HomeMy WebLinkAboutPermit D09-220 - JONES RESIDENCE - GARAGE AND CARPORT DEMOLITIONJONES DEMOLITION
13039 56 AV S
D09 -220
Parcel No.: 2172000050
Address: 13039 56 AV S TUKW
Suite No:
Tenant:
Name: JONES RESIDENCE
Address: 13039 56 AV S , TUKWILA WA
Owner:
Name: JONES THOMAS A +KRISTIN K
Address: 13039 56TH AVE S , SEATTLE WA 98178
Phone:
Contact Person:
Name: ANDY JONES
Address: 13039 56 AV S , TUKWILA WA 98178
Phone: 206 251 -8416
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
Contractor:
Name: SWOPE EXCAVATION & CNSTRT LLC
Address: 3201 SW ROXBURY ST , SEATTLE WA 98126
Phone: (20)852 -2395
Contractor License No: SWOPEEC910PG
DESCRIPTION OF WORK:
DEMOLITION OF 600 SF GARAGE AND 600 SF CARPORT. DRIVEWAY AND FOUNDATIONS TO ALSO BE REMOVED TO
PREPARE FOR UNDERGROUND UTILITY INSTALLATION.
PUBLIC WORKS ACTIVITIES INCLUDE EROSION CONTROL.
Value of Construction:
Type of Fire Protection:
Type of Construction:
doc: IBC -10/06
Cityef Tukwila •
$6,000.00
DEVELOPMENT PERMIT
* *continued on next page **
Permit Number: D09 -220
Issue Date: 11/12/2009
Permit Expires On: 05/11/2010
Expiration Date: 10/07/2011
Fees Collected: $322.62
International Building Code Edition: 2006
Occupancy per IBC:
D09 -220 Printed: 11 -12 -2009
Public Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant: N Number: 0 Size (Inches): 0
Flood Control Zone:
Hauling: N Start Time: End Time:
Land Altering: Volumes: Cut 0 c.y. Fill 0 c.y.
Landscape Irrigation:
Moving Oversize Load: Start Time: End Time:
Sanitary Side Sewer:
Sewer Main Extension:
Storm Drainage:
Street Use:
Water Main Extension:
Water Meter:
Permit Center Authorized Signature:
doc: IBC -10/06
City olTukwila •
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
- Igo 0 S
Private:
Profit: N
Private:
Permit Number: D09 -220
Issue Date: 11/12/2009
Permit Expires On: 05/11/2010
Date:
Public:
Non - Profit: N
Public:
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 o ork. I am authorized to sign and obtain this development permit.
Signature: A .6//._. re._ . Date: II
Print Name:
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.
D09 -220 Printed: 11 -12 -2009
Parcel No.: 2172000050
Address: 13039 56 AV S TUKW
Suite No:
Tenant: JONES RESIDENCE
1: ** *BUILDING DEPARTMENT CONDPI'fONS * **
8: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * **
doc: Cond -10/06
•
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: D09 -220
Status: ISSUED
Applied Date: 10/13/2009
Issue Date: 11/12/2009
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.
9: Any material spilled onto any street shall be cleaned up immediately.
10: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation
off-site or into existing drainage facilities.
11: From October 1 through April 30, cover any slopes and stockpiles that are 3H: 1V 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.
12: 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.
13: 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.
* *continued on next page **
D09 -220 Printed: 11 -12 -2009
• •
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 of law and
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
construction or the performance of work.
Signature:
Print Name: T f f 6 m
doc: Cond -10106 D09 -220
Date:
ordinances governing
or local laws regulating
Printed: 11 -12 -2009
CITY OF TUKWILA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
Intp://www.cltukwila.wa.us
SITE LOCATION
Site Address: J31 SS A1/ -5
Tenant Name: T110414 A_ :'DrvE4
Property Owners Name: ANDY .TOl1ft:-
Mailing Address: .5P1WIE
Building Permit No. ` V l
Mechanical Permit No.
Plurribing /Gas Permit No.
Public Works Permit No;
Project No.
