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Permit MI96-0031 - PUGET SOUND PATTERN WORKS - DEMOLITION
V(10.-.401' P�TT6gf,I Wow, MThUD- 0031 City of Tukwila( (206) 431 -3670 Community Development / Public Works • 6300 Southcenter Boulevard, Suite 100 • Tukwila, Washington 98.188 •MISCELLANEOUS PERMIT WARNING: IF CONSTRUCTION BEGINS BEFORE APPEAL PERIOD EXPIRES, APPLICANT IS PROCEEDING AT THEIR OWN RISK. Parcel No: Address: Suite No: Location: Category: Type: Zoning: Const Type: Gas /Elec.: Units: Setbacks: Water: Wetlands: 336590 -1940 6406 S 143 ST ASFR MISCPERM M1 V -N 001 North: N/A Permit No: Status: Issued: Expires: MI96 -0031 ISSUED 12/23/1996 06/21/1997 Occupancy: PRIVATE GARAGE UBC: 1994 Fire Protection: .0 South: .0 East: .0 West: .0 Sewer: N/A Slopes: Y Streams: Contractor Licence No: DEMOLMI178N2 OCCUPANT OWNER CONTRACTOR PUGET SOUND PATTERN WORKS 6406 S 143 ST, TUKWILA WA 98168. WORM MARY HAMILTON 6406 S 143 ST, SEATTLE WA DEMOLITION MAN, INC. 8129 OCCIDENTAL AVE S, SEATTLE 98108 CONTACT JIM JUSTIN 6406 S 143 ST, TUKWILA WA 98168 **************************************************** * * * * * * * * ** * * * * * * * * * * * * * * * * * * * ** Permit Description: DEMOLITION OF AN OUT BUILDING. **************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Construction Valuation: $ 1,850.00 PUBLIC WORKS PERMITS: *(Water Meter Permits Listed Separate) Eng. Appr: Curb Cut /Access /Sidewalk /CSS: N Fire Loop Hydrant: N No: Flood Control Zone: N Hauling: N Start Time: Land Altering: N Cut: Landscape Irrigation: N Moving Oversized Load: N Start Time: End Time: Sanitary Side Sewer: N No: Sewer Main Extension: N Private: N Public: N Storm Drainage: N Street Use: N Water Main Extension: N Private: N Public: N **************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** TOTAL DEVELOPMENT PERMIT FEES: $ 2,046.50 **************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Phone: 206 763 -3366 Phone: 439 -6810 Size(in): .00 End Time: Fill: Permit Center Authorized Signature: 7?J_ .6_ -- Date: 0-"a173-9:1c, 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 provision of any other state or local laws regulating construction or the performance of work. I am authorized to sign for and obtain this development permit. itSignature: Print Name: .r/i / "^ /_= " -' / Date:,_,C����ry 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. CITY,.OF TUI WILA A(fdress:' 6406:.:; Suite Tenant: Status: ISSUED • •rvpe.: , MISCPERM •Applied : '12/04/1996 Far•:ce1 #: 336590..1940 Issued: 12/23/1996 :+fc :•k' *`k **`k *.k* *•k *•4 * *'k ** k•k•k'k k *•k•k * *•4* 4 4 k *•k* :k** *•k** k•k•k`k**•k *•k ** *'k** 4* ** k*•k*' *•k. *•k* *•k *. Perrni t,' Cond.i ti ont ' 1. . N'o -: changes wi l 1 be ,rnade . to the plans un]ess approved by the Ar-:chitect or Engineer and the Tukwila Build.ing.Division.. :? All :perm.iis, inspection racer cis, and.appr.�o:ved plans 'shall be • • available at the job °site pr'i'or' to "the`: :start ;a.f any con - struction These ;documents ,are to,.be maintai.ned,..and avail- able until final in:pect`ion ;approval is granted , 4. All construction to be `dome ins• conformans. a with approved plans `and .r?equir ements .of the Uniform Building ;Code '(;1994 Edition) as` amended:` . Validity of Permit The issuance of a permit or approval of plans.,,. ,,,spec'i f i ca t i ons', anti `compirra,t,i ons shall . notbe... con+ - str ued to ,be a permit for,: or an approval of, a.nv v�i.olation,. of arayof; t;he pro'v i s i ons ofhe building code ar,. of any otherordlna,nce .of the ,.jurisdic.tion. No perrni t pt esurning give authority to violate o,' cancel.: the provisions ot.. .this code •shal1_ .be , va l i,d, ,1. 143 'ST.. CITY OF T'IKWILA 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. Appilcatlons will not be accepted through the mail or facsimile. Project Name/Tenant: POET SO0/U6 / ?