Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Permit MI01-186 - DOAK HOMES - LOT 29 - DEMOLITION
DOAK HOMES L0T29 MIO1186 City of !ukwi1a Department of Community Development / 6300 Southcenter 8L, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 MISCELLANEOUS PERMIT Parcel No.: 0179000150 Address: 12247 43 AV S TUKW Suite No: Tenant: Name: DOAK HOMES INC - LOT 29 Address: 12247 43RD AVENUE SOUTH, TUKWILA, WA Owner: Name: DOAK HOMES INC Address: 11917 4 AV SW, SEATTLE WA Contact Person: Name: DARRYL DOAK Address: 11917 4 AV SW, SEATTLE WA Contractor: Name: DOAK HOMES INC. Address: 11917 4TH AVENUE S.W., SEATTLE, WA Contractor License No: DOAKHI *092NZ Permit Number: MI01.186 Issue Date: 02/07/2002 Permit Expires On: 08/06/2002 Phone: Phone: 206-571-2280 Phone: 206 246-6587 Expiration Date: 08/01/2003 DESCRIPTION OF WORK: DEMOLITION OF HOUSE AT 12247 43RD AV S. NEW HOME TO BE CONSTRUCTED. PW activities Include inspection of water supply and sanitary sewer capping. Value of Construction: Type of Fire Protection: Type of Construction: $6,000.00 Fees Collected: $71.50 Uniform Building Code Edition: 1997 Occupancy per UBC: 0007 Pubik Works Activities: Curb Cut /Access/Sldewalk/CSS: N Fire Loop Hydrant: N Flood Control Zone: N Hauling: N Land Altering: N Landscape Irrigation: N Moving Oversize Load: N Sanitary Side Sewer: Y Sewer Main Extension: N Storm Drainage: N Street Use: N Water Main Extension: N Water Meter: Channelization / Striping: Number: 0 Size (Inches): 0 Start Time: End Time: Volumes: Cut 0 c.y. Fill 0 c.y. Start Time: End Time: Public: Private: Private: ** Continued Next Page ** Public: doc: Miscperm MI01.186 Printed: 02.07.2002 City of ukwi1a Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 Permit Center Authorized Signature: Date: et- ,1'1902 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 mechanical permit. Signature: Print Name: Date: This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or If the work is suspended or abandoned for a period of 180 days from the last Inspection. doc; Mc :perm MI01.186 Printed: 02.07.2002 City of 'iukwila Department of Community Development / 6300 Southcenter SL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 Parcel No.: 0179000150 Address: 12247 43 AV S TUKW Suite No: Tenant: DOAK HOMES INC - LOT 29 PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: MI01 -186 ISSUED 11/00/2001 02/07/2002 1: Disconnected side sewers which will be reconnected in the near future shall be capped at the property line. Disconnected water supply which will be reconnected in the near future shall be capped at the water meter. 2: No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division. 3: All construction to be done in conformance with approved plans and requirements of the Uniform Building Code (1997 Edition) as amended, Uniform Mechanical Code (1997 Edition), and Washington State Energy Code (1997 Edition). 4: Validity of Permit. The issuance of a permit or approval of plans, specifications, and computations shall not be con- strued to be a permit for, or an approval of, any violation of any of the provisions of the building code or of any other ordinance of the Jurisdiction. No permit presuming to give authority to violate or cancel the provisions of this code shall be valid, 5: All permits, Inspection records, and approved plans shall be available at the job site prior to the start of any con- struction. These documents are to be maintained and avail- able until final Inspection approval is granted. 6: CONTRACTOR SHALL NOTIFY PUBLIC WORKS UTILTIY INSPECTOR MR. GREG VILLANUEVA 0 (206)433.0179 OF COMMENCEMENT AND COMPLETION OF WORK AT LEAST 24 HOURS IN ADVANCE. 7: 8: CLEAN AND REMOVE DEBRIS FROM CITY CATCH BASIN IN AND AROUND HAULING ROUTES. 9: Any septic tanks in the area shall be pumped empty and removed or filled with sand. A copy of documentation from the business that performed the pumping shall be provided to the City Utilities Inspector, 100 Abandoned side sewers shall be capped at the main. 11: Any material spilled onto any street shall be cleaned up immediately, 12: I hereby certify that I have read these conditions and will comply with them as outlined. All provisions of law and ordinances governing this work will be complied with, whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provision of any other work or local laws regulating construction or the performance of work, Signature: Print Name: doc: Conditions MI01.186 Printed: 02.074Q02 CITY OF T" 'KWILA Permit Center 6300 Southcenter Boulevard, Suite 100 Tukwila, WA 98188 (206) 431 -3670 Miscellaneous Permit Application Application and plans must be complete in order to be accepted for plan review. Applications will not be accepted through the mail or facsimile. Project ame/Tenant: - 14: /444,4 /A /C. Description of work to be done (please be specific): rewto %',i/i e , 4 04- ,' "A 7L /2 2 yi 7 -. 19 3,,44/2 a , 5' e"4'/f4 /1,t0w /i vrn e >40 GQ r 1"*wc/'':" , Value of Construc0c9: 6'9c'0 Site Ad ress 1 2- 2 '/ 7 9 3,-d4-6>e 5 City Sate /Zip: r4, ez,eX .. Tax Parcel Number: . 0 i 7pee, c' i LCO -- oL,..., Phone: ( 20 ..-Z "6 - 6-5--Y-7 Property e d w / /�t il Adtl►ois: • ater 1 11-0 C City /S ite/hip: Street Address: -- G *e>.e .S' CC, Cit State/Zip: 5' ' ,rte - 'r; / Fax #: ( ) siyt -,°1cP i Contractor: 7/2/A Q ` Phone: ( ) Street Address: City State/Zip: Fax 11: ( Architect: 4/ ' Phone: ( ) Street Address: City State/Zip: Fax #: ( ) Engineer: Phone: ( ) Street Address: , , , City State/Zip: Fax II: ( Canf Person: Street Address. ` " /� �y - G r C�itty State/Zip: /..r 6 Fax Si: ( ) MISCELLANEOUS PERMIT REVIEW AND APPROVAL RE UESTED: (TO RE FILLED OUT BY APPLICANT) Description of work to be done (please be specific): rewto %',i/i e , 4 04- ,' "A 7L /2 2 yi 7 -. 19 3,,44/2 a , 5' e"4'/f4 /1,t0w /i vrn e >40 GQ r 1"*wc/'':" , Will there he storage of flarnmable/combustible hazardous material in the building? ❑ yes no Atta chh list of materials and flora a Iocai!w an se ilrate 8 1/2 X 11 Hi iy'r indikatln uantities & Material Safettlata Sheets t..� Above Ground Tanks Antennas/Satellite Dishes Bulkhead /Docks Commercial Reroof Demolition ❑ Fence ❑ M;muforturt:d 1-10thilitilepldeemont only Parking Lots ❑ Retalnin Walls ❑ Tem orwi, Facilities U Tree Cuitln, APPLICANT REQ UEST FOR MISCELLANEOUS PUBLIC WORKS PERMITS Channelizittiott/Slriping ❑ Flood Control Zone ❑ Landscape Irrigation ❑ Storm Drainage ❑ Water Meter /Exempt ❑ Water Motor /Permanent 1 ❑ Water Meter Temp 0 ❑ Miscellaneous Curb cut/Acceis/SIdewalk L_! Fire Lou)i/I (ydr.int (main to vaull)N: Size(s): ❑ Land Altering: 0 Cut cubic yards 0 Fill cubic yards 0 _in, ft,gratling/eloaring ❑ Sanitary side Sower N: ❑ Sewer Main Extension Private 0 Public ❑ Street Use ❑ Water MAtin Extension 0 Private 0 Public Size(s): 0 Deduct 0 Water Only Site(s): .-,,_ ___ Slio(i): Est, quantity: gal j Move;; Oversized Load /I tattling Schedule: MONTI FLY SERVICE RULINGS TO: Name: Phone' i' >- Adtl►ois: • ater .a-G' d►r,.# • . ,.