HomeMy WebLinkAboutPermit MI97-0188 - ARCHER RESIDENCE - DEMOLITIONflKedlitEK
13IVIANI DIY
MT'IP- r It)
City of Tukwila [.
(206) 431 -3670
Community Development / Public Works • 6300 Southcenter Boulevard, Suite 100 • Tukwila, Washington 98188
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:
217200 -0025
13013 56 AV S
DEMO
MISCPERM
LDR
DEMO
001
North:
TUKWILA
Contractor License No:
.0 South:
Sewer:
Scopes:
Permit No:
Status:
Issued:
Expires:
MI97 -0188
ISSUED
12/05/1997
06/03/1998
Occupancy:
UBC: 1994
Fire Protection: N/A
.0 East: .0 West:
TUKWILA
Y Streams:
OCCUPANT ARCHER BRYAN & DIXIE
13013 56 AV S, TUKWILA WA 98178
OWNER ARCHER BRYAN & DIXIE
13013 56TH AVE S, TUKWILA WA 98178
CONTACT DIXIE ARCHER
13013 56 AV S, TUKWILA WA 98178
k**************************************************• k* * * ** * * * ** * * * ** *. * * ** * ** * * * * * * **
Permit Description:
DEMOLITION OF 1500 S.F. SINGLE FAMILY RESIDENCE
AND WATER SERVICE CAPPING. EXISTING WATER METER
WILL STAY ON SITE FOR THE NEW RESIDENCE.
EXISTING SEPTIC SYSTEM SHALL BE ABANDONED.
k*************************************************** * * * ** * * * * * * * * * * * * * * * * * * * * * * * * **
Construction Valuation: $ 3,800.00
PUBLIC WORKS PERMITS: *(Water Meter Permits Listed Separate) Eng. Appr: JJS
Curb Cut /Access /Sidewalk /CSS: N
Fire Loop Hydrant: N No: Size(in): .00
Flood Control Zone: N
Hauling: N Start Time: End Time:
Land Altering: N Cut: Fill:
Landscape Irrigation: N
Moving Oversized Load: N Start Time: End Time:
Sanitary Side Sewer: N No:
Sewer Main Extension: N Private: Public:
Storm Drainage: N
Street Use: N
Water Main Extension: N Private: Public:
k*************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ***
TOTAL DEVELOPMENT PERMIT FEES: $ 4,226.50
k******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** i * * ** * ** * ** * * * * ** * * * * * * * * * * * * * * * * * * * * * * **
.0
Phone: (206)248 -2551
Phone: 206,248 -2551
Permit Center Authorized Signature:_
Date: /
I hereby certify that I have read and examine • 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 ermit.
!AAA_ ...9.4.=...atif-A."-----
Signature:
Print Name: r_ �6__r��' -"
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.
Date
A"d "iir:e. s :
Sul "t:e::
'Tenant:
:TYpei MI ?,GPERM
Parse 1 # ,2172000025
1301356 A
Status: ISSUED
Applied: 10/17/1997
•issued: 1.2/.05/1997'
* rk 'k k •k. * •k •k'•k •k •k kb '.* 'k 'k * •k •k ••k 1t' k *" k `k k * * 'k •k'k'k k •k * •k b k •k •k k *''k kb •k •k k 'k :k •k 'k •k * k k k k k •k "k •k * `k •k •k k. •k •k *
Permit conditions:
1'.. Temporary erosion control measures shall be implemented as
the first order of .business,,,to pr.event sedimentation off
site` or into existing ; tors m ;;'ir•.a�:in`age "'fadi;l7ties.
.
The site: shall have ;'p;ernanent erosion o r ont of ;:measures In
'Place as soon as posy ib i e after f it e l grading '.'.has. "..been
'completed and prior to the Fi'n'al Inspection,;, {'
ALL CONSTRUCTION AC:TIVIYT:Y ASSOCIATED', WITH;: TH1S DEMOL =ITION
SHALL BE L,IMITED TO `='WITHIN 10',9E THE BUILDIN6;:.EXTERIOF,.
'Sewer andf water. ' ut i• +l i t i es; sha i i be Plugged a t' the ;ma inns i f
they are .,to be, abandane•d`. I i�. .they: will be •used aga in . i n ':
the 'near:<,f+utiire for a'• new ;bui•l'diri
g,..ti,ey shall, be.•.,cappeti
at the property line and. at:" the water meter respectively.
c ONCE THE DOME'STIG`:`WATER•;SEFVICE HAS., BEEN CAPPED. ^ CONTACT
J20603479 OTIR IN-SOECTIONCAPPEO. SERVICE. ), .v
..THE4EXISTI,WS:qPTI,C TASk-SHALt BE PUMPED EMPTY AND REMOE0
PR MilED. WITWSANa;'A.tOPY:OrDNUOENtATIO FROM THE
CITY OF TI UKWILA
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 mall or facsimile.
