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Permit D04-020 - DOAK HOMES - LOT 12 GARAGE DEMOLITION
DOAK HOMES GARAGE DEMO 12224 45 AV S D04 -020 Z ul 6 JU. U O' CO • W'' W =; J H' W O CO W, _` Z�: I- 0 W; U , O N; 0 = W! O w Z: -- z City of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 DEVELOPMENT PERMIT Parcel No.: 0179000725 Permit Number D04-020 Address: 12224 45"S TUKW Issue Date: 02/27/2004 Suite No: Permit Expires On: 08/25/2004 Tenant: Name: DOAK HOMES INC - LOT 12 Address: 12224 45 AV S, TUKWILA WA Owner: Name: DOAK HOME SINC Phone: 206 372 -2280 Address: 11812 26 AV SW, BURIEN WA Contact Person: Curb Cut / Access / Sidewalk / CSS: Name: DARRYL DOAK Phone: 206 372 -2280 Address: 11812 26 AV SW, BURIEN WA Fire Loop Hydrant: Contractor: Number: 0 Name: DOAK HOMES INC. I Phone: 206 246 -6587 ' Address: 11917 4TH AVENUE S.W., SEATTLE, WA Contractor License No: DOAKHI *092NZ Expiration Date: 08/08/2005 DESCRIPTION OF WORK: Start Time: DEMOLITION OF EXISTING 800 SQ FT GARAGE, SHOWN AS STUCTURE W ON SITE MAP PROVIDED BY APPLICANT. NO PUBLIC WORKS ACTIVITIES i N Value of Construction: $ $5,000.00 Fees Collected: $51.50 Type of Fire Protection: N/A Uniform Building Code Edition: 1997 Type of Construction: Occupancy per UBC: 0017 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: n Public: n Storm Drainage: N Street Use: N Prol:lt: N Non - Profit: N Water Main Extension: N Private: n Public: n Water Meter: N doc: Devperm D04 -020 Printed: 02 -27 -2004 r z �z '~ w u� D . 00 ND CO W �w w LLa d = w �— _ zl-- I— 0; Z F— w UJ U D. O N D k•- w W LL� —0. .. Z w 0 �` Z City of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 Permit Center Authorized Signature: li _ (� Date: - 7 I hereby certify that I have read and examined 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 const coon or the performance of work. I am authorized to sign and obtain this development permit. Signature: x� Date: z n Print Name: i) r �rL4Z�L 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 u� D UO CO o . to W J = H CO W WO w? COa w Z �. H O. Z H- w UJ � o° U O N 3 H WW U u. O Z; 111 U N H= O Z �. City of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 PERMIT CONDITIONS Parcel No.: 0179000725 Permit Number: D04-020 Address: 12224 45 AV S TUKW Status: ISSUED Suite No: Applied Date: 01/20/2004 Tenant: DOAK HOMES INC - LOT 12 Issue Date: 02/27/2004 1: ** *BUILDING DEPARTMENT CONDITIONS * ** 2: All permits, inspection records, and approved plans shall be available at the job site prior to the start of any construction. These documents are to be maintained and available until final inspection approval is granted. 3: All construction to be done in conformance with approved plans and requirements of the Uniform Building Code (1997 Edition) as amended, Uniform Mechanical Code (1997 Edition), and Washington State Energy Code (1997 Edition). 4: Validity of Permit. The issuance of a permit or approval of plans, specifications, and computations 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 ordinance of the jurisdiction. No permit presuming to give authority to violate or cancel the provisions of this code shall be valid. 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. Signatu Print Name: , r Date: - .2 7 - D Y z Z '~ W � JU U0 N J = H co U- W O L Co = CJ �W F— O z F— U� 0 co o � w F- U'. LL �. z W co O z CITY OF TUKWILA . Community Development Department i Public Works Department Permit Center R Igo H 6300 Southcenter Blvd., Suite 100 . Tukwila, WA 98188 Lt,� Jz 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 King Co Assessor's Tax No.: _0 / 900 — 01.2 }^ Site Address: /�-��g �'l } /!�l /�'U w� /� Suite Number: Floor: Tenant Name: ` New Tenant: [] .... Yes C] ..No Property Owners Name: Mailing Address: E -Mail Address: Day Telephone: - 2�9 —�2 2 City State Zip Fax Number: Company Name: , -v� �/ �l�s e ml G Mailing Address: /ZIK/..— ;k 6731 "1 -5 Gt' City State zip Contact Person: a Day Telephone: 72 -22g"o E -Mail Address: Fax Number: 2—OX Contractor Registration Number: &/jf 0?2 Voi Expiration Date: o * *An original or notarized copy of current Washington State Contractor License must be presented it t e time of permit issuance ** w'AI2CHITECT OF:RECQRD All` Mans' mustbe% ek stam` 1' Company Name:, Mailing Address: Contact E -Mail Address: Compan Mailing City State Day Telephone: Fax Number: Zip Contact Person: � rn �r Je C p/l, Day Telephone: 1 -/ 2 C .- /0$� E -Mail Address: Fax Number Vpplications%onnit application (3.2000 31200 Page t Z W W W JU 0 NO J = (1) LL WO 9-1 LL Q �D = F W Z F O Z E- w W U� O- 0H W H LL O . Z . W U= O Z r uty 060- .... Mailing Address: / / /,. A 6 ,T�p to °W f�luri tlt'/JJ 46loO City State � .,�. ..,,: "z.tf +11v' Si , �r ! '.• i „ -..y,+ y`, r:.iy.,, tryn - ,;+;y 7” . .�"�y •���{.'�. �c'S .:: t ,xf ea a .}. r.r.. K YY3 w .�.. +4 ' `y �- . ! � � m r� �: n ,., ., � �� + _.JFi+^t1`ti:�n �s�i��� „C�� 1�'�{��J �•= � ♦ #o tii }�i�'` ro�I•'k �lA`gI'. } MSC •�'•1. J«• ti�7+TM f, �' {,� �r !� , � , XZY, , i7.'h•.�:. 1. ,►±, ? },,.Ctiil..lJC�tiP:r 7 �3.'.' t. ��.. n. n✓ 1E7k'+. sa. M. k. �+! �, 1:! �' �.{'• K' 1 •.f vc 3��l�. t” i':7_ Valuation of Project (contractor's bid price : $ a, X61 Existing Wing Valuation: $ Scope of Work (please provide detailed i.._ ;cmation): B Zk,�� Will there be new rack storage? F] ..Yes ❑.. No If "yes ", see Handout No. for requirements. 1 :rl �t c} 4 w :` Prrovide All Building.Area Irn S..quare Footage:Belovs >:; y�J {; ;• . -J� 'v':JA e. '.ir.. ., ..:� t [ ;.,. 4r. t.,,l, �.t r .r �:�{ A.,: +; i,r aY:• s �?Addttton to y; 5..i T1 ,1 7J t'rr f ting C 1'F JY V f f >3J o ;•,�� [�. C nstruct on er , o ; Relnodei ' Structure , 1 r. New r t .. UB 'r. `.iTBC . µper y ;, -?: Accessory; Structure! Attached ;Garage' Retached`•Garage' '> Attached' Cttrport Detached Carport r " 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 '[]..No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑.. Sprinklers []..Automatic Fire Alarm []..None E]. Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? [] .. Yes EJ •.No If' yes ", attach list of materials and storage locations on a separate 8 -112 x 1I paper indicating quantities and Material Safety Data Sheets. %applicationalpamit application (3.2003) 3/2003 Page 2 i Z Q ~ w �C U CO) LU W H NLL W } O } �J LL ? N W H Z� Z0 W W U� O- 0 1.- W HF- U . F— W Z U= O Z '^.i � r, l yen t' "v�sy 't, rf.