-Tr 2/U GUOo. ks, /�v� Value of Construction: 18.50°' Site Address: ,0/9 .s0U77¢ /4 3 eb City State /Zip: Sr vie w /L /Q- u,1 9848 Tax Parcel Number: 33576- / 940 --O! Property Owner: j-61/ s Z Tv s i/ ,v h' '/L D' /t/ L,--- Phone: 3 %- 6810 Street Address: (olio& .5ovT /y3 £/'J City State /Zip: 57 Tvkw //g /tir¢ f a/G 8 Fax #: 4(1ob )' 9.3- 4g /�/ Phone: '.-39"- Gel o Contact Person: :S t vt4 40 J/ ft) Street Address: _ , 6900 .Soo,* /�.3 et, .Si City State /Zip: 'To Aiv/2Ft ube1_ ?gib 8. Fax #: x/39- 68 /9 Contractor: Ii/v161- /!'i0xo / 2,• -i l 1 ti e Phone: %6 3- D "rno Street Address: City State /Zip: ;7 i 0CC/ D U7, 1- /90I S• .s 4= /9rrGEwi y2C6$ Fax #: G3 . - A 76 %8l Architect: 0 Standby Phone: Street Address: City State /Zip: Fax #: Engineer: A /`� Phone: Street Address: City State /Zip: Fax #: MISCELLANEOUS PERMIT REVIEW AND. APPROVAL REQUESTED: (TO :BEF /LLED'OUTBYAPPLICANT) Description of work to be done: i vEmal.,Yon! OF: c'-0 Ccf A0/LD/x'{- 4/.... G X 3 / z 3/ y SQ /'i. Will there be storage of flammable /combustible hazardous material in the building? ❑ yes Jill no Attach list of materials and storage location on separate 8 1/2 X 11 a er indicatin uantlties & Material Safety Data Sheets ■ Above Ground Tanks lJ Antennas /Satellite Dishes Bulkhead/Docks Commercial Reroof Demolition El Fence CI Mechanical C:1 Manufactured Housing•Replacement only Parking Lots ❑ Retaining Walls ❑ Temporary Pedestrian Protection/Exit Systems ❑ Tem • orary Facilities ❑ Tree Cutting •APPLICANTsREQUEST ,FORMISCELL'ANEOUS' PUBLIC.WORKS,PERMITS';,: Channelization/Striping ❑ Flood Control Zone ❑ Landscape Irrigation ❑ Storm Drainage ❑ Water Meter /Exempt # ❑ Water Meter /Permanent # ❑ Watet Meter Temp # ❑ Miscellaneous ❑ Curb cut/Access /Sidewalk tJ Fire Loop /Hydrant (main to vault) #: Size(s): ❑ Land Altering: 0 Cut cubic yards 0 Fill cubic yards 0 sq. ft.grading/clearing ❑ Sanitary Side Sewer #• ❑ Sewer Main Extension 0 Private 0 Public ❑ Street Use ❑ Water Main Extension 0 Private 0 Public 0 Deduct 0 Water Only SIze(s): Size(s): SIze(s : Est. quantity: Moving Oversized Load/Hauling gal Schedule: MONTHLY SERVICE BILLINGS TO: Name: Na .S C P. d / CgS 26 Tit /- / S h' '/L D' /t/ L,--- Phone: Address: City /State /Zip: 0 Water 0 Sewer 0 Metro 0 Standby WATER METER DEPOSIT /REFUND BILLING: Name: V,//1- Phone: Address: City/State/Zip: 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 foe schedules. Expiration of Plan Review - Applications for which no permit is issued within 180 days following the date of application shall expire by limitation. The building official may extend the time for action by the applicant for a period not exceeding 180 days upon written request by the applicakti ed in Section 107.4 of the Uniform Building Code (current edition). No application shall be extended more than oppy OF TUKWILA [Date application accepts is DEC U ti 1996 Date applic lion expire _ n Applicatioclken by: (Initials) I ALL MISCELLANEOUS PE" ' T APPLICATIONS MUST BE SUBM D WITH THE FOLLOWING: ➢ ALL DRAWINGS SHALLE AT A LEGIBLE SCALE AND NEATLY DRAWN ➢ BUILDING SITE PLANS AND UTILITY PLANS ARE TO BE COMBINED ➢ ARCHITECTURAL DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED ARCHITECT ➢ STRUCTURAL CALCULATIONS AND DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED STRUCTURAL ENGINEER ➢ CIVIL/SITE PLAN DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED CIVIL ENGINEER (P.E.) ❑ SUBMIT APPLICATION AND REQUIRED CHECKLISTS FOR PERMIT REVIEW 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 Submit checklist No: M -9 ❑ Antennas /Satellite Dishes Submit checklist No: M -1 ❑ Awnings /Canopies - No signage Commercial Tenant Improvement Permit ❑ Bulkhead/Dock Submit checklist No: M -10 ❑ Commercial Reroof Submit checklist No: M -6 0 Demolition Submit checklist No: M -3, . M -3a ❑ Fences - Over 6 feet in Height Submit checklist No: M -9 ❑ Land Altering!Grading/Preloads Submit checklist No: M -2 ❑ Loading Docks Commercial Tenant Improvement Permit. Submit checklist No: H -17 ❑ Mechanical (Residential & Commercial) Submit checklist No. M -8, Residential only - H -6, H -16 Submit checklist No: H -9 ❑ Miscellaneous, Public Works Permits ❑ Manufactured Housing (RED INSIGNIA ONLY) Submit checklist No: M -5 ❑ Moving Oversized Load /Hauling Submit checklist No: M -5 ❑ Parking Lots Submit checklist No: M -4 ❑ Residential Reroof - Exempt with following exception: If roof structure to be repaired or replaced Residential Building Permit Submit checklist No: M -6 Submit checklist No: M -1 ❑ Retaining Walls - Over 4 feet in height ❑ Temporary Facilities Submit checklist No: M -7 ❑ Temporary Pedestrian Protection/Exit Systems Submit checklist No: M -4 ❑ Tree Cutting Submit checklist No: M -2 ❑ 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 ". Building Owner /Authorized Agent If the 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 application and obtain the permit will be required as part of this submittal. 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER OR AUTHORIZED AGENT: Signature: ; , ktl4 Z. /.• (,,,�C0 Date: /.2 Print name: Jtl lv S -10 S 1 J ii) Phone: `/ 4y E0/0 Fax #: y.3 6.2I ,y Address: ' Ll 0 L, cal o if 1 9 .. Y' o f, •, C j /St to /Zip: G, ,; . MI..r1MT.00C 7/11/96 ***A*************************************************8***A****** ClTY OF TUKWILA. WA M79,(1.1... g03 TRANSM3T ******8**************N**A71* *W** *****A********************A** TRANSMIT Number : R9600524 Amount: 20)46.50 12/20/96 09:26 Payment Method: CHECK Notation: PUGEF SOUND PW Init: KJP • 'Ter'mit''No: MI9.67003.1 Type:. MISCPERM MISCELLANEOUS 'PERMIT ParceT-No: 336590-1940 Site AdOress; 006 S:143 ST. 'Total reeal . 2046.30, This Payment 2,046 :.50 Total ALL pints: 2.046•.50 Balancev. • icii*.**********.1%*******.k**Ik“.4(****i*4***********114. AccountCOde • Description 000/322.100 BUILDING - RES 000/386.904 STATE BUILDING SURCHARGE 000/386.908 BUILDING BOND/DEPOSIT Amount . • 42.00 4.30 ".) (:$00 • 00 -?, , 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 Pr.. :ct: rr. lit ' Ck (b 'lla - , • 3: of inspe on: , Acjd ` s )93 t Date ca i •. � /i7 �a m. Special instructions: ��Sk� IkhAei& •�. f-DrQ o p k + j 0\)-e. . ( IVGriP1 ,eil� Date wanted Reques er: r ', u st 11 )G (" tog ) 0 Phone No."f Approved per apoplicaiie codes. Corrections required prior to approval. Inspect 4, AlLis LJ $42.00 REINSPEC IFON FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd„ Suite 100. CaII to schedule reinspection. _ .. 1 rv_•_. Date: 1 INSPECTION RECORD Retain a copy with permit INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 Y PERMIT NO. (206) 431 -3670 - Project: rV `�' �ui tU fo{ rn Ty t' w VorK lion: n' ,1 E6 not Address` :"� ,, nn 5 j' ll Date called: Special Instructions: D2 MCA 'It i Qn Date wanted: a.m. p.m. Requester: Phone No.: f ri Approved per applicable codas. Corrections required prior to approval. COMMENTS: Inspector: gUN\ Date: (0 $42.00 REIN ECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Cali to schedule reinspection. 1 r%...... • SENDER: • Complete atoms 1 r "ir 2 for additional services. • Complete items 34 Is & b. • Print your name anb ,..dross on the reverse of this form so that we can return this card to you. • Attach this form to the front of the mallpleco, or on the back If space does not permit. • Write "Return Receipt Requested" on the mallpioco below the article number. • The Return Receipt will show to whom the article was delivered and the date delivered. I als' wish to receive the follo)n services (for an extra fee): 1. ❑ Addressee's Address 2. ❑ Restricted Delivery Consult postmaster for fee. 3. Article Addressed to: d . MR JIM JUSTIN PUGET SOUND PATTERN WORKS 6406 S 143 ST TUKWILA WA 98168 LETTER OF INCOMPLETE APP. M196 -0031 5. Signature (Addressee) 1- w cc 6. Signat a (Agent) _)•(// —7 HPS Forrtf 3811, December 1991 4a. Article Number P 112 198 049 4b. Service Type ❑ Registered ❑ Insured G4 Certified ❑ COD 0) E 0) to a 0. a) tI m cc E a ar et cn c ❑ Express Mail KI Return Receipt for Merc ndise c 7. Date of D:liver Z 1 �t B. Ad.resse ='s Add i ss (Only if requested c and fee is paid) in L 0 T 1— *U.S. O P O: 1992- 323.402 P 112 198 0149 RVCO4it f (.1f Certified Mail MR JIM JUSTIN 6406 S 143 ST '1'UKW I LA WA 98168 .32 1.10 1.10 ,1 2.52 a MAILED 12/16/96 LE TER OF INCOMPLETE AI'1'. M196 -0031 DOMESTIC RETURN RECEIPT UNITED STATES POST" SERVICE .,6 Official Business F", (.." 