HomeMy WebLinkAboutPermit D11-054 - CARNAY RESIDENCE - DEMOLITIONCARNAY DEMOLITION
13357 35 AV S
Di 1-054
City oibI'ukwila
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
Parcel No.: 7358600140
Address: 13357 35 AV S TUKW
Suite No:
Project Name: CARNAY DEMOLITION
DEVELOPMENT PERMIT
Permit Number: D11 -054
Issue Date: 03/21/2011
Permit Expires On: 09/17/2011
Owner:
Name: CARNAY HENRI K
Address: 4901 36TH AVE NE , TACOMA WA 98422
Contact Person:
Name: SUZANNE BREEN
Address: 116 CLAY ST NW, SUITE B1 , AUBURN WA 98001
Contractor:
Name: A PLUS REMOVAL AND RECYLNG LLC
Address: 116 CLAY ST NW STE B -1 , AUBURN WA 98001
Contractor License No: PLUSRRR922CG
Phone: 206 - 730 -6448
Phone: 253 737 -4441
Expiration Date: 04/05/2012
DESCRIPTION OF WORK:
DEMOLITION 1200 SF SFR AND 774 SF DETACHED GARAGE: HAUL AWAY BURNT DEBRIS. SITE TO BE LEFT CLEAN OF
DEBRIS. REMOVE SHRUBERY AND SLABS AROUND HOUSE. CAP SSS AT FOOTPRINT OF HOUSE AND DISCONNECT WATER
AT METER.
PROJECT ON VALLEY VIEW SEWER AND WD #125 WATER.
Value of Construction: $7,000.00 Fees Collected: $369.97
Type of Fire Protection: International Building Code Edition: 2009
Type of Construction: V -B Occupancy per IBC: 0022
Electrical Service Provided by:
* *continued on next page **
doc: IBC -7/10
D11 -054 Printed: 03 -21 -2011
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: Private: Public:
Storm Drainage:
Street Use: Profit: N Non - Profit: N
Water Main Extension: Private: Public:
Water Meter: N
Permit Center Authorized Signature:
6L
Date:
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 pe •••rmance of work. I am authorized to sign and obtain this development permit and agree to the conditions attached
to this permit.
Signature:
Print Name:
S tit Za v C efl
Date: v
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.
PERMIT CONDITIONS:
1: ** *BUILDING DEPARTMENT CONDITIONS * **
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: All construction shall be done in conformance with the approved plans and the requirements of the International
Building Code or International Residential Code, International Mechanical Code, Washington State Energy Code.
5: 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.
6: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of,
doc: IBC -7/10
D11 -054 Printed: 03 -21 -2011
any violation of any of the provisions of the bng code or of any other ordinances of the f Tukwila. Permits
presuming to give authority to violate or can he provisions of the code or other ordinanc 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.
7: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * **
8: Contractor shall notify Public Works Project Inspector at (206)433 -0179 of commencement and completion of work at least
24 hours in advance.
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: IV 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.
14: ** *PLANNING DEPARTMENT CONDITIONS * **
15: The garage shall also be demolished, as shown on project plans submitted with application.
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D11-054 Printed: 03 -21 -2011
CITY OF TUKIlliA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.ci.tukwila.wa.us
Building Pet No. t ‘, `, '-- (15-LJ
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.