�gr;•e, -w xr.r� �x; n. .� tlt4't"{.C. ; , (`'r ry `i :,� h , r ,'jt tY; •: yk A'•' r.:rt r' t , ti, R 4ii •V , +�.a -t �• .Fw�.f�:.: tti ' S,Ss` ,r,'ii� t'+3W,CiV1�c+c. . ��•7:�.. � d�„' j,+•5�d•1��b;:1)v'M>?1��'r�' IMF'; �.•? iUT. 7F� 'ik�,l+itk,'i�S��'r�{�1;'�y4�` Scope of Work (please provide detailed iriwati 0 n ) a' �i i } ;j Call before you Dig: 1 -800- 424 -5555 . ���`� ;;,;;�*`�..,:'�'x3��Please referto`Publlc;�l!.oi•.ks Buffetih' #l��for�fees ancl.esti � �'���•�rktw4 ��+�:�•a Water District ...Tukwila ❑... Water District . # 125 .. Highline 0 ...Renton [� ...Water Availability Provided Sewer District []...Tukwila ❑... ValVue .. Renton ❑ ...Seattle ❑ ... Sewer Use Certificate C1 ...Sewer Availability Provided E].. Approved Septic Plans Provided ...Septic System- For onsite septic system, provide 2 co' pies 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) ❑ .. Geoteehnical Report ❑ ... Traffic Impact Analysis ❑ ...Bond ❑ .. Insurance C].. Easement(s) ❑ .. Maintenance Agreements) ❑ ... Hold Harmless Proaosed 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 cubic yards ❑ ... Total Fill cubic yards ❑ .. Right -of -way Use - Profit for less than 72 hours ❑ .. Right -of -way Use – Potential Disturbance ❑ .. Work in Flood Zone C].. Storm Drainage []..' Sanitary Side Sewer ❑ .. Abandon Septic Tank El ...Cap or Remove Utilities ❑ .. Curb Cut ❑ ... Frontage Improvements ❑ .. Pavement Cut Fj ...Traffic Control E].. Looped Fire Line ...Backflow Prevention - Fire Protection " Irrigation " Domestic Water " ;f i 1. 4 {{ 1 ❑ .. Grease Interceptor ❑ .. Channelization [] .. Trench Excavation ❑ .. Utility Undergrounding ❑ ... Permanent Water Meter Size... WO# ❑ ...Temporary Water Meter Size.. WO# ... Water Only Meter Size............ WO# 0–Deduct Water Meter Size........ to ❑... Sewer Main Extension ............ Public Private ... Water Main Extension .............Public Private Fire Line Size at Property Line — [] ... Water [] ...Sewer Monthly Service Billing to: Number of Public Fire Hydrant(s) 0 ...Sewage Treatment Name: Day Telephone: Mailing Address: City state Zip Water Meter Refund/Billing: Name: Day Telephone: Mailing Address Ci State Zip tappliutiomlpmnit application (3.2003) 3/2003 Page 3 Z W OC � QQ� JU (3 0 NO CO W J l N u. WO J IL C =W Z 1-- Z F LU 5 UO O N D H WW H u. O --Z W U= O Z 1'. Ci S!:. �. lTtYa. CS1: 5:: i.°, va' Y' isi'.. 45?. iw�slchkiwYlrlxxWr.., t7v» �. x�x- iwsE. ww. e.. •r.......r.......__....__. -..._ .._. .. MECHANICAL CONTRACTOR INFORMATION Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Contractor Registration Number: Expiration Date: * *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance ** Valuation of Project (contractor's bid price): $ Scope of Work (please provide detailed information): Use: Residential: New .... ❑ Commercial: New .... E] Fuel Type Electric ..... ❑ Gas....❑ Replacement .... ❑ Replacement .... ❑ Other: Indicate type of mechanical work being installed and the quantity below: Unit TYPet' :... ... = ].Qt ` i:Umt Type �; ._: , QtY Unit:Type' ; . Qty , Boile "rLCompiressor Qty: Furnace <IOOK BTU Air Handling Unit >= 10,000 CFM Other Mechanical Equipment 0 -3 HP/ 100,000 BTU Furnace >100K BTU Evaporator Cooler 3 -15 HP /500,000 BTU Floor Furnace Ventilation Fan 15 -30 HP /1,000,000 BTU Suspended /Wall/Floor Mounted Heater Ventilation System 30 -50 HP /1,750,000 BTU Appliance Vent Hood 50+ HP /1,750,000 BTU Heat/Refrig/Cooling System Incinerator - Domestic Air Handling Unit <= 10,000 CF Incinerator— Comm/Ind 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 extend the time for action by the applicant for a period not exceeding 180 days upon written request by the applicant as defined in Section 107.4 of the Uniform Building Code (current edition). No application shall be extended more than once. 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 07 OR THO ED AGENT: Signature: Date: — 0 ^ 0 y Print Name: Mailing Address: Day Telephone: o? D6 7� ~2z State Zip Date Application Accepted: I Date Application Expires: Staff in• •al - -�0•-d �-f ? -ZD�d y S Upplications%pumit application (3.2003) 312003 Page 4 5-0510 ME! 1 t 11 Z :3: Z JU UO UU J = H CO) LL WO U. C0 = �w z H H O W ~ W U� O- o I— W III H� -O Z W CO O Z i City of Tukwila 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 RECEIPT Parcel No.: 0179000715 Address: 12228 45 AV S TUKW Suite No: Applicant: DOAK HOMES INC - LOT 12 Permit Number D04 -020 Status: PENDING Applied Date: 01/20/2004 Issue Date: Receipt No.: R04 -00051 Initials: SKS User ID: 1165 Payment Amount: 51.50 Payment Date: 01/20/2004 03:40 PM Balance: $0.00 Payee: DOAK HOMES, INC. TRANSACTION LIST: Type Method Description Amount ---- - - - - -- -- - - - - -- --------------------- - - - - -- ------ - - - - -- Payment Check 3508 51.50 i ACCOUNT ITEM LIST: Description Account Code Current Pmts ------------------------ - - - - -- ---------- - - - - -- ------ - - - - -- BUILDING - NONRES 000/322.100 47.00 STATE BUILDING SURCHARGE 000/386.904 4.50 Total: 51.50 doc: Receipt Printed: 01 -20 -2004 z JU UO Cl) LL. W O LL C d �W Z H f- O z I— 2 -9. U� O �; �H WW H 160 ui z H = O � z INSPECTION RECORD Retain a copy with permit INSPECTION NO. P P6)431-3670 . CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 ( Corrections required prior to approval. 1...- F- Proj t: Type of Inspection.. A ress: _ 2,2 Date Called: _ Special lnstr tions: Date Wanted: a.m. p.m. Requester: V✓ Phone No: Z ;F- Z W 3 00 Cl) 0 W = J 9 L W O. 9-j LL Q = d. �W Z F- I— O W H LLI � p U O - 0 F- W W LL H Lll Z U N, H 3:; O Z } INSPECTION RECORD t Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 PM* ct: 1 io Type of Inspec n: Address. ate Called: �;a -C2 Special Instructions: Date Wanted: , a. m Requester: Phone No: Inspecto . � Dater $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: Date: ::�:j Z �Z �W JU UO W = H N LL. W O. 9Q N� _CY �W Z I— z W W U� O N OH W W S F— ll. O ..Z W UN H= O }" .Z Feb 20 04 01:45p Rmerican Environmental Cc 206 522 4099 P -1 PO Box 81 SeaWe, WA 98108-1005 .. • • �' Phone: (206) 267 -0746 or (800) 357"/60 �• ~' '/ ;: Environmental Construction LLC Paz; (206) 5224099 Asbestos - Load - Mold - Demolition WA State Ci0111raCtor 0 AMERIEC996MB February 20, 2004 Darryl Doak Doak Homes Inc 11817 26" Ave SW Buden, WA 98146 Fax: 206.246.5991 - -- Letter of Completion - -- I (AEC Job # 4038) Re' Asbestos