HomeMy WebLinkAboutPermit D08-306 - WOODEN III LLC RESIDENCE - RESIDENCE DEMOLITIONWOODEN II
DEMOLITION
3914 S 115 ST
D08 -306
Parcel No.: 3351400005
Address: 3914 S 115 ST TUKW
Suite No:
Tenant:
Name: WOODEN II DEMOLITION
Address: 3914 S 115 ST , TUKWILA WA
Owner:
Name: NGUYEN JIMMY H
Address: 10810 MANITOU PARK BLVD NE , BAINBRIDGE ISLAND WA 98110
Phone:
Contact Person:
Name: GEORGE STEEN - LARSEN II
Address: 980 S HARNEY ST , SEATTLE WA 98108
Phone: 206 805 -1442
Contractor:
Name: CHATER CONST INC
Address: 980 S HARNEY ST , SEATTLE WA 98108
Phone: 206 - 382 -1900
Contractor License No: CHARTCI171PM
doc: IBC -10/06
CityV Tukwila 1
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Fax: 206 - 431 -3665
Web site: http: / /www.ci.tukwila.wa.us
DEVELOPMENT PERMIT
* *continued on next page **
Permit Number: D08 -306
Issue Date: 06/16/2008
Permit Expires On: 12/13/2008
Expiration Date: 10/18/2008
DESCRIPTION OF WORK:
DEMOLITION OF EXISTING 1460 SF SFR
Public Works activities include SEPTIC ABANDONMENT, WATER CAPPING (WM is REMOVED ALREADY) AND
EROSION CONTROL.
Value of Construction: $2,500.00 Fees Collected: $460.23
Type of Fire Protection: NONE International Building Code Edition: 2006
Type of Construction: VB Occupancy per IBC: 0022
D08 -306 Printed: 06 -16 -2008
Public Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant:
Flood Control Zone:
Hauling:
Land Altering:
Landscape Irrigation:
Moving Oversize Load:
Permit Center Authorized Signature:
Signature:
Print Name:
doc: IBC -10/06
City ATukwila �
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206- 431 -3670
Fax: 206 - 431 -3665
Web site: http: / /www.ci.tukwila.wa.us
N
N
Number: 0 Size (Inches): 0
Start Time:
Volumes: Cut 0 c.y.
Start Time: End Time:
Sanitary Side Sewer: Y
Sewer Main Extension: Private: Public:
Storm Drainage:
Street Use: Profit: N Non - Profit: N
Water Main Extension: Private: Public:
Water Meter: N
Permit Number: D08 -306
Issue Date: 06/16/2008
Permit Expires On: 12/13/2008
End Time:
Fill 0 c.y.
Date: 62 ' (/
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
construction or the performance of work. I am authorized to sign and obtain this development permit.
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.
D08 -306 Printed: 06 -16 -2008
Parcel No.: 3351400005
Address:
Suite No:
Tenant:
3914
WOODEN II DEMOLITION
1: ** *BUILDING DEPARTMENT CONDITIONS * **
•
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 - 431 -3665
Web site: http: / /www.ci.tukwila.wa.us
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
D08 -306
ISSUED
05/29/2008
06/16/2008
2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the
Building Official.
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
granted.
4: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary
sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other
excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of
this requirement.
5: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the Cityof Tukwila
Permit Center.
6: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building
Department (206- 431 - 3670).
7: 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
presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila
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.
8: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * **
9: Minimum 48 hours in advance applicant shall contact Public Works and schedule a Pre - Construction meeting with Public
Works Project Inspector Mr. Greg Villanueva.
PRIOR TO STRUCTURE DEMOLITION, due to unknown location of septic system tank, existing sanitary sewer pipe(s) shall be
chasedto locate septic tank.
10: Contractor shall notify Public Works Utility Inspector at (206)433 -0179 of commencement and completion of work at least
24 hours in advance.
11: Contractor shall notify Public Works Utility Inspector Mr. Greg Villanueva at (206)433 -0179 of commencement and
completion of work at least 24 hours in advance.
12: Any material spilled onto any street shall be cleaned up immediately.
13: Sewer and water utilities shall be plugged at the mains if they are to be abandoned. If they will be used again in the
near future for a new building, they shall be capped at the property line and at the water meter respectively.
14: Any septic tanks in the area shall be pumped empty and removed or filled with sand. A copy of the documentation from
the business that performed the pumping shall be provided to the City Utilities Inspector.
doc: Cond -10/06
D08 -306 Printed: 06 -16 -2008
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 - 431 -3665
Web site: http://www.ci.tukwila.wa.us
15: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation
off-site or into existing drainage facilities.
16: From October 1 through April 30, cover any slopes and stockpiles that are 3H:1 V or steeper and have a vertical rise of
10 feet or more and will be unworked for greater than 12 hours. During this time period, cover or mulch other disturbed
areas, if they will be unworked more than 2 days. Covered material must be stockpiled on site at the beginning of this
period. Inspect and maintain this stabilization weekly and immediately before, during and following storms.
17: From May 1 through September 30, inspect and maintain temporary erosion prevention and sediment at least monthly. All
disturbed areas of the site shall be permanently stabilized prior to final construction approval.
18: The site shall have permanent erosion control measures in place as soon as possible after final grading has been
completed and prior to the Final Inspection.
doc: Cond - 10/06
* *continued on next page **
D08 -306 Printed: 06-16 -2008
•
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 - 431 -3665
Web site: http: / /www.ci.tukwila.wa.us
I hereby certify that I have read these conditions and will comply with them as outlined. All provisions
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
construction or the performance of work.
Signature:
Print Name:��Gl� -f��—
doc: Cond - 10/06 D08 - 306
Date: co , 1 ( .
of law and ordinances governing
other work or local laws regulating
Printed: 06 -16 -2008
Tenant Name:
Property Owners Name: 1 v > -TtT
Mailing Address:
CITY OF TUKWILO
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
wa. us
Name:
Mailing Address: 9
E -Mail Address: �2c1j a 1^ f lerra1, . C_An
GENERAL CONTRACTOR INFORMATION -
(Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5))
Contact Person:
E -Mail Address:
Contractor Registrati
•
n Num
er: C.44A ",F 11 l FH
City
Contact Person: Day Telephone:
E -Mail Address: _ Fax Number:
Q:\Applications\Forms- Applications On Line \3 -2006 - Permit Application.doc
Revised: 9 -2006
bh
Building PerrNo.
Mechanical Permit No.
Plumbing/Gas Permit No.
Public Works Permit No.
Project No.
(For office use only)
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.
SI41orscYC. * *Please Print **
SITE LOCATION
Tow
V 335'It -j tv - c ,
King Co Assessor's Tax No.:'eifGI6g.TcoC ► 23
Site Address: r� � L-{ ) 5-M �^r; "Tv w1L4 , U q S ite�Number: Floor:
Co New Tenant: ❑ Yes ❑ ..No
City
State
1E 4tC
Zip
CONTACT PERSON - who do we contact when your permit is ready to be issued
Day Telephone: Q6- _ I uZ.