* *Please Print **
SITE LOCATION
Site Address: 1 57 54'4 AVe, S
Tenant Name: n f -
Property Owners Name: Herl ji Cadrn (1
Mailing Address: 3
King Co Assessor's Tax No.: -71S" 9 60-0 19 t/
Suite Number: n f)'- Floor:
nr
New Tenant: ❑ Yes ❑ .. No
City
35136
Zip
CONTACT PERSON - who do we contact when your permit is ready to be issued
Name: 3117OX g-()
Mailing Address: k tQ C1.[LU S+ I *g 1
E -Mail Address:
W' _VA it i. 1 Wt. L
Day Telephone: ZbL 736 (2 q q 5
AthbuTh wig can
City State Zip
E' Fax Number: 26-3737 14 7 (.00
GENERAL CONTRACTOR INFORMATION -
(Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5))
Company Name: P 1LL5
Mailing Address:
fo !,
Contact Person: cJlil, �-A1 one 6r0)2,r)
E -Mail Address:
Contractor Registration Number: 'P Luse R9 22
d
c
Day Telephone: 20151_ State 30 (12
ax Number: 253 737 to CJ
Expiration Date: 1— 5 - Zfl 1
OF RECORD - All plans must be stamped by Architect of Record
Company Name:
n
Mailing Address:
City
Day Telephone:
Fax Number:
Contact Person:
E -Mail Address:
State
Zip
ENGINEER OF RECORD - All plans must be stamped by Engineer of Record
Company Name:
n4
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
State
Zip
H:\Applicalions\Focma- Applications On Linc\2010 Applications\? -2010 - Permit Applicationdoc
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Page 1 of 6
BUILDING PERMIT INFORMATIO06 -431 -3670
1
Valuation of Project (contractor's bid price): $
Scope of Work (please provide detailed information):
III •
SA !AU.I
Existing Buil.'ng Valuation: $ l I OClb. Q 0
Ire 1:. _a _ '11
w '
1,611 ,
.tom 1 �� .fc� s r : NM �ra� /1i M �r"
• se— •'.con ,4.1
Will there be new rack storage? ❑ Yes
4-}Zo motor-
iv 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): 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: 1 ci 1 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 0.......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
ve Department.
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ti
Existing
Interior Remodel
Addition to
Existing
Structure
New
Type of
Construction per
IBC
Type of
Occupancy per
IBC
1 °` Floor
n
yr� o-
„/�
A--
n t
rd Floor
n
n
r) n-
1
3`a Floor
nQ
n\q-
nr)-
Floors thru
0a-
11 0-
n-
Basement
,() 4
n A-
I() 4
Accessory Structure*
n Pi-
nil-
n R-
Attached Garage
n A-
I/1 Pt-
n 4
Detached Garage
In
i 1A-
n n-
Attached Carport
n pr
n 1)--
^ r l
Detached Carport
0
f
r) , ^
Covered Deck
0A-
I1 11-
,^ Pr
Uncovered Deck
n Pr
A A-
ii Pr
C
_ \ /
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: 1 ci 1 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 0.......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
ve Department.
H :\Applications\Fonns- Applications On Line \2010 Applications \7 -2010 - Permit Application.doc
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Page 2 of 6
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•
•
. 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 0 NER ' AUTHORIZED A
Signature:
Print Name: t2_ ovane t reen
Mailing Address: ) 112 i� f Nu) 4t el
Date: t , r
Day Telephone: 20 t 4 73 0 (Q `1
oub�am Loft- �1
city state zip
Date Application Accepted: '2
-3 1
Date Application Expires: - '
H:\Applications\Favns- Applications On Iino\2010 Applications \7 -2010 - Permit Applicatioadoc
Revised: 7 -2010
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Staff Initials: li
Page 6 of 6
• Ii0
r----- wq City of Tukwila
zDepartment 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
Parcel No.: 7358600140
Address: 13357 35 AV S TUKW
Suite No:
Applicant: CARNAY RESIDENCE
RECEIPT
Permit Number: D11 -054
Status: PENDING
Applied Date: 03/03/2011
Issue Date:
Receipt No.: R11 -00398
Payment Amount: $143.97
Initials: WER Payment Date: 03/03/2011 09:50 AM
User ID: 1655 Balance: $226.00
Payee: A PLUS REMOVAL AND RECYCLING
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 11430 143.97
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
PLAN CHECK - NONRES
000.345.830 143.97
Total: $143.97
doc: Receiot -06 Printed: 03 -03 -2011
•
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
Parcel No.: 7358600140
Address: 13357 35 AV S TUKW
Suite No:
Applicant: CARNAY DEMOLITION
RECEIPT
Permit Number: D11 -054
Status: APPROVED
Applied Date: 03/03/2011
Issue Date:
Receipt No.: R11 -00544
Initials:
User ID:
Payee:
WER
1655
Payment Amount: $226.00
Payment Date: 03/21/2011 08:59 AM
Balance: $0.00
SUZANNE BREEN
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 1437 226.00
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
BUILDING - NONRES
STATE BUILDING SURCHARGE
000.322.100 221.50
640.237.114 4.50
Total: $226.00
doc: Receipt -06 Printed: 03 -21 -2011
Lv)
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
Permit Inspection Request Line (206) 431 -2451
Projec
L -rr� Demo
•
Type of �Gp, ct'
IdtG. J
— i)e ,.4- 4 iu in 1.e.P4 . F,,,,,,, f e, di
Address:
I9. %SI �7 35 Ave-
5
Date Called:
3 j95itl
Special Instructions:
1/- 30
r4- III
Date Wanted:m
? /2`6 / 11
P.m.