1 PENALTY FOR PRIVATE DEC j i .1aps TO AVOID PAYMENT •• 1,..;JL: OF POSTAGE, $300 c,c-Avivmruyv Print your name, address and ZIP Code here • KELCIE J PETERSON • CITY OF TUKWILA 6300 SOUTHCENTER BL #100 TUKWILA WA 98188 P 112 198 DI-I9 Receipt or Certified Mail MR JIM JUSTIN 6406 S 143 ST TUKWILA WA 98168 .32 1.10 1.10 $ 2.52 MAILED 12/16/96 LETER OF INCOMPLETE APP. • MI96-0031 j li fe ft. TerS11• . "//.// /.lf / / / ,007 vs) .tstkvgow 6.0 pcmal+irroN:.. OP TM'3 • -/'sk Pr r:i wi. w 250' To Top RivEk BANK AREA r1tR17 . (An LL 13E D15r Rl ev Lo 10 3' DEC() :co+ciciere: • • pR1vE Wfl� • AC • •s .5 FY t s rink• 13011.01611y I understand that the Plan Check approVaIS;are uh;ect to errors and omissions and approvaCof .ti,ans does not authorize the violation of any adopted code or ordinance. Receipt of con- tractor's copy of approved plans acknowledged. f21/1/WA/ 1_ r tdd By Date 40(o 5•• 143 RO sr Tv kwit gi %Am EXIST1Ntr House • Permit No. MLglp_-OD PUGET SOUND PATTERN WORKS, INC 6406 S.143 RD ST TUKWILA, WA. 98168.4626 it 37- 41510 Jim TusTIN. CM ofTUK`Eo APPRO D C 2 0 1596 BUILDING DIVISION (A e OF, t t MVILA DEC 0 4 1996. VI • DEC o '9E 0 :e3PI'I F'UGET :,i UND HIF' F'. Agency Case Nr 'ET SOI.7ND AIR POLLUTION CONTROL ENCY k 110 Union Street, Suite 500, Seattle, WA 93101.2038 9602961 .igcncy Use Only NOTICE OF INTENT TO PERFORM: P Date Received PC4 OEC 51996 A ;envy Use Only A. Project Tvoe: 1 1. (21 Asbestos Removal ( 2, 1.l Asbestos Removal St Demolition 13. 3iit, Demolition. No Asbestos Removal 1 B. Property 1 Owner; Jr ?+IA I- T USA /.0 Property Owner's Mailing Address: lc 3107!; (yy Ra City: /) /<c-U;. 4 Phone: t .2 State: 60/I Zia: e b) 93Y –v3/O C. Asbestos ,L 4s6PAWCLEAPlr. fl1U WILL OE NUR RLTJRNAfAIUAOLABEL Contractor: - A///4 No. of Structures: (see back if . 1) Contractor I Owner /CEO: RECEIVED GtN 0E- Mk" ' 'l Phone: ( ) tt!` r, ., ., . , Contractor 1 Job No,: Mailing Address: Total uantit to be Removed: N I Will all asbestos material be Yes / Linear Ft. Square Ft. 0 removed by oroiect completion? ❑ No City: ,�... _ State: 1 Zip: Fax, ( ) pifutiT OCNTa- 260 - 999 linear feet or 160.44999 square feet 10 Days D, Site Address: (c 510 t. 5CUi,'. /y sea 2- rU 5i , City: 2D 14.)14- % /Al ' I State: k•t /-rz I Zip: ?x /68 I Phone: (42OL) '35.'- 63 /0 Project Manager or Contact Person: J ri r ki t --E-7—C7 S. ■ Asbestos Survey or ❑ Mat'I Presumed: No. of Structures: / Date Survey was Conducted: H PROJECTS _ Was Asbestos CC i. / % - /y ,9;'‘, I g If No, Zr i- Z?l,c2 Z- .8/K - oY Certification No.: Found? • Yes Attach Survey I Expiration Date: :.Z ,22/9? AHERA Building NV „ ILI,IURver ISREQL'fRED BEFORE AUDEM01.17 Inspector Name: T C FF 0 OR-Ai F. Demolition Information: No, of Structures: Start Date: /7S )i Demolition PROT NAME HERE, EATER MA /UNO ADDRESS IN50X JOU A Contractor: p 2.! / & I' 1 r.?M /niC IJ� • U Training Fire (List Fire Dept. as demolition contractor below) al Ordered Dernolition (attach copy of Order) . %4D!N'GSVA ' Otpr. HERE Phone: (,2C6 ) %(3-3 34,E G. Asbestos Project Information: No. of Structures: (see back if . 1) Start Date: Completion Date: Wk. Days: M T W Th F Sa Su Hours: Total uantit to be Removed: N I Will all asbestos material be Yes / Linear Ft. Square Ft. 0 removed by oroiect completion? ❑ No Thermal System Insulation: I Boiler\Fumace Ins. Duct Ins. U ripe Ins. Other: Surfacing Mat'1: ❑ Fireproofing ❑ Paints Plaster Cl Textured Coatings Other: Misc. Mat'l: I D Cement Bd. ❑ Cement Pipe ❑ Flooring Mat'1 ❑ Rooting Mat'l r.. Other. H. Asbestos/Demolition Project Categories: 1, ❑ Owner- Occupied Residential. Asbestos Removal Project 1 ❑ Owner - Occupied Residential Asbestos Removal & Demolition Project I ❑ Owner•Occu•ied Residential Demolition Pro'ect, No Asbestos Removal Notification Waiting Project Fee Period Prior Notice NON-REFUNDABLE . NW , All Other Demolitions With No Asbestos Removal Pro'ect 10 Days ill 11111hurziallill, III atile ' _ - • 10. 