-© "ewer Avefr x, City /S ite/hip: r'"Q Metro '-'0 Standby WATER METER DEPOSIT /REFUND HILLINC: Name: Address: Phone: Liiv/SIate/ZIP: h. Value of Construction - In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject to possible revision by the Permit Center to comply with current fee schedules. Expiration of Plan Review 'Applications for which no permit is issued within 180 days following the date of application shall expire by limitation. The building official may extend the time for action by the applicant for a peiiod not exceeding 180 days upon written request by the applicant as defined in Section 107.4 of the Uniform Building Code (current et ition). No application shall be extended more than once. Date applicat jp_ accepted: 9/9/99 mis<<uottlor 1 Date application'? Applicatir ti (initials) Al l MIS(_ 111 ANT OHS Pf RMII APP11( A LIONS Mt/S1 III SUBMIT if D Wllll Tll f ()HOMING: D ALLD RAVINGS SHALL BE AT A LEGIBLE SCALE AND NEATLY DRAWN * D BUILDING SITE PLANS AND UTILITY PLANS ARE 70 BE COMBINED > ARCHITECTURAL DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED ARCHITECT > STRUCTURAL CALCULATIONS AND DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED STRUCTURAL ENGINEER > CIVIIJSITE PLAN DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED CIVIL ENGINEER (P.E.) • :it . • ❑ Current copy of Washington State Department of Labor and Industries Valid Contractor's License, If not available at the time of application, a copy of this license will be required before the permit is issued, unless the homeowner will be the builder OR submit Form H -4, "Affidavit in Lieu of Contractor Registration ". Rullding Owner /Authorized Agent If tho applicant Is other than the owner, registered architect/engineer, or contractor licensed by the State of Washington, a notarized letter from the property owner authorizing the agent to submit this permit appl /cation and obtain the permit will bo required as part of this submittal. 1 NERDY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO HE TRUE UNDER PENALTY OF PENURY 811 THE L.4WS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. WILDING OWN R OR A ti(R iI! , \l'I'I I( AIION ANI) RI(1t)IRI1) ( III( KIISIS IOK I'ER.titII REVIEW Submit checklist No: M -9 Above Ground Tanks/Water Tanks - Supported directly upon grade exceeding 5,000 gallons and a ratio of height to diameter or width which exceeds 2:1 ❑ Antennas /Satellite Dishes Submit checklist No: M -1 ❑ Bulkhead /Dock Submit checklist No: M -10 ❑ Commercial Reroof Submit checklist No: M -6 Fax H: (r�/i4.�,�-u - Demolition Submit checklist No: M -3 ❑ Fences - Over 6 feet in Height Submit checklist No: M -9 ❑ Land Altering/Grading/Preloads Submit checklist No: M -2 ❑ Miscellaneous Public Works Permits Submit checklist No: H -9 ❑ Manufactured Housing (RED INSIGNIA ONLY) Submit checklist No M -5 ci Moving Oversized Load /Hauling '= ' Submit checklist No: M -5 ❑ Parking Lots Submit checklist No: M-4 ❑ Retaining Walls - Over 4 feet in height Submit checklist No: M -1 ❑ Temporary Facilities Submit checklist No: M -7 Tree Cutting Submit checklist No: M -2 ❑ Current copy of Washington State Department of Labor and Industries Valid Contractor's License, If not available at the time of application, a copy of this license will be required before the permit is issued, unless the homeowner will be the builder OR submit Form H -4, "Affidavit in Lieu of Contractor Registration ". Rullding Owner /Authorized Agent If tho applicant Is other than the owner, registered architect/engineer, or contractor licensed by the State of Washington, a notarized letter from the property owner authorizing the agent to submit this permit appl /cation and obtain the permit will bo required as part of this submittal. 1 NERDY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO HE TRUE UNDER PENALTY OF PENURY 811 THE L.4WS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. WILDING OWN R OR A THORIZED AGEN i Signature: .• .0/ lir Data :// „_ 0/0 Print name: l : ` Phone :�0, t2 et "'fi S' 7 Fax H: (r�/i4.�,�-u - Address: i City / it): *MY afi1;pnu.u:uc *�M * # *. * ***** * *#i1#: k* * * * * ** * **A * * # * *likk * * * *A k* ***** ** Y OF TUKWILA WA TRANSMIT ****************** i******** Akk * *****4A **h ** * * * * *A * *k * * *k * ** 4NSMIT Number: 80101422 Amount: 51.50 11/08/01 11:52 iyment Method: CHECK Notet lon: DARRYL DOAK, SR !nit: SKS Permit No: M/01•186 Type: MISCPERM MISCELLANEOUS PERMIT Parcel No: 017900 -0140 Site Address : 12247 43 AV S Total Fees: 51.50 T fiat Payment 51.50 Total ALL Pmts: 51.50 Balance* .00 kk *400.* ***4 r#* ** **AA* Atir***** *** ** *A * * * * *AAAAk **AAA**A* * *A**** Acoount Code Description Amount 000/322.100 BUILDING - N0NRES 47.00 000/386.904 STATE BUILDING SURCHARGE 4.50 L City of Tukwila 6300 Sauthcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 Parcel No.: Address: Suite No: Applicant: Receipt No.: Initials: User ID: 0179000150 12247 43 AV S TUKW DOAK HOMES INC - LOT 29 8020000180 SKS 1165 RECEIPT Permit Number: Status: Applied Date: issue Date: M101.186 APPROVED 11/08/2001 Payment Amount: 20.00 Payment Date: Balance: 02/07/2002 12:08 PM $0.00 Payee: DOAK HOMES TRANSACTION LIST: Type Amount Method Description Payment Chock 1504 ACCOUNT ITEM LIST: Current Pmts Description 20.00 Account Code IN3P FEE - SME /SSS 402/342.400 20.00 Total: 20.00 575 02/08 9716 TOTAL 20.00 Printed: 02.074002 doe: Receipt INSPECTION RECORD Retain a copy with permit INSPECTION NO CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd, #100, Tukwila, WA 98188 Project: PERMIT NO (206)431-3670 T e of Inspection: Special Instructions: 1 pester: Approved per applicable codes. 0 Corrections required prior to approval. COMMENTS: • Ins pi- ctor. ANN Date: 1 IA_ 0 2 Prior to inspection, fee must be paid 147.00 REINSPECTION FEE REQUIRED. . tr `at 6300 Southcenter blvd., Suite 100, Cal) to schedule reins Date; ection, • •• INSttCiI0N NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd, #100, Tukwila, WA 98188 INSPECTION RECORD Retain a copy with permit PERMtr NO (206)431.3670 ., Pro Type of Inspection: A, dress: 1_. ..4 Date called: 2 Specie instructions: Date want .; 1 1 a, M, v� :' ° p.m. Requpster: . P.o: ,c71 2.2-5/0 AEl Approved per applicable codes. 555 0 Corrections required prior to approval. COMMENTS: • visommi rl Inspector: Date: 647,00 REINSPECTION FEE REQUIRED, Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reins'ection. Receipt No; Date; 1 • • 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 •ii Asbestos 5 u rvey 12247 43rd Avenue South Tukwilla, WA t, HAZARDOUS MATERIALS SERVICES MANAGEMENT TRAINING SERVICES Rv NYL LABORATORIES INC www.nvllaba.com munafC nvllabs.com 1.888.NVL.LABS (685.5227) 4708 AURORA AVE. N. SEATTLE. WA 98103 2 i-W L ft I 00 2W w u. 8 W O w �o t w W�_ r rr, riaj ran L A B S HAZARDOUS MATIRIALS SURVICSS FILE COPY 4,1.4 71, 4, !rl .. lif4AA'!• 0.9.4117.0 `I Asbestos Survev 12247 43rd Avenue South Tukwilla, WA Date Prepared October 30, 2001 Prepared for: Darryl Doak Doak Homes Inc. 11917 4th Avenue Southwest Seattle, WA 98148 Prepared By: Building Inspector Cert. #: Expiration Date: Date Inspected: Project #: Lisa Kollasch 998518 April 27, 2002 October 24, 2001 2001 -1078 12247 43rd Avenue South, TukwUla, Washington 2001 -1018 TABLE OF CONTENTS Subject 1.0 SCOPE OF WORK 2.0 SURVEY METHOD 3.0 LABORATORY INFORMATION 4.0 BUILDING DESCRIPTION 5.0 FINDINGS 6.0 CONCLUSIONS AND RECOMMENDATIONS 7.0 LIMITATIONS OF SURVEY APPENDICES Page 1 2 3 04 7 Sample Locations (Map) A Laboratory Results B AHERA Certifications & Laboratory Qualifications C 12247 43rd Avenue South, Tukwilia, Washington 2001 -1078 1.0 SCOPE OF WORK An investigative survey for asbestos containing materials (ACM) was conducted on a residential structure located at 12247 43rd Avenue South, Tukwilla, Washington. The inspection was conducted on October 24, 2001 by Lisa Ko!leach, an AHERA certified building inspector. This inspection was performed at the request of Darryl Doak of Doak Homes Inc. There was no access to basement crawlspace at time of this survey, The purpose of this inspection was to identify asbestos containing materials that would be impacted by the planned demolition of this structure, The asbestos survey section is written to comply with the AHERA asbestos sampling procedure as stated in 40 CFR 763,88. This protocol is required for all asbestos surveys prior to a building demolition under the Puget Sound Clean Air Agency, (PSCAA), Regulation