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 **
King Co Assessor's Tax No.: a 17at0oo5'O
Suite Number: Floor:
New Tenant: ❑ Yes ❑ .. No
City
(F our ofce'use only)
State
Zip
CONTACT PERSON - who do we contact when your permit is ready to be issued
Name:
4NDr To S
Mailing Address: 303 9- Sb TN
E -Mail Address: AJDivi. y/oX . evr11
Day Telephone: QO(Q- a S/ 9 l &
7" view 4B
City State Zip
Fax Number: aOG - '7i.3
GENERAL CONTRACTOR INFORMATION -
(Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5))
6Wope e X( AV4 TIDN ODA/sT/EUGTii'd 41- S
Company Name:
Mailing Address: 3 a 9) $ (OX AIM ' Sr 5E W�
City State
Contact Person: /Y1 1 CHAE L 5 WO P,‘ Day Telephone: a04- 85 - x345
E -Mail Address: 66 Wo pg, Xt4J4.T/D#) Q NDTInkt . roof Fax Number:
Contractor Registration Number: W Op E C 9 l O PG
Contact Person:
E -Mail Address:
Expiration Date: / %7 /2o4
State
gs��ae
Zip
ARCHITECT OF RECORD - All plans.must be wet stamped by Archite
of Record
Company Name:
Mailing Address:
city
Day Telephone:
Fax Number:
Zip
ENGINEER OF RECORD - All plaint must be wet stamped by Engineer of kecord
Company Name:
Mailing Address:
City
Day Telephone:
Fax Number:
Contact Person:
E -Mail Address:
H:\Applications\Forms- Applications On Line\2009 Applications \1 -2009 - Permit Application.doc
Revised 1 -2009
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State
Zip
IOW
BUILDING PERMIT INFORMti ION - 206- 431 -3670
Valuation of Project (contractor's bid price): $ (Q, OD[) Existing Bui im y ation: $
Scope of Work (please provide detailed information): REInvvg A.)C l.5 0,114 GA /M / ( Di
6F' �; 1
OR 1li61)A Y 17 L D FDUNDAT log/. ,4A/ P/PYP14 , 9E WON vNOf4 GleDuA)D OTAITifer
INSTAL i,AnOitt
Will there be new rack storage? ❑ Yes
[k. No If yes, a separate permit and plan submittal will be required.
Provide All Building Areas in Square Footage Below
1" Floor
2" Floor
3 Floor
Floors
Basement
Accessory Structure!'
Attached Garage
Detached Garage
Attached Carport
Detached Carport
Covered Deck;'
Uncovered Deck
000 c,
Interior Remodel
Addition to
Existing
Structure
Type of
Construction per
IBC
Type of
Occupancy per
IBC
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 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: Handicap:
Will there be a change in use? ❑ Yes ❑ No If "yes ", explain:
FIRE PROTECTION /HAZARDOUS MATERIALS:
❑ Sprinklers ❑ Automatic Fire Alarm ❑ None ❑ Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes ❑ No
If `yes', attach list of materials and storage locations on a separate 8 - 1/2 " 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.
H:\Applications\Forms- Applications On Line\2009 Applications \I-2009 - Permit Application. doc
Revised: 1 -2009
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Page 2 of 6
PERMIT APPLICATION NOTES — Applicable to all permits in this application
Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject
to possible revision by the Permit Center to comply with current fee schedules.
Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation.
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 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 OWNER AUTH IZED AGENT:
Signature: ,4X 9it,Qd
Print Name: T NM k5 4 . TOrtig 4
Mailing Address: )30Aq- 6 14 Ve S
H:1Applications\Forms- Applications On Line\2009 Applications \I -2009 - Permit Application.doc
Revised: 1 -2009
bh
Day Telephone:
T KeaLA
City
Date: /O /4309
State Zip
Date Application Accepted:
l0l ( � I 0
Date Application Expires:
a -ili a Il�o
Staff Initials:
Page 6 of 6
Fixture Type:
Qty
Fixture, Type:
Qty
ixture Type:
Qty
Fixture Type:
Qty
Bathtub or combination
bath/shower
Bidet
Clothes washer, domestic
Dental unit, cuspidor
Dishwasher, domestic,
with independent drain
Drinking fountain or
water cooler (per head)
Food -waste grinder,
commercial
Floor Drain
Shower, single head trap
Lavatory
Wash fountain
Receptor, indirect waste
Sinks
Urinals
Water Closet
Building sewer and each
trailer park sewer
Rain water system — per
drain (inside building)
Water heater d/or vent
I strial waste treatment
int- eptor, including trap
and t, except for kitchen
type g . e interceptors
Each grease trap
(connected to not more
than 4 fixtures - <750
gallon capacity)
Grease interceptor for
commercial kitchen ( >750
gallon capacity)
Re. r or alteration of
w er piping and /or water
eatment equipment
Repair o :Iteration of
drainage • vent piping
Medical gas piping
system serving 1 -5
inlets /outlets for a
specific gas
Each additional medical
gas inlets /outlets greater
than 5
Backflow protective
device other than
atmospheric -type vacuum
breakers 2 inch (51 mm)
diameter or smaller
Backflow prot- ive device
other than atmos. 'eric -type
vacuum breakers . -r 2
inch (51 mm) diame
Each lawn sprinkler
system on any one meter
including backflow
protection devices
Atmospheric -type vac . m
breakers not includ- in
lawn sprinkler ba ow
protections (1-
Atmospheric -type
vacuum breakers not
included in lawn
sprinkler backflow
protections over 5
Gas piping outlets
PLUMBING AND GAS PIPING PERMIT INFORMATION - 206- 431 -3670
PLUMBING AND GAS PIPING CONTRACTOR INFORMATION
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Contractor Registrati.n Number: Expiration Date:
Valuation of Project (con . ctor's bid price): $
Scope of Work (please prov ' e detailed information):
Building Use (per Int'l Building Code).