259 linear feet or 48. 159 square feet see back of form for options 3 Da s • ► 4. • 260 - 999 linear feet or 160.44999 square feet 10 Days 5. 0 1,000.9,999 linear feet or 5,000.49,999 sguare feet 10 r . ,_ s _t•;mi• S750 10 • " 'y �A��s?�'"i ° 6 10 't.'4 Q ne• 1i � :. 6, • 10,000. 49,999 linear feet or 50,000.99,999 square feet 7. 10 50,000 - 99,999 linear feet or 100.000. 149,999 square feet S. ■ 100,000+ linear feet or 150,000+ square feet 10 .. .:• ' s • w;— S 10,000 er•enc Asbestos Pro'ect or CI Emer•encv Demolition Pro'cct Prior 1 otice Twice Proiect Fee 10. • Alternate Means of Com•hence for friable materials, or • Demolitions 10 -Da Review Period Twice Proiect Fee 11. • Alternate Means of Comoliance for nonfriable asbestos materials Concurrent with Proiect Twice Proiect Fee I. 1 do hereby certify that the information contained in •us notification, and supplemental data described herein. is to the test of my knowledge accurate and complete. 1 shall not cause or allow any asbestos project or demolition activities to begin unttl'the appropriate waiting period has :lapsed. J Signature A j7.z -- w:Ple.5 12/.5 /9e,-.. ,Representing Daic Compfarcncss Review Performed Syr '11 PSAPCA Form No 66.160 (Revised 10/96) Aft • 7t'`J rti envy Vs' O•LY DEC 03 '96 03 :54PN PUGET SOUND AIR p The Puget Sound Air Pollution Control Agency tr�ArCA) is the local air pollution authority for Snohomish, Kiio6.-Pierce and Kitsap Counties. PSAPCA's Regulation III, Article 4, requires advance notification be submitted w PSAPCA, on Agency - aoprovea form no. 66.160 (Revised 10/96), for any asbestos project involving materials equal to or greater in size man 10 linear feet or 48 square feet and for any demolition project. regardless of asbestos content, involving structures with a projected roof area greater than 120 square feet, Notices of Intent should be mailed or hand delivered to PSAPCA (address on reverse side) with the appropriate project fee, A PSAPCA representative will review the notification, and if it is completed correctly a copy will be returned by mail within 3 to 5 days to the mailing address entered in box C and box J. The returned copy will be your valid notification. Asbestos ancj demolitio._ rn o'egts involving materials and structures below jhe notification thresholds liste.d above are still sub,�ect to thattate_r_tmiLer, Article 4. J. Demolition '' "" " "' ' " Contractor: DErnoUio/v /27F1/'J / / U-- Owner /CEO: ,"d /i,&/ Mc ft?E j_ 1-,140 Contractor's Job n: _ Mailing Address: 44),/ 77 OCC1O EV7 /4L. 19d .SO VI Phone: (gyp.,) 763-3366 City: f -7T6E State: GUS Zip: 92iC e Fax: ( (-,) "7 3— / yG GUIDELINES FOR SUBMITTING AN ASBESTOS /DEMOLITION NOTIFICATION Box A. Check the appropriate project type. Box 13. Enter the legal property owner information. For Owner - Occupied Residential Removal Projects (category #1) where the property owner's mailing address differs from the site address, a letter must be submitted explaining why the addresses are different. Box C. Enter the asbestos contractor and mailing address or other properly trained company or person performing the asbestos project. Contact the Washington State Dept. of Labor & industries or OSHA for worker trainin?Jcertiftcation requirements. Box D. Enter the project site address for the asbestos project or demolition. include a designated project manager of contact person, Box E, Check asbestos survey or material presumed. If asbestos survey is checked, fill out all information requested. All demolition with or without an asbestos removal must have an asbestos survey performed by an AHERA Building Inspector. De:molition with no asbestos discovered in the survey must submit a copy