III, and revised February 12, 1998. The asbestos survey also satisfies the "Good Faith" asbestos Inspection requirements as stated In Washington Administrative Code (WAC) 298.82- 07221(2), "identification ", As stated in this regulation, the owner of a structure scheduled to be renovation /demolished must provide a contractor with a written report of the asbestos containing materials to be disturbed during renovation /demolition, The National Emission Standards for Hazardous Air Pollutants (NESHAP), 40 CFR Part 61 requires a survey by an accredited asbestos Inspector prior to demolition of a structure, A floor sketch Indicating sampling locations has been Included in Appendix A. NVL Laboratories, Inc., 4708 Aurora Avenue North, Seattle, WA 98103 Ph (206) 547.0100 • Fx (206) 6341936 Pane 1 i 12247 43rd Avenue South, Tukwilla, Washington 2001 -1078 2.0 SURVEY METHOD Asbestos Survey Method A walk- through inspection of all accessible areas of this structure was performed to identify potential asbestos - containing materials. The walk- through inspection included a review of the internal and external aspects of this structure. The locations and types of potential asbestos containing materials were noted. Sufficient bulk samples of building materials (vinyl floor tile, roofing, well materials, etc.) were obtained of each material to satisfy the requirements of the Asbestos Hazard Emergency Response Act (AHERA) rules and regulations, These samples were placed into plastic sample bags, numbered and recorded. Homogeneous Materials Homogeneous materials are defined as an area of Asbestos- Containing Material (ACM) or Presumed Asbestos - Containing Material (PACM) which appears similar throughout in terms of color, texture, and date of material application. The report listing for homogenous materials will appear as follows: Sample Number Material Descrlption white floor the Location Asbest os % Area f e) Friable (yeslno) ob# -01.01 kitchen ob# -01 -02 white floor tile kitchen ob *01.03 white floor tale kitchen Under OSHA Guidelines, a minimum of three negative analysis of a single suspect homogeneous asbestos containing material is required to prove a negative result for surfacing materials and thermal system insulation. NVL Laboratories, Inc., 4708 Aurora Avenue North, Seattle, WA 98103 Ph (206) 547-0100 • Fx (206) 634 -1936 Page 2 12247 43rd Avenue South, Tukwllia, Washington 2001 -1078 3.0 LABORATORY INFORMATION Laboratory Analysis -- Asbestos Samples are analyzed in our laboratory using polarized light microscopy (PLM) with dispersion staining. If samples are not homogeneous, then subsamples of the components were analyzed separately. All Bulk samples are analyzed using EPA Method 600 /R- 93/116 with the following measurement uncertainties for reported % Asbestos (1%=0-3%, 5 %= >1 -9 %, 10 %= 5 -15 %, 20 % =10 -30 %, 50 % =40 -60 %). For samples containing more than one separable layer of materials, the report will include findings for each layer (labeled Layer: 1, Layer: 2, etc.). The asbestos concentration in the sample is determined by visual estimation. Laboratory Accreditation Professional accreditations for NVL Laboratories, Inc., include the following: NVL Laboratories, Inc., is currently accredited by the National Institute of Standards and Technology (NIST) under the National Volunteer Laboratory Accreditation Program ( NVLAP) program for bulk asbestos fiber analysis. NVLAP Lab Code 102063.0, NVL Laboratories, Inc., is approved by the American Industrial Hygiene Association (AIHA) Asbestos Analysts Registry (AAR) program for airborne asbestos fiber analysis. Counter ID 7412. NVL Laboratories, Inc., is currently accredited by the American Industrial Hygiene Association (AIHA) under the Industrial Hygiene Laboratory Accreditation Program ( IHLAP). The IHLAP program is designed specifically for laboratories Involved In analyzing samples to evaluate workplace exposure. Certification Number 563. NVL Laboratories, Inc,, 4708 Aurora Avenue North, Seattle, WA 98103 Ph (208) 547 -0100 • Fx (206) 634.1836 Page 3 12247 43rd Avenue South, tukwifia, Washington 2001-1078 4.0 BUILDING DESCRIPTION General Building type: This is a two story single - family residence with a detached carport. Primary external components: The primary external components are concrete and horizontal wood siding. Type of foundation: There is a concrete perimeter with post and pier. Roofing materials: The roof is 3 -tab asphalt, Window types: There are aluminum window frames with no putty and wood windows with putty. Flooring: The substrate is wood with carpet, sheet vinyl and vinyl tile, Thermal systems wlinsulation type: There is electric baseboard heating, No suspect thermal insulation was noted on piping. Finishing: There is wood paneling and stucco. NVL Laboratories, Inc., 4708 Aurora Avenue North, Seattle, WA 98103 Ph (206) 547.0100 ' Fx (206) 634.1936 Page 4 J j J J 12247 43rd Avenue South, 7ukwille, Washington 2001 -1078 5.0 FINDINGS Inventory of Suspect Asbestos- Containing Materials Sample Number Material Description Location Asbestos ( %) Area (ft) Friable yes /nod 2001 -1078- 1 -1 1- brown sheet vinyl 2- mastic northeast bedroom, closet floor 1:ND 2:ND 2001 -1078- 1 -2 1- brown sheet vinyl 2- mastic northeast bedroom, closet floor 1:ND 2:ND 2001 -1078- 1- textured wall living room 1:ND 2 -1 _ 2- mastic 2 :ND 2001 -1078- 1- textured wall living room 1:ND _- a. -_ 2- 2 2- mastic 2:ND 2001 -1078- popcorn ceiling living room 3 __._. -186 yes 3-1 2001 -1078- popcorn ceiling living room 3 3 -2 ,.�. 2001 -1078- popcorn ceiling living room 3 3 -3 2001 -1078- 1- white vinyl the laundry room 1 :3 190 no 4 -1 2- allow mastic 2:ND 2001 -1078- 1 -white vinyl file laundry room 1:3 4 -2 2- allow mastic 2 :ND 2001 -1078- 1 -brown shoot first floor, base of stairwell 1:ND 5.1 vinyl 2:ND 2- yellow mastic 2001 -1078- 1 -brown sheet first floor, base of stairwell 1 :ND 5.2 vinyl 2:ND . 2- allow mastic 2001.1078- 1 -tan sheet vinyl _ _ bathroom floor 1:ND 8 -1 2- backing /mastic 2:ND 2001.1078 - _ 1- tan sheet vinyl bathroom floor 1:ND 8.2 2- backin • /mastic 2:ND 2001 -1078- 1- tan laminate second floor, ceiling 1:ND T -1 2- • ra backing 2 :ND 2001.1078- 1- tan laminate ' second floor, ceiling 1:ND 7 -2 2- ra backin_ . 2:ND 2001 -1078- window putty south ND 8.1 2001 -1078• window putty northeast 2 5 yes 84 windows 2001 -1078- 1- 3 -tab asphalt house roof 1:ND 9 -1 2- 3 -tab asphalt 2 :ND 2001 -1078 1- 3 -tab asphalt house roof 1:ND 9 -2 2- 3 -tab asphalt 2:ND ND w- None Detected NVL laboratories, Inc., 4708 Aurora Avenue North, Seattle, WA 98103 Ph (206) 547 -0100 • Fx (206) 634-1936 Page 5 1§. 12247 43rd Avenue South, Tukwilia, Washington 2001 -1078 Asbestos - continued Sample Number Material Description Location Asbestos ( %) Area (ft2) Friable (yes /no) 2001 -1078- concrete /mortar/ house exterior, south ND 1.0 -1 paint 2001 -1078- concrete /mortar/ house exterior, south ND 10 -2 • aint 2001 -1078- vapor barrier paper house exterior, under ND _11 -1 horizontal wood siding 2001 -1078- vapor barrier paper house exterior, under ND 11 -2 horizontal wood sidin. 2001 -1078- rolled asphalt carport roof ND 12 -1 2001 -1078- roiled asphalt carport roof ND 12 -2 ND - None Detected Any suspect material(s) not identified above should not be disturbed, and tested immediately, The suspect material must be treated as asbestos containing until testing proves otherwise, NVL Laboratories, Ino„ 4708 Aurora Avenue North, Seattle, WA 98103 Ph (206) 647.0100 • Fx (206) 634 -1936 Page 6 12247 43rd Avenue South, Tukwilia, Washington 2001-1078 6.0 CONCLUSIONS AND RECOMMENDATIONS ASBESTOS The following summarizes the homogeneous Asbestos - Containing Materials (ACM) and Presumed Asbestos - Containing Materials (PACM) identified at the residential structure located at 12247 43rd Avenue South, Tukwilla, Washington. 