Occupancy (per Int'l Building Code):
Utility Purveyor: Water:
Indicate type of plumbing fixtures and /or gas pipin, outlets being in . led and the quantity below:
H:\Applications\Forms- Applications On- Line\2009 Applications \1-2009 Permit Application.doc
Revised: 1-2009
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City State Zip
Day Telephone:
Fax Number:
wer:
Page 5 of 6
Parcel No.: 2172000050
Address: 13039 56 AV S TUKW
Suite No:
Applicant: JONES RESIDENCE
Receipt No.: R09 -01593
Initials: JEM Payment Date: 10/13/2009 11:36 AM
User ID: 1165 Balance: $0.00
Payee: THOMAS A. JONES
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 8693 322.62
Authorization No.
ACCOUNT ITEM LIST:
Description
BUILDING - NONRES
PLAN CHECK - NONRES
STATE BUILDING SURCHARGE
•
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
Account Code Current Pmts
000/322.100
000/345.830
640.237.114
RECEIPT
Total: $322.62
•
Permit Number: D09 -220
Status: PENDING
Applied Date: 10/13/2009
Issue Date:
Payment Amount: $322.62
192.80
125.32
4.50
PAYMENT
RECEIVED
doc: Receiot -06 Printed: 10 -13 -2009
Project: ��; o
F-1 odki Ion e S >>
Type ofJ{
(✓J
Address:
�
I -3033( � nue_ 5-
Date Called: t
3 , s f i o
Special Instructions:
Date Wanted:
3/15 lr
a.m.
p.m.
Requester:
Pre'd
Phone No:
20 Co -ZS 1 - 84/ CP
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Approved per applicable codes. El Corrections required prior to approval.
COMMENTS:
Inspector:
Date: 3 1 `7 /b
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 - -
Type of Inspection:
T
Address: .. .
13039 S Ail_ J.
Date Called:
1 1
Special Instructions:
to o," ft fr; ( k I lair-
Date Wanted:
'
p.m.
Requester:
Phone No:
74 tB y 2S
V 4:o
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
COMMENTS:
tr Mk" ` ' / 1 7 u79)
Inspector
.-L"
Date:
.�'
- /
0 50 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
• a) at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
ipt No.: (Date:
M Approved per applicable codes. Corrections required prior to approval.
Pr o'
t k AJ� ? 's -
Typ of Inspection:
Hfe - lPvr,.) C -�✓.
Address:
�0 S Cv Au S
3
Date Called:
Special Instructions:
Date Wanted:
Ii --
/ ( —OS
m.
Requester:
Phone 4.
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION t1L.
6300 Southcenter Blvd., #100, Tukwila, WA 98188
(206)431 -3670
Approved per applicable codes. Corrections required prior to approval. -
COMMENTS:
vJ
b-- Ga 1\uf•j c
�> r A- -E r `'A51) P 7.7171)A f o f
Ins
I Date: 1 ( ' — z) c l
ri $60.00 REINSPECTION FE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
'Date:
COMMENTS:
Type of Ins ec ' on:
/CS C.
Add � S
Date Called: 3 /
5;4 4uc
IvIS40.11
f c.4y
o(OA(d�S
rx(an
-
1C1(4) pi '€-r4 y l l,r�.. _
Project:
TeI P S t r°S idoile e
Type of Ins ec ' on:
/CS C.
Add � S
Date Called: 3 /
Special Instructions:
�al ( I. '�
A 0( -to +nS ?.
Date Wanted: ,�la� /a l
a.m.
ff
Requester:
iy,/ .TY1FS
Pho eN ? ^L. ask GY /6.
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
❑ Approved per applicable codes.
Corrections required prior to approval.
Inspector: "`
Date: r
t( 2 4 fU 9
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:
TEMPORARY EROSION CONTROL SEED MIX
X Weight
X Purity
R Germination
(T.-1r.p.■ or' red. fame
•
40
98
90
/*Ns. ,are gm: ..- ..an.,,.