_,.r
I
•
Ity
City
is
State Zip
Fax Number: 20:0 , 3 FL • (y•-S?,
Company Name: ( �a�i� d C'�i� -� 1 1 se ..
Mailing Address: t r, wad 90-S 1C
State Zip
Day Telephone: Z Z. Ftets. J Ii 4Z
Fax Number: 71( . 'ZRZ..
Expiration Date: jp . l g. Zcx >R
ARCHITECT OF RECORD — All plans must be wet stamped by Architect of Record
Company Name:
Mailing Address:
City State Zip
Contact Person: Day Telephone:
E -Mail Address: Fax Number
ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Record
Company Name:
Mailing Address:
State
Zip
Page 1 of 6
BUILDING PERMIT INFOON — 206 -431 -3670
Valuation of Project (contractor's bid price): $_ 2 Existing Building Valuation: $
Scope of Work (please provide detailed information):
Will there be new rack storage? ❑ Yes Q No If yes, a separate permit and plan submittal will be required.
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): Q' d $ Floor area of principal dwelling: 1 (oC..5 Floor area of 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: A Handicap: v 4
Will there be a change in use? Yes ❑ No If "yes ", explain: T —ie - rkt ' afr <7it..ur':a
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑ Sprinklers ❑ Automatic Fire Alarm None
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes p' No
If 'Yes', attach list of materials and storage locations on a separate 8 x 11 " paper including quantities and Material Safety Data Sheets.
SEPTIC SYSTEM
❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health
Department.
Q: \AppbcationsWotms- Applications On Linen -2006 - Permit Application.doc
Revised: 9 -2006
bit
.11111 .e _
a i
❑ Other (specify)
Page 2 of 6
Existing
Interior Remodel
Addition to
Existing
Structure
New
Type of
Construction per
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
Covered Deck
Uncovered Deck
BUILDING PERMIT INFOON — 206 -431 -3670
Valuation of Project (contractor's bid price): $_ 2 Existing Building Valuation: $
Scope of Work (please provide detailed information):
Will there be new rack storage? ❑ Yes Q No If yes, a separate permit and plan submittal will be required.
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): Q' d $ Floor area of principal dwelling: 1 (oC..5 Floor area of 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: A Handicap: v 4
Will there be a change in use? Yes ❑ No If "yes ", explain: T —ie - rkt ' afr <7it..ur':a
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑ Sprinklers ❑ Automatic Fire Alarm None
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes p' No
If 'Yes', attach list of materials and storage locations on a separate 8 x 11 " paper including quantities and Material Safety Data Sheets.
SEPTIC SYSTEM
❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health
Department.
Q: \AppbcationsWotms- Applications On Linen -2006 - Permit Application.doc
Revised: 9 -2006
bit
.11111 .e _
a i
❑ Other (specify)
Page 2 of 6
PERMIT APPLICATION NOT — Applicable to all permits in this .appication
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.
Building and Mechanical Permit
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).
Plumbing Permit
The Building Official may grant one extension of time for an additional period not exceeding 180 days. The extension shall be requested
in writing and justifiable cause demonstrated. Section 103.4.3 Uniform Plumbing Code (current edition).
I HEREBY CERIIttY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING O I : ° • R U
Signature:
Print Name:
Mailing Address:
Date Application Accepted:
FM- �►jZ} - i.� i tr
osfr
Q:\Applications\Forms- Applications On Line \3 -2006 - Permit Application.doc
Revised: 9 -2006
bh
Date: (' 5 . --ze,
Day Telephone: - 24.3gZ • I Scrc,
City State Zip
Date Application Expires:
1 (eel /01
Staff Initials:
Page 6 of 6
Parcel No.: 3351400005
Address: 3914 S 115 ST TUKW
Suite No:
Applicant: WOODEN II DEMOLITION
Receipt No.: R08 -02120
Payee: CHARTER CONSTRUCTION
ACCOUNT ITEM LIST:
Description
rinr.: RPr int -f1R
PW BASE APPLICATION FEE
PW PERMIT /INSPECTION FEE
PW PLAN REVIEW
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 -431 -3665
Web site: http: / /www.ci.tukwila.wa.us
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 20818 280.00
000/322.100
000/342.400
000/345.830
RECEIPT
Permit Number: D08 - 306
Status: APPROVED
Applied Date: 05/29/2008
Issue Date:
Payment Amount: $280.00
Initials: WER Payment Date: 06/16/2008 09:18 AM
User 1D: 1655 Balance: $0.00
Account Code Current Pmts
250.00
15.00
15.00
Total: $280.00
3675 06/16 9711 TOTAL 280.00
Printari: (1R-1 R-200R
Parcel No.: 3351400005
Address: 3914 S 115 ST TUKW
Suite No:
Applicant: WOODEN II DEMOLITION
Receipt No.: R08 -01846
Initials: JEM
User ID: 1165
Payee: CHARTER CONSTRUCTION, INC.
ACCOUNT ITEM LIST:
Description
BUILDING - NONRES
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 -431 -3665
Web site: http: / /www.ci.tukwila.wa.us
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 5242 100.00
RECEIPT
Account Code Current Pmts
000/322.100 100.00
Total: $100.00
Permit Number: D08 -306
Status: PENDING
Applied Date: 05/29/2008
Issue Date:
Payment Amount: $100.00
Payment Date: 05/29/2008 11:50 AM
Balance: $80.23
2972 05/29 9711 TOTAL 10000
doc: Receiot -06 Printed: 05 -29 -2008
Parcel No.: 3351400005
Address: 3914 S 115 ST TUKW
Suite No:
Applicant: WOODEN II DEMOLITION
Receipt No.: R08 -01847
ACCOUNT ITEM LIST:
Description
BUILDING - NONRES
PLAN CHECK - NONRES
STATE BUILDING SURCHARGE
City of Tukwila
Payee: CHARTER CONSTRUCTION, INC.
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 -431 -3665
Web site: http.• / /www.ci.tukwila.wa.us
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 5243 80.23
000/322.100
000/345.830
000/386.904
RECEIPT
Initials: JEM Payment Date: 05/29/2008 11:51 AM
User ID: 1165 Balance: $0.00
Account Code Current Pmts
6.50
69.23
4.50
Total: $80.23
Permit Number: D08 - 306
Status: PENDING
Applied Date: 05/29/2008
Issue Date:
Payment Amount: $80.23
2971 05/29 9711 TOTAL 80.23
doc: Receipt-06 Printed: 05 -29 -2008
Project: /
Gfiva i
j ?f.j / //d
Type of Inspection:
If ,/{✓''7
rgsi s /
/ 3 .- -• s .
Date Called:
Special Instructions:
Date WAnted: ea.m
G - /g Q?' p.m.
Requester:
Phone No
a06 375 -- .3 ' 70
De - 16'6.