Abatement Services at: 12228 45 Ave South, Tukwila, WA 98178 r ; 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 NVL Laboratories, Inc,, dated January 15, 2004 and our Proposal & Contra dated February 2, 2004. Therefore, the work areas are safe (in respect. to asbestos exposure) for re- occupancy or j demolition. Please call me at 206 - 523 -4441 if you have any questions or comments regarding this Letter of Completion Respectfully submitted, 7Lul n Environmental Construction, LLC gECEIVLeD OITY OP TVKWILA r llows — Adhi nis tive Assistant I t GLa PERMIT CENTER z - z MW U0 CO W = CO LL W 0 LL < � a = w Z z° W LU �o U 0 I— w w . �0 .. z. W U CO). z Feb 20 04 01:45p American Environmental Cc 206 522 4059 p.3 job Number 4038 Labor and Industries . NOTICE OF Industrial Hygiene Compliance ASBESTOS AB ATEMENT addresses and phone numbers on page 2) Today's Date February 1 2004 1 PROJECT THIS NOTICE MUST BE RECEIVED NO LATER THAN 10 CALENDAR DAYS PRIOR TO THE START DATE COMPLETE ALL APPLICABLE BOXES — INCOMPLETE OR ILLEGIBLE NOTICES WILL NOT BE ACCEPTED MAIL OR FAX TO THE RE ZONAL OFFICE — CIRCLE CHANGES ON AMENDED i OT!CES Notice date: 02 / 11 1 W I i al [✓] ended ❑ Site Work Hours Su Mo Tu We Th Fr Sa Start d ate: 02 / 20 ! 04 On old ❑ OfFHold ❑ 8:00 am am X X X X X c0 Completion: 02 129 / 04 I Emergency ❑ pm 5 : 0 0 pm I Proje(A Dates and Work Hours must be Exact CONTRACTOR Q Indoors ❑ Outdoors PROPERTY OWNER Company Name CONTROL MEASURES Name ❑ Duct paper American Environmental Construction LLC ❑ Wrap & cut Doak Homes Inc ❑ VAT Contractor Certification Number Q Wet ruelhods T Owner's Agent ❑ Roofing 1338 n Q HEPA vacuum. D arryl Dua © Other Whit Vinyl Sig �... Manual methods Company ❑ Other .._.___,__ ❑ Other ❑ Mag, pipe insulation Doak Ho ntes Inc RES PIRATORY PROTE CTION Pr,,qTl4ame ❑ M pipe ins. Address r.0 D i .at Bellows ❑ F ull fac APR 1 Type C p dem 11817 26th Ave SW ❑ Other Phone Number City State ZIP +4 (206 ) 523 - 4441 B urien WA 98146 Job Site C.A.S. Phone number John Asselin (206) 372 -228D JOB SITE _ FACILITY Address Type 12228 45th Ave South Commeric Building Name _ Room Age Size 1947 . 500 Sq Ft - 1 -Floor T W A ❑ Remodel ❑Repair E] Demolition ❑ Mfaintenance ZIP-4 County WA King QUANTITY OF ASBESTOS TO BE: Q REMOVED ❑ ENCA Quantity 170 square feet Q Indoors ❑ Outdoors ❑ Fireproofing ❑ Boiler insulation CONTROL MEASURES ❑ Popcorn ceiling ❑ Duct paper El Neg, pres. enclosure ❑ Wrap & cut 0 CAB ❑ VAT ❑ Glove bag Q Wet ruelhods T 0 Sheet vinyl ❑ Roofing ❑ Mini enclosure Q HEPA vacuum. ❑ Asbestos paper © Other Whit Vinyl Critical barriers Manual methods Quantity linear feet ❑ Other .._.___,__ ❑ Other ❑ Mag, pipe insulation ❑ Cement asbestos pipe RES PIRATORY PROTE CTION ❑ Air cell pipe insulation ❑ M pipe ins. C] !! m APR �? I Type C continuous flow r.0 D i ❑ D uct tape ❑ F ull fac APR 1 Type C p dem ❑ Other _ ❑ Other ❑ PAPA E3 Other F413. 025.000 notice ofasbestos abatement project 11-01 For clean copies go to http: 11www.lni.wa.gev /forms1 'G,„ "t wS+.C {�ii$ru ' tia'(°?!.! ';a�.'i'dy�; ^:,`'dj�'i ".2Y5't5ti s '` T"ru4� �' N�•`:.'c i.liku. S:6F h . �.nKkY: 7 iT:n. L' SiT ::a+ .t+S«'�.. z ~w tr � UO O W = H 0 u_ WO }} J LL Q = �W z= H O z l— U� ON O H W W LL O z W U =. O ~ z Z Feb 20 04 01:45p American Environmental Co 206 522 4099 p.2 Agency Case No. PUGET SOUND CLEAN AIR Date Received AGENCY 110 Union Street, Suite 500 ` Seanle. WA 98101 -2038 www,pscleanair.org Agency We Omly t NOTICE OF INTENT .�gencp use ditty A. Protect Tyne: I. ❑ Fria ble AsbyilotRem oval 2. Wf Friable Asbestos Removal & Demolition 3. ❑ Demolition Only _ B• Property Owner: Doak Homes In Start I Phone 206.372.2280 I Mailing Address 11817 26th Ave SW C;t ; Burien State WA �; : 98146 Demolition iasert tlamnlltiwt contractor's walling address vn back Will nonfriabie asbestos be left in place during demo ?U Yes No Contractor: W G Blakley C. Asbestos VA N. VIA Will ut %tK 'i'tNY.NrIldA ,i,t %r. Contractor American Environmental Constouction LLC Owner /CEO: John As selin Misc. Mat's Maiiin .Address: P.O. BOX 81005 206 523 -4441 Phone: � � Contractor Job No.: 4038 city: Seattle State WA zi : 98108 -1005 Fes; (206 j 522 -41099 Asbe Demo _ + ? a 10 - 2591inear feet and /or a 48 - 159 square feet of asbestos D. Site Address 12228 4 5th Ave South C; ; Tukwil -T-Zip: 98178 Site .Manager Darryl Doak S :- 1,000 linear feet andlor >5,000 square feet of asbestos Local Phone 206.372.3280 $750 S250 G. Emergency Asbestos Project or U Emergency Demolition Project Prior Notice Twice Project Fee E. M Asbestos Surveyor ❑ Mat'I Pre sum No. of Structures: 1 Datc of Asbestos Survy: 1.15 -04 Was Friable Asbestos Identified? W Yes UNo Was N;onfriabie Asbestos Identified? llYes QNo Attach a copy gr1he survey when friable asbestos has not been identified. AHERA Building Inspector Lisa Kollasch Certification 9: F-i Date: 1004952/4 -22-04 an A11FRA Surrev is reou,red horn" aU dr,nohonrr urvirrit F. Demolition Start No. of 1. Training Fire (List Fire Dept.) Information: Date: 2-24-04? Structures: 1 2. ❑ Or dered Demolition (attach co v of Order) Demolition iasert tlamnlltiwt contractor's walling address vn back Will nonfriabie asbestos be left in place during demo ?U Yes No Contractor: W G Blakley Other. If yes, list type and qty. G. Friable Asbestos Project Information: Start Date: 2 -2 0 - 0 4 Comp letion Date: 2-23-04 Worst D 44 0 W A Sa Su Hours: Will all friable asbestos Yes mater4als bee removed? ❑ No Total Qty. to be Removed: Lin ear Ft. 17 0 S uare Ft, Thermal System Insulation: I LJ lloilcr%Vurnace fns. U Duct ins. U Pipe Ins. Other. B. ❑ Demolition Project (with or without asbestos removal project) Surfacing . Mat'I: I U Fireprooling U Paints M Plaster U TuxturW Coatings Other. *(Asbestos removal can begin upon notification: demolition must wait 10 days) Misc. Mat's F I W C:cmunt 13d. LJ Ccmcnt Pipe J Friable Flooring Ox Rooting Mat'] Other. White Sheet vinyl H. Asbestos /Demolition Project Categories: Notirlcation Period Project Demolition 1. Single - Family Residence: vnna :: Fee Surchar e A. ❑ Asbestos Removal Project Only A. Prior Notice. A. $25 B. ❑ Demolition Project (with or without asbestos removal project) 8. 