Annual 4614.4;rWlr,46. as
lr- p...
441
98
90,
R.atop. or colonial Mmtpra..
ynxsts■ abs or ANTON 4406.
10
I 92
e5'
1NYG dutch dower
RIINna mew
10
9e
90
BELL COPY
Permit No0. 2h
violation of any adopted code or ordinance. Ft
!S ac cnowl
REVISIONS
No changes shall be made to the scope
of work without prior approval of
Tukwila Building Division
NOTE: Revisions will require a new plan submitt&
and may include additional plan review fees.
•
SEPARATE PERMIT
REQUIRED FOR:
eW �nca
Electrical
Plumbing
Gas Piping
City of Tukwila
BUILDING DIVISION
pproved Field Copy
Date: o/la /n
City Of 'Thkwila
BUILDING DIVISION
TREE LEGEND:
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AR APPROXIMATE
SLOPE LEGEND:
a CBS
A. 01-1173
SE E41171 (9' OP)
1)1 }1127
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99 E 41107 (13- CM
NOTE 90 14' (1051) 40 TEE 19 TR
FLOG ESEYA(O FIX 116 91E 1115
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OOH') BERME STMINO PROECT SITE 109
1 REOI6T A RAZ 1090 019117 90ECTO1 AT LEAST 24 4090 (1 90100 DAY)
N AIMEE BY CALL 79-431-0179.
9. ALL 109 914(1. COMM 10 DE¢ ARMED CRAMS ANT. OGINOS 190 TEE
ARMED RMS RUNE PRE-APPROVAL 00 DE OINK DE MEEK NO DE
OTT O ARUM
1 review
approval IS subject to eras and onission=reararel SIAIDYOS 11IIER915E AMPAED °
iroyal of construction documents does not ao 51 4or eo'' 9X11 MNOITAN A O9WIIT 9:T Cr OOOO 0101911E EN-91E
it T ' .' 96411 ROAD RECCIO DRAINS 719 10 P OEC1 71AL 0009.
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1016 AMORAL 9009E 1A90(TA10I.
adglatk6 90 MOTES ITES 95111 IE COE 0051 DE 0=201 0 A
UONSED LAID 91R*ET00. 100011 DA11O WALL LE NA1 191 MI
90.011 9011 A F19013(10 NNE DE 00T111 91111 710r0 0361:90
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OE 10 91601Ci00
SHEET INDEX
L. MON 001110. RAN
L' 11*14 90 110116 RANI
1 ROM N101DOIT RAN
4 CETAUS
ILO •910E 1010(1011- RERK 110 IT RM
GRAPHIC SCALE
0
20
LOCATIONS SHOWN FOR EXISTING UT)UTIES ARE APPROXIMATE.
PRIOR TO STARTING CONSTRUCTION,
CONTACT ONE -CALL (1- 800 - 424 - 5555) FOR UTILITY LOCATIONS.
t01 1
11,(001 50..U.
GRADING AND EROSION CONTRO NOTES
1 111E E0030 PEE NO SEOOIT C91RQ (FY)
01990 01 DE NROED RAYS AK WOW
400011090
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14100101 140 01.1.90 1106 ND 46711
ENTRANCE,
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1 00 Y9T 1 710001 9PO10R 56 PRONE
1 EEFURT 110 I41014100 1089 WA91ES 10
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EROSION CONTROL PLAN
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VIEWED FOR
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OCT 2, 2 2009
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PERMIT CENTER
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SEATTLE ASBESTOS TEST, LLC
19711 Scriber Lake Road, Suite D, Lynnwood, WA 98036
Phone: (425) 673 -9850, Fax: (425) 673 -9810
www.seattleasbestostest.com / steve@seattleasbestostest.com
Property Location: N� °'r
Mah rgsviewRnnpf
13039 56th Ave. Tukwila, WA 98178
^wn (w�►n. �
Prepared for:
Prepared by:
Inspection Date:
Report Date:
ASBESTOS SURVEY REPORT
Thomas Jones
Mr. Thomas Jones
13039 56th Ave. Tukwila, WA 98178
Steve (Fanyao) Zhang
AHERA Cert. 10304594; expiration date: 03/201
Seattle Asbestos Test, LLC
19711 Scriber Lake Road, Suite D
Lynnwood, WA 98036
10/7/2009
10/9/2009
NVLAP ACCREDITATION LAB CODE: 200768 -0
AHERA Inspector Number
10304594
Note: Summary information for asbestos at named property can be found in "Conclusions" section of the
report, in the floor plans, or in table 3, Nature and Distribution of Asbestos. A "Point Count Supplement", if
attached, may change the original asbestos percentage.