INSPECTION RECORD
Retain a copy with permit
INSP CTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION 14
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
I Approved per applicable codes. 0 Corrections required prior to approval.
COMMENTS:
Inspe or:
4 2,0 fritY (! 1 l(-ff (i; :il
$61 .00 REINSPECT ' N FE REQUIRED. Prior to inspection, fee must be
p. id at 6300 Southce ter . lvd., Suite 100. Call to schedule reinspection.
Re tpt No.: , 'Date:
t!ossmeaue,a..sataalm......magaluestrattme6.atadstftedratit~Savitake4Agtalftiltabahat91..r.................— _A. AA
Project:
Type of specti n: r a il
Address:
3114 C°
I IS
Date Called:
Special In tructions:
Q 21 Z I - J \
PPt l
Date Wanted: ^ , t L -- J � `
`"� t
Requester:
Phone
2 G - 3 r)5 - 3F?
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION l�-
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (20 -3670
0 Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
°"r( -tt 2 to — 15 G. r ac I&-r..,1.
f&J A-AA,
Inspector:
Date:
❑ $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
'Date:
tip
COMMENTS:
Type of Inspection:
pr ' - e„ (it /p /c _,Oc k c.
. v.' 1, .J/ f-P d A f.` L ,/, i4
�
4 J .
� lA pT / ..)/k 2 (,
1 (_ A IJ4 < } J All L<•f i)ti Z(ic
I, )0I fri A-0 J s �A-�
1 . ) / iv , < :
✓ �P ,,
(or Li :I Ci, t`
L.:A-5/ e c..Q ; .NA .
.& JLIf L. A
a L 1.!7 Al
yi
� pelts tt ''� t l.�), -1 .
t " f
1
Project:
I J O CIA 1 6)6in O
Type of Inspection:
pr ' - e„ (it /p /c _,Oc k c.
Address:
3emS. lit; 51
Date Called:
Special 1 structions:
7......
Date Wanted: 7 -
7 - l 1
a.m.
cp, i'.
Requester:
`
Phone No:
- 4tr 1
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION F-
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -360
Approved per applicable codes. Corrections required prior to approval.
Inspecfor:
Date:
? -2(
El $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
'Date:
Project: •
(,(loon /t i ? nlo
Type of Insp coon.
( 61401
Date Called:
Address: 1 I S y
Special Instructions:
Ca I I 3 0 /".) 'L-
'� -}
! 1 D6 1 o 111 ? =."
Date W ,t) a
°G( Jh) /(
p.m.
:
Requester
an , 00Ic/5
Pho l
. 375 5k7 0
1
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
El Approved per applicable codes.
INSPECTION RECORD
Retain a copy with permit
D08
PERMIT NO.
Corrections required prior to approval.
COMMENTS:
0 ,1} q l w l y w,T94 ax.„ r�
Ci/(6/ds'
Inspector:
6A)
Date: te.
❑ $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
(Receipt No.:
Date:
Project:
kid Oaf(J 1) 1>M0 .
Type of Ins ectio
uc1 F - i , 1 ,
Address:
^3//V $ /J st
Date Called:
0
L B y AN.
Special Instructions:
( 11 Q v rn '�
1Q C 1 �'S �'
-Fob
Date Wanted:
oe/ /516 k
C
p.m.
Requester:
�C'Dtc -C /W
No:
aDb 805-19 CaesX) or
COMMENTS:
,
') 5 $ --
L B y AN.
1 16 k
-1
1
le . F.It Sib/
C
Gosp
InaiA cpt-w-e ..)
,;;;
Pt• q( j 2y
Am
(0 1ve - su -+.A
■-4,S. Al<
,t
016 I °X
NO
Cb14
p L ,I� � l.fa — '
1
1
)
11
Approved per applicable codes.
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
w/- 7fa/ Ccta
u Corrections required prior to approval.
Inspector:
GfeJ
Date: q
ri $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
iDate:
. 3' d�k
Pro )4 '> , t/ �l
Type of Inspection: - < - Cal
Address: 1 O 3L „ , n �
Date Cal e /,
Special I 'DO
` " " ` _ Instructions:
f� 1
to 6k4 ,kg cci
Wante /
a.m..
ens
Reques
a®� 91
/fO/
) W
LPe
s
.
DM-306e
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670,
❑ Approved per applicable codes.
rrectiohs 0 '
quuiired p ior'toapproval.
COMMENTS:
coy -0414 -6AAdLo,
Inspector:
r ate: ? j r Cg
ri $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
1/4.30081e
S 112m St
02008 Goog
\AC'
FILE
Permit No.
By
Date:,
Seattle, WA 98168
uet tuoogle Manson your phone
Text the word . GMAPS* to 466453
• 4" 511111S:
<PI
117111P1
it!
• cn.
Oth "
oP
AO.
Or
Duwarrush
Pan
Mop One 02008 NAVT
Plar review approval Is subject to errors and omissions.
Approv a! of construction dot:wants does not authorize
the violation of any adopted code or ordinance. Receipt
o' approved Field Copy and conditions is acknualedged:
REVISIONS
\---
No changes shall be made to the scope
of work without prior approval ot
Tukwila Building Division.
NOTE: Revisions will require a new plan submittal
and may include additional plan review tees.
Coi-
REVIEWED FOR
CODE COMPLIANCE
APPROVED
JUN - 6 2008
City of Tukwila - - - -
BUILDING DIVISION
S 1 is 1 1 4 -
F-
/
32
19'6? 4,
These plins have been reviewed by the Public
Works Department for conformance with current
City standards. Acceptance is subject to errors and
omissions Which do not authorize violations of
adopted standards or ordinances. The responsibility,-
for the adequac: of the design rests totally with
designer. Additions, deletions or revisions to these
drawings after this date will void this acceptance
and will- reci resubmittal of revised drawings
for subsequent approval. .
_
Final acceptance is subject to field inspection by
the Public Works utilities inspector.
POS Date: By:
as.
•
Denot.-t-rie I HC. far
5EPAyzorE Prze-corisrizterfory
P-€667/N4 w/7 Pitoitie ~it's INSAgerbst.
/5 MagileEl), PRIOR 70 betio aenfe6- fl
57gste7 ebtee 70 aNieNOVN
LOCiarneW Dfl SEPree TA14.0 S9iV/Mar
5EN4X Pfd(s) S etiffileeZ 71:7
i fte , e 4r1 V SIEI 770A
RECEIVED
CITY OF TUKWILA
MAY 2 9 2008
PERMIT CENTER
E.
id
67 ,
LL
Project Number
Inspection Date
Report Date
Inspected By
AHERA Certification
Expiration Date
IL.
L A B S S
HAZARDOUS MATERIALS SERVICES
r\ T"' 1! r
r
a _
N:1.6 v b t ems- 6 J a` :.� cw
Asbestos Surve
3914 S. 115 St.
Tukwila, WA 98168
Prepared For
Mr. Mike Cruse
Project Manager 1' (.,e7",.