10 Days" B. $50 *(Asbestos removal can begin upon notification: demolition must wait 10 days) Note: !f the single fa*r residence is owned by onefamily who has been or will be using the residence as their domicile, the above haves JA or 1B mar he checked A sin le amity residence does riot include rental ro erty. multi- amity units, or any tn&ed -use buildin ►. ? All Other Demolitions With No Asbestos Re Pro'eet 10 Days S2 00 Friable Asbestos Projects (other than S ingle Family Residen Asbe Demo _ + ? a 10 - 2591inear feet and /or a 48 - 159 square feet of asbestos Prior Notice 10 Days $100 S100 4. 260 . 999 linear feet and,or 160 - 4,999 square feet of asbestos 10 Days $200 S 100 S :- 1,000 linear feet andlor >5,000 square feet of asbestos 10 Days $750 S250 G. Emergency Asbestos Project or U Emergency Demolition Project Prior Notice Twice Project Fee (St ncle•Fu'pi1v Itcsidences art =rnpt fimm emergency tee: lio wo , cr, property owners must provide a written emergency r ueq est) 1. I crulOu t1w inibrm: Lion contained ' ; notif cation & supplemental dati is, to the best afrny knowledge. accurate c pla . �^\,• /. �/ American Envimnrnental construction LLC . 7 V - Sbnafurr arn.cN,vino Drug Saund Mutt Air Agency Fonn Noe 66.160 (Revised 9103) rS Agency Use Only Rerrvred Ar Z = F `~ W J UO W= CO) LL WO LQ = a �W Z E- H O W �5 U� ON 0 1— W LL F- LL' O Ili Z L) PX O ~ Z rYXKeJ�l.C'Y+HM.Ke!<Mr� M" vnna :: M� w. Mgr... x. .k�KnKrnw.n,�..wn.•na..a,.��m.w. .+....�.«. +,.errwa. ..+..AFL. . +iii.'( , i W Feb 20 04 01:46p American Environmental Co 206 522 4099 p.4 WASTE SHIPMENT RECORD Job No #4038 Z Z '~ W oc � 00 w� U) L w J LLj 0) (� W Z 11-.. Z� W U� ON to I— W I— W0 W 0 O }' Z 1. Site Name and Address: Owner's Name: Owner's Phone No.: 122280 Ave South - ? Darryl @ 206.372.2280 ;;:,•;,,,;;;,; Tukwila, WA 88178 2. Operators Name and Address: Supsrrisors Name: Operator's Phone No.: American Environmental Construction LLC �J$f Phone: (206) 523.4441 P.O. Box 81005 Fax: (206) 522.4099 Seattle, WA 98108 -1005 3. Waste Disposal Site (WDS): Name, Address, and Physical Site Location: WDS Fhone No.: •;,:, ; Greater Wenatchee Regional Landfill -2802 191 South Webb avenue .:;'. Wenatchee, WA 98802 ` 4, Responsible Local or State Agency Name and Address: Puget Sound Clean Air Agency 110 Union Street, #500 Seattle, WA 98101 ;;....:;• 5. Description of Waste Material No. of Containers Total Cluentit . F. Containers T . Total Quantity No. Type M ` (Yd Friable Asbestos Containing Materials G • 14 • r3 l tai �• Non-Friable Asbestos Contalning Materials •-- ` "� B. Spec!sl Handling Instructions and Additional Information: r i Y , ` 9. T I : I hereby declare that the contents of this consignment are fuil� and accurately described `.1; : , proper above by per shipping names end are classified, packed, marked and labeled, and are In all respects in proper condition for . ' transport by highway according to applicatile International and government regulations, ` Printe f yped Name: Signature Month Day Year Z Z '~ W oc � 00 w� U) L w J LLj 0) (� W Z 11-.. Z� W U� ON to I— W I— W0 W 0 O }' Z JHN-19 -2004 b2 NVL LHBS 2 066341936 P.©i T . NVL Laboratories, Inc .., ,' wwNNra►IYW�NweN 4708 Aurora Ave. N., Seattle, WA 98103 t Voice: 206,347.0100 Fax: 206.634.1936 FAX COVER SHEET To: Darryl Doak Company: Doak Homes Fax number: (206 -) 246 -599 Tel. number: (206) 246 -658 Email address: Date: 1/19/2004 From: Lisa Kollas( Total pages: 11 DESCRIPTION OF DOCUMENT (S) Draft copy of your report. CITY R ECEIVED F TA j JAN l 0 2004 COMMENTS PERMIT CENTER Please call if you have any questions 1 CITY OF TUKWILA t APPROVED FEB 0 c� n004 AS NO U BUILDING DIVISION _ of 1z I Privileged and Confidential Laboratory- Client Communications This facsimile message is privileged and confidential and is intended solely for the use of the individual named above. If you are not the intended recipient, you are hereby advised that any dissemination, i distribution or copying of this communication is prohibited. If you have received this Fax in error, I Immediately notify sender by telephi ne and return the original Fax message to sender by mail, Z = t~ Z �D UQ N J W O g �_ LL C� = a �w Z �o w� �5 O co, O i- w LO 111 Z U= Z I f all pages are not received, please n otify se nder as soon as possible at (20 6)547 -0100. i foil- 2D q JAN-49 2004 12 53 hJUL LABS c�E�bbs41':l ib I-'. b2 qV tx v a� r r ;x C f L 4 v r 1 6 a j s h T . INJ\VVIL L A �B S HAZARDOUS MATIRIALS SERVICIS Asbestos Survev 12228 45 Avenue South Tukwila, WA Date Prepared January 19, 2004 Prepared for: Darryl Doak Doak Homes Inc. 11812 26 Avenue Southwest Surien, WA 98146 Prepared By: Lisa Kollasch Building Inspector Cert. #: 1004952 Expiration Date: April 22, 2004 Date Inspected: January 15, 2004 Project #: 2004 -8 z z � 4 W W � UO W W. J W WO } J LL Q = Cy. W. Z �. zo �o W W w z, U CO. H � O : z JAM -19 -2004 12:58 ski_ LASS 2066341936 P.13 t - . c • . ! ~•, M A S A N D O U D MAT 3 N 1 A l 1;,;� "MANAUMENT • THAMINC • Utl SUMUS t i F,. I N VI January 19, 2004 - L A B S j H A 2 A R D O U 3 Z M A T! R i A L 3 =- i David Gamez : R R v i c e 3 Sound Asbestos Abatement J.- LU i P O Box - 58414 QQ Renton, WA 98058 U O CO) 13 RE: Asbestos & Other Fiber Analysis: NVL Batch # 2400403 w = LU J (— . CO u„ Dear Mr. Gamez, W O Enclosed please find test results for the air samples submitted to our laboratory for analysis. u_ j Examination of these samples was conducted in accordance with the NIOSH 7400 method. N C7 Results are reported in fibers per cubic centimeter (fibers/cc) and in fibers per square millimeter F W 3 (fibers/mm'), The working range for the NIOSH 7400 method is between 100 and 1300 fibers Z H per square millimeter. Results are not blank corrected unless field blanks provided. p Z �_. Washington State Department of Labor and Industries requires that an employer provide 5 M airborne asbestos concentrations less then 0.1 fibers per cubic centimeter of air as an average o Lob #: 1024 for eight hours, and less than 1.0 fibers per cubic centimeter of air over a sampling period of CO) thirty minutes to the employees (WAC 296 -62- 07705). For recent regulation updates please o F - call the regulatory agencies. W W U 31< A� "i' L Washington State Department of Labor and Industries also requires that post - abatement U. E-. a9 ""' V,, (clearance) area samples must not exceed the pre - abatement fiber concentration or 0.1 fibers — O ACCIIEDITED I per cubic centimeter whichever is lower (WAC 296 -62- 07709). iii Z. LABORATORY U N The EPA definition of clean air is less than 0.01 fibers per cubic centimeter. ~O Z Inter and intra- laboratory relative standard deviations can be made available upon request. We are pleased to have been of service and hope to work with you again. If you should have any questions regarding the NIOSH 7400 method or the results please feel free to caii. Sincerely, Munaf Khan, Laboratory Director JAN 19 1. 