1. Popcorn Ceiling: (material number 2001-1078-3) There is approximately 180 fe of asbestos- containing popcorn ceiling in the first floor living room. 2. White 12 "x12" Vinyl Tile: (material number 2001. 1078.4) There is approximately 190 ft2 of asbestos - containing white 12 "x12" white vinyl floor tile in the kitchen and laundry room. The associated yellow mastic did not test positive for asbestos. The substrate is wood. 3. Window Putty: (material number 2001 - 1078.8) There are 6 windows with asbestos - containing putty associated with this residence. If discovered, all ACMs that will be disturbed as a natural part of renovation /demolition and are required to be removed and disposed of in accordance with Washington State Regulations. Washington State Department of Labor and Industries and PSCAA require that the abatement be performed using Certified Asbestos Workers under the direct on -site supervision of a Certified Asbestos Supervisor. Further, NVL suggests that an AHERA inspector review this property after abatement to ensure all ACM has been removed by the contractor. Hidden wall and ceiling cavities that are not accessible during the time of surveying can sometimes conceal ACM. Thus, NVL recommends that an AHERA Inspector /proJect manager be on site at the time of renovation /demolition to ensure that any potentially asbestos - containing materials uncovered during the process of renovation /demolition be dealt with properly, NVL Laboratories, Inc., 4706 Aurora Avenue North, Seattle, WA 88103 Ph (206) 647.0100 • Fx (206) 634.1836 Page 7 12247 43rd Avenue South, Tukwilla, Washington 2001 -1078 7.0 LIMITATIONS OF SURVEY The sole purpose of this survey report is to document asbestos - containing materials discovered in the survey of suspect materials by NVL Laboratories personnel at the residential structure located at 12247 43rd Avenue South, Tukwilla, WA on October 24, 2001. This site visit consisted of a thorough visual walk - through of the building for the purpose of viewing and sampling potential ACMs. As hazardous material surveys are non - comprehensive by nature, NVL Laboratories, Inc., cannot be held liable for materials which require destructive means to access, materials which are hidden from sight (e.g. materials hidden behind walls), materials which cannot be found due to their obscure nature, or which otherwise cannot be discovered with reasonable diligence, This document is the sole property of NVL Laboratories and the property owner, or his agent, authorizing this survey, Inspected by: Lien Kollnsch AHERA Building Inspector AHERA Certification No.: 998518 AHERA Certification Expires on: Aprll 27, 2002 Reviewed by: Benjamin T. Cook, CHMM Hazardous Materiels Specialist Certified Hazardous Materials Manager NVL. Laboratories, Inc., 4708 Aurora Avenue North, Seattle, WA 98103 Ph (206) 547.0100 • Fx (206) 634.1936 Page 8 s -. t i i NVL Laboratories, Inc. 4708 Aurora Ave. N., Seattle, WA 98103 Bulk Asbestos Fiber Analysis Tel: 206.547.0100 Pax; 206.634.1936 NVLAP #102063 Client: NVL Field Services Division Address: 4708 Aurora Ave. N. Seattle, WA 98103 Attn.: Ms. Lisa K. Project: 12247 43rd Ave. 5., Seattle NVL Batch Number: 21- 11897.00 Client Project #: 2001 -1078 Number of samples: 25 Lab ID #: 21106188 Client Sample #: 2001 - 107844 Sample Location: 12247 43rd Ave. S., Seattle Description: LAYER 1: Brown vinyl material, LAYER 2: Black fibrous asphaltic material with mastic OTHER FIBROUS MATERIALS: LAYER 1: Cellulose 1% LAYER 2: Cellulose 60% NON- FIBROUS MATERIALS: LAYER 1: Vinyl /binder LAYER 2: Binder & filler, Asphalt /binder, Mastic /binder ASBESTOS TYPE: PERCENT LAYER 1: *None Detected ND LAYER 2: *None Detected ND Lab ID #: 21106189 Client Sample #: 2001- 1078 -1 -2 Sample Location: 12247 43rd Ave. S., Seattle Description: LAYER 1: Brown vinyl material, LAYER 2: Black fibrous asphaltic material with rntmtie OTHER FIBROUS MATERIALS: LAYER 1; Cellulose 1% LAYER 2: Cellulose 60% Lab ID #s 21106190 NON - FIBROUS MATERIALS: LAYER 1: Vinyl /binder LAYER 2: Binder & filler, Asphalt /binder, Mastic /binder ASBESTOS TYPE: PERCENT LAYER 1: *None Detected ND LAYER 2: *None Detected ND Client Sample #: 2001. 1078.2.1 Sample Location: 12247 43rd Ave. S., Seattle Description: LAYER 1: Tan sandy brittle material with paint, LAYER 2: Gray fibrous material with mastic OTHER FIBROUS MATERIALS: LAYER 1; Cellulose 3% LAYER 2: Cellulose 65% NON - FIBROUS MATERIALS: LAYER 1; Binder & filler, Granules, Paint LAYER 2; Binder & filler, Mastic /binder Sampled by: Lisa Kollasch of NVL Lab. Analyzed by: Wei Long Tai Date: 10/26/2001 Reviewed by: Nick Ly Date: 10/26/2001 1---7;a01: Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. y AI sam • es 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 samples were 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 U.S. Government. Page 1 r NVL Laboratories, Inc. 4708 Aurora Ave. N., Seattle, WA 98103 Bulk Asbestos Fiber Analysis Tel: 206.547.0100 Fax: 206.634.1936 NVLAP #102063 ti Client: NVL Field Services Division Address: 4708 Aurora Ave. N. Seattle, WA 98103 Attn.: Ms. Lisa K. Project: 12247 43rd Ave. S., Seattle NVL Batch Number: 21- 11897.00 Client Project «: 2001 -1078 Number of samples: 25 ASBESTOS TYPE: PERCENT LAYER 1: *None Detected ND LAYER 2: *None Detected ND Lab ID #: 21106191 Client Sample #: 2001 - 1078 -2 -2 Sample Location: 12247 43rd Ave. 5,, Seattle Description: LAYER 1: Tan sandy brittle material with paint, LAYER 2: Cray ftbrnus material with mastic OTHER FIBROUS MATERIALS: LAYER 1: Cellulose 3% LAYER 2: Cellulose 65% NON- FIBROUS MATERIALS: LAYER 1: Binder & filler, Cranulus, Paint LAYER 2: Binder & filler, Mastic /binder ASBESTOS TYPE: PERCENT LAYER 1: *None Detected ND LAYER 2: *None Detected ND Lab ID #: 21106192 Client Sample #: 2001- 1078.3.1 Sample Location: 12247 43rd Ave, 5,, Seattle Description: Tan lumpy foamy material with paint OTHER FIBROUS MATERIALS: Cellulose 4% NON - FIBROUS MATERIALS: Binder & filler, Paint ASBESTOS TYPE: PERCENT Chrysotile 3% ■11111■11111•1•11■W 4111111! Lab ID #: 21106193 Client Sample #: 20014078.3 -2 Sample Location: 12247 43rd Ave. S., Seattle Description: Tan lumpy foamy material with paint OTTIER FIBROUS MATERIALS: Cellulose 4% NON - FIBROUS MATERIALS: Binder & filler, Paint (Sample results are continued on the next page.) Sampled by: Lisa Kollasch of NVL Lab. Analyzed by: Wei Long Tai Date: 10/26/2001 Reviewed by: Nick Ly Date: 10/26/2001 Sri /�rI��► Nick nical D _ � ___ i Note; If samples are not homogeneous, then subsamples of the components were analyzed separately.