Requester:
.-)u2a/VI e_
Phone No:
g c -`7 - C 4'8
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
•
— i)e ,.4- 4 iu in 1.e.P4 . F,,,,,,, f e, di
1411 eA ease A a(;r4- CUUGr';( ()IJ4
5fra u, • 44 64 Sesd t A - F rv?e-le of
-F( ya.iLd
_ .-
Inspector: 95
Dat /
1(
n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
r. .
•
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
•
CITY OF' TUKWI'LA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
p11=ds�1
Pfoject:
(1-A Vk klA tit
.
Type of Inspection: '.
A1d -s6S -3 3 6
u
Date Called:
Special Instructions:
F' 611 s
V
0-161 8'5-01
1tequester:
Date Wanted: � � I t
�.
Phone No:
_-7ab -%y-4g
vl, Approved per applicable codes. D Corrections required prior to approval.
COMMENTS:
ef 1911 '1€‘61,".,o
Date
-2 (
n EINSP CTION FEE REQUIR {D. Prior to n'xt inspection, fee must be
paid at • 00 Southcenter Blvd. Suite 100. Call to schedule reinspection.
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO. I
CITY OF TUKWILA BUILDING DIVISION C/v"'
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
Dl 1 -o5A}
Pr j.c e 44 U }
Type of r e ectio� S -'
66/‘
Address: L
i 3359 35 A 5,
Date Called:
& TxIWU
Special Instructions: ions:
0449 1 2 -v 4
1471 Id A
Date Wanted:
` 2 i /�
a.m.
Requester:
Phone No:
2.04-"730- 404
-48
D
Approved per applicable codes. a Corrections required prior to approval. i1/44
COMMENTS:
`r.--06)iP
& TxIWU
z- ~� RPM
c---b \\ 0 tei M `' 6 -0 A n :7`,
JAS to A
nefM •`t`
-xr
(-of
raJ I D :
; (J&A,
o^. Lk
,
R.\;
7 1- )ArKJ -f
Sry0e-t
tic-4-
Inspector:
h tl
Date: -% 1 � � `(
ri REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
1S
INSPECTION RECORD
Retain a copy with permit V 1 Y
INSPECTION NO. - PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Pta c
rn
Type ofI ection: 7 €
Ad: -SS:
! 3357. 3
Ave -5�
Date Called:,/'
3I 7..1 I l
Special Instructions:
rj; \Q`.3°
-f) •
Date Wanted:
1 1
Requester,
Phone No
- Ot- 7-0 -te94,
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
Pre--Co Cdnlfa&+i1 ovi - s -
F;14Vol
Inspector:
Date: I
JhfilfI
1-1$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:
4okretA sQuale i ill aeoelo [ sheC! 1,9H4 ss '
REVISIONS
No changes shall be made to the scope
of work without prior approval of
Tukwila Building Division.
NOTE Revisions wiH require a new plan sebmittal
and may include additional plan review fees.
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sus - salmi-am: side se
th
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stir
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211
Pit No.
C ar-as e,
ILIA 4o4o.1 el)
4o bc. o , ltsVNe4
1111-17aibi'1'1;"
31.'
y
ne
123
1 35 ? +tve S
T�1twi 1a
House
120 1-crbak s uace
4-o be. c Imo
Slab
r
2 -I-1 i
321
R VIEWED FOR
'ECOMPLIANC
Poonvgn
AR 1 0 2011
L
ity of Tukwila
BUI i ING DIVISION
Pt4 review approval is subject to gars and omissions.
tcfiova! of construction documents does not authorize
_ :y.atior► o. Eny adopted code or °rdinanoe. ReceOt
a� 1.pproved . Copy and contgions is wedged:
Date:
`.0
PLANNING APPROVED
No changes can be made to these
plans without approval from the
- -�-- -- F?da Ia+rl D'ivisionvf DCD
Approved By: 3 11.111/11
Date:
o'e
RECEIVED
MAR 0 $ 2011
TUKWILA
PMO wona
071 g-61/
City Of Tukwila
BUILDING DIVISION
s q'
b11"--054
ECEIVEr
MAR 03 2011
PERMITCENTEF
pscleanair.org
Pu i :t 5oti s Afierity
... .eau ... ........1444 ... .e, .2o11...ow..1. ..V }....v4.0,011n
FILE COPY
Permit No.,
Single - Family Notification Case #0 201100509
This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall
available for inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)).