2004 12'53 NVL LABS .u., 2066341936 P.03 TABLE OF CONTENTS Subject Page t 1.0 SCOPE OIL WORK 1 P 3 4 5.6 T 8 A B C z Ix • z. w: 6 U Cl) w =' J � Cl) U. w O g J' U- < C �. Fw z� �- O z t- w U O U o t-. w w. O ui z co O z JAN -19 -2001 12: 53 NVL LABS 2066341936 P. W4 ML Laboratories,' I nc. l: � 4708 Aurora Ave. N„ Seattle, WA 98103 « Tel: 206.547.0100, Fax: 206.634,1936 ACCREDITED wuuw,nvllabs.co . Asbestos And �r Fibers Ana IS LASORATaIpY by Phase Contrast Microscopy Client: Sound Asbestos Abatement Batch #: 2400403.00 Addres: P O Box - 58414 Method: NIOSH 7400 Renton, WA 98058 Client Project *SWV310358 Attention: Mr. David Gamez Samples Received: 2 Samples Analyzed: 2 Project Location: MT- 4110 -BR Lstb ID:24001934 Client's Sample #: DG011304-01 Date sampled: 1/13/2004 Time Flow Rate Sample type: Inside regulated area Start 07:54 PM 9.60 Location: Main Terminal bridge level MT4110BR meal room 3' N 3'E R3G End 10:07 PM 9.60 Activity: n/a Minutes 133 Ave. 9.60 Worker: n/a Comments: Liters Pump ID LOO fibers/cc Fiberslfids Fibers /mm RL flcc F�berslCC 1276.8 #1 min 0.030 max 0.392 351100 44.6 0.002 0. Lab I 24001935 Client's Sample #: DG011304 -02 mate sampled: 1/13/2004 Time Flow Rate Sample type Excursion Start 08:40 PM 2.50 Location: Bridge 'level T NE R3G End 09:10 PM 2.50 Activity: Hepa vac and wet wipe Minutes 30 Ave. 2.50 Worker: Anna Gamez Comments: Liters Pump ID LOQ fiberslcc Fibersifids Fiberstnim' RL flcc fiberslcc 75 #4 min 0.513 max 6.673 0/100 < 7.0 0.036 < 0 .036 Blank ave .(f/nim) 0,0 Micro. field area Sampled by: Client Analyzed by: Zubair Ahmed Reviewed by: Munaf Khan 0.00785 Effe. filtr ation area (mm`) 385 Precision +1 -16% Accuracy +/- 1070 Date: 01/14/2004 Date: 01/19/2004 Munaf Khan, Laboratory Director • Sarnples are analyzed in acoordam* with the NIOSH 7400 (13sue 2:15 August 1994). It the samplao wer9 no; Collected by NYC Laboretortes, their the accuracy or the results is limited by the methodology and acuity of the sample collector. The LOO, Limits of Quantification, are the fiber concentrations, for the given volume of the sampled air, above and below which the results may be unreliable. The RL, Reporting Limit defined in h4ethod 7400 as LOD. is the fibers/cc below whic t resu,ts ma y not ba confidenlly distinguished from bacicground levels. Page 1 of 1 • Z 3:Z �w �U U CO CO LU J = H CO LL W O LL? CO CY = W Z� 1— O Z w U� ON 0 I_ w H LL —0 ill Z Cr) O Z JANJ-19 -2004 12'- 54 WL.LABS An investigative survey for asbestos containing materials (ACM) was conducted on a residential structure located at 1222845' Avenue South, Tukwila, Washington. The inspection was conducted on January 15, 2004 by Lisa Kollasch, an AHERA certified building inspector. This inspection was performed at the request of Daryl Doak of Doak Homes Inc. The purpose of this inspection was to identify asbestos containing materials that would be impacted by the planned demolition of this structure. The attic space was excluded from this survey, due to lack of access. The white sheet vinyl splashguard noted in the water heater room and the storage shed were also excluded, due to lack of access. The interior of the container exterior and adjacent to the front door was excluded, due to lack of access. The asbestos survey section is written to comply with the AHERA asbestos sampling procedure as stated in 40 CFR 763.86. This protocol is required for all asbestos surveys prior to a building demolition under the Puget Sound Clean Air Agency, (PSCAA), Regulation III, Article IV, revised July 13, 2000. The asbestos survey also satisfies the "Good Faith" asbestos inspection requirements as stated in Washington Administrative Code (WAC) 296 -62- 07221(2), "identification ". As stated in this regulation, the owner of a structure scheduled to be renovation /demolished must provide a contractor with a written report of the asbestos containing materials to be disturbed during renovation /demolition. The National Emission Standards for Hazardous Air Pollutants (NESHAP), 40 CFR Part 61 requires a survey by an accredited asbestos inspector prior to demolition of a structure. A floor sketch indicating sampling locations has been included in Appendix A. NVL Laboratories, Inc., Page 1 4708 Aurora Avenue North, Seattle, WA 98103 Ph (206) 547.0100 • Fx (206) 634 -1936 Z J- Z M w D U0 Cl) 0 J � U. w 0 J LL Q N d t- 0 Z I— w L Dp U ON o I— . W U LL Z w 0 1- z Homogeneous Materials Homogeneous materials are defined as an area of Asbestos- Containing Material (ACM) or Presumed Asbestos - Containing Material (PACM) which appears similar throughout in terms of color, texture, and date of material application. The report listing for homogenous materials will appear as follows: Sample Number JAN-19 -2004 12:55 NUL LABS 20663419 *36 '. P.06 Location Asbestos % Area (ft) Friable eslno 'ob# -01 -01 1white floor tile _ kitc � ' .2. 0 SURVEY METHOD Asbestos Survey Method A walk- through inspection of all accessible areas of this structure was performed to identify potential asbestos- containing materials. The walk - through inspection included a review of the internal and external aspects of this structure. The locations and types of potential asbestos containing materials were noted. Sufficient bulk samples of building materials (vinyl floor tile, roofing, wall materials, etc.) were obtained of each material to satisfy the requirements of the Asbestos Hazard Emergency Response Act (AHERA) rules and regulations. These samples were placed into plastic sample bags, numbered and recorded. Homogeneous Materials Homogeneous materials are defined as an area of Asbestos- Containing Material (ACM) or Presumed Asbestos - Containing Material (PACM) which appears similar throughout in terms of color, texture, and date of material application. The report listing for homogenous materials will appear as follows: Sample Number Material Des cription Location Asbestos % Area (ft) Friable eslno 'ob# -01 -01 1white floor tile _ kitc _ _ ob# -01 -02 ob# -01 -03 white floor t ile w hite floor the k kitc Under OSHA Guidelines, a minimum of three negative analysis of a single suspect homogeneous asbestos containing material is required to prove a negative result for surfacing materials and thermal system insulation. i NVL Laboratories, Inc., Page 2 4708 Aurora Avenue North, Seattle, WA 96103 Ph (206) 547 -0100 • Fx (206) 634 -1936 Z J.