 333 -3850 + Signature: Date: 4. 'transporter art: (Acknowlcdgment of receipt of materials) Agent: Dower _ _ Company: NTSI I D&B Trucking Address: 1 905 East Lincoln Ave.. Tacoma, %VA 98421 Phone: -383 -3860 Signature: Date: DISPOSAL: (Certification of reeeipt'of asbestos materials covered by this manifest, except as noted in item 11 bcluw.! W Waste Disposal Site: Northern Wasco Co unty Landit•.I Name and and Title: _ � , Date: _ : Signature: " Phone: 11. DISCREPANCY SPACE: (Add anachmrnis as ne:ded) _ _ - _.•_� (Rcvis:d 0103) I Z �Z '~ W 0 Cl) C0 LLI J = C0 LL WO �_j LL Q = a �W Z 1 Z� W LU �p U ON 0 }— WW F_ LL O .. Z w U= O~ Z Bee 08 05 09:528 American Envi Agency Casa X , I t 200503701 ronmental Co 206 522 4499 p.J , - PUG-;:T SOU?t1D CLEAN A� , Date_ R.ctivedJ i AGENCY i 1 10 Union Street, Suite 500 Seattle, WA 98101 -:03 �j� www.pscleanai l rfgcnc i Um Only 1�it`iYti�ll NOTIC E OF IN TENT ru\r -18t ....�...�..... / .......+.....: A. P'raiect Tynci 1. Q Friable .Ashrstnt Rernovnl 2 ­ 0 Friable AK -ma Re eni &_ t nntition 3. 5f Derrrnliti niv .- --...._..__ ! Property Owner D oak Homes In Phone: 206 .246.658 7 I rr�i :int:.��� :ass: 'tf 1� 26th /�Ve SW ci,� -: Barlett w s�att t ^Ir i m 98 1'q6 I rrr+ li... ��r. dr.. Mw• r. r. .r..�\�r.�l \�.M+�a\.�YrF. Yll.l \� rW�\I'�YrriiOM�\iiii�r�-w��Y�� C. ASbCS'tOS r :r,t rxsxrt.t.;,rrt.r, w:,.uR rn err,:ruu turn n:.ut•. �....��_... —�_... �' ~) C� nrrn A merican Environmental Construction LL.0 I OwnerlCE Joh ASS elin Ontractor f 't 4 il!n 2 Adtircs5: �? _r1, BOX 8 405 i Ff :opt' ( SE-44• , 1oc crv: Seattle l state: WA 2i :9$108 -1005 Fax: (206), 522 -4099 l 549. D. Site •�Y wrWlwJ Addres 11520, 11633, 11640 East Marginal Way South � City. Seattle } z; . _ 08 , Site•-'-' - ..�_._._, 1l Darryl Doak Local Phone: 206.3 2.2280 F,. Aesios 5une�- or 4 �o. of Date of Asbestos Was Friable Asbestos Identified ?1'esN. ? �' �iat'1 Prtstarned _ 1 Stntctltres: sun'e:': it "� -OS I Was S�Yrs Al IERA Building Gcrtification A: Au ?.ch a copy of the sur•►kv wh2n.0able ashavos tnspc :tor. Carl Oytestra Exr.. Date. 101664516- 7 7 -ttti has noi been ' i tit "..N RA aur is m oved before Otl drutotttron P. -Opeu F. t7emaiition Start p� ctr < ter I No. of Tcasning Fire (List Fire Dept,) Informati Date: BID � 72 11- d Structures: 3 Ordered Dtmo! :tir�r, ( at `ach coop' of rr1e= ! I3en :o!itivn lru trtdarrtotrrtatcont ►atlor'intotltrraddre ro:r 6a :k Will ionfriable asbestos be Nit in place during demo? U Yes U No ! Contractor Darryl Deak If yt:s, list type and .ley. Note disposal mgArements in St_p 6 (on back). I G. Friable Asbestos I Work Days: � t 7 Sa Su Project Information: 1 start Date: Completion Dot :: Hours: Will all Friable asbestos C) Yes � I coal Oiy. to be Removed: Linear Ft. _Square Ft, rtateria!s be removed? Q No ! l3 iiu11c:6Ft: Irsulation LJ Duc: Insttiatien_ lttsulation i= fireproofing Paints Plaster T cx:ered Coatin l�;nt Board Cement Pi' Friable. Floo 7 ing LJ Friatile Roofing Mtueriat Other: H. ,AshestosiDemolition Project Categories: Notifimtion Period project netuulitfon i !. single- Fnmily Residence (owner - occupied;: Fee Surcher A. Cl Asbestos Removal Project Only A. ?rior i�fo6ce A S25 B. C7 Demolition Prpject (with or without asbestos removal project) B. 10 Gays' B. S5o { eiAsbesto, remo val can begin coon notification: d emolition must wain 10 da:vs't Niotc: ;crndy rt:sidonca 4 owned by one family t•rho: has been or,will be using the residence as their domicr.'e, the above bares 't or 18 may be cieecked If this is not an owner - occupied residence, one of the categories listed below must be used instead. Z single .'wind •, rasidaptce does net 1rclua't rental oroaerrv. nttull- famil) units. or n>tv »ti Ld.use huddincr. 