of the survey along with the notification. Asbestos removal projects only may check the material presumed box if all materials are to be removed and disposed of as asbestos - containing materials in accordance with PSAPCA Regulation 111. Article 4. Box F. Enter the demolition project information. If the structure is to be used in a training fire, list the fire department responsible for conducting the burn as the demolition contractor in box .1. if the property owner has been ordered to perform a demolition by government official, submit a copy of the order from the appropriate official. Box G. Enter all asbestos project information requested. All multiple structure asbestos project notifications must be submitted with a work plan including a map of the area, site address for each structure, type and amount of asbestos in each structure, and a detailed work schedule. Box H. Check one project category in boxes 41.8. The project fee includes the demolition fee. Asbestos removal projects and demolition with an asbestos removal involving less than 10 linear feet or 48 square feet may be filed as project category 03. An emergency asbestos project or demolition may be requested by checking the appropriate job size category in boxes 02 -9 and then checking the applicable emergency box in category 09. Emergency asbestos project notifications must be submitted with a letter from the property owner explaining the necessity for the emergency. Emergency demolition notifications must be submitted with a letter from an authorized government official or a licensed structural engineer documenting that the structure is iii imminent danger of collapse, To request an alternative means of compliance for friable or nonfriable materials, check the appropriate job size category in addition to the applicable box in categories 410. and #11. A work plant must be submitted by an appropriately trained individual along with the notification. Box 1. Sign the notification certifying the accuracy and completeness of the information provided on the'fonn. Box J, Enter demolition contractor mailing information (on back). rl inrtdatork; amendments are required for changes that increase the project type. job size category, the types of asbestos materials to be removed and work schedule changes. No fee is required for work schedule changes if the contractor is participating in the Agency work schedule fax program. A S50,00 processing fee is required for all other amendments. For technical assistance, contact Tom Hudson at (206) 639 -4058. Larry Vaughn (206) 689 -4035 or Kwame Agyei (206) 689- 4054. For inquiries concerning notification and amendment status contact Anne Morgan (206) 639.4090. 1 MriRE9 Op telt cop,/ PLAN LE / UTING SLIP ACTIVITY NUMBER / CI: G1 2 - OD \ _ DATE 2 - 4 -1(2_ PROJECT NAME Wb � scut.Ib 1PAT1 ERN \AJORKE DEPARTMENT: BUILDING DIVISION FIRE PREVENTION Ej PLANNING DIVISION E] PUBLIC WORKS El STRUCTURAL PERMIT COORDINATOR El DETERMINATION OF COMPLETENESS: (T,Th) COMPLETE U COMMENTS ' DUE DATE - 5 -9(p NOT COMPLETE ED NOT APPLICABLE El TLJES /THURS ROUTING: PLEASE ROUTE fl NO FURTHER REVIEW REQUIRED L ROUTED BY STAFF Ei (If routed by staff, make copy to master file & enter Sierra.) REVIEWERS INITIAL DATE t APPROVALS OR CORRECTIONS: (ten days) DUE DATE 12 —I ct(c) APPROVED El APPROVED W/ CONDITIONS NOT NOT APPROVED (attach comments) Q REVIEWERS INITIAL DATE CORRECTION DETERMINATION: DUE DATE APPROVED Ej APPROVED W/ CONDITIONS p NOT APPROVED (attach comments) 0 REVIEWERS INITIAL DATE (Cerdficadoa of occupancy required. CITY O-TUKWILA Department of Community Development Building Division - Permit Center 6300 Southcenter Boulevard, Tukwila, WA 98188 Telephone: (206) 431 -3670 REVISION SUBMITTAL DATE: /./.2 a f 9G PROJECT NAME: /3067 PLAN CHECK/PERMIT NUMBER: / - �C' D 63 [.Vale./z5 / /•!/c PROJECT ADDRESS: 6 L/ 06 .5 0- /4'3 / e/ s% uka/ d W . 't/!4. 