REVIEWED Vo
CODE COMPLIANCE
APPROVED
OCT 2 2 201i9
City of Tukwila
BUILDING DIVIRInna
CiTY V DLA
OCT 13 2009
PERM1TCEIdTER
PO°1
SEATTLE ASBESTOS TEST, LLC
Total Miscellaneous Material
NVLAP ACCREDITATION LAB CODE: 200768 -0
19711 Scriber Lake Road, Suite D, Lynnwood, WA 98036 AHERA Inspector Number
Phone: (425) 673 -9850, Fax: (425) 673 -9810 10304594
www.seattleasbestostest.com / steve@seattleasbestostest.com Property Location
13039 56th Ave. Tukwila, WA 98178
Purpose /Scope of Survey
This survey is intended to investigate, sample and test ACM in
accordance with 40 CFR 763.86, the EPA regulations for Asbestos
Hazard Emergency Response Act (AHERA). The client named will
use this report to meet their regulatory requirements in their project.
Method . I • �i; findings
In pection, sanstf§ - assessment procedures were performed in
e r ance with the ARERA guidelines published by the U.S.
EPA in -40 'CFR Part 763 subpart E, October 30, 1987. The survey
include three integrated tasks: visual inspection, sampling and
quantification. Special attention should be paid to the following:
material classification, recognizing of homogeneous areas,
differentiation between friable and nonfriable asbestos, and
interpretation of testing results.
Material classification
There are three main kinds of material according to EPA sampling
guidelines. They are Surfacing Material, Thermal system Insulation,
and Miscellaneous material. The classification bears implications for
number of samples to be taken. For Surfacing material, there's the
3 -5 -7 rule, meaning 3 samples from less than 1,000 square feet area,
5 samples from 1,000 to 5,000 square feet area, and 7 samples from
greater than 5,000 square feet area. For Thermal system material,
with some exceptions, 3 samples should be taken for each
ti klp • - neous area. For Miscellaneous material, at least one sample
iwithald be taken from each homogeneous material.
Table "1 shows the types of material recognized during the survey,
n liand.th'e following is a tabulated summary of the material types:
> 3
Page 1 of 5
i
SEATTLE ASBESTOS TEST, LLC
19711 Scriber Lake Road, Suite D, Lynnwood, WA 98036
Phone: (425) 673 -9850, Fax: (425) 673 -9810
www.seattleasbestostest.com / steve@seattleasbestostestcom
Total Thermal System Insulations (TSI)
Total ACM found on the property
aboratory Testing Results
NVLAP ACCREDITATION LAB CODE: 200768-0
AHERA Inspector Number
10304594
Properly Location
13039 56th Ave. Tukwila, WA 98178
Total Surfacing Material
> 0
Homogeneous Areas
Homogeneous material means an area of surfacing material, thermal
system insulation material or miscellaneous material that is uniform in
color and texture. It should be pointed out that materials appear to be
homogeneous and adjacent to each other may in fact have different
contents in terms of asbestos, and only laboratory testing will decide
whether they are really the same homogeneous area.
Table 2 shows the identified homogeneous areas for this survey.
Total homogeneous areas
For each homogeneous area, its representative location and sample
number are given in the table.
Friable vs. Non friable
A material that contains asbestos is friable if the material, when dry,
may be crumbled, pulverized, or reduced to powder by hand
pressure, and includes previously non - friable material after such
previous nonfriable material becomes damaged to the extent that it
meets the criteria as a friable material.
The term friable during an AHERA asbestos survey applies only to
ACM, and table 3 shows friable ACMs and nonfriable ACMs during
this survey.
0
3
> 0
Page 2 of 5
SEATTLE ASBESTOS TEST, LLC
19711 Scriber Lake Road, Suite D, Lynnwood, WA 98036
Phone: (425) 673 -9850, Fax: (425) 673 -9810
www.seattleasbestostest.com / steve@seattleasbestostestcom
NVLAP ACCREDITATION LAB CODE: 200768 -0
AHERA Inspector Number
10304594
Property Location
13039 56th Ave. Tukwila, WA 98178
Analytical testing is done in house in Seattle Asbestos Test, which is
a NVLAP Accredited lab and participates in PAT rounds administered
by NVLAP. Seattle Asbestos Test has over 20 years of analytical
testing experience among its key analysts, and it conducts extensive
inter- and intra- laboratory QA/QC testing.
The method of testing employed are polarized light microscopy, or
PLM. For QC purposes, one in every ten samples are analyzed as
duplicate and check samples are randomly cross - analyzed by
different analysts
Table 4 is the test results for the samples taken during the survey.