- w � JU U O �o W =. J � W LL w o u_ N Cl = w Z _ ? t—. �- O Z �o U O N o � W �- O .. Z w 0 JAN -19-2004 12-55 ,NUL LABS X066341936 P.07 r �. 12228 45 Avenue South, Tukwila WA Project► 2004.8 3.0 LABORATORY INFORMATION , Laboratory Analysis — Asbestos i Samples are analyzed in our laboratory using polarized light microscopy (PLM) with dispersion staining if samples are not homogeneous then subsamples of the components were analyzed separately. All Bulk samples are analyzed using EPA Method 600 /R 93/116 with the following measurement uncertainties for reported % Asbestos (1 % =0 -3 %, 5%= 1 -9 %, 10 %= 5 -15 %, 20 %= 10 -30 %, 50 %= 40 -60 %). For samples containing more than one separable layer of materials, the report will include findings for each layer (labeled Layer: 1, Layer 2, etc.). The asbestos concentration in the sample is determined by visual estimation. Laboratory Accreditation Professional accreditations for NVL Laboratories, Inc., include the following: NVL Laboratories, Inc., is currently accredited by the National Institute of Standards and Technology (NIST) under the National Volunteer Laboratory Accreditation Program ( NVLAP) program for bulk asbestos fiber analysis. NVLAP Lab Code 102063 -0. NVL Laboratories, Inc., is approved by the American Industrial Hygiene Association (AIHA) Asbestos Analysts Registry (AAR) program for airborne asbestos fiber analysis, Counter ID 7412. NVL Laboratories, Inc.. is currently accredited by the American Industrial Hygiene Association (AIHA) under the Industrial Hygiene Laboratory Accreditation Program (IHLAP). The IHLAP program is designed specifically for laboratories involved in analyzing samples to evaluate workplace exposure. Certification Number 563. I i I Z Z 2 aa 5 UO N CO) ULI J � co) U. W O. LL a CO) D = CJ �. w Z �.. f- O Z� ua 5. U� co — � t- ww LL O Z U - O H. Z No central HVAC system was noted in residence or outlying buildings. Fiberglass insulation was noted in wall and ceiling cavities of northeast shed. Finishing: Wood paneling and wallboard were noted on walls and ceilings of residence. Press wood was noted on walls of the south storage shed. Wallboard was noted on walls and ceilings of the northeast shed. Wood paneling was noted on walls and ceilings of the northwest shed. No finishing was noted on the carport. NVL Laboratories, Inc., Page 4 4708 Aurora Avenue North, Seattle,'AJA 98103 Ph (206) 647 -0100 - Fx (206) 634.1936 JAN-19 -2004 12056 NJL LABS 2066341936 P.08 12228 45` ". Avenue South, Tukwila, WA ` I : 4.0 BUILDING DESCRIPTION ' I. General Building type: This is a one story single - family residence with three detached sheds and a carport. Primary external components: W � The residence has T -11 siding. All three sheds have wood panel siding. 3 0 Type of foundation: J = i The residence has a post and pier foundation. The northeast and south storage sheds have a 'co) u- O concrete slab foundation. The carport has a post and pier foundation. The northwest shed has g a wood foundation. j Roofing materials: u . = a. F - w z The residence has 3 -tab asphalt and rolled asphalt. All three detached sheds have rolled asphalt roofing. The carport has corrugated plastic roofing. z O UJ w D Window types: o U N: O There are aluminum frarned windows with no putty, aluminum framed windows with putty and o wood framed windows with putty. = w f- Flooring: z CO) The residence has vinyl tile flooring over a wood substrate. The northwest shed has a wood ~ substrate, The northeast and south sheds have carpet flooring over a concrete substrate. The z i carport has a dirt substrate. Thermal systems w /insulation types: No central HVAC system was noted in residence or outlying buildings. Fiberglass insulation was noted in wall and ceiling cavities of northeast shed. Finishing: Wood paneling and wallboard were noted on walls and ceilings of residence. Press wood was noted on walls of the south storage shed. Wallboard was noted on walls and ceilings of the northeast shed. Wood paneling was noted on walls and ceilings of the northwest shed. No finishing was noted on the carport. NVL Laboratories, Inc., Page 4 4708 Aurora Avenue North, Seattle,'AJA 98103 Ph (206) 647 -0100 - Fx (206) 634.1936 JAN -19 -2004 156,,. NVL LABS 2 Material Descri 20E6341936 P.�79 Are ft Friable ealn_oL 2004 -8- 1 -1 _ 1- white sheet vinyl t 1 :ND I 2- backin mastic I 2 2004 -8- 1- light brown 45� Avenue South, Tukwila, WA 1 :3 1 115 No 2 -1 I 12228 Pr # 2004 -E &.-, z �Z '~ w e` 2 JU U0 CO 0 CO J H CO LL w LL Q �D i �. w Z O R W w 2 5. U CO off ww U U_ ~O w z U =' 0 E- z JAN -19 -2004 ',12:57 WL LABS 2066341936. P.110 ` °' 12228 45 Avenue South, Tukwila, WA z �z '~ w � rn o CO J � CO) U w Ei U. < N CY �w zx w� Do U N o— W U U- 0 . . z. U z JAN-19 -2004 12:57 NVL LABS 1 � 12228 45'" Avenue South, Tukwila, WA .� Project # 2004 -A i 6.0 CONCLUSIONS AND RECOMMENDATIONS ASBESTOS The following summarizes the homogeneous Asbestos - Containing Materials (ACM) and Presumed Asbestos - Containing Materials (PACM) identified at the residential structure located at 12228 45 Avenue South Tukwila Washington, 1. Light Brown 9 "x9" Vinyl Tile: (material number 2004- 8 -2 -1) There is approximately 115 ft` of asbestos- containing light brown 9 "x9" vinyl floor tile in the living room. The associated black mastic did not test positive for asbestos. The substrate Is wood. 2. Dark Brown 9 "x9" Vinyl Tile: (material number 2004.8.3 -1) There is approximately 115 ft of asbestos - containing dark brown 9 "x9" vinyl floor the in the living room. The associated black mastic did not test positive for asbestos. The substrate is wood. 3. Cement Asbestos Board: (material number 2004- 8 -9 -1) There is approximately 150 ft of cement asbestos board siding along the exterior perimeter of this residence. 