Charter Construction _
980 S. Harne St.
Seattle, WA 98108
2008 -219
April 18, 2008
April 22, 2008
Fran Wade
#1028665
April 2, 2009
- REVIEWED
CODE MPLIANCE
APPROVED
JUN - 6 2008
FIE COPY
RECEIVED
CITY OF TUKWILA
MAY 2 9 2008
PERMIT CENTER
w 30b
TABLE OF CONTENTS
1.0 SCOPE OF WORK 3
2.0 SURVEY METHOD 4
3.0 LABORATORY INFORMATION 5
4.0 BUILDING DESCRIPTION 6
5.0 FINDINGS 7
6.0 CONCLUSIONS AND RECOMMENDATIONS 8
7.0 LIMITATIONS OF SURVEY 9
APPENDICIES
A Sample Locations (Floor Plan)
B Laboratory Results
C Laboratory and AHERA Certifications
3914 S. 115` St.
Tukwila, WA 98168
Project Number: 2008 -219
1.0 SCOPE OF WORK
An investigative survey for asbestos - containing materials was conducted on a two story single
family house located at 3914 S. 115 St., Tukwila, WA 98168 on April 18 2008.
Fran Wade, an AHERA certified building inspector conducted this study at the request of Mr. Mike
Cruse, Project Manager of Charter Construction.
The purpose of this inspection was to identify asbestos - containing materials that would be
impacted by the planned renovation /demolition of this structure.
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 under the Puget Sound Clean Air Agency
(PSCAA Regulation III, Article IV, rev. July 13, 2000) for all asbestos surveys prior to a building
demolition.
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 renovated /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 plan indicating locations of samples collected by NVL personnel has been included in
Appendix A.
NVL Laboratories, Inc.
4708 Aurora Ave N
Seattle, WA 98103
Phone (206) 547 -0100 • Fax (206) 634 -1936
3
3914 S. 115 St.
Tukwila, WA 98168
Project Number: 2008 -219
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.
Homogeneous Materials
Homogeneous materials are defined as an area of asbestos - containing material or presumed
asbestos - containing material 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 Description by Layer Location Asbestos Quantity Friable
Layer 1 is not asbestos - containing
Layer 2 is asbestos - containing
Location description
Under OSHA Guidelines, a minimum of three negative analyses of a single suspect homogeneous
material are required to prove a negative result for surfacing materials and thermal system
insulation.
NVL Laboratories, Inc.
4708 Aurora Ave N
Seattle, WA 98103
Phnna l9MR1 c t7 -nl nn • Fax (9061 8341936
1. %
2. %
"X" LF /ft
Yes /No
4
3914 S. 115 St.
Tukwila, WA 98168
Project Number: 2008 -219
3.0 LABORATORY INFORMATION
Laboratory Analysis: Asbestos
Samples are analyzed in our laboratory using polarized Tight microscopy (PLM) with dispersion
staining. If samples are not homogeneous, then sub - samples of the components are 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.
AAR 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.
IHLAP Certification Number 563
NVL Laboratories, Inc.
4708 Aurora Ave N
Seattle, WA 98103
Phnno (,na1 ca7_n1nn • Pnv a4d10.a r,
3914 S. 115 St.
Tukwila, WA 98168
Project Number: 2008 -219
4.0 BUILDING DESCRIPTION
General Building Type This is a two story single family house.
Primary External Components The exterior is comprised of horizontal wood siding.
Foundation Type The house has an on -grade concrete foundation.
Roofing Material(s) The roof is comprised of tri -tab asphalt shingles.
Window Type(s) The windows are vinyl framed without glaze.
Flooring The flooring is mostly hardwood, with areas of sheet vinyl.
Thermal Systems With Insulation The house is heated by an electric furnace with no visible
insulation.
Finishing
The house is finished with drywall for the lower level south
end and upper level, the north end and some walls are
unfinished. There is grey fibrous insulation in the attic and
no visible crawl space.
NVL Laboratories, Inc.
4708 Aurora Ave N
Seattle, WA 98103
Phone (2061547 -0100 • Fax (2061634
6
Sample Number
2008 - 219 -1 -1
Material Description by Layer
1: Joint compound with paint
2: Drywall
Location 1
Living room
Asbestos
1: 2 %**
2: ND
Quantity * **
Unknown
Friable* 1
1: Yes
2: N/A
2008 - 219 -1 -2
1: Joint compound with paint
2: Drywall
Kitchen
1: ND
2: ND
2008 - 219 -1 -3
Drywall with paint
Stairwell
ND
2008 - 219 -1 -4
1: Joint compound with paint
2: Drywall
Bedroom 1
1: ND
2: ND
2008 - 219 -1 -5
1: Joint compound with paint
2: Drywall
Bedroom 2
1: ND
2: ND
2008 - 219 -2 -1
1: Grey flower patterned sheet vinyl
2: Black asphaltic fibrous backing with mastic
Living room
1: ND
2: ND
2008- 219 -3 -1
1: Beige mosaic style sheet vinyl
2: Black asphaltic fibrous backing
Bedroom 1
1: ND
2: ND
2008 - 219 -4-1
1: Tan patterned sheet vinyl
2: Black asphaltic fibrous backing with mastic
Bedroom 3
1: ND
2: ND
2008 - 219 -5 -1
Grey rock wool insulation
Attic
ND
2008 - 219 -6 -1
Black felt
Under siding
ND
2008 - 219 -7 -1
1: Tri -tab asphalt shingle
2: Black felt
Exterior roof
1: ND
2: ND
3914 S. 115 St.
Tukwila, WA 98168
Project Number: 2008 -219
5.0 FINDINGS
ND
None Detected
The friability of this material was determined at the time of this inspection. Subsequent activities such as demolition, renovation, or
abatement may affect the friability of this material.
This material contains less than 1% asbestos if it is considered as a component of the composite wall system.
These quantities are only an estimate of the asbestos containing material discovered on site. Accuracy of these estimates must be verified
by the asbestos abatement contractor on site.
Any suspect material(s) not identified above should not be disturbed and should be tested
immediately. The suspect material must be treated as asbestos - containing until testing proves
otherwise.
NVL Laboratories, Inc.
4708 Aurora Ave N
Seattle, WA 98103
Phnne r2nR\ c4.7-111 nn • Fax (MMR1 R34-193R 7
3914 S. 115 St.
Tukwila, WA 98168
Project Number: 2008 -219
6.0 CONCLUSIONS AND RECOMMENDATIONS
Asbestos
The following is a summary of asbestos - containing materials and presumed asbestos - containing
materials that were identified at 3914 S. 115 St., Tukwila, WA 98168 on April 18 2008 by NVL
personnel.
Materials Containing <_ 1% Asbestos
• Joint compound with paint
Sample number: 2008 - 219 -1 -1
There is an unknown quantity of joint compound
with paint associated with the wall system of this
house. However, this material was found to
contain less than 1% asbestos when considered a
component of the composite wall system.