Project re/Tenant: n
' rG 411 Pe..\.e r
Descriptionr to be done:
/;kL. 1�Otl ,^�
Value of Conucjypr�
41300 o
Site Address: ,/
City State /Zi :
,
Tax Parcel Numh r:
Pro Owner:
1e 14-4.1 Ir. t, c ►—
Phone:
Q 0 (0 • VS .A SS )
Street Address:
0 Sewer
ity State /Zip:
Fax #:
Contact P
ry�-11 ilre 6 e
Phone: r L.. L
co�� ►� j_�
Street Address: / G
Ave
City State /Zip:
Fax #:
Phone: page(
Contractor:
Street Address
City State /Zip:
Fax #:
Architect:
Phone:
Street Address:
City State /Zip:
Fax #:
Engineer:
Phone:
Street Address:
City State /Zip:
Fax #:
_ MISCELLANEOUS:PERMIT• REVIEW AND APPROVAL REQUESTED: (TO BE FILLED OUT BYAPPLICANT).:
Descriptionr to be done:
/;kL. 1�Otl ,^�
Will there be storage of flammable /combustible hazardous material in the building? ❑ yes n no
Attach list of materials and storage location on separate 8 1/2 X 11 paper indicating quantities & Material Safety Data Sheets
❑ Above Ground Tanks ❑ Antennas /Satellite Dishes ❑ Bulkhead /Docks ❑ Commercial Reroof
❑ Demolition ❑ Fence ❑ Mechanical ❑ Manufactured Housing - Replacement only
❑ Parking Lots in Retaining Walls ❑ Temporary Pedestrian Protection /Exit Systems
❑ Temporary Facilities ❑ Tree Cutting
APPLICANT :REQUEST.,FOR MISCELLANEOUS PUBLIC WORKS PERMITS '.
❑ Channelization /Striping in Curb cut/Access /Sidewalk ❑ Fire Loop /Hydrant (main to vault) #: Size(s)•
❑ Flood Control Zone ❑ Land Altering: 0 Cut cubic yards 0 Fill cubic yards 0 sq. ft.grading /clearing
❑ Landscape Irrigation ❑ Sanitary Side Sewer #: ❑ Sewer Main Extension 0 Private 0 Public
❑ Storm Drainage ❑ Street Use ❑ Water Main Extension 0 Private 0 Public
❑ Water Meter /Exempt # Size(s): 0 Deduct 0 Water Only
❑ Water Meter /Permanent # Size(s):
❑ Water Meter Temp # Size(s): Est. quantity: gal Schedule:
❑ Miscellaneous ❑ Moving Oversized Load /Hauling
MONTHLY SERVICE BILLINGS TO:
Name:
I Phone:
Address:
City /State /Zip:
0 Water
0 Sewer
0 Metro 0 Standby
WATER METER DEPOSIT /REFUND BILLING:
Name:
Address:
jPhone:
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 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 period not exceeding 180 days
upon written request by the applicant as defined in Section 107.4 of the Uniform Building Code (current.edition). No application
shall be extended more than once.
Date application accepted: ,
I -2 -cf
Date application expires:
CIS
Applicati.n a.J • (initials)
ALL MISCELLANEOUS PE • T APPLICATIONS MUST BE SUBMI ' D WITH THE FOLLOWING:
A ALL DRAWINGS SHALL BE AT A LEGIBLE SCALE AND NEATLY DRAWN
A BUILDING SITE PLANS AND UTILITY PLANS ARE TO BE COMBINED
A ARCHITECTURAL DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED ARCHITECT
➢ STRUCTURAL CALCULATIONS AND DRAWINGS REQUIRE STAMP BY WASHINGTON
LICENSED STRUCTURAL ENGINEER
➢ CIVIUSITE PLAN DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED CIVIL ENGINEER
(P.E.)
❑ 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..
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS
PERMIT.
BUILDING OWNER OR AUTHORIZ D AGENT:
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
❑
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
❑
Miscellaneous, Public:Works Permits •
Submit checklist .• No: H -9 .
CI
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
10 be. repaired or replaced
Residential Building Permit
Submit checklist ' No: M -6
❑
Retaining:Walls - Over 4 feet in height
Submit checklist No: M -1
❑
Temporary Facilities
Submit checklist No: M -7
❑
Temporary Pedestrian Protection/ExittSystemS •
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..
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS
PERMIT.
BUILDING OWNER OR AUTHORIZ D AGENT:
Signature: D
Date: /6) / •
Print name: v i'c t 1
1. ►, u‘ 1-1 /, c \\.c e_ P
PY7g, ,;)S5j F
Fa #: S d;)n' _
Address:
i30 5
5 , .41)1_, i o , e
es;?: i ti/vri 9
9,6• )7x-
nnr.sCPAAT nnr 7/11X96
1tk *k4c4* kkA* h* 1 %:*kkk•.1 * * *k *A4* * * *kA44eA **A** *A *a1 *A *k *A•A *. *A
w1TV OF , TU(.�3I1.H
'WA.'
'WA ' h T RANSN]1
* k* *,•k * * **k* 4k**1*•�.hA 1'S. : *k} *A*.4kkA'lAt **.,4kk
TRNN3M):1' Number: . "101,7:006flI imc>uni;� " 4.226..50 12/05/97 10~:15.
Payment Hethod d CHL {:It Not ation . DIXIE L ARCHER Iri i t r WOU•
Permit` Noi. 1I97-01