— A1tbut *nip es 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 samples were 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 net be used to claim product endorsement by NVLAP or any other agency of the U.S. Government. Page 2 NVL Laboratories, Inc. 4708 Aurora Ave. N., Seattle, WA 98103 Bulk Asbestos Fiber Analysis Tel: 206.547.0100 Fax: 206.634.1936 NVLAP #102063 Client: NVL Field Services Division Address: 4708 Aurora Ave. N. Seattle, WA 98103 Attn.: Ms, Lisa K. Project: 12247 43rd Ave. 5., Seattle ASBESTOS TYPE: Chrysotile NVL Batch Number: 21- 11897.00 Client Project #: 20014078 Number of samples: 25 PERCENT 3% Lab ID #: 21106194 Client Sample #: 20014078 -34 Sample Location: 12247 43rd Ave. S., Settle Description: Tan lumpy foamy material with paint OTHER FIBROUS MATERIALS: Cellulose 4% NON - FIBROUS MATERIALS: Hinder & filler, Paint ASBESTOS TYPE: PERCENT Chrysotile 3% Lab ID #: 21106195 Client Sample #: 2001 - 1078.4 -1 Sample Location: 12247 43rd Ave. S., Seattle Descriptions LAYER 1: Tnn vinyl tiler, LAYER 2: Yellow mastic OTHER FIBROUS MATERIALS: LAYER 1: Cellulose 1% LAYER 2: Cellulose 4% NON - FIBROUS MATERIALS: LAYER 1: Vinyl /binder LAYER 2: Mastic/binder ASBESTOS TYPE: PERCENT LAYER 1: Chrysotile 3% LAYER 2: *None Detected ND Lab ID #: 21106196 Client Sample #: 2001- 1078.44 Sample Location: 12247 43rd Ave. S., Seattle Descriptions LAYER 1: Tan vinyl tile, LAYER 2: Yellow mantic OTHER FIBROUS MATERIALS: LAYER 1: Cellulose 1% LAYER 2: Cellulose 4% ASBESTOS TYPE: NON - FIBROUS MATERIALS: LAYER 1: Vinyl /binder LAYER 2: Mastic /binder PERCENT (Sample results are continued on the next page.) Sampled by: Analyzed by: Reviewed by: Lisa Kollasch of NVL Lab. Wei Long Tai Date: 10/26/2001 Nick Ly Date: 10/26/2001 rAlp c �f�echnical �; • r Note; If samples are not homogeneous, then subsamples of the components were analyzed separately. All • ulk 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 %= 545 %, 20 %= 10 -30 %, 50 %= 40.60%). This report relates only to the items tested. If samples were 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 U.S. Government. Page 3 ri 1 NVL Laboratories Inc. 4708 Aurora Ave. N., Seattle, WA 98103 Bulk Asbestos Fiber Analysis Tel: 206.547.0100 Pax: 206.634.1936 NVLAP #102063 Client: NVL Field Services Division Address: 4708 Aurora Ave. N. Seattle, WA 98103 Attn.: Ms, Lisa K, Project: 12247 43rd Ave. 5,, Seattle NVL Batch Number: 21- 11897.00 Client Project #: 2001 -1078 Number of samples: 25 LAYER 1: Chrysolite LAYER 2: *None Detected 3% ND Lab ID #: 21106197 Client Sample #: 20014078 -54 Sample Location: 12247 43rd Ave. S., Seattle Description: LAYER 1: Yellow sheet vinyl, LAYER 2: Yellow mastic OTHER FIBROUS MATERIALS: LAYER 1: "None Detected LAYER 2: Cellulose 6% NON - FIBROUS MATERIALS: LAYER 1: Vinyl /binder LAYER 2: Mastic/binder ASBESTOS TYPE: PERCENT LAYER 1: *None Detected ND LAYER 2: *None Detected ND Lab ID #: 21106198 Client Sample #: 2001-1078-5-2 Sample Location: 12247 43rd Ave. S., 8entt1v Description: LAYER 1: Yellow sheet vinyl, LAYER 2: Yellow MIMIC OTHER FIBROUS MATERIALS: LAYER 1: "None Detected LAYER 2: Cellulose 6% NON - FIBROUS MATERIALS: LAYER 1: Vinyl /binder LAYER 2: Mastic /binder ASBESTOS TYPE: PERCENT LAYER 1: ''None Detected ND LAYER 2: *None Detected ND (Sample results are continued on the next page.) Sampled by: Lisa Ko11asch of NVL Lab. Analyzed by: Wei Long Tai Date: 10/26/2001 Reviewed by: Nick Ly Date: 10/26/2001 ■ Note: If samples are not homogeneous, then subsamples of the components were analyzed separately, —All-bu - • p es 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%, 509:, = X10.60 %). This report relates only to the items tested. If samples were 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 U.S. Government. Page 4 rprzdivor is eehni ire • r it NVL Laboratories Inc. 4708 Aurora Ave. N., Seattle, WA 98103 Bulk Asbestos Fiber Analysis Tel: 206.547.0100 Fax: 206.634.1936 NVLAP #102063 Client: NVL Field Services Division Address: 4708 Aurora Ave. N. Seattle, WA 98103 Attn.: Ms. Lisa K. Project: 12247 43rd Ave. S., Seattle NVL Batch Number: 21- 11897.00 Client Project 1: 2001 -1078 Number of samples: 25 Lab ID #: 21106199 Client Sample #: 20014078 -64 Sample Location: 12247 43rd Ave. 5., Seattle Description: LAYER 1: White sheet vinyl, LAYER 2: Gray fibrous material with yellow mastic OTHER FIBROUS MATERIALS: LAYER 1: 'None Detected LAYER 2: Cellulose 65% NON-FIBROUS MATERIALS: LAYER 1: Vinyl /binder LAYER 2: binder & filler, Mastic /binder ASBESTOS TYPE: PERCENT LAYER 1: *None Detected ND LAYER 2: *None Detected ND Lab ID #: 21106200 Client Sample #: 2001 - 1078.6 -2 Sample Location: 12247 43rd Ave. S., Settle Description: LAYER 1: White sheet vinyl, LAYER 2: Gray fibrous material with yellow mastic OTHER FIBROUS MATERIALS: LAYER 1: •Nuns Detected LAYER 2: Cellulose 65% NON-FIBROUS MATERIALS: LAYER 1: Vinyl /binder LAYER 2: Binder & filer, Mastic /binder ASBESTOS TYPE: PERCENT LAYER 1: *None Detected ND LAYER 2: *None Detected ND Lab ID #: 21106201 Client Sample #: 2001- 1078.7 -1. Sample Location: 12247 43rd Ave. S., Seattle Descriptions LAYER 1: Tan paper with paint, LAYER 2: Gray fibrous material OTHER FIBROUS MATERIALS: LAYER 1: Cellulose 45% LAYER 2: Cellulose 70% ASBESTOS TYPE: NON - FIBROUS MATERIALS: LAYER 1: Pinder & filler, Paint LAYER 2: Binder & filter PERCENT (Sample results are continued on the next page.) ..rr Sampled by: Lisa Kollasch of NVL Lab, r� .�" Analyzed by: We Long Tai Date: 10/26/2001 f %!�i% Reviewed by: Nick Ly Date: W/26/2001 Nic . ,��P' nical Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bu Th pies are analyzed using EPA 600/R. 93/116 Method with the following, measurement uncertainties for the reported % Asbestos (1 %= >0 -3%, 5 %= >1.9 %, 109% 5•15 %, 20%= 10 -30%, 50%=40.60 %). This report relates only to the items tested. If samples were not collected by NVI. 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 U.S. Government. Page 5 j NVL Laboratories, Inc. Tel: 206.547.0100 Pax: 206.634.1936 4708 Aurora Ave. N., Seattle, WA 98103 Bulk Asbestos Fiber Analysis NVLAP #102063 Client: NVL Field Services Division Address: 4708 Aurora Ave. N. Seattle, WA 98103 Attn.: Ms. Lisa K. Project: 12247 43rd Ave. S., Seattle NVL Batch Number: 21- 11897.00 Client Project #I: 2001 -1078 Number of samples: 25 LAYER 1: *None Detected LAYER 2: *None Detected ND ND Lab ID #: 21106202 Client Sample 0: 2001 - 1078 -7 -2 Sample Location: 12247 43rd Ave. S., Seattle Description: LAYER 1: Tan paper with paint, LAYER 2: Gray fibrous material OTHER FIBROUS MATERIALS: LAYER 1: Cellulose 45% LAVER 2: Cellulose 70% Lab ID #: 21106203 NON - FIBROUS MATERIALS: LAYER 1: Binder & filler, ('pint LAYER 2: Binder & filler ASBESTOS TYPE: PERCENT LAYER 1: *None Detected ND LAYER 2: *None Detected ND Client Sample #: 20014078.8 -1 Sample Location: 12247 43rd Ave. S., Seattle Description: Tan brittle material with paint OTHER FIBROUS MATERIALS: Cellulose 2% NON - FIBROUS MATERIALS: Hinder & filler, Paint ASBESTOS TYPE: PERCENT *None Detected ND WOIMIO Lab ID #: 21106204 Client Sample #: 2001- 1078.8.2 Sample Location: 12247 43rd Ave. S., Seattle Description: White brittle material with paint OTHER FIBROUS MATERIALS: Cellulose 1% ASBESTOS TYPE: NON-FIBROUS MATERIALS: [finder & filler, Paint PERCENT (Sample results are continued on the next page.) Sampled by: Lisa Kollasch of NVL. Lab. Analyzed by: Wei Long Tai Reviewed by: Nick Ly Date: 10/26/2001 Date: 10/26/2001 liar. „OPP tc fifir chnical Direr' i Note; If samples are not homogeneous, then subsamples of the components were analyzed separa e 1 ni. • . es are analyzed using F.['A 600/R- 93/116 Method with the following measurement uncertainties far the reported % Asbestos 1 % = >0.3 %, 5 %= >1.9%, 109'„ =5 -15 %, 20% =10•30%, 50%=40 -60 %). This report relates only to the items tested. If samples were 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 U.S. Government. Page 6 i§ NVL Laboratories Inc. Tel: 206.547.0100 Fax: 206.634.1936 4708 Aurora Ave. N., Seattle, WA 98103 Bulk Asbestos Fiber Analysis NVLAP #102063 Client: NVL Field Services Division Address: 4708 Aurora Ave. N. Seattle, WA 98103 Attn.: Ms, Lisa K. Project: 12247 43rd Ave, S., Seattle Chrysotile Lab ID #: 21106205 Client Sample #: 2001407844 Sample Location: 12247 43rd Ave. S., Seattle Description: LAYER 1: Black fibrous asphaltic material, LAYER 2: Black asphaltic material with granules NVL Batch Number: 21- 11897.00 Client Project #: 2001 -1078 Number of samples: 25 2% OTHER FIBROUS MATERIALS: NON - FIBROUS MATERIALS: LAYER 1: Cellulose 65% LAYER 1: Asphalt /binder, Binder & filler LAYER 2: Cellulose 4 %, Cross fibers 35% LAYER 2: Asphalt /binder, Sand /binder ASBESTOS TYPE: PERCENT LAYER 1: *None Detected LAYER 2: *None Detected ND ND Lab ID #: 21106206 Client Sample #: 20014078.9 -2 Sample Location: 12247 43rd Ave S., Seattle Description: LAYER 1: Black fibrous asphaltic material, LAYER 2: Black asphaltic material with granules OTHER FIBROUS MATERIALS: NON - FIBROUS MATERIALS: LAYER 1: Cellulose 65% LAYER 1: Asphalt /binder, Binder & filler LAYER 2: Cellulose 4%, Class fibers 35% LAYER 2: Asphalt /binder, Sand /binder ASBESTOS TYPE: PERCENT LAYER 1: *None Detected ND LAYER 2: *None Detected ND Lab ID #: 21106207 Client Sample #: 2001.107840.1 Sample Location: 12247 43rd Ave, 5., Seattle Description: Cray sandy brittle material with paint OTHER FIBROUS MATERIALS: Cellulose 2% r • Sampled by: Elsa Kollasch of NVL Lab. Analyzed by: Wei Long Tai Date: 10/26/2001..