Fee Amount Paid
Credit Card Transaction
Transaction Date
Owner's Name
Project Street Address
City
Contact Person
Mailing Address
$75.00
# VTHF6DC7EB76
03/02/11
Henri Carnay
13357 35th Ave S
Tukwila
Suzanne Breen
Phone (253) 925 -7228
Zip
Phone
98168
(206) 730 -6448
be
This project Includes a demolftlon.
Demolition Start Date 03/07/11 Completion Date 05/30/11
Demolition will be completed by a demolition contractor
This Is an emergency project. The emergency reason:
There was a sudden, unexpected event that resulted in a public health or safety hazard.
I certify that:
(1) This Is a single - family residence project. The structure Is used by one family who owns the property as their domidle.
(2) The information I have provided Is to the best of my knowledge accurate and complete.
(3) I understand the fee for this Notification Is nonrefundable.
Create Another Notifieatioq
View History
If you have questions, contact us at asbestos @pscleanalr.org or 206.689.4058.
_ REVIEWED FOR
CODE PLIANCE
A PDRnVED
MAR 10 2011
City of Tukwila
BUILDING DIVISION
)f1
bkv- 051-1
Loa Out
RECEIVED
MAR 087011
TUKWILA
PUBLIC WORKS
ECEIVED
MAR 03 2011
PERMIT CENTS
3/2/2011 9:49 AM
FILE COPY
Polarized Light Microscopy Test Report
EPA Method 600/R- 93/116
Client CMB Demo & Abatement Specialist
cmbdemo ai@yahoo. com
Project Number NA
Project Name 13357 35th Ave S Tukwila
Client Orion
Number Number Stereo Scope Exam
01 10222 -66 Exterior Siding
Homogeneous
02 10222 -67 Wall Texture
Homogeneous
03 10222 -68 Wall Texture
Homogeneous
04 10222 -69 Wall Texture
Homogeneous
05 10222 -70 Wall Insulation
Homogeneous
06 10222 -71 Wire Insulation
Homogeneous
Date
Page
Invoice
Date Received
REVIEWED FOR
CODE COMPLIANCE
APpotweD
MAR 1 2011
City of Tukwila
BUILDING DIVISION
February 22, 2011
Page 1 of 1
110691
February 22, 2011
Sample Asbestos Other
Treatment Percent Type Fibers
Chloroform ND
ND
ND
ND
ND
ND
Cellulose
Cellulose
Cellulose
Cellulose
Cellulose
Cellulose
Dup: Laboratory QA/QC Duplicate; M; Mastic [(a), (b), (c), etc.1: Sample layers numbered from front to back
Comments: For layered samples, each component has been analyzed separately. ND means non - detect for asbestos fibers by RECEIVED
EPA Method 600/R- 98/116.Disclaimers: PLM has been known to miss asbestos in a small percentage of samples that RECEIVED
contain asbestos. Thus, these laboratory results represent due diligence, however negative or <1 % PLM results can not be
guaranteed. Per EPA guidelines samples will be archived for 30 days then will be disposed of. This report may only be
reproduced in full with written approval of ORION Environmental Services.
Analyzed By \ !, ... l_ <. -' - Reviewed By
Dennis Rauschenberg
Laboratory Analyst
•
•
MAR 0 6 7011
PUBL Cu WORKS
Donna McNeal
Laboratory Director / CEO RECEIVED
MAR 03 Z011
: veyme tirYiri» 4 ,SI,the3 3 ed.,frPi 0.4101i€-€rri {s,
i€
. _. _ s_..._ (. ... '7'5.1'-('_:!7.1 i
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PERMIT CENTER
t\--05L1
i
11
Clip
Ad A '
;vim & .abatement tittreintio
Tel
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E-
www•.cmbdemo.com
W ENVIRONMENTAL SERVICE3,YNC.