For each sample, it is sub - divided into layers if the sample is
separable, and each layer is then prepared into slides and analyzed
separately. Each layer is also described to show its color, and nature,
so that it provides a check to the homogeneous area classification
done on site. Different from the lab report format, which is listed in the
appendices, Table 4 also shows the location of each sample, and the
material as seen by the inspector on -site. This kind cross- reference
enhances degree of certainty to the final report.
The following is a tabulated summary
Total number of samples
Total number of layers —
Conclusions
Inspected is the garage behind the main house. The garage is
composed of brick exterior walls (sample 1), and shingle composition
roofing (sample 2). The interior flooring is concrete and gravel
(sample 3), the walls are the same as exterior wall, and there's no
ceiling present except wood beams. The car port is made of wooden
pillars and fiber glass top.
3
3
Page 3 of 5
SEATTLE ASBESTOS TEST, LLC
19711 Scriber Lake Road, Suite D, Lynnwood, WA 98036
Phone: (425) 673 -9850, Fax: (425) 673 -9810
www.seattleasbestostest.com / steve@seattleasbestostest.com
Respectfully Submitted,
Steve (Fanyao) Zhang
NVLAP ACCREDITATION LAB CODE: 200768 -0
As such, materials that are not addressed in this survey should be
assumed ACM and should be treated as such unless additional
samples were taken and tested otherwise. Any effort for additional
survey that may take place after the release of this report should be
in the form of an addenda.
This report is for the exclusive use of Client named and their
representatives. The inspection and the report follow the general
guidance recommended by AHERA, and no any other warranty,
express or implied, is made. Any unauthorized use or use of this
report beyond its scope are strictly prohibited, and Seattle Asbestos
Test, LLC and its inspectors resume no liability.
AHERA Inspector Number
10304594
Property Location
13039 56th Ave. Tukwila, WA 98178
Limitations
Major limitations of this survey are: (1) it's impossible to sample every
inch of building material by the method called, (2) sample appears
the same, i.e., homogeneous may in fact be different in terms of
asbestos containing, (3) concealed or difficult -to- access materials,
such as underground constructions, areas under vast carpeted
spaces where it is difficult to reveal everything under the carpet,
materials inside walls, or under plywood if destructive sampling is not
possible, building foundations, floor substrates, live electric wires,
crawl spaces, areas where the inspector has no access, and debris
pile from burning can not be adequately sampled, (4) random
sampling scheme called by the method may skip areas that contains
asbestos, and (5) measurements of area, length and size are all
estimated, and should not be relied on for bidding purposes.
Page 4 of 5
SEATTLE ASBESTOS TEST, LLC
19711 Scriber Lake Road, Suite D, Lynnwood, WA 98036
Phone: (425) 673 -9850, Fax: (425) 673 -9810
www.seattleasbestostest.com / steve@seattleasbestostest.com
Appendices
Table 1: Types of Material
Table 2: Homogeneous Areas
• Table 3: Nature and Distribution of Asbestos
Table 4: Analytical Testing Results
Floor Plans
Laboratory Analytical Report & Chain of Custody
* Table 3 not attached because no ACM was found
NVLAP ACCREDITATION LAB CODE 200768-0
AHERA Inspector Number
10304594
Property Location
13039 56th Ave. Tukwila, WA 98178
Page 5 of 5
SEATTLE ASBESTOS TEST, LLC
19711 Scriber Lake Road, Suite D, Lynnwood, WA 98036
Phone: (425) 673 -9850, Fax: (425) 673 -9810
www.seattleasbestostest.com / steve@seattleasbestostest.com
NUMBER SAMPLE
LAYER MATERIAL MATERIAL DESCRIPTION LOCATION
TYPE
1 1 M Gray sandy/brittle material Ext wall
2 1 M-02 Black asphaltic material with sand Roof
3 1 M-03 Gray hard material with black asphaltic and sand garage floor
NVLAP LAB CODE: 200768 -C
AHERA Inspector Number. 10304594