= �,.;,� Reviewed by: Nick Ly Date: 10/26/2001 Nic . r i r Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using EPA 600/103 /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 samples were 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 U.S. Government. Page 7 NON - FIBROUS MATERIALS: Binder & filler, Granules;, Paint ASBESTOS TYPE: PERCENT (Sample results are continued on the next page.) I NVL Laboratories, Inc. Tel: 206.547.0100 Fax: 206,634,1936 4708 Aurora Ave. N., Seattle, WA 98103 Bulk Asbestos Fiber Analysis NVLAP #102063 Client: NVL Field Services Division Address: 4708 Aurora Ave. N. Seattle, WA 98103 Attn.: Ms. Lisa K. Project: 12247 43rd Ave. S., Seattle NVL Batch Number: 21- 11897.00 Client Project #: 2001 -1078 Number of samples: 25 *None Detected ND Lab ID #: 21106208 Client Sample #: 2001 - 1078404 Sample Location: 12247 43rd Ave. 5., Seattle Description: Cray sandy brittle material with paint OTHER FIBROUS MATERIALS: Cellulose 2% ASBESTOS TYPE: *None Detected NON - FIBROUS MATERIALS: Binder de filler, Granules, Paint PERCENT ND Lab ID #: 21106209 Client Sample #: 2001 - 1078.11 -1 Sample Location: 12247 43rd Ave. S., Seattle Description: Black fibrous asphaltic material OTHER FIBROUS MATERIALS: Cellulose 70% ASBESTOS TYPE: PERCENT *None Detected ND IINIMmew NON - FIBROUS MATERIALS: Asphalt /binder, Binder & filler Lab ID #: 21106210 Client Sample #: 2001 - 107841 -2 Sample Location: 12247 43rd Ave. S., Seattle Descriptions Black fibrous asphaltic material OTHER FIBROUS MATERIALS: Cellulose 70% ASBESTOS TYPE: PERCENT *None Detected NON- FIBROUS MATERIALS: Asphalt/binder, Binder & filler ND (Sample results are continued on the next page.) Sampled by: Lisa Kollasch of NVL Lab. Analyzed by: Wei Long Tai Date: 10/26/2001 Reviewed by: Nick Ly Date: 10/26/2001 Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bu 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 samples were 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 NV1. Laboratories, Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the U.S. Government. Page 8 NVL Laboratories, Inc. 4708 Aurora Ave. N,, Seattle, WA 98103 NVLAP Bulk Asbestos Fiber Analysis #102063 Tel: 206.547.0100 Pax: 206.634,1936 Client: NVL Field Services Division Address: 4708 Aurora Ave. N. Seattle, WA 98103 Attn.: Ms. Lisa K. Project: 12247 43rd Ave. 5., Seattle .- .1160.... fill•M NVL Batch Number: 21- 11897.00 Client Project #: 2001.1075 Number of samples: 25 Lab ID #: 21106211 Client Sample #: Sample Location: 12247 43rd Ave. 5,, Seattle Description: Bieck asphaltic material with granule OTHER FIBROUS MATERIALS: Cellulose 3 %, Glass fibers 20% 20014078424 ASBESTOS TYPE: *None Detected NON - FIBROUS MATERIALS: Asphalt /binder, Sand /binder PERCENT ND Lab ID #: 21106212 Client Sample #: 20014078424 Sample Location: 12247 43rd Ave, 5., Seattle Description: Black asphaltic material with granules OTHER FIBROUS MATERIALS: Cellulose 3%, Glass fibers 20% MINIM ASBESTOS TYPE: *None Detected NON - FIBROUS MATERIALS: Asphalt /bindur, send /binder PERCENT ND Sampled by: Lisa KoBasch of NVL Lab. Analyzed by: We Long Tai Date: 10/26/2001 Reviewed by: Nick Ly Date: 10/26/2001 VINMENNIMNIMINIO err► Ali ii a u. • trector 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 samples were 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 U.S. Government. Page 9 NVL Laboratories, Inc. 4708 Aurora Ave N, Seattle, WA 98103 Tel: 206.547.0100 Emerg. Pager: 206.344.1878 1.&88.NVL.LABS (685.5227) Client NVL Field Services Division Address 4708 Aurora Ave. North AIN of CHSAMP E LOG 0( 01-2 c0l Seattle, WA 98103 6516 Project Manager tIl I111111eek Project Location ) 4'4-- `/3�`.. A� �e 6 tt , W 4\ Phone: (208j 547 -0100 Fax (208) 834 -1936 NVL Batch Number Client Jab Number aCIDI - 10 'mac`* Total Samples J Turn Around Time 0 1-Hr 0 24 -Hrs 0 4 Days d 2 -Hr Days 0 5 Days 0 4 -H0fS2ts Days - Nlea cal or T Tlesss Mad 4 H Email address 0 Asbestos Air 0 PCM (NIOSH 7400) 0 TEM (NIOSH 7402) 0 TEM (AHERA) d TEM (EPA Level II) 0 Other bsstos BUIk 19134ALM (EPN800/R -93/1 18) 0 PLM (EPA Point Count) Cd PLM (EPA Gravimetry) 0 TEM Bulk ALS 0 Total Metals 0 TCLP Dot: Limit 0 ppm (MS) 0 ppb ( ©FAA) Matrix 0 Air Fitter d Paint Chips 0 Drinking water 0 Paint Chips (Area) 0 DustAvipe 0 Waste Water 0 Soil _.._ RCRA Maws CJ AN 8 D Arsenic (M) 0 Lead (Pb) 0 Barium (Ba) 0 Mercury (Hg) 0 Cadmium (Cd) 0 Selenium (Se) 0 Chromium. (Cr) 0 Silver (Ag) __ . - ., Other Meals CJ AN 3 0 Copper (Cu) 0 Nickel (NI) 0 Zinc (Zn) © Otlwr Types of Analyels 0 Fiberglass 0 Nuisance Dust 0 Rotometer CaNbration 0 Other (Specify) 0 SI ca 0 Respirable Dust Mokt/Fungus (Please use Mold COC Recived Condition of Package: 0 Good 0 Damaged (no spillage) 0 Severe damage (spillage) Company Time 1 _— -I -.1 R � shod � L�rS� � - ti � use - - �i�l 1�ii�� ��I1r;.r�r AN1����1M Recived �N . h ki921.11111121111111111111111111 i% zed 1 �Ilr� M r Results Called MO Results Faced b MF _,,/ _,,_ ArAir ,,, .rw- Special Instructions: Unless requested in writing, all samples will be disposed of two (2) weeks after analysis, 1 NVL Laboratories, Inc. 4708 Aurora Ave N, Seattle, WA 98103 Tel: 206.547.0100 Irtnerg. Pager: 206.344.1878 1.888.NVL.LABS (685.5227) Client NVL Field Services Division CHAIN of CUSTODY SAMPLE LOG Address 4708 Aurora Ave. North Seattle, WA 98103 6516 Project Manager t✓i ,cL��c��keL50-° Project Location } • Phone: (206) 547 -0100 Fax: (206) 834 -1936 NVL Batch Number Client Job Number Total Samples Tum Around Time Cl 1 -Hr Cl 24 -Hrs 0 4 Days Cl 2 -Hrs CI 2 Days El 5 Days C14 -Hrs 0 3 Days L 16 to 10 Days Please call for TAT less than 24 His Email address 0 Asbestos Air 0 IPM (NIOSH 7400) tI TEM (NIOSH 7402) CI TEM (AHEI2A) d TEM (EPA Level 11) 0 Other 0 Asbestos Bulk (o PLM (EPA/600/R Count) 93/110) 0 PLM (EPA Point Cnt) 0 PLM (EPA Gravimetry) 0 TEM Bulk METALS 0 Total Metals 0 TCLP Mt Limit 0 ppm (OAS) 0 ppb (OFAA) Matrix 0 Air Faker 0 Paint Chips 0 Drinking water 0 Pain Chips (Area) 0 Dust/wipe 0 Waste Water c:i Soli RCRA Metals ) AN g 0 Arsenio (As) 0 Lead (Pb) 0 Barium (Bs) d Mercury (Hg) 0 Cadmium (Cd) 0 Selenium (Se) t: Chromium (Cr) 0 Silver (Ag) ^_. , Other Metals 0 AN 3 0 Copper (Cu) 0 Nickel (NI) d_� �n�_s__ 0 Other Types of A sb 0 Fiberglass 0 Nuisance Dust 0 Rotometer Calibration 0 Other (Specify) 0 Silica 0 Re , able Dust Mold/Fungus Please use Mold COC MC $h.d ' Condition of Package: 0 Good © Damaged (no spillage) 0 Severe damage (spillage) Seq. N Lab IO Client Baran . Number Comments 1 Skin Heim" Urn 111111E2=16 .5a. t-cA cut-, MC $h.d ' Received , rirl rr ow r W Aral lied `d 11111111111111111 11=1.11111 Results Called MIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Results Faxed by 111111111111111.11111111111111111111111111111111111111 Special Instructions: Unless requested in writing, all samples will be disposed of two (2) weeks after analysis, 1 NVL Laboratories, Inc. CHAIN of CUSTODY 4708 Aurora .Ave N, Seattle, WA 