Environmental Consulting 84 Compliance
Chain of Custody Form
Dustin Blankenship
Owner /Operator
425 477 -8737 Cell
cmbdemo@yahoo.com
206 -350 -8398 Fax
WANCMBDEDA9094
I'. W11A���I�'.11{'i • kd ,- 1 I
(" cctilio1;A :Ah'i linic•n( (. ∎,nti:iclnr
Laboratory ID:
Projecf# /Name:
Date Sampled:
Sampled By:
Turn- Around Time (Please check appropriate box)
4 -hour * • ❑ 24 -hour * D 3 -day
Relinquished By:
Signature:
Printed Name:
Company Name:
Time: .
Date:
Notice: Simples must be enclosed in a sealed bag or
' container. Unless otherwise requested all samples will be
disposed of five (5) working days alter analysis. You will
be contacted lr'the sample Is insuffldent in quantity for
analysts. Analysis method is in accordance with EPA
Method 600 /R -93 -116 for Polarized tight MTCroscopy.
Received By
Signature:
Printed Name:
Company Name:
Time:
Date:
Received By:
Signature:
Printed Name:
Company Name:
Time:
Date:
* Additional charges apply for 4 -hour and 24 -hour sample analysis. Please contact NOW Environmental forfurther details:
34004 9th Avenue South, Suite 12, Federal Way, WA 98003
Phone: (253) 927 -5233 FAX: (253) 924 -0323
E -mail: lnfo(enowenvironmentai.com Website: www,nowenvironmental.com
Description of Sample 11
Analysis (checlrappropriate box)
❑ Asbestos ❑ Lead ❑ Mold ❑ Other
Sampleji 11
❑ Asbestos ❑ Lead .0 Mold ❑ Other
❑ Asbestos ❑ Lead ❑ Mold ❑ Other
❑ Asbestos ❑ Lead ❑ Mold ❑ Other
❑ Asbestos 0 Lead ❑ Mold ❑ Other
❑ Asbestos ❑ Lead ❑ Mold ❑ Other
❑ Asbestos ❑ Lead ❑ Mold • ❑ Other
❑ Asbestos ❑ Lead ❑ Mold 0 Other
❑ Asbestos ❑ Lead ❑ Mold ❑ Other
O Asbestos ❑ Lead ❑ Mold ❑ Other
f❑
.
❑ Asbestos Lead ❑ Mold ❑ Other
❑ Asbestos ❑ Lead ❑ Mold ❑ Other
Relinquished By:
Signature:
Printed Name:
Company Name:
Time: .
Date:
Notice: Simples must be enclosed in a sealed bag or
' container. Unless otherwise requested all samples will be
disposed of five (5) working days alter analysis. You will
be contacted lr'the sample Is insuffldent in quantity for
analysts. Analysis method is in accordance with EPA
Method 600 /R -93 -116 for Polarized tight MTCroscopy.
Received By
Signature:
Printed Name:
Company Name:
Time:
Date:
Received By:
Signature:
Printed Name:
Company Name:
Time:
Date:
* Additional charges apply for 4 -hour and 24 -hour sample analysis. Please contact NOW Environmental forfurther details:
34004 9th Avenue South, Suite 12, Federal Way, WA 98003
Phone: (253) 927 -5233 FAX: (253) 924 -0323
E -mail: lnfo(enowenvironmentai.com Website: www,nowenvironmental.com
C DEMO ATEMENT SPECIALIST
March 1St, 2011
Henry Carnay
Attention: Henry
Subject: Good Faith Inspection Letter
Single Family Residence
13357 35th Ave S
Seattle WA
On January 21st, 2011, I Dustin Blankenship conducted a targeted assessment of suspect asbestos -
containing materials (ACM) associated with the single family residence located at 13357 35th Ave S.
Seattle WA (subject property).
The purpose of the survey was to provide information in order to meet the AHERA asbestos sampling
protocol as stated in 40 CFR 763.86. This sampling protocol is required for all asbestos surveys prior to
renovation or demolition of a building under the Puget Sound Clear Air Agency, Regulation III, Section 4.
In addition, the survey assists the building owner in meeting the "Good Faith Inspection" requirements
as stated in Washington Administrative Code 296 -62- 07721, (Communication of Hazards to Employees).
Under the regulation, the Owner of a building to be renovated or demolished must present a contractor
with a written statement whether the materials to be disturbed contain asbestos prior to submitting
bid.