9d/6 0 CONTACT PERSON: •Si vtr Tu S I i w REVISION SUMMARY: P06-5T PHONE: I/ g l- G 8/C _svvjvd 4/ of po 2 L 07;4,A, co TeeZ. SHEET NUMBER(S) "Cloud" or highlight all areas of revisions and date revisions. CITY OF TUKWIIA DEC 2 0 1906 Kop PERMIT CENTER SUBMITTED TO: NVED Q /QR Vr^,7L'. ��:,.7 "f"i• �Cnm ir2 « ?u*pY� `'iiz "'1R '".7h�;u` 7,'C):':h•.kd:�. PLAN REVIEW / ROUTLNG SLIP ACTIVITY NUMBER /_l.• (Q OO- \ DATE 12 -1- - 910 PROJECT NAME W.6101 SCUAh PAP-N V1}ORK DEPARTMENT: BUILDING DIVISION 1 PUBLIC WORKS E FIRE PREVENTION PLANNING DIVISION' STRUCTURAL n PERMIT COORDINATOR Q DETERMINATION OF COMPLETENESS: (T,Th) COMMENTS ' DUE DATE i2 - S -1() NOT COMPLETE E NOT APPLICABLE fl TUES /THURS ROUTING: PLEASE ROUTE fl NO FURTHER REVIEW REQUIRED -- . ROUTED BY STAFF (If routed by staff, make copy to master file & enter Sierra.) REVIEWERS INITIAL DATE t?/ 4 APPROVALS OR CORRECTIONS: (ten days) DUE DATE 12 -1 - 61( APPROVED`L APPROVED W/ CONDITIONS C NOT APPROVED (attach comments) Li REVIEWERS INITIAL i' `� (! DATE - CORRECTION DETERMINATION: APPROVED' fl APPROVED W/ CONDITIONS DUE DATE NOT APPROVED (attach comments) 0 REVIEWERS INITIAL DATE (Ccaificadon of occupancy required. 'r, .;�..�� &�iR.!9 Y, t . '1:1 • * rodt9,y{YI "�.,� c�htit a : , y��:+�t�,t'µ ' s' , uyr�', ,�#� nn. 1,�" �.s'?o�.'.4,��d fb�v:.. a'. r_.; �{ ,.�:.,�,f�liS,��rr.,'`-_�rri.�; •,ii�G +�. ,,. , Lti4.;:` fl''Yt;4",`�5�, ;C''�?l..c.�!.t: h� <� {.> . +�1u:k.: M1.�++;�i'..�tr • PLAN REVIEW / ROUTING SLIP ACTIVITY NUMBER ni11. C RQ OQ-j 1 DATE 12 - 4 - 9 (p PROJECT NAME U� �J 1_S_ �x.� Nlb -- TPA P-N \A oRKG DEPARTMENT: BUILDING DIVISION ❑� PUBLIC WORKS FIRE PREVENTION II STRUCTURAL ❑ PLANNING DIVISION ❑ PERMIT COORDINATOR ❑ DETERMINATION OF COMPLETENESS: (T,Th) DUE DATE t2 - 5 - (v COMPLETE ❑ COMMENTS ' NOT COMPLETE ❑ NOT APPLICABLE TUES /TSURS ROUTING: PLEASE ROUTE E NO FURTHER REVIEW REQUIRED, . ROUTED BY STAFF ❑ (If routed by staff, make copy to master file & enter Sierra.) REVIEWERS I•ITIAL -24i , 4- DATE /.2-75—/T • APPROVALS OR CORRECTIONS: (ten days) DUE DATE 2 _ I ` %.0 APPROVED ❑ APPROVED W/ CONDITIONS ❑ NOT APPROVED (attach comments) ❑ REVIEWERS INITIAL DATE CORRECTION DETERMINATION: APPROVED r7 APPROVED W/ CONDITIONS DUE DATE NOT APPROVED (attach comments) ❑ REVIEWERS INITIAL DATE (Certificadoa of occupancy required. ) +71�T5 jl y,F df.:a vt 4TATS t v:t,.y.y{�,yy�Yby�lyyY {�3�yt hp! #y�1(y�Hyy�t r..s,, ,;.Ye e;, �• SP. F�k1'+ t% e{ ��t'. r: iF r.:. 1�.: 4evIA 5l+ 4C'1 I42. fe? ilf; l% Aaief� tvi]v'AZ'IJi...IAT.Y'G.�'W N4.�2�4'ai",'�ii�v4 °l�'fF'.�.M:, r 1 ff. PLAN REVIEW / ROUTING SLIP ACTIVITY NUMBER AcE.Q-oo\ DATE 12 -4-9(0 PROJECT NAME DEPARTMENT: BUILDING DIVISION PUBLIC WORKS El FIRE PREVENTION E PLANNING DIVISION' a STRUCTURAL E PERMIT COORDINATOR D DETERMINATION OF COMPLETENESS: (T,Th) COMPLETE COMMENTS ' NOT COMPLETE DUE DATE i2.— 5'9C0 NOT APPLICABLE TUES /THURS ROUTING: PLEASE ROUTE fl NO FURTHER REVIEW REQUIRED li ROUTED BY STAFF Ej (If routed by staff, make copy to master file & enter Sierra.) REVIEWERS INITIAL G'l DATE )2—f61q APPROVALS OR CORRECTIONS: (ten days) DUE DATE 12 - 16\ - Clgo APPROVED ❑ APPROVED W/ CONDITIONS NOT NOT APPROVED (attach comments) ti REVIEWERS INITIAL DATE CORRECTION DETERMINATION: APPROVED. a APPROVED W/ CONDITIONS DUE DATE NOT APPROVED (attach comments) Q REVIEWERS INITIAL DATE (Cenifiadon of occupancy required. ) c,c vp sd PLAN REVIEW / ROUTING SLIP ACTIVITY NUMBER An: (AU OO. DATE 12 -4-9(0 PROJECT NAME ?ULEI E 1 SQ�,� n11� FA-E-a ti Z)(. DEPARTMENT: BUILDING DIVISION PUBLIC WORKS FIRE PREVENTION E STRUCTURAL PLANNING DIVISION' El PERMIT COORDINATOR DETERMINATION OF COMPLETENESS: (T,Th) DUE DATE 'a— 5 - COMPLETE El NOT COMPLETE COMMENT 1 A I IJ PG q__6 (9 if0Se /�'!UD $ul3/ r 60py of T/os TUES /TIIURS ROUTING: PLEASE ROUTE ROUTED BY STAFF El (If routed by staff, make copy to master file REVIEWERS INITIAL • DATE NOT APPLICABLE M IT fl2oH MP2 70H I-/uDSoiv /3--4/./ /7vAw NO FURTHER REVIEW REQUIRED & enter Sierra.) APPROVALS OR CORRECTIONS: (ten days) APPROVED APPROVED W/ CONDITIONS E. REVIEWERS I ITIAL DATE DUEDATE 2rI-10 NOT APPROVED (attach comments) (Z 12`'lq4 CORRECTION DETERMINATION: APPROVED l l APPROVED WI CONDITIONS DUE DATE NOT APPROVED (attach comments) Q REVIEWERS INITIAL DATE (Cernfiadoa of occupancy required. ) : 1n=: ti% M' r: 1:':,' h` 4;znn��hM1'1f,+fy ?