4. Rolled Asphalt Roofing: (material number 2004- 8 -18 -1) 'there is approximately 350 ft of asbestos- containing rolled asphalt roofing on the residence. Approximations of square footage are offered as an added service to the client. These numbers are not exact values and should be confirmed by the client and participating contractors. If discovered, all ACMs that will be disturbed as a natural part of renovation /demolition and are required to be removed and disposed of in accordance with Washington State Regulations. Washington State Department of Labor and Industries and PSCAA require that the abatement be performed using Certified Asbestos Workers under the direct on -site supervision of a Certified Asbestos Supervisor. Further, NVL suggests that an AHERA inspector review this property after abatement to ensure all ACM has been removed by the contractor. Hidden wall and ceiling cavities that are not accessible during the time of surveying can sometimes conceal ACM. Thus, NVL recommends that an AHERA inspector /project manager be on site at the time of renovation /demolition to ensure that anv aotentialiv asbestos- P.� 11 � � z _ ~ z }' w t � WU 00 Cl) o co W J C/) u_ w LL rn � = a w z� HO z r- W w U ON (31-- Uj UJ U- ~ O w z CO z JH ly��a� 1�!:!DH NVL LHHb 12228 4b'h Avenue South, Tukwiia, WA r'_;-,Project 0 2004 8 7.0 ' LIMITATIONS OF i 'ak9baJ41y�b N. lc The sole purpose of this survey report is to document asbestos - containing materials discovered in the survey of suspect materials by NVL Laboratories personnel at the residential structure located at 12228 45 Avenue South, Tukwila, Washington on January 15, 2004. The attic space was excluded from this survey, due to lack of access. The white sheet vinyl splashguard noted in the water heater room and the storage shed were also excluded, due to lack of access. The interior of the container exterior and adjacent to the front door was excluded, due to lack of access. This site visit consisted of a thorough visual walk - through of the building for the purpose of viewing and sampling potential ACMs. As hazardous material surveys are non - comprehensive by nature, NVL Laboratories, Inc., cannot be held liable for materials which require destructive means to access, materials which are hidden from sight (e.g. materials hidden behind walls), materials which cannot be found due to their obscure nature, or which otherwise cannot be discovered with reasonable diligence. This document is the sole property of NVL Laboratories and the property owner, or his agent, authorizing this survey, Inspected by: Reviewed by' Lisa Kollasch AHERA Building Inspector AHERA Certification No.: 1004952 Andre Zwanenburg AHERA Certification Expires on: April 22, 2004 Project Manager NVL Laboratories, Inc., Page 8 4708 Aurora Avenue Norm, Seattle, WA 981o3 Ph (206) 547 -0100 - Fx (206) 634 -1936 Z z �w 5 00 to 0 . LU CO U. w 2 U.< CO D = W Z �. t— O w ~ W U� O� 3 W W O: �Z O Z #HJLI 313ldV400NI 980 / So hlr yea/ Z� L li3tcv3o stwii3a d ME 0 C Ndr Z g'60[ .9)31 o•twXFUJuAsrJ Zt'60t : ,ZL)31 03A1303U SZ'Z t t �3! Y?!9 3NYA 'ViS (d�C.y� J'1sAL - 4.V : S y s L9'S0[ t.SF1jl 19 t t .31m 13did NLLSIX3 dWJ r V 0. A, � � s �� mac ' I'm .uS _•.•• ••••• — a= at as o a .n. rs s >..� a s am 7 om mm a ate. s a vi X ;4o9 =�s• en a3esia.Z t t- -.0 0X x r Y a a V � r f 07 A ll C C3 m X v, ! c� No off s dNf01?!0 0 sm-W 1 43x0 a m i G G 0 I Q AYM3l1 0 13AY ONLLS ct m G. w (d�C.y� J'1sAL - 4.V : S y s L9'S0[ t.SF1jl 19 t t .31m 13did NLLSIX3 dWJ r V 0. A, � � s �� mac ' I'm .uS _•.•• ••••• — a= at as o a .n. rs s >..� a s am 7 om mm a ate. s a vi X ;4o9 =�s• en a3esia.Z t t- -.0 0X x r Y a a V � r f / N ti F L� Py z r E g 05 = 1 b NOTICE: IF THE DOCUMENT IN THIS FM IS THE CLEA THIS NOTICE IT IS DUE TO THE QU i' c: m 3 A ll 1 C3 m X v, ! c� No off s dNf01?!0 0 sm-W 1 43x0 Nwow 1N0 3Z� 39 m 25 0 I y S� AYM3l1 0 13AY ONLLS ct m w �+ A 604 '7 3 ro �' 1.3 d OHd .L GULLS .S A� a 11Y 0 r�3t 1IV 1Y SNI t9 -got ZL wi, 33N31 ttt a HSV2! /M dWJ „9£ JN lX3 P f � co ul ,s m ca 1 / N ti F L� Py z r E g 05 = 1 b NOTICE: IF THE DOCUMENT IN THIS FM IS THE CLEA THIS NOTICE IT IS DUE TO THE QU i' c: m 3 �u 1 C3 IW3 ci tl lu ct m w �+ A '7 3 Q1! Q U ZL i ttt t0 (r ` N f � co ul ,s m ca �u 1 _ 11 I �Xf �rpr • January 23, 2004 City of Tukwila Steven M. Mullet, Mayor Department of Community Development Steve Lancaster, Director Darryl Doak 11812 26` Avenue SW Burien, WA 98146 RE: Letter of Incomplete Application #1 Development Permit Application D04 -020 Doak Homes — Garage Demo — 45 Avenue South Dear Darryl: This letter is to inform you that your application received at the City of Tukwila Permit Center on January 20, 2004, is determined to be incomplete. Before your application can continue the plan review process the following items need to be addressed: Building Department: Ken Nelsen, Senior Plans Examiner, at 206 431 -3677, if you have questions concerning the following: 1. Site plan must show existing site conditions. Please address the above comments in an itemized format with applicable revised plans, specifications, and/or other documentation. The City requires that four (4) completes of revised plans, specifications and/or other documentation be resubmitted with the appropriate revision block. In order to better expedite your resubmittal a `Revision Submittal Sheet' must accompany every resubmittal. I have enclosed one for your convenience. Revisions must be made in person and will not be accepted through the mail or by a messeneer service. If you have any questions, please contact me at the Permit Center at (206) 433 -7165. Sincerely, Stefania Sp cer Permit Technician f Enclosures File: Permit File No. D04 -020 i 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 z �Z '~ W u� D . JU U0 CO) to LU J 3: N LL W } O 9J LL Q CO = �W ` Z H F— O Z I— W �p U O -. 0 F— Uj =U H � LL O W Z U CO); P H , O Z a PERMIT COORD COPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D04 -020 DATE: 01 -30 -04 PROJECT NAME: DOAK HOMES - GARAGE DEMO - LOT 12 SITE ADDRESS: 45 AVENUE SOUTH Original Plan Submittal Response to Correction Letter # Response to Incomplete Letter # 1 Revision #after /before permit is issued DEPARTMENTS Q /+V- 4 Idinsion Q Fire Prevention ❑ Planning Division ❑ D blic� 4rks -V4 Structural ❑ Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 02 -03 -04 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 ROUTING: Please Route ❑ Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS: _ DATE: _ APPROVALS OR CORRECTIONS Approved ❑ Approved with Conditions Notation: REVIEWER'S INITIALS: DUE DATE: 03 -02 -04 Not Approved (attach comments) ❑ DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents /routing sllp.doc 2 -28.02 PERMIT COORD COPY z �z �w QQ JU UO U W = to w w LLQ co) =d F w z w� w U� O� D F- wW U u. O. .z W CO) PM Z PERMIT COORD COPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D04 -0020 DATE: 01 -20 -04 PROJECT NAME: DOAK HOMES - GARAGE DEMO - LOT 12 SITE ADDRESS: 122XX 45 AVENUE SOUTH X Original Plan Submittal Response to Correction Letter # Response to Incomplete Letter # Revision # after /before permit is issued DEPARTMENTS: 51 klaL, - 22 0 c, .