98103 Tel: 206,547.0100 Emerg. Pager: 206.344.1878 1.888.NVL.LABS (685.5227) Client NVL Field Services Division Address 4708 Aurora Ave. North SAMPLE LOG Seattle, WA 98103 6516 Project Manager Ms, Lisa Kollasch Project Location 12247 43rd Ave S, Seattle, WA NVL Batch Number 2111897.00 Client Job Number 2001 -1078 Total Samples 25 Turn Around Time 2 Days Due Date 10/26/2001 Time,2 :00 PM Email address Phone: (206) 547 -0100 Fax: (206) 634-1936 E Asbestos Air t7 PCM (NIOSH 7400) 0 TEM (NIOSH 7402) 0 TEM (AHERA) ❑ TEM (EPA Level II) 0 Other E:rAsbestos Bulk PLM (EPA/600/R- 93/116) 0 PLM (EPA Point Count) 0 PLM (EPA Gravimetry) CJ TEM Bulk METALS 0 Total Metals 0 TCLP DO. Limit 0 ppm (AAS) 0 ppb (GFAA) Matrix 0 Air Filter 0 Paint Chips 0 Drinking water 0 Paint Chips (Area) CI Dust/wipe 0 Waste Water 0 Soil RCRA Metals 0 All d 0 Arsenic (As) 0 Lead (Pb) 0 Barium (Ba) 0 Mercury (Hg) 0 Cadmium (Cd) 0 Selenium (Se) 0 Chromium (Cr) 0 Silver (Ag) Other Metals 0 All 3 0 Copper (Cu) 0 Nickel (NI) 0 Zinc (Zn) "1 ® Other Types of Analysis 0 Fiberglass 0 Nuisance Dust 0 Rotometer Catibrat on 0 Other (Specify) CJ Silica 0 Respirable Dust Mold /Fungus (Please use Mold COC) Condition of Package Good 0 Damaged (no spillage) 0 Severe damage (spillage) Client Sam 2001.10781.1 2001. 1078.1.2 21108190 21108191 21100109 21100200 21106201 21100202 2001. 1078.2.2 2001. 1078.3.1 2001-1078-3-2 200110784.3 2001. 1078.4.1 2001.1078.4.2 2001. 1078.5.1 2001. 1078.5.2 2001. 1078.0.1 2001. 1078.0.2 2001. 1078.7.1 2001-1078-7-2 Sian Below Compan Date Time Sampled by Client Relinquished by __. Received by Michelle Stratton NVL 11)/24/01 IIIIIIIIIIIII IIIIIMIIIIIIM 2 :00 PM Analysed by Results Called by Results Faxed by Special Instructions: Unless requested In writing, all sample will be disposed of two (2) weeks after analysis. Page 1 of 2 NVL Laboratories, Inc. 4708 Aurora Ave N, Seattle, WA 98103 Tel: 206.547.0100 Emerg. Pager: 206.344.1878 1.888.NVL.LABS (685.5227) Client NVL Field Services Division CHAIN of CUSTODY SAMPLE LOG Address 4708 Aurora Ave. North Seattle, WA 98103 6516 Project Manager Ms. Lisa Kollasch Project Location 12247, 43rd Ave S, Seattle, WA Phone: (206) 547 -0100 Fax: (206) 634 -1936 0 Asbestos Air 0 PCM (NIOSH 7400) 0 TEM (NIOSH 7402) 0 TEM (AHERA) 0 TEM (EPA Level 11) 0 Other NVL Batch Plumber 2111897.00 Client Job Number 2001-1078 Total Samples 2 5 Tum Around Time 2 Days Due Date 10/26/2001 Time 2:00 PM Email address .. ' PLM EPA/600 /R- 93/116) (] PLM (EPA Point Count) d PLM (EPA Gravlmetry) 0 TEM Bulk METALS o Total Metals d TCLP Dot. Limit 0 ppm (AAS) 0 ppb (GFAA) Matrix 0 Air Filter 0 Paint Chips 0 Drinking water 0 Paint Chips (Area) 0 Dust/wipe 0 Waste Water Soil m_.. RCRA Metals d All d 0 Arsenic (M) 0 Lead (Pb) 0 Barium (Ba) 0 Mercury (Hg) 0 Cadmium (Cd) 0 Selenium (Se) 0 Chromium (Cr), _0 Sliver (Ag) Other Metals 0 All 3 0 Copper (Cu) 0 Nickel (NI) D 21nc (2n) o Other Types of Analysis O Fiberglass 0 Nuisance Dust 0 Rotomotor Calibrat on 0 Other (Specify) 0 Silica 0 Respirable Dust Mold/Fungus (Please use Mold COC) Condition of Package ® Good 0 Damaged (no spillage) 0 Severe damage (spillage) 20 w El El El Lab ID Client Sa o Numbs Comments 21108203 2001. 1078.8.1 21108204 2001. 1078.8.2 21108205 2001.1078.0.1 21108208 2001. 1078.0.2 21108207 2001.1078.10.1 21108208 2001.1078.10.2 21108209 2001-1078.11.1 21106210 2001. 1078.11.2 2001-1078-12.1 2001. 1078.12.2 2110621 1 21106212 A A A A A Sian Below Comqan Date Time Sampled by lir111111111111111 10/24/01 MEM 2:00 PM Relinquished by Received by Michelle Stratton Analysed by NEM Results Called by Results Faxed by a .� Special Instructions: Unless requested In writing, all samples will be disposed of two (2) weeks after analysis. Page 2 of 2 1 TI' 0 • * Certificate of Accreditation GJ `a 30 g `w C u v:�'O u V.CW„ u co 0 o a .uci8 cu ata .808E tc ad o `o a 01 Li LE � S C• U «r •C a co a ro bK 4 •� 1.7 0 t IQ 0 'RI .� 6 "a otA gia 0 Lab Code: 102063-0 NVLAP -o7C t11-95) National Institute of Standards and Technology National Voluntary Laboratory Accreditation Program 180AEC GUIDE 25 :1990 Scope of Accreditation '190 9002:1987 BULK ASBESTOS FIBER ANALYSIS 4t Page: 1 of 1 NVLAP LAB CODE 102063 -0 NVL LABORATORIES, INC. 4708 Aurora Avenue N. Seattle, WA 98103 Mr. Nghiep Vi I.y Phone: 206 -547 -0100 Fax: 206 -634 -1936 E -Mail: munaf@nvllabs,com URL: http://www.nvIlabs.com NVLAP Code Designation 18/A01 EPA- 600/M4- 82- 020:1ntcrim Method for the Determination of Asbestos in Bulk Insulation Samples September 30, 2002 Effective through For the National Institute of Standards an lchnology NVEAP -01$ (11.95) 1 PERMT COORD COPY PLAN REVIEW/ROUTING SLIP ACTIVITY NUMBER: MI01 -186 PROJECT NAME: DOAK HOMES -- LOT 29 SITE ADDRESS: 12247 43RDAVENUE SOUTH .2(2(,_ ,Original Plan Submittal ,_,_„Response to Correction Letter #, ,Response to Incomplete Letter # Revision # After Permit Is Issued AAPART__ EN_IS: Building Division DWG. 110 1', -" P b is Wo ks Fire Prevention �f. Structural tc-L3�v fat Structural PlannQng'Division tM�t, c( -c3-or Permit Coordinator DETERMIN TION OF COMPLETENESS: (Tues., Thurs.) Complete ej Comments: Incomplete DUE DATE: 11 -13 -01 Not Applicable TUES /THURS ROUTING: Please Route Ili Structural Review Required REVIEWER'S INITIALS: a No further Review Required DATE: APj' QRREC.TIONS: (ten days) Approved EI Approved with Conditions REVIEWER'S INITIALS: DUE DATE 12 -11 -01 Not Approved (attach comments) L_J DATE: CQRRECTION DETERMINATION; Approved Approved with Conditions Ej REVIEWER'S INITIALS: WRROUTE.pOC 5/99 DUE DATE Not Approved (attach comments) DATE: PLAN REVIEW /ROUTING SLIP TIVITY NUMBER: _MI01- 186_, PROJECT NAME: DOAK HOMES _. --. LOT 29 SITE ADDRESS: 12247 431113 AVENUE SOUTH Original Plan Submittal Response to Correction. Letter #_ DATE: 11 -8 -01 _.._�...., Response to incomplete Letter # Revision # Permit Is Issued DEPARTMENTS: Building Division Public Works Fire Prevention Structural ❑ Planning Division ❑ ❑ Permit Coordinator 1:3 DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Incomplete El Comments: DUE DATE: 11 -13 -01 Not Applicable ❑ TUESITHURS ROUTING: Please Route ❑ Structural Review Required REVIEWER'S INITIALS: No further Review Required DATE: APPROYI!► ISS EC(TINS: (ten days) Approved ❑ Approved wi h Conditions 1„ REVIEWER'S INITIALS: DUE DATE 12 -11 -01 Not Approved (attac DATE: 1 t corn rents) ❑ CORRECTION DETERMINATION: Approved E Approved with Conditions REVIEWER'S INITIALS: WRRauTE.Doc 5/99 DUE DATE Not Approved (attach comments) El DATE: 1 g t'ERM1T NO.: 13U!LUfNU PERINIti S INSI'CC'1'tONS d d 0 d d 0 13 EJ 00001 Progress Inspection Stnms 00002Pre-construction 00003 Invcstigntinti 00004 OK to Occupy 00005 Remove Slop Work Order 00006 ..... Follow -up 00001 t'te4r;t11vc Inspection 000511 W51:c Itesidetithd 011(160WA Vetrlilntion /lndnor AQC. 00070 .. NI.ItA InspectiimiNfidol it 5lrticl 00011.... ftlobile I bume 1 k how Imp 00072 hinttistl?e tines (10090..,...,,(tesleet fnt1(1tr3 Fooling t)tnins 00100 ,... Fomnttatiotl Innings 00200...,,..: t"o i itbiI on Walls 001511...,,.,:. Foundation Insiriniion 00300...:..,:. Cln(telc Slob /Stab Instilntiom 00150.,.....,, Crsia•I Space 004011,......., Shear 1V8Il Nailing: (1045()..,:..... Plywood Wall Shenthinp 00500,.,,. hoof ShenlIt)lg Nulling 00525,..,..,., Plywood 1)eck NitIUiits 00556,,.,.,..,1 Mlerimr Wall Sheathing 0(1611(1.,,,., -Kinston y t`Irirney 006111,.,;...,. Chimney lnsb111atinn /►111 Types 0070(1 .... Fro this 01)730:..,,..,, ItooflCcilirlg Iisamlatitm+ 00/100,—„,„ floor insulation 0011111..:,... Wnl l I ,mitt Inn 001102,.,,:,,. I;xlrthir hoof In4ulnllm l 001111)..::,,::, ()Inrini; Imspettian 001115,::,:,::. Lighting nod Conitols 00000:::,,:,.: Suspended Ceiling 0 0011:,,,.:::, Inlethlr Walibnntil Fa410011g 0 Ot11,,,:,>,..I:xlerlrn WnNhnntd'listening 0 110.,,,:,,:. ihr.Plnve Inspection 115.,,._,:Ninon Inspection 0 120,.,..,.,, I'te.l.)enmt 141),,.,,,,., 1'te,testrof 4110„ ,.,..1'imtl.File 700 „„ Finnl.11nilrlintt 0 400,,,,,,.., Iilnnl•Itctoni. 