The OSHA asbestos standard(s) regulate occupational exposure to asbestos, including asbestos -
containing materials. Please see (a) Scope and Application and (b) Definitions for "Asbestos" and
"Asbestos- Containing Material," for the General Industry, Construction and Shipyard asbestos
standards.
In the OSHA Construction Standard, work involving materials containing 1% or Tess asbestos is
considered unclassified. Unclassified asbestos operations cover employees likely to be exposed
in excess of the permissible exposure limit (PEL) who are performing operations not covered by
Class I through IV. For construction work involving unclassified asbestos, the applicable
requirement includes an exposure assessment, use of vacuum cleaners equipped with HEPA
filters, use of wet methods and prompt cleanup of debris, use of respirators and protective
clothing, training, and record keeping. Air monitoring of personnel is required as part of the
exposure assessment.
If discovered, all asbestos - containing materials that will be disturbed as a natural part of
renovation and /or demolition 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 by a Certified Asbestos Supervisor. Further, NVL suggests that an AHERA inspector
review this property after abatement to ensure all asbestos - containing materials have been
removed by the contractor.
Hidden wall and ceiling cavities that are not accessible during the time of surveying can
sometimes conceal asbestos - containing materials. Thus, NVL recommends that an AHERA
inspector /project manager be on site at the time of renovation /demolition to ensure that any
potentially asbestos - containing materials uncovered during the process of renovation /demolition
be dealt with properly.
NVL Laboratories, Inc.
4708 Aurora Ave N
Seattle, WA 98103
Phnna r'na\ 54.7_m nn • FAY 1 na\ R14.-1 WAR
3914 S. 115 St.
Tukwila, WA 98168
Project Number: 2008 -219
7.0 LIMITATIONS OF SURVEY
The sole purpose of this survey report is to document asbestos - containing materials discovered
by NVL Laboratories personnel in the April 18 2008 survey of suspect materials at the two story
single family house located at 3914 S. 115 St., Tukwila, WA 98168.
This site visit consisted of a thorough visual walk- through of the building for the purpose of viewing
and sampling potential asbestos - containing materials. 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
Fr ' n Wade
AHERA Building Inspector
AHERA Certification #1028665
Expiration Date April 2, 2009
NVL Laboratories, Inc.
4708 Aurora Ave N
Seattle, WA 98103
Reviewed By
Syed Hasan
Manager Field Services
oti.,.,o ( A \ RA7 -111 nn • Foy M(1R1 RZd109R Q
I I f
IL.
L A B S
Appendix A
Sample Locations (Map)
A BS
IM1A.80.440 wautianstrocia%
, • • . • LE.Nie
•
•
. • ..• .
.44,4••••?444.
f - -; • r -!••
' ! ! • ' '
•
• 1 • . - •
f • '
1
• .• • , ,
, •
3q1LI lijrcwILA WA qUgoi,,ANIL IF d00?
rtt.t (owl-4147.i DN./ MNIo )AN 1/VAN:
£.V€ N 451
tee. 24:le.S4/.410o 1A.X 2t16.:134.1fJ5 Page
1: fc)66Z
• . .
• • • • 1 I 1'1 I.
tj
•
•
; • .
• ' • • 4 , 1 - : ' ' • •; • #
.s•H BIOS, LE4D.RtIM N•13 LO
• • •
EI
• • 4;
•
i . ; •
" 1 • • `. • • -4.— 41
• . , . .. . .
z a ;
• • :.± •
• • ! 4
! ' -• • :
-3 • !
IIIIIIMMINIE
1111111111111111
• -1 "
,
•,• •--: " - • - : ; -,•• -- ': — ; : .. :, ! . , • , : : I • --, i ' •, , , . .., f.. , • , , :. 1
:. ;.. ; .i ; , ,. :-;-,;•--: •• i , :•, .- ••• ... , " 1 i-: ,- -.. t I -i t i .', ' .i. - ‘.-- : ' : - - •' '••• •.- -4 -• •:- , , .., - 1
:.' ' ' ' .....i li : . ': .;,. : ' ...:........ ,.....' *– : .• ■ ,
•••■•••••••■•• ......}... . .
r : .. . _ , ,, ,.. :: , .: . :. „ „„. . ',... , 'I .,;'. _ ; :, ' . .., . , ..; -' ..; ._,7.1.„ , • .! 1 ., : ..., ', ..-; 1 :. ,.., ., j. : ...&....:...,-: ,.... •---:..; 4. .e.-....;,:..;_.........
. ,
. . „ .. ,..
■ , . . . . . : , . ::, 1_1 i • : ; ; '•• -','• ' : - i• '- - , ', -• -i ! : 4, : -
• . ,
,. . • .. , . . „. :, : , :, , • . . • , • .. . . i : ; ,.. ; ••• i • • 7 • .• .. ■ : r ■ • • • ... • . i i •••i-• i - . • ,• • 4 ;
,• . , ;
; : 4 , ; ,) 1,3 : ; . „ ; , • -
.J 4,-..E ' ' n••■•1••■•■■•••■■■••••••:■
1.$118.10/1.4.MIIS 14E*.Vtt'7
AB S
iau
1 ,1/4 • •
•.
•
•
'I • • •.;•
• - •
r •
47•Qii •/..0:Ro.,?R‘t. ATE 1• ."SSAT'T LE, WI. Si 1•G
ts . .4 7 . 1 0 0 A 3:
3ii Li S. 115a ST.,7)414/HA ka
CAA TTJ2, ( - r
Location
. • ‘• : :
; • ;.;
• '
• '
4.
4.5"BESTOS„ LEAD; 14.'Ar' k`a rlitTALS:. IC LP. Mil Lit
F e
b t c?608-- 19
Maze by F WAbE.
A .
,42
I
• ;
- • •
- • - - ,•• ' • • •
;;••• - -
' • t
; -3 —4 , •
!• • ', • • : • 3
• :
• ,
•
: 5 • •
'' • , • •.: 7 ••• - 1 •••• - • : •
•1 1 ; . : : . • ; ; 4 ; .
!•:: ■••1• 5 t t ": t 7 ' , -r, • .4 48 : ....L. : .
v -r • .., .
ALLT-10-3Se,,k1.- '.• 7 s , • •
• :,. ; ' 3 , , ; :
3 . . • . : • ' • • •. .7 3 . % ; , , .
ufwvw. v I bi_tiff
f 4.8./1311:;14115 iffiLfnni
IN c L ,h•
L A B S
Appendix B
Laboratory Results
NVL Laboratories, Inc.
4708 Aurora Ave. N., Seattle, WA 98103
Tel: 206.547.0100, Fax: 206.634.1936
www.nvllabs.com
Bulk Asbestos Fibers Analysis
[AV
Lap
For the scope of accreditation under NVLAP Lab Code 102063 -
Client: NVL Field Services Division
Address: 4708 Aurora Ave. N.