Property Location
13039 56th Ave. Tukwila, WA 98178
Table 1: Types of Material 3 Total Material Type
SEATTLE ASBESTOS TEST, LLC
19711 Scxiiber Lake Road, Suite D, Lynnwood, WA 98036
Phone: (425) 673 -9850, Fax: (425) 673-9810
www com / steve@seattleasbestostesicom
Table 2: Homogeneous Areas
SAMPLE LAYER
NUMBER
H MOGBIEO1J8>u:EAs
Gray sandylbrittle material
Black asphaltic material with sand
Gray hard material with black asphaltic and sand
NVLAP LAB COD: 200768-0
AHERA inspector Number. 10304594
Proparty Location
13039 56th Ave. Tukwila, WA 98178
3 Total Homogeneous Areas
SAMPLE LOCATIONS
Ext wall
Roof
garage floor
SEATTLE ASBESTOS TEST, LLC
19711 Scriber Lake Road, Suite D, Lynnwood, WA 98036
Phone: (425) 673 -9850, Fax: (425) 673 -9810
www.seattleasbestostest.com / steve@seattleasbestostest.com
Table 4: Analytical Testing Results
SAMPLE
NUMBER LAYER
1
2
3
1
1
1
DESCRIPTION
Gray sandy/brittle material
Black asphaltic material with sand
Gray hard material with black asphaltic and sand
MATERIAL
TYPE
M-01
M-02
M-03
NVLAP LAB CODE: 200768 -0
AHERA Inspector Number. 10304594
Property Location
13039 56th Ave. Tukwila, WA 98178
3 Total Layers
SAMPLE LOCATION
End wall
Roof
garage floor
ASBESTOS
TYPE
N/A
N/A
N/A
N/A
N/A
N/A
SEATTLE ASBESTOS TEST, LLC
19711 Scriber Lake Road, Suite D, Lynnwood, WA 98036
Phone: (425) 673 -9850, Fax: (425) 673 -9810
www.seattleasbestostest.com / steve@seattleasbestostest.com
FLOOR PLAN AND SAMPLING SCHEME
Property Location:13039 56th Ave. Tukwila, WA 98178
Batch Number 200969075 Job Number: N/A
Date analyzed: 10/9/2009 Samples Taken: 3
1 2
Street
Main House
Garage
3
Car Port
Note: (1) Positive samples in bold face and underlined, (2) Map not exact, not in scale
NVLAP ACCREDITATION LAB CODE: 200768 -0
AHERA Inspector Number. 10304594
Property Location
13039 56th Ave. Tukwila, WA 98178
SEO#
CLIENT SAMPLE #
SAMPLE DESCRIPTION
LAB ID
A/R
1
1
Seattle Asbestos Test, LLC
/ 6? . -
2
2
Seattle Asbestos Test, LLC
y
3
3
Seattle Asbestos Test, LLC
3
4
An
Seattle Asbestos Test, LLC
10!1/2009
5
,,-
Seattle Asbestos Test, LLC
10/2909
6
"
Seattle Asbestos Test, 11.0
/ 'r' T
7
8
9
10
.
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Print Name
9 .......-- g - ----nati
Company Name
Date
Time
SampledSteve ( Fanyao) ?bang
Seattle Asbestos Test, LLC
/ 6? . -
Rellnqulshed.Steve (Fad) Mang
`� -1
Seattle Asbestos Test, LLC
y
Delivered'Steve ( Fanyao) Zbang
it
Seattle Asbestos Test, LLC
3
Received Steve (Fanyao) Zhang
An
Seattle Asbestos Test, LLC
10!1/2009
Analyzed Weilong tai
,,-
Seattle Asbestos Test, LLC
10/2909
ReportedSteve ( Fanyao) Zhang
"
Seattle Asbestos Test, 11.0
/ 'r' T
SEATTLE ASBESTOS TEST, LLC
19711 Scriber Lake Road, Suite D, Lynnwood, WA 98036
Tel: (425) 673-9850 Fax: (425) 673 -9810
www.scaWeasbestostest.com
Accredited, Experienced, Insured, and Well Managed!
Client: Thomas Jones
Address: Mr. Thomas Jones
13039 56th Ave. Tukwila, WA 98178
Phone: Fax:
CHAIN OF CUSTODY
ANALYSIS: BULK ASBESTOS TEST POINT COUNT (400) , POINT COUNT (1000) _ __, POINT COUNT (Gravimetric) , Other
Email:
Job#:N /A
Project Loc.:13039 56th Ave. Tukwila, WA 98178
Number of Samples:3
Sample Condition: Good Damaged Severe Damage(Spillage)
NVLAP Accredited, 200768-0
Lab Batch#:200969075
Result reporting method: Phone , Fax , Email , Pick -up report
Seattle Asbestos Test warrants the test results to be of a precision normal for the type and methodology employed for each sample
submitted and disclaims any other warrants, expressed or implied, including warranty of fitness for a particular purpose and warranty
of merchantability. Seattle Asbestos Test accepts no legal responsibility for the purpose for which the client uses the test results.
By signing on this form the clients agree to relieve Seattle Asbestos Test of any liability that may arise from the test results.
Invoices paid late may be charged of interest, and invoices go to collection may be charged 17% to 25% of collection fee.