0) 1(111,,,,,,,,, Site Visit 0400(),,.,,,,.• Speclnl.(;rmttrele 040(11,,,,,,,,, Spectn1•11olts in Ci►m(r►:ie 04001 Spe(inl =thins /Resist Clare i'tntne 04003,.,,,,.,, Specini•Rciif .Steel t4esUcss 0 040114,.,,..,Special•Wetding 04005..,.,.,Specin1•I Ilgt .Strength Dolling 040(6... :: Spccinl•S(iticltunl tvhisont y 04007 Spel'inl•Reinf (I) limns CmicseIet 04008 Speclnl ,-lnsulttting Clint', Fill 04009Special'Sptay I' iteptonlim6 04010 Specinl•I'iting, Picts, Caissons O 04011..,,,, Spccinl,Sh(rtercte c 04012..,,..•,• Spccial•(JIadint4, I:x(av /f Ili [) 04013 1ieciaMiclaining Wall O 04014 Specint- i'nnels 0 04015 Spccial.Smoke control System TENANT NAME: CONDITIONS X0001 No cbnllges to pinits unless approved by l)ldg Div (1011(1 Specinl inspection required. notify t31dg Div DOD 1.(011000111(211 i01 I Special inspector shall submit rnnl signed report 01112 New ceiling grid & light fixture shall meet lateral bracing (: 11ot t I'nttitinn tvnlls nt)nclfcd In ceiling grid U 0014 )readily nccessible ntcess to roof mounted equipment U 0015 I,tigineetct) ttiiSs drntvimgt & talcs shill hC on Site U 11016 1:xposed insulntiotl backing mnletinl Ca itrl11 Subgtadr ptcpnrntittn including tlt:rin;tge., excavation (1 0()111......... $lnternevt from tooling rmnttnc(rrr verifying fire rctatdard cuss of roof 11111') All ctmistruction in Ire dime itt Cllilftltrliatice tv /nlrpr►lveti pinny U"No work shall be slime in nddi0nn to those litotlifientinns.. '' 0i102 Plumbing permits shall be oItsthted through Kittg to 1:1 110211Sirtttllnal lrliscrvolion slit II be provided tat Ibis posjetl • 0ti21 All food incpnratinn establishments must have King t'n (� t)r122 t'ite reintdnrll ttenletl wool) shall have finale spread of (� j nm21 .. t'totify Iltilklliltr Division pipet Iii placing any concrete Li 002.1 .._. . All spiny npplieti t1reI11iuiI1np shall be special impeded Li 0024 All wood to remain in prated concrete shall be mettles) • 02(t All vtrtcttirnl lunsonty shall be spccint inspected 11021 Vnlidily of Permit 00211 flack slurn(te trquhes sepntnte permit 11t101 ;.:: Electrical permits riittnined thtrnlgh 1. its 1 0n111.. IJn ateupnnty of witting until !hunt insp by Illdg Div 11011 Remove nil weeds, emtttele. stone fotrntlntlons, lint eanticle 00 if► ftlammin(trirers installntiott )tatrm°tioms reunited ml ails "111 II mit Mitsui nllntted pet 1')')7 WA Slate Ftietity ('rule:” 11(1114 Cimino 1)i'to ohtnln fns!► far %valet /sewer connect 00111 A t' of f) %VIII i►e tesinked lilt this petntit itn10 final npptovnl for nil 11 twin' the limits of Use SC Moll 0001 All meehnnitnl work shrill be snider sepninte permit (:j UI) t0 /',11 construction noise to be in comgrlinnce with 1121 ft1t 1011 VentlInll,m l4 'vilified firs nil new moms As spaces mtltls All prrlmlla, )salt ovoids �t� nlrpsnve(i plots nvnilnble m)0rr . All s int'0unl cm+nIIC 11111111 be tpetlal li prvtell "Applitanl shrill obinin n %tpninle plumbing permit lion% Fang Co" 1 _J "Ant'botinil A11 new conslnict ntul gnhatnnsinl in(provcnienl ahnti ll R11011101111 pictent 1111111111111" El 0u117 All sitmcuunl welding shall lie done by 1VA11O (vilified Ou )tspecbu nOUR ....... Alt Itiltlwsiretlitih halting stint! be spreinl impeded ULI 1!1)01) Dolts iui inlletl in clrllttele shall be special impeded t►0i I Comply tvifs icslnhcusenlc of l NIC 16,04 001.1 Itemovnl of septic hulks requite nlgtrovnl null ((ltlplinm(a with King Co 11enith 1)epl. "Obtain teq(iited inspections from nppsoptinte wilier & setter districts" 0 - 1.1,cl limning appliances lj "Appliances, which genctrste.... Lij "Water heater stall he anchoictl.... (I "Retool" 0 0 ffist 0 Dale: W Date: lirittli) 4 PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: MI01 -1.86 PROJECT NAME: DOAK HOMES LOT 29 SITE ADDRESS: 12247 43RD AVENUE SOUTH ,,,, 1.Original Plan Submittal DATE: 11- $ -01_ _._ .. Response to Incomplete Letter # Response to Correction Letter # -- _Revision # Permit Is Issued DEPARTMMT_S: Building Division ❑ Public Works ❑ Fire Prevention Structural Planning Division Permit Coordinator DETERMINATION OF COMPLETE ESS: (Tues., Thurs.) Complete ❑ Comments: Incomplete EJ DUE DATE: 1 1-1 3-01 Not Applicable ❑ TUES/THURS ROUTING: Please Route ❑ Structural Review Required REVIEWER'S INITIALS : "_"( No further Review Required DATE: //" P ,u APISOVALS OR CORRECTIONS: (ten days) Approved l.� Approved with Conditions J Not Approved (attach comments) ❑ REVIEWER'S INITIALS: DUE DATE 12-11-01 DATE: rQ.RRECTION DETERMINATION: DUE DATE Approved ❑ Approved with Conditions E Not Approved (attach comments) El REVIEWER'S INITIALS: DATE: WRROUTF.POC 5/99 PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PROJECT NAME: DOAK HOMES -- LOT 29 SITE ADDRESS: 12247 43RD AVENUE SOUTH MI01 -186 Plan Submittal DATE: 11 -8 -01 __Response to Incomplete Letter # Response to Correction Letter # #_— After Permit Is Issued DEPARTMENTS: : Building Division ❑ Public Works ❑ Fire Prevention Structural Planning Division ❑ Permit Coordinator DETERMINATION OF COMPLETEN. SS: (Tues., Thurs.) Complete > Incomplete ❑ Comments: DUE DATE: 11 -13 -01 Not Applicable ❑ TUES /THURS ROUTING: Please Route ❑ Structural Review Required REVIEWER'S INITIALS: No further Review Required DATE: M PROVALS OK CQf JjQNS: (ten days) DUE DATE 12 -11 -01 Approved J Approved with Conditions ❑ Not Approved (attach comments) ❑ REVIEWER'S INITIALS: DATE: CORRECTION DETERMINATION: Approved J Approved with Conditions REVIEWER'S INITIALS: WRROUTI.DOC 5/99 DUE DATE Not Approved (attach comments) ❑ DATE: i PLAN REVIEW /ROUTING SLIP tIVITY NUMBER: MI01- 1.86 DATE: 1141.01,..A_ ,._. OIECT NAME: DOAK HOMES LOT 29 SITE ADDRESS: 12247 or AVENUEmSOUTH ,, , a,,,,,,,.Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # After Permit Is Issued DEPARTMENTS: Building Division ❑ )-11 Public Works Fire Prevention Structural Planning Division ❑ ❑ Permit Coordinator DETERMINATION OF COMP ETENESS: (Tues., Thurs.) Complete EI Comments: Incomplete DUE DATE: 11 -13 -01 Not Applicable Ej TUES/THURS ROUTING: Please Route Structural Review Required ❑ No further Review Required DATE: - Ord ' G�1 REVIEWER'S INITIALS: APPROVALS OR CORRECTIONS: (ten days) Approved ❑ Approved with Conditions REVIEWER'S INITI DUE DATE 12 -11 -01 Not Approved (attach comments) ED DATE: ��— .1•11.■.■ ..■w :4RRECTIQN DETERMINATION; Approved ❑ Approved with Conditions IJ REVIEWER'S INITIALS: 1PRgOUTE.oOC 5(99 DUE DATE Not Approved (attach comments) ❑ DATE: LICENSE DETAIL INFORMATION Form STATE OF WASHINGTON DEPARTMENT OF LABOR AND INDUSTRIES Specialty Compliance Services Division P. O. Box 44000 Olympia, WA 98504 -4000 THE RESULT OF YOUR INQUIRY FOR LICENSE NUMBER SELECTED IS: LICENSE DETAIL INFORMATION Current Filter: None Registration,/ or License DOAKHI•092NZ Name DOAK HOMES INC Address 11917 4TH AVE SW Address Cky SEATTLE State WA Zip 98146 Phone Number 2062466687 Effective Date 8/9/91 Expiration Date 8/1/03 Registration Status ACTIVE Type CONSTRUCTION CONTRACTOR Entity CORPORATION Specialty Cods GENERAL Other Specialties UBI Number 601329337 *r* Y1EW_PRINCIPAL 41N_.NER,(S)FOR THIS_LI�EN E #.* *. *: *_'tEw_CP TR.ACT0R_EQND /_SAVINP.S IN.FORNIATIOtt *_ *_* *. *_ *c± ECK INQUIRY FOR SUIVIMONS:AND__COMP_.LAI.NTS* * !i.,%'_!....yrgYV CONTRACTOR INSURANCEJNEQEMA,Tl0N * * Page 1 of 1 New inquiry by CITY, NAME, PRINCIPAL OWNER NAME, NUMBER, URI NUMBER or return to the L &I Construction Compliance Home Page https : / /wws2.wa.gov /ini/bbip/TF2Form .asp ?License =DOAKHI *092NZ 10/10/01 1