2. '4 All Other Demolitions (with no Asbestos removal or Nontriable Asbestos 10 lays t only or less thun 10 linear fe et andlcr 4 8 square feet of friable Asbesto Friable Asbestos Projects (other than Single Famiiy Residence): Asbestos D emo J. C3 2 !0. 259 linear feet::tt /orZ 49 - 159 square feet of asb estos I Prior Notice 10 Days 5100 4. ' X6 0.999 linear . ect and/or 160 - 4,999 souare feat or-asbestos 10 Days .200 5 i 110 .i. TJ >1.000 linear feet and/or >5.000 s ware feet of asbe stos 10 Days 1 ab00 5 100 i 6.0 Emergency Asbestos Project or U Emergency De Demolitien project Prior Notice � SSG Emergency Fee i ISina�le`Ytly ftesidmwi arc exern tram cmerzercv fee: h owever, ecoperty ountrsmust provide a Hrtten emen_•cncy c ueS:i L L _J h t t rtiry f it tine trtbrmaunn center c n (.kit, ttcuficrion d: supplement -{ data u, to the asst r•f Im 00tAltrlge, ac:ura c rk conalcte. Age -y 'set (}ni✓ %' _ ^" � Am erican Environmentzt Cun6trutt L.L_C 41.25 -05 t 7 Sif,nvturt _ Krcrirrnune .^. Date `n' u'ed ,• Puget S,.;n: 0=1 At' Arx =%;• =Orin No. E6.160 (it aaistc 1'15) TS R ECEIVED 1 . Z h Z �W JU UO Cl) 0 �w w LL L CO = W z _ ZF- W �5 U O� 0H WW F W0 w U= O Z . . l:¢9"�+r�?r!:ttt<?? �^. tS:• M�it= �' ldn' a' tR' u! F' ShYx�r�7+'�rAS�fi-+= :<afir+w•,r+ lip= t. �+ �y�^ s: e* rh• ac : ?r�+rc^.?,rn,��..�,n•«rbY'?ry" eft• 5gnxt/ er.» yr✓ LVr.., M,;; rz��t- p�ri�� .tAPtifa•fa:s,Yaixvt7�SCi'!fha Dec 08 05 09:52a American Environmental Cc 206 522 4099 p.2 C f Job Number 5 55 -1 Labor and Industries „,, NOTICE OF Industrial Hygiene Compliance i AS BESTOS ABATEMENT (Regional addresses and phone • numbers on page 2) �''” ' PROJECT Today's Date Nov ember 28, 205 1 THIS NOTICE MUST 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 REG IONAL OFFICE -- CIRCLE CHANGES 014 AMENbEn NOTICES N ot i ce date: 11 / ZS i Q5 Ini I ❑ tnended Q Site W ork Ho ur s Su Mo Tu We Th Fr 5a f Start date: 12 /07,'05 On Ole Q Off Hold (] 8:00 am �! X I X i X X X to -�- i Compl 12 / 3 1105 Emergency [] pm 4:09 pm Project Dates and Wefx Hours must be Exact d CONTRAC'T'OR P PROPER'T'Y OWNER Company Name N Name American Environmental Construction LLC D Doak H omes Inc _ Contrac r Certification Number O Owner's Agent - _ 1338 D Darryl Doak i ur C Company -^ ' D Doak Homes la cd Namc A Address ura Bello 1 1181 26th Me S SW hone Number C City � — — State , ZIP *4 t (206) 523.4441 B Burien W WA 9 8146 Job Site C.A.S. P Phone number John Asselin ' ' (206) 372 -2284 r i JOB SITE F FACILITY Address T Type 11620 Epst MUM inal Wa South R Residential Structure Building Namc R Room A Age Size 40 Years nla ! City r r� QUANTITY OF ASBESTOS TO BE: [] REMOVED ❑ ENCAPSULATED Quantity 310 square feet ❑ Indoors Q O utdoors ❑ Fire ❑ Bo iler ins ulation CONTROL MEASURES © Popcom ceiling Duct paper it Neg. p enclosure ❑ Wrap & cut i ❑ CAB ✓❑ VAT ❑ G love bag Q Wet me �❑ Sheei vinyl ❑ Roofing ❑ :Mini enclosure - ❑ - H - FPA vacuum ❑ Asbestos paper L ❑ Other Critical barri _ Q Nlan4al methods Q uantity linear feet ❑ Other ❑✓ Othe R A ren ❑ ?rMag. pipe insulation ❑ Cement asbestos pipe RESPIRA PRO [] Air cell pipe insulation ❑ Mudded pipe ins. ❑ % mask APR Typt! C contin flow [j Ducting/duct insulation ❑ Duct tape ❑ Full face APR Type C pressure demand �] Other i [� Other _ Q PRPR ❑ Other F413- 025 -COO notice of asbestos abatement project 11 -01 For clean copies go to thttp: / /www.Ini.Nva.govifornis' i ... Z Z �W QQ JU 00 to J -r C0 LL Wo J L? � = W H ZF- W W D0 ON 0 t- WW F-F- L- O W Z U= O Z F413- 025 -COO notice of asbestos abatement project 11 -01 For clean copies go to thttp: / /www.Ini.Nva.govifornis' i ... Z Z �W QQ JU 00 to J -r C0 LL Wo J L? � = W H ZF- W W D0 ON 0 t- WW F-F- L- O W Z U= O Z W I� CD A7 � O Moog � W NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR - THAN THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT., PERMIT COORD COPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D05 -403 PROJECT NAME DOAK HOMES ❑ No further Review Required ❑ DATE: SITE ADDRESS 11640 EAST MARGINAL WY S X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # After Permit Issued DEPARTMENTS d� � Bui di g , lic Works I vi Am AP 1 5� w OL Fire Prevention Structural ❑ DATE: 11 -09 -05 ' Im AT II Pl nning Division d Permit Coordinator ❑ DETERMINATION OF COMPLETENESS (Tues., Thurs.) Complete 1� Incomplete ❑ Comments: DUE DATE: 11 -10-05 Not Applicable ❑ Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES/THURS ROUT NG: Please Route Structural Review Required REVIEWER'S INITIALS: APPROVALS OR CORRECTIONS Approved ❑ Approved with Conditions 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 DUE DATE: 12-08 -05 Not Approved (attach comments) ❑ z z "~ w J0 UO (l O J = I.— S2 LL w 2� IQ = �w Z z� w w U� ON O I-- wW Ir— ILL O !LI z U= O z 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 1 11812 26TH AVE SW Address 2 Impaired City SEATTLE County KING State WA Zip 98146 Phone 2062466587 Status ACTIVE Specialty 1 GENERAL Specialty 2 UNUSED Effective Date 8/9/1991 Expiration Date 8/8/2007 Suspend Date CBIC Separation Date 08/01/2001 Parent Company 1 Previous License DOAKH* *10605 Next License #3 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 1 Cancelled 1 $12,000.00 08/01/2001 #3 CBIC I SC9910 1 08/01/2000 1 08/01/2001 1 $6,000.00 Pagel of 3 https: // fortress. wa. gov /lni /bbip /printer.aspx ?License= DOAKHI *092NZ 12/08/2005 S� tQQY W, JU UO ND J � CO W WO �J U. Q N� = �W Z H E- O Z 1— LU �j U� O �. 0 1-- W LL F- 0 •Z W U =. O Z File: D05 -0403 35mm Drawing yP. 'Vk 1)11 , 'U 7 _JW J1, i I "7 UP" 64 IX, I AV 5 T ... - A l f 0 Mt 4� 7k. 3, • y r -�� ' .� .. .,,G }- :.rt� .:K' .rte '} � ! i}. - � t ,.a �/ :t 4��r: 3 IR RJ • �,rr y ' _ ..<� -.. � �1 _ y ,,"�•; �t.. ?' � it f > .� ..n , .. � `„� •r. ;e _ 3� :d �.� � .. S,r '- A W.. A, !,7 Pq l .d t n Adw 4� 4 t Z 'T Q +ac ` - W� 1 � 1 2 P! _1 4Q * 417; j " 4 A R I P 1 E I r�� : 1 .. - - � , L SY� � ,t .tJ� , ri: ,- 0 f A I 7 Nib 77;5 Zg M-f, Wlr, �.- �..,�.'�, - ...n __S•. ,- °',�`',�.� +'„+",,.��riv^±' -•. - I i I zF 04 " NO. wn=2 review approval i Su ,_a__ t10 en and =bSkXV Uj= proval of construction docume d oes not aUthWW violation o; : accepted code or ordinan R ejCSW approve- By ( conditions Is aclavwWged: Date: City Of Tukwila " V ' : "A E ­ ;:7x nw t .1 i I zF 04 " NO. wn=2 review approval i Su ,_a__ t10 en and =bSkXV Uj= proval of construction docume d oes not aUthWW violation o; : accepted code or ordinan R ejCSW approve- By ( conditions Is aclavwWged: Date: City Of Tukwila