- 1-Zv° � f Buildtn Division Fire Prevention [� Planning Division Public Works VL1 Structural ❑ Permit Coordinator DETERMINATION OF COMPLETENESS (Tues., Th .) DUE DATE: 01 -22 -04 Complete ❑ Incomplete Not Applicable ❑ Comments: Permit Center Use Only c/ INCOMPLETE LETTER MAILED: �'"7 LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg V Fire ❑ Ping ❑ PW ❑ Staff Initials: TOES /THURS ROUTING: Please Route ❑ Structural Review Required REVIEWER'S INITIALS: ❑ No further Review Required ❑ DATE: APPROVALS OR CORRECTIONS Approved ❑ Approved with Conditions ❑ Notation: REVIEWER'S INITIALS: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: DATE: Documents /routing sllp.doc 2 -28 -02 PERMIT COORD COPT( :1,.. :t.tt. .f! .x' : . �Yb: { l i&..J +Ln I :`zF. t.� ;',�i'.i a: �:yA�' ��,�" -,., t.iV . � +j, � .t',+S,r n`c �:GiQ.i�1J: jt.YL.a'cnW'Lf:Y:b . •re.vX:r Pw.w DUE DATE: 02 -19 -04 Not Approved (attach comments) ❑ Z '~ w �U U CO 13 co W �w w J LL Q V1 � = �w z w� w U 0— o F- wW U- O 6i U= z •...,,\ City of Tukwila Department of Community Development - Permit Center 6300 Southcenter Blvd, Suite 100 Tukwila, WA 98188 (206)431 -3670 Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Date: D G Plan Check/Permit Number: Response to Incomplete Letter # ❑ Response to Correction Letter # ❑ Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner Project Name: 110 (1t S Ie Demo Z-0 Project Address: / Z Z hk y Contact Person: , / Phone Number: � 06 - . Summary of Revision: 1 - P �' T" S��F //1 /V e- wi f ell 0 s . 4 0 Sheet Number(s): "Cloud" or highlight all areas of revision including date of revision Received at the City of Tukwila Permit Center by: 15:�/ ❑ Entered in Permits Plus on 08/06/03 z z �w QQ JU UO N o J = H CO LL WO 9-J LL CO)d �w z F- 1--0 w Do U 0 E- =U LL Z ui �_ O Z NW 1/4, SE1 /4, SECTION 10, T23N, R4E, W.M. EXISTING PROPOSED 15' SIDE 1 ,7 17 SANITARY SEWER MH #1334 -2A SEWER AND DRAINAGE EASMENT ` > IE 8• " N) : 1203.82 IN FAVOR OF LOT 9 -12 IE(8 S): 103.98 IE(6 "SW):104.05 EXISTING FIRE HYDRANT IE(6 "E): 103.90 3 0 -x Ln EXISTING UTILITY POLE INSTALL WATER METERS EXISTING AND SERVICE CONNECTION GAS LINE PER CITY STANDARDS (TYP) OH - 0H OH ON -- ----OH off OH OH OH OH -o/ OH C% OH OH T EXISTING WATER r MAIN �+ G G G G G G G G G G C _ 1 -- - - -- - -- 1-6" PVC CLEAN -CUT 1 -8" PVC TESTING TEE I E: 103.76 INSTALL 1' POLY '� I WATER LINE (TYP) 25' 200 PSI DRISCO PIPE 8'PVC SIDE SEWER, X2.00 % 1-VPVC WYE 1.6'X4"PVC REDUCER t' PVC SIDE SEWER s -z.00% NTH 4' CLEAN-OUT PIEAR BUILDING NYLLL DOWNSPOUT CONNECTION POINT (TYP) DRAINAGE PLAN NOTES: 1. STORM WATER RUNOFF FROM THE ROOF AND DRIVEWAY AREAS FROM EACH LOT SHALL BE DIRECTED TO THE PERFORATED TIGHTLINE CONNECTION WITH A POSITIVE DISCHARGE CONNECTION TO CB2. 2. THE FINAL GRADE ELEVATIONS SHOWN ON THIS PLAN MAY BE ADJUSTED AS NESESSARY TO REDUCE CUTS /FILLS AND /OR MAINTAIN 1% MIN /5% MAX SLOPES FOR DRIVEWAY DRAINAGE FLOWS PERFORATED TIGHTLINE CONNECTION. THE PROPOSED RESIDENCE FINISHED FLOOR SHALL BE AT AN ELEVATION HIGHER THAN THE EXISTING PAVEMENT IN 45TH AVE. S. 4. INSTALL FILTER FABRIC OVER ALL CATCH BASIN OPENINGS DURING CONSTRUCTION. 5. SOIL LOG TEST HOLES WERE DUG ON THE FRONT HALF OF THE LOTS. THE SOIL TYPE AND STRATIFICATION WAS TYPICALLY AS FOLLOWS: 0 -6' BROWN SANDY SILT, MOTTLED 6 -9' BLACK FINE SAND WATER SEEPING AT 6' DEPTH ON 1/6/04 SCS SOIL CLASSIFICATION: URBAN LAND THE ON —SITE SOILS ARE NOT ADEQUATE FOR INFILTRATION IN ACCORDANCE WITH THE KING COUNTY SURFACE WATER DESIGN MANUAL. 6. ALL ON —SITE PVC PIPE SHALL CONFORM TO ASTM D- 3034— SDR35. LOT . LOT 9 LOT 10 LOT 11 LOT 12 3000 SQ.FT. AREA 3000 SQ.FT. 3000 SQ.FT. 3000 SQ.FT. ROOF AREA 1242 SQ.FT. 1242 SQ.FT. 1242 SQ.FT. 1242 SQ.FT. DRIVE & WALK AREA 574 SQ.FT. 574 SQ.FT. 574 SQ.FT. 574 SQ.FT. TOTAL IM PERVIOUS AREA 1816 SQ.FT. 1816 SQ. FT. 1816 SQ.FT. 1816 SQ.FT. TAX LOT NO. 017900 -07/0 017900-07 017900 -- 0 ??O 017900 -0,. - 1 1 -6 PVC CLEAI4.OUT „ 'P11�C 3Z.O0X, I-T PVC TESTING TEE 2. I �■�► 6wMSmq2.00X IE: 104.22 III I III PERFORATED TIGHTLINE CONNNEC71ON III III ilk - it WITH POSITIVE DISCHARGE TO C82 (TYP) AV III ' it it i VWC SIDE SEWER, 5=2.00 % N1 III 14"PVC WYE I� lop 14rX4"PVC REDUCER _ C r 4 _77 4" PVC SIDE SEWER / 5=2.00% WITH / . An CLEAN -•OIIT NEAR / .I i 3 F. F. 113.54 PROPOSED $ - caRacE 0;0,.j PROPOSED UNDERGROUND / I POWER,PHONE & N CABLE 55 -- 6" i //• oo .�� r BULI ING WALL wilil l00 0r Q F.F. 112.99 F.F. 112.60 Q �' F.F. 113.27 Y PROPOSED PROPOSED Y PROPOSED GAS VICE UNE (TYP) i .Pp , _ I a GARAGE I GARAGE d GARAGE i . I f Y i J OOF DOWNSPOUT \ 25 5. 5.0� / �.0' r / 5.0 S. o 0100-�.0 5. It • OVERFLOW PROPOSED PROPOSED PROPOSED PROPOSED I RESIDENCE RESIDENCE I RESIDENCE I j RESIDENCE FLOW 4 0 I I 1 I SL s s r '� � � s , f _ _ _ � - 20 0 �a o 20 0 Lot 12 Lot 10 Lot 9, Lot 11 SEi ATRIATE PPr7rfiiT REOUIZcD FOR: t, lECHAl%-.0 N AL 4 wv- ' LE "ZoAL �LL,. ..iul{tl%7 GAS PIPING CITY OF Tl.3:�'IL A i Rts!t r - • - .G D ,VJS:ON� _ b _ I '1 V -: PERFORATED TIGHTLN E CONNECTION ALONG NORTH SIDE OF DRIVEWAY 20' WN LENGTH VATH WASHED Road EXTENDED TO THE DMEWAY SURFACE 4" PVC PERF. 5 I b �IIL �I PERFORATED TIGHTLINE CONNECTION ,�� b. oono� �G r ,•� jr ar GRAPWC SCE s v s 10 AL J � � G CLEARING UMIT IS THE PROPERTY UNE • �� �lr i / J Nom 1 _ smair TRY SEAR SMALL W. m nmft gum PER 11KMA 90VAS111WIM SW OEM SS-2 -.� �.. .+s* ,....�. -....� . :_•..� - �- - ,� - r'is;. .�...R +fir.: ....�.._ Z ` - -.: -. _.._ _ � .'_ ``.- � � rA a.Aw it Ile a+ 110M MjCH AP" TM OF VIES I WAY Ps PERFORATED TIGHTUNE CONNECTION ANID DRIVEWAY DRAINAGE COLLECTKN ::- L ._ J MAX OENSM (SEE ZM%X- l;;A7X rS ON SHM t i PR E DR CROSS SCPuE: fo =r • • 's F i L- ^' r'd tr �ei ih' r' ?^ ,�', ^,!C ao- m ovalS are under ota .. �� ; 'Id aoPrc gal of L c e, , c. =� u _ - t any o!arls does not c` con- cr Ca... 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