Checks with NSF will be charged $50.
Lab ID
Client i D mple
Layer
Description
%
Asbestos
Fibers
Non - Fibrous
Components
,�
Non - asbestos
Fibers
1
1
1
Gray sandy/brittle
material
None
detected
Sands, Filler
3
Cellulose
2
2
1
Black asphaltic
material with sand
None
detected
Asphalt/binder, Sand
25
Cellulose
3
3
1
Gray hard material
with black asphaltic
and sand
None
detected
Asphalt/binder,
Binder /filler, Sand
2
Cellulose
SEATTLE ASBESTOS TEST, LLC
Lynnwood Laboratory 19711 Scriber Lake Rd, Suite D, Lynnwood, WA 98036; Tel: 425.673.9850, Fax425.673.9810
Bellevue Laboratory: 12727 Northup Way, Suite 24, Bellevue, WA 98005; Tel: 425.861.1111, Fax: 425.861.1118
Website: hupJ /www.seauleasbestostest.com, E- mail: admain@seattleasbestostest.com
Attn.: Mr. Andy Jones
Client Andy Jones
Address:13039 56th Ave, Tukwila, WA 98178
Email: ajones@viox.com
Project 13039 56th Ave, Tukwila, WA 98178
Analyzed by: Shabnam Carman/Weilong Tai
ANALYTICAL LABORATORY REPORT
PLM by Method EPA/600 /R- 93/116
Tel• 206.251.8416
NVLAP Accreditation
Lab Cods 200768-0
Client Job #: N/A
Laboratory Batch #: 1
Date Received: 10/7/2009
Samples Received: 3
Date Analyzed: 10/8/2009
Samples Analyzed: 3
Report reviewed by. eve (Fanyao) Zhang, President
ACTIVITY NUMBER: D09 - 220 DATE: 10 - -
PROJECT NAME: JONES DEMOLITION
SITE ADDRESS: 13039 56 AV S
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # Revision # After Permit Issued
DEPART ENTS: - 0 1
tS Building Division v
b1' JJG j1o'
u is Works /
Complete ❑
Comments:
PLAN REVIEW/ROUTING SLIP
�
PERMIT COORD COPY.
Fire Prevention
Structural
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Incomplete U
A/* 10-19
sfri u/. IO-AS-vq
Planning Division •
Permit Coordinator ❑
DUE DATE: 10-15-09
Not Applicable
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 n Structural Review Required n No further Review Required
REVIEWER'S INITIALS:
APPROVALS OR CORRECTIONS:
Approved ❑ Approved with Conditions
Notation:
REVIEWER'S INITIALS:
Documents/routing slip.doc
2 -28 -02
DATE:
DATE:
DUE DATE: 11-12-09
Not Approved (attach comments) n
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections:
Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
License
Name
Type
Specialty 1
Specialty 2
Effective
Date
Expiration
Date
Status
SWOPEEL933L8
SWOPE
EXCAVATION
&
LANDSCAPING
CONSTRUCTION
CONTRACTOR
DEMOLITION
EXCAVATION /GRADING
6/28/2007
6/28/2009
REREGISTERED
Bond
Bond
Company
Name
Bond
Account
Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Bond
Amount
Received
Date
1
OLD
REPUBLIC
INS CO
YLI263171
08/01/2009
Until
Cancelled
$12,000.00
10/07/2009
Insurance
Company
Name
Policy
Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Amount
Received
Date
1
LIBERTY
NORTHWEST
INS CORP
BH053618386
03/27/2009
03/27/2010
$1,000,000.00
10/07/2009
Name
Role
Effective Date
Expiration Date
SWOPE, MICHAEL KEY
PARTNER /MEMBER
10/07/2009
SWOPE, EMILY MARIE
PARTNER /MEMBER
10/07/2009
Untitled Page
o
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.
Business and Licensing Information
Name
Phone
Address
Suite /Apt.
City
State
Zip
County
Business Type
Parent
Company
SWOPE EXCAVATION &
CNSTRT LLC
2068522395
3201 SW ROXBURY ST
SEATTLE
WA
98126
KING
Limited Liability Company
UBI No. 602933757
Status ACTIVE
License No. SWOPEEC910PG
License Type CONSTRUCTION
CONTRACTOR
Effective Date 10/7/2009
Expiration
Date
Suspend Date
Specialty 1 GENERAL
Specialty 2 UNUSED
10/7/2011
Other Associated Licenses
Page 1 of 1
Business Owner Information
Bond Information
Insurance Information
https: // fortress .wa.gov /lni/bbip /Detail.aspx 11/12/2009