Building Description:
Home is a single level residence on poured foundation with multiple layers of siding and aluminum style
windows. Roof has slight pitch with composition style roofing with multiple layers. The interior of the
home consist of wood decking flooring with multiple floor coverings. The home has two bedrooms,
living room, kitchen and bathroom. Front of residence has nob and tube electrical wiring with the back
of the house having 14 and 12 gauge wiring. Walls consisted of drywall throughout (with wood paneling
in some places).
Methods of the Survev:
A walk through inspection of the subject property was performed to identify suspect ACM. Sub- surface
suspect materials were investigated as were concealed spaces, on a limited basis as the space was
severely damaged by fire, was not properly shored at the time of inspection, and the scene had not
been fully released to investigate all units by the Redmond Fire Department.
The survey was performed following a modified sampling protocol for the demolition as outlined under
AHERA, 40 CFR 763, the Puget Sound Clean Air Agency, Regulation III, Article 4, and the State of
Washington Department of Labor and Industries WAC 296 -62 -077021. The approximate quantity of
each homogeneous material was determined by field measurements.
Materials within the building that were similar in color, texture, and date of material application were
identified as a homogenous sampling area (HSA) and recorded. Representative bulk samples from each
HSA were collected in accordance with protocols outlined in the USEPA AHERA regulations.
Sections of the material that were removed were placed in sealed containers, marked with a sample
identifier and delivered under proper chain of custody procedures to the laboratory for analysis. All
samples were taken within EPA guidelines to minimize potential contamination to the surrounding area.
Bulk sample locations, notes, and observations were made on site at the time of sampling.
A total of six (6) bulk material samples were collected and analyzed for asbestos. Samples, copies of field
the data sheet, and chain of custody submittal sheets were delivered to the laboratory for asbestos
analysis. As specified in 40 CFR Chapter I (1 -8 -87 edition) Part 763, Subpart F, Appendix A, each sample
was analyzed using polarized Tight microscopy (PLM) /dispersion staining techniques, in accordance with
U.S. EPA Method 600/M4 -82 -020. Detection limits for this type of analysis are approximately one
percent by volume. Materials containing more than one percent by volume are considered to be ACM.
Please Read:
All Discovered Asbestos Containing Material that will be disturbed as a natural part of the
renovation /demolition are to be removed and disposed of in accordance with the Washington State
Regualations. Washington State Department of tabor and Industries and PSCAA require that the
abatement be performed using Certified Asbestos Workers under the direct on -site supervision of a
Certified Asbestos Supervisor. Further CMB, suggest that an AHERHA inspector review this property
after abatement to ensure all ACM has been removed by the contractor.
Hidden wail and ceiling cavities that are not accessible during the time of the surveying can
sometimes conceal asbestos containing materials. Thus, CMB recommends that and AHERA
inspector /project manager be on sit at the time of renovation /demolition to ensure that any
potentially asbestos containing materials uncovered during the process of renovation /demolition be
dealt with and handled properly.
This site visit consisted of a thorough visual walk through of the building for the purpose of viewing
and sampling asbestos containing material. As hazardous material surveys are non - comprehensive by
nature, CMB Demo and Abatement Specialist, 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.
•
Joanna Spencer - Re: 13357 35th Ave S, Tukwila Demo D11 -054
Page 1 of 1
From:
To: Joanna Spencer
Date: 03/04/2011 2:42 PM
Subject: Re: 13357 35th Ave S, Tukwila Demo D1.1 -054
Joanna Spencer,
The water and sewer have already been capped. The home owner told me that the Valley
View Sewer District capped the sewer and WD #125 capped the water. The power was
disconnected immediately after they put the fire out. The property does not have gas. On the
plans I submitted it shows where the locations of the utilities are capped at. If you have any
more questions please let me know.
Thank you
Suzanne Breen
A Plus Removal & Recycling
116 Clay St NW #B -1
Auburn, WA 98001
206 - 730 -6448 cellular
253 - 737 -4441 office
253 - 737 -4760 fax
aplusremoval @comcast.net
Original Message
From: "Joanna Spencer" <jspencer @ci.tukwila.wa.us>
To: "Suzanne Breen <aplusremoval" <Suzanne Breen <aplusremoval @comcast.net>
Sent: Friday, March 4, 2011 1:50:15 PM
Subject: 13357 35th Ave S, Tukwila Demo D11 -054
Suzanne,
The house to demolished is in Tukwila but sewer is provided
by Valley View Sewer District @ 206 242 -3236 and water is provided
by WD #125 at (206)242 -9547.