Seattle, WA 98103
Attention: Mr. Syed Hasan
Project Location: 3914 S. 115th Street
Tukwila, WA 98168
Lab ID: 28028834 Client Sample #: 2008 - 219 - 1 - 1
Location: 3914 S. 115th Street
Comments: Composite result for whole sample is less than 1% asbestos
Layer 1 of 2 Description: Off -white compacted powdery material with paint
Non - Fibrous Materials:
Binder /Filler, Calcareous particles, Paint
Layer 2 of 2 Description: Off -white chalky material with paper
Non - Fibrous Materials:
Gypsum /binder
Lab ID: 28028835 Client Sample #: 2008 - 219 - 1 - 2
Location: 3914 S. 115th Street
Layer 1 of 2 Description: Trace off -white compacted powdery material with paint
Non - Fibrous Materials: Other Fibrous Materials:%
Binder /Filler, Calcareous particles, Paint None Detected ND
Layer 2 of 2 Description: Off-white chalky material with paper
Non - Fibrous Materials: Other Fibrous Materials:%
Gypsum /binder Cellulose 15%
Glass fibers 1%
Lab ID: 28028836 Client Sample #: 2008 - 219 - 1 - 3
Location: 3914 S. 115th Street
Layer 1 of 1 Description: Off -white chalky material with paper and paint
Non - Fibrous Materials:
Gypsum /binder, Paint
Lab ID: 28028837 Client Sample #: 2008 - 219 - 1 - 4
Location: 3914 S. 115th Street
By Polarized Light Microscopy
Other Fibrous Materials:%
None Detected ND
Other Fibrous Materials:%
Cellulose 14%
Other Fibrous Materials:%
Cellulose 13%
Glass fibers 1%
Batch #: 2804933.00
Client Project #: 2008 -219
Date Received: 04/18/2008
Samples Received: 11
Samples Analyzed: 11
Method: EPA/600R- 93/116
Asbestos Type: %
Chrysotile 2%
Asbestos Type: %
None Detected ND
Asbestos Type: %
None Detected ND
Asbestos Type: %
None Detected ND
Asbestos Type:
None Detected ND
Sampled by: Client
Analyzed by: Lyudmila Veh
Reviewed by: Nick Ly
Date: 04/21/2008
Date: 04/21/2008
a e irec
Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using EPA 600 /R
- 93/116 Method with the following measurement uncertainties for the reported % Asbestos (1 % =0 -3 %, 5 % =1 -9 %, 10 %= 5 -15 %, 20 %= 10 -30 %, 50 % =40
-60 %). This report relates only to the items tested. If sample was not collected by NVL personnel, then the accuracy of the results is limited by the
methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories, Inc. It shall
not be used to claim product endorsement by NVLAP or any other agency of the US Government.
Done 1 ..f A
NVL Laboratories, Inc.
EMV
Lap
4708 Aurora Ave. N., Seattle, WA 98103 For the scope of accreditation under NVLAP Lab Code 102063 -0
Tel: 206.547. 206.634.1936
www. nvllabsabs.co m Bulk Asbestos Fibers Analysis
www.co
Client: NVL Field Services Division
Address: 4708 Aurora Ave. N.
Seattle, WA 98103
Attention: Mr. Syed Hasan
Project Location: 3914 S. 115th Street
Tukwila, WA 98168
Layer 1 of 2 Description: Off -white compacted powdery material with paint
Layer 2 of 2
Non - Fibrous Materials:
Binder /Filler, Diatoms, Paint
Description: Off -white chalky material with paper
Non - Fibrous Materials:
Gypsum /binder
Lab ID: 28028838 Client Sample #: 2008 - 219 - 1 - 5
Location: 3914 S. 115th Street
Layer 1 of 2 Description: Trace off -white compacted powdery
Non - Fibrous Materials:
Binder /Filler, Paint
Layer 2 of 2 Description: Off -white chalky material with paper
Non - Fibrous Materials:
Gypsum /binder
Lab ID: 28028839 Client Sample #: 2008 - 219 - 2 - 1
Location: 3914 S. 115th Street
Layer 1 of 2 Description: Light gray thin sheet vinyl
Non - Fibrous Materials:
Vinyl /binder
Layer 2 of 2 Description: Black asphaltic fibrous backing with mastic
Non - Fibrous Materials:
Asphalt/binder, Mastic /binder
Lab ID: 28028840 Client Sample #: 2008 - 219 - 3 - 1
Location: 3914 S. 115th Street
By Polarized Light Microscopy
Other Fibrous Materials:%
None Detected ND
Other Fibrous Materials:%
Cellulose 17%
material with paint
Other Fibrous Materials:%
None Detected ND
Other Fibrous Materials:%
Cellulose 20%
Other Fibrous Materials:%
None Detected ND
Other Fibrous Materials:%
Cellulose 59%
Synthetic fibers 1%
Batch #: 2804933.00
Client Project #: 2008 -219
Date Received: 04/18/2008
Samples Received: 11
Samples Analyzed: 11
Method: EPA/600R- 93/116
Asbestos Type: %
None Detected ND
Asbestos Type: %
None Detected ND
Asbestos Type: %
None Detected ND
Asbestos Type: %
None Detected ND
Asbestos Type: %
None Detected ND
Asbestos Type: %
None Detected ND
Sampled by: Client
Analyzed by: Lyudmila Veh
Reviewed by: Nick Ly
Date: 04/21/2008
Date: 04/21/2008
ec or
Nick Ly,
Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using EPA 600/R
- 93/116 Method with the following measurement uncertainties for the reported % Asbestos (1 % =0 -3 %, 5 % =1 -9 %, 10 %= 5 -15 %, 20 %= 10 -30 %, 50 % =40
- 60 %). This report relates only to the items tested. If sample was not collected by NVL personnel, then the accuracy of the results is limited by the
methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories, Inc. It shall
not be used to claim product endorsement by NVLAP or any other agency of the US Government.
Attention: Mr. Syed Hasan
Project Location: 3914 S. 115th Street
Tukwila, WA 98168
Layer 1 of 2
Layer 2 of 2
Client: NVL Field Services Division
Address: 4708 Aurora Ave. N.
Seattle, WA 98103
NVL Laboratories, Inc.