�.::jCiii -�.`' CITY CF TUKWILA Permit Center 6300 Southcenter Boulevard, Suite 100 Tukwila, WA 98188 Telephone: (206) 431 -3670 ,+7PrSittel61 i lr�lKiY'tmapv$: ts- xisr9'„�774�I'X" PERMIT INTAKE CHECKLIST MISCELLANEOUS f ►:1 t k sets of plans Application ca Checklist complete Application taken by: 8 M e MU0. -Li Energy checklist not needed: (Applicant signature) Permit Number: Project Number: / y +ICI to Ot.) t T t Plan Review Meeting Date: 12 15 °'to Application Complete ❑ Name: Application Incomplete Name: l/LOCL.Pi Date: ( ` -9(0 Date: Date: (dI "5 - I (a SINGLE FAMILY COMMERCIAL ❑ 4 sets of plans ❑ 5 sets of plans ❑ Application ❑ Application ❑ Checklist complete ❑ Checklist complete MISCELLANEOUS f ►:1 t k sets of plans Application ca Checklist complete Application taken by: 8 M e MU0. -Li Energy checklist not needed: (Applicant signature) Permit Number: Project Number: / y +ICI to Ot.) t T t Plan Review Meeting Date: 12 15 °'to Application Complete ❑ Name: Application Incomplete Name: l/LOCL.Pi Date: ( ` -9(0 Date: Date: (dI "5 - I (a !a- r; <.ry 4'? r:.�= 1'v "7:;7J1 ��:.�f+'i'i:;' . i!:✓, r�N? t t:2lzi:A`•t. >';>Y$irir#`f;:Sn'C Ac, .:22:+.f14V3v.:�iR;,�Yr kG"r'.:`JS16fdrttt'Xn ?iLd }, . YAM.xf?310.Kdi1 y,r, 7K:', Nr 4A' C?;. Yi7L! ktti',1r4M!;M/f7niipl'Uv.:/tt. City of Tukwila •I; 1q�.1f'L•'e�'«r4.Tw,+�. i.�l?'x ::�'bN +l+'f..T.('F'F`�C¢�.. ' FILE COPY John W. Rants, Mayor Department of Community Development Steve Lancaster, Director December 16, 1996 Mr. Jim Justin 6406 S 143rd Street Tukwila, Washington 98168 Dear Mr. Justin: SUBJECT: Development Permit Application Number MI96 -0031 NOTICE OF INCOMPLETE APPLICATION Puget Sound Pattern Works 6406 S 143 St This letter is to inform you that your permit application received at the City of Tukwila Permit Center on December 4, 1996 was determined to be incomplete. Before your permit application can begin the plan review process the following requirements from the Public Works Department must be met. Public Works Department: Contact Joanna Spencer, Development Engineer, at 433 -0179 if you have any questions regarding the following comments. 1. Obtain Puget Sound Air Pollution Control Agency (PSAPCA) Permit from Mr. Tom Hudson © 689 -4058 and submit a copy of the approved permit to the Permit Center. (See Attachment). Also, a bond must be made in the amount equal to the cost of construction plus 10% and must be posted prior to issuance of permit. The bond required for this permit application is $2,035.00. (See attachment). In order to better expedite your resubmittal a Revision Sheet must accompany every resubmittal. I have enclosed one for your convenience. Revisions must be made in person and will not be accepted through the mail or by a messenger service. If you have any .questions please contact me at the City of Tukwila Permit Center a (206) 431 -3672. Sincerely, Kelcie J. Peterson Permit .Coordinator Enclosure CERTIFIED MAIL Fi tE � ix �l��v %� le M196-00314 City of Tukwila Department of Community Development John W. Rants, Mayor. Steve Lancaster, Director MEMORANDUM. LAURIE ANDERSON, FINANCE FROM: SHELLIE BATES, PERMIT CENTER DATE: JANUARY 31, 1997 SUBJECT: RELEASE BOND /DEPOSIT Please release the $2,000 bond /deposit to PUGET SOUND PATTERN WORKS. The demolition work was signed off by the building inspector on January 30, 1997. The original transaction was December 20, 1996, Receipt #5799 for $2,046.50. Please return the check to me and the applicant will pick up the check. Thank youl ///9/A7 Date. ' DEPARTMENT OF LABOR AND INDUSTRIES THIS CERTIFIES THAT THE PERSON NAMED HEREON IS REGISTERED AS PROVIDED BY LAW AS A STATE OF WASHINGTON C‘;‘••••••"2"r:.a .�� ��. l. .tt• 1 i•i ;»` 4Em'L mZ /7(5>NZ.