Do you have district's approvals for water & sewer cappings?
Joanna Spencer
Development Engineer
City of Tukwila
Public Works Department
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188 -2544
phone: 206 - 431 -2440
fax: 206 - 431 -3665
jspencer@ci.tukwila.wa.us
FILE COPY
PERMANENT
DII- 054
file: / /C: \Documents and Settings \joanna.TUKWILA \Local Settings \Temp\XPgrpwise \4D... 03/04/2011
PLA
• •
R UTING SLIP
ACTIVITY NUMBER: D11 -054
PROJECT NAME: CARNAY DEMOLITION
SITE ADDRESS: 13357 35 AV S
X Original Plan Submittal
Response to Correction Letter #
DATE: 03 -03 -11
Response to Incomplete Letter #
Revision # After Permit Issued
DEPARTMENTS:
lul dins Ivi I
Public Works
t■
Air ANA- 3-21„19-t1 �- M 3 1Fire Prevention Planning Division
Structural
Permit Coordinator
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
L)z
DUE DATE: 03-08-11
Not Applicable
n
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS ROUTING:
Please Route Structural Review Required n No further Review Required
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS:
Approved In Approved with Conditions Not Approved (attach comments) n l'''
Notation:
REVIEWER'S INITIALS: DATE:
DUE DATE: 04 -05 -11
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
Documents /routing slip doc
2 -28 -02
Contractors or Tradespeople Prrier Friendly Page
1
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 A PLUS REMOVAL AND RECYLNG LLC UBI No. 602796477
Phone 2537374441 Status Active
Address 116 Clay St Nw Ste B -1 License No. PLUSRRR922CG
Suite /Apt. License Type Construction Contractor
City Auburn Effective Date 2/7/2008
State WA Expiration Date 4/5/2012
Zip 98001 Suspend Date
County King Specialty 1 General
Business Type Limited Liability Company Specialty 2 Unused
Parent Company
Other Associated Licenses
License
Name
Type
Specialty
1
Specialty
2
Effective
Date
Expiration
Date
Status
SHARPHL947P7
SHARP HOMES LLC
Construction
Contractor
General
Unused
10/27/2006
7/16/2011
Active
MICHATS01OCR
MICHAEL T SHARP
CONSTRUCTION
Construction
Contractor
General
Unused
2/19/1999
2/18/2001
Archived
CAPITHL93004
CAPITAL HOMES LLC
Construction
Contractor
General
Unused
9/24/2007
9/24/2009
Expired
MICHAT59526MMICHAELTSHARP
CONSTRUCTION
Construction
Contractor
General
Unused
1/14/2005
1/14/2007
Expired
Business Owner Information
Name
Role
Effective Date
Expiration Date
BREEM, SUZANNE
Partner /Member
02/07/2008
Bond Amount
SOHAL, HARMINDEEP
Partner /Member
02/07/2008
11/01/2008
SHARP, MICHAEL
Partner /Member
02/07/2008
04/07/2008
Bond Information
Page 1 of 2
Bond
Bond Company Name
Bond Account Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Bond Amount
Received Date
3
Coreat American Ins.
6137973
03/17/2011
Until Cancelled
$12,000.0003/21
/2011
2
CBIC
SH7192
04/26/2010
Until Cancelled
03/10/2011
$12,000.0005/03 /2010
1
CBIC
SH7192
02/05/2008
04/26/2010
02/05/2010
$6,000.0002/07/2008
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information
Insurance
Company Name
Policy Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Amount
Received Date
4
Starr Surplus
Lines Insurance
SLSLEIL72016211
02/05/2011
02/05/2012
$1,000,000.0002
/01/2011
3
STARR
INDEMNITY &
LIBILITY
SISLEIL72011410
02/05/2010
02/05/2011
$1,000,000.0002
/05/2010
2
ATLANTIC CAS
INS CO
L0710028531
02/02/2009
02/05/2010
$1,000,000.0002
/09/2009
1
ATLANTIC CAS
INS CO
AC1196824
02/05/2008
02/05/2009
$1,000,000.0002
/07/2008
Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period
https://fortress.wa.gov/lni/bbip/Print.aspx
03/21/2011