4708 Aurora Ave. N., Seattle, WA 98103
Tel: 206.547.0100, Fax: 206.634.1936
www.nvllabs.com
Bulk Asbestos Fibers Analysis
aS
Lap
For the scope of accreditation under NVLAP Lab Code 102063 -
Description: Beige thin sheet vinyl
Non - Fibrous Materials:
Vinyl /binder
Description: Black asphaltic fibrous backing
Non - Fibrous Materials:
Asphalt/binder
Lab ID: 28028841 Client Sample #: 2008 - 219 - 4 - 1
Location: 3914 S. 115th Street
Layer 1 of 2 Description: Tan thin sheet vinyl
Non - Fibrous Materials:
Vinyl /binder
Layer 2 of 2 Description: Black asphaltic fibrous backing wit
Non - Fibrous Materials:
Asphalt/binder, Mastic /binder
Lab ID: 28028842 Client Sample #: 2008 - 219 - 5 - 1
Location: 3914 S. 115th Street
Layer 1 of 1
Description: Gray fibrous material
Non - Fibrous Materials:
Fine particles, Glass beads
Lab ID: 28028843 Client Sample #: 2008 - 219 - 6 - 1
Location: 3914 S. 115th Street
Layer 1 of 1 Description: Black asphaltic fibrous felt
Non - Fibrous Materials:
Asphalt/binder
By Polarized Light Microscopy
Other Fibrous Materials:%
Cellulose 45%
Other Fibrous Materials:%
Cellulose 62%
Synthetic fibers 1%
Other Fibrous Materials:%
None Detected ND
h mastic
Other Fibrous Materials:%
Cellulose 60%
Other Fibrous Materials:%
Cellulose 5%
Mineral wool 85%
Other Fibrous Materials:%
Cellulose 71%
Batch #: 2804933.00
Client Project #: 2008 -219
Date Received: 04/18/2008
Samples Received: 11
Samples Analyzed: 11
Method: EPA/600R- 93/116
Asbestos Type: %
None Detected ND
Asbestos Type: %
None Detected ND
Asbestos Type: %
None Detected ND
Asbestos Type: %
None Detected ND
Asbestos Type: %
None Detected ND
Asbestos Type: %
None Detected ND
Sampled by: Client
Analyzed by: Lyudmila Veh
Reviewed by: Nick Ly
Date: 04/21/2008
Date: 04/21/2008
Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using EPA 600 /R
- 93/116 Method with the following measurement uncertainties for the reported % Asbestos (1 % =0 -3 %, 5 % =1 -9 %, 10 %= 5 -15 %, 20 %= 10 -30 %, 50 % =40
-60 %). This report relates only to the items tested. If sample was not collected by NVL personnel, then the accuracy of the results is limited by the
methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories, Inc. It shall
not be used to claim product endorsement by NVLAP or any other agency of the US Government.
Layer 2 of 2
Client: NVL Field Services Division
Address: 4708 Aurora Ave. N.
Seattle, WA 98103
Attention: Mr. Syed Hasan
Project Location: 3914 S. 115th Street
Tukwila, WA 98168
NVL Laboratories, Inc.
XIV
Lip
4708 Aurora Ave. N., Seattle, WA 98103 For the scope of accreditation under NVLAP Lab Code 102063 -
Tel: 206.547.0100, 206.634.1936
www. nvllabsabs.co m Bulk Asbestos Fibers Analysis
www.co
By Polarized Light Microscopy
Lab ID: 28028844 Client Sample #: 2008 - 219 - 7 - 1
Location: 3914 S. 115th Street
Layer 1 of 2 Description: Black asphaltic material with granules
Non - Fibrous Materials: Other Fibrous Materials:%
Asphalt/binder, Granules Mineral wool
Description: Black asphaltic fibrous felt
Non - Fibrous Materials: Other Fibrous Materials:%
Asphalt/binder Cellulose 69%
Batch #: 2804933.00
Client Project #: 2008 -219
Date Received: 04/18/2008
Samples Received: 11
Samples Analyzed: 11
Method: EPA/600R- 93/116
Asbestos Type: %
20% None Detected ND
Asbestos Type: %
None Detected ND
Sampled by: Client
Analyzed by: Lyudmila Veh
Reviewed by: Nick Ly
Date: 04/21/2008
Date: 04/21/2008 Nick
Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using EPA 600 /R
- 93/116 Method with the following measurement uncertainties for the reported % Asbestos (1 % =0 -3 %, 5 % =1 -9 %, 10 %= 5 -15 %, 20 %= 10 -30 %, 50 % =40
-60 %). This report relates only to the items tested. If sample was not collected by NVL personnel, then the accuracy of the results is limited by the
methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories, Inc. It shall
not be used to claim product endorsement by NVLAP or any other agency of the US Government.
Seq. #
Lab ID
Client Sample Number
Comments
A/R
1
Relinquished by
,2 — a )1 -Hi
`�j/j, f � !: '�
w_ —
�
1��� �
2
Anal zed b
Results - : - , y
l -2
/
�/� _
A'/f�
��
3
�y
1 a'. 0
I
• Arsenic (As) • Chromium (Cr
❑ TCLP
❑ Cr 6
4
• ■ Drinking water • ■ Paint Chips in %
j -4
■ GFAA (ppb)
❑ Dust/wi a Area ) Chi s ■ Paint
P ( P in cn
5
1 -5
• Other Types
6
• Silica • Nuisance Dust • Respirable
a_I
of Analysis
7
3 -1
8
4! —!
9
5 -!
10
,6
11
'7-1
12
13
14
15
Sam .led b
---
FIWN '
EPA III
�i: _tl. _1th..if •r
' .∎
..,, V
.,'
1 I-•
11 V :° I
�NM
E '�Q
TL«Mr / l
Relinquished by
it i 2�
`�j/j, f � !: '�
w_ —
�
1��� �
Received b
Anal zed b
Results - : - , y
//���
�. IZAR-1Q
/
�/� _
A'/f�
��
/ i / '
j �.
�y
1 a'. 0
Results Faxed by
• Arsenic (As) • Chromium (Cr
❑ TCLP
❑ Cr 6
• ICP (ppm)
• ■ Drinking water • ■ Paint Chips in %
❑ Asbestos Air
• PCM (NIOSH 7400) ❑ TEM (NIOSH 7402) • TEM (AHERA) ❑ TEM (EPA Level II) ❑ Other
Asbestos Bulk
NI PLM (EPA/600 /R- 93/116) ❑ PLM (EPA Point Count)
BULK
• PLM (EPA Gravimetry) • TEM
❑ Mold /Fungus
• Mold Air • Mold Bulk _ • Rotometer Calibration
METALS
Det. Limit
Matrix
Other Metals
❑ All 3
• Copper (Cu)
•
■ Nickel (Ni)
• Zinc (Zn)
RCRA Metals • All 8
• Total Metals
• FAA (pp
❑ Air Filter • Soil
• Arsenic (As) • Chromium (Cr
❑ TCLP
❑ Cr 6
• ICP (ppm)
• ■ Drinking water • ■ Paint Chips in %
• ■ Barium (Ba) • ■ Lead (Pb)
■ GFAA (ppb)
❑ Dust/wi a Area ) Chi s ■ Paint
P ( P in cn
H
■ Cadmium ( Cd ) ■ Mercu Mercury ( g)
• Other Types
• Fiberglass
• Silica • Nuisance Dust • Respirable
Dust • Other (Specify)
of Analysis
NVL Laboratories, Inc.
4708 Aurora Ave N, Seattle, WA 98103
Tel: 206.547.0100 Emerg. Cell: 206.914.4646
1.888.NVL.LABS (685.5227) www.nvllabs.com
Client NVL Laboratories Inc
Street 4708 Aurora Ave N
Seattle, WA 98103
Project Manager Syed Hasan
Project Location 3914 S. 115th Street
Tukwila, WA 98168
Phone: (206) 382 -1900
Fax: (206) 382 -0450
Condition of Package: ❑ Good ❑ Damaged (no spillage) ❑ Severe damage (spillage)
S ian RPInw
1I
CHAIN of CUSTODY /1 �
SAMPLE LOG 0)04 3
NVL Batch Number
Client Job Number
Total Samples
Turn Around Time
Email address
Cell ( 206 ) 805 -1
2008 -219
11
❑ 1 -Hr ❑ 8 -Hrs K2 Days ❑ 5 Days
❑ 2 -Hrs ❑ 12 -Hrs 3 Days ❑ 6 -10 Day
❑ 4 -Hrs ❑ 24 -Hrs ❑ 4 Days
Please call for TAT less than 24 Hrs
mikechartercon.com
•
Special Instructions: Unless requested in writing, all samples will be disposed of two (2) weeks after analysis.
Results report to
?(,.IoF
IN \�ILs w
L A B S
Appendix C
AHERA Certification & Laboratory Qualifications
United States Department of Commerce
National Institute of Standards and Technology
Ce F . ff sate of Accre flt Lion to I / EC 1 7025 :2 05
BULK AS
NVLAP LAB CODE: 102063 -0
NVL Laboratories, Inc.
Seattle, WA
is accredited by the National Voluntary Laboratory Accreditation Program for specific services,
listed on the Scope of Accreditation, for:
ESTOS FI
E ANALYSIS
This laboratory is accredited in accordance with the recognized International Standard ISO /IEC 17025:2005.
This accreditation demonstrates technical competence for a defined scope and the operation of a laboratory quality
management system (refer to joint ISO - ILAC -IAF Communique dated 18 June 2005).
£ .l wr OF CO
i� .
o `"
2007 -10 -01 through 2008-09-30 * :! ,
Effective dates 0 0 -•%ly ,`0
STAT OF A
For the National Institute of Standards and Technology
NVUAP -0!C (REV. 2006- 09 -13)
[ntA
Pae,c 1 of 1
2007 -10 -01 through 2008 -09 -30
National Voluntary
Laboratory Accreditation Program
SCOPE OF ACCREDITATION TO ISO /IEC 17025:2005
NVL Laboratories, Inc.
4708 Aurora Avenue N.
Seattle, WA 98103
Mr. Nghiep Vi 1,y
Phone: 206 -547 -0100 Fax: 206- 634 -1936
E Mail: nick.l(anvllabs.corn
URL,: http: / /www.nvllabs.corn
BULK ASBESTOS FIBER ANALYSIS (PLM() NVLAP LAB CODE 102063 -0
NVLAP Code Designation / Description
18/A01 EPA- 600LM4 -82 -020: Interim. Method for the Determination of Asbestos in Bulk Insulation
Samples
Effective dates For the ational In rte of Standards and Technology
NVLAP -01S (REV. 2005- 05 -19)
certificate of QComptetton
Irk.$ ructor
� rovtder
Cert. Number: E ` C 1085
'fjiO to to certtfp that
Francis M. Wade
taco Oacttofacctorttp completeb
4 ijouro of refreoYjer training a an
Asbestos Building Inspector
to comply tuithj the training lequirennento of
'CEQCZ( Effie 3131 / 40 CIA 763 (aToQ oi)
Expiration Date: Apr 2, 2009
Argus Pacific. Inc. • 1900 W. Nickerson. Suite 315 • Seattle, Washington • 98119 • (206) 285.3373 • fax (206) 285.3927
Joanna Spencer -_Re: 3914 S. 115th St _.. __' - 1
From:
To:
Date:
Subject:
Richard Takechi
Joanna Spencer
06/02/2008 5:04 pm
Re: 3914 S. 115th St
The water bill is $58.00 (excludes the turn -on fee). If they want it turned back on, an extra $25.00.
The surface water balance is $69.08.
»> Joanna Spencer 06/02/2008 4:06 pm »>
They have a pending demo permit, so we can make them pay off the ballance.
How much is it ?
Thanks, Joanna
»> Richard Takechi 06/02/2008 4:04 pm »>
That's a border line account. We're not charging them sewer. They're either on septic or they're in Valley View. The water
is currently off due to non - payment. There's both a water and surface water balance due.
»> Joanna Spencer 06/02/2008 3:34 pm »>
Richard;
Are they on sewer or still on septic ?
Thanks, Joanna
PERMANENT FILE COPY.
ACTIVITY NUMBER: D08 -306 DATE: 05 -29 =08
PROJECT NAME: WOODEN II DEMOLITION
SITE ADDRESS: 3914 S 115 ST
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # Revision # after Permit Issued
DEPARTMENTS: r�
B g l 'vision
Pu li oxks
Complete
Comments:
J
Documents/routing slip.doc
2 -28-02
PERMIT COORD COPY •
PLAN REVIEW /ROUTING SLIP
IM-v
APPROVALS OR CORRECTIONS:
Approved ❑ Approved with Conditions
Notation:
REVIEWER'S INITIALS:
Fire revention
Structural
ETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Incomplete
TUES/THURS ROU ING:
Please Route Structural Review Required
REVIEWER'S INITIALS:
Permit Center Use Only
INCOMPLETE LETTER MAILED:
LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
n
sittA_ C0-3-0
Planing Division
❑ Permit Coordinator
DUE DATE: 06-03-08
No further Review Required
DATE:
Not Approved (attach comments)
DATE:
Not Applicable
DUE DATE: 07 -01-08
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
License Information
License
CHARTCI171PM
Licensee Name
CHARTER CONST INC
Licensee Type
CONSTRUCTION CONTRACTOR
UBI
600479166
Ind. Ins. Account Id
VICE PRESIDENT
Business Type
CORPORATION
Address 1
980 S HARNEY STREET
Address 2
City
SEATTLE
County
KING
State
WA
Zip
981082744
Phone
2063821900
Status
ACTIVE
Specialty 1
GENERAL
Specialty 2
UNUSED
Effective Date
10/14/1983
Expiration Date
10/18/2008
Suspend Date
Separation Date
Parent Company
Previous License
TELESGI179JD
Next License
Associated License
Business Owner Information
Name
Role
Effective Date
Expiration Date
FIRMANI, FRANK
PRESIDENT
10/14/1983
Bond
Amount
SALADINO, PETER C
VICE PRESIDENT
10/14/1983
081S103572915BCM
Bond Information
Bond
Bond
Company
Name
Bond Account
Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Bond
Amount
Received
Date
#6
TRAVELERS
CAS &
SURETY CO
081S103572915BCM
07/22/2001
Until
Cancelled
$12,000.00
10/18/2001
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.
Page 1 of 3
https: // fortress. wa. gov /lni/bbip /printer.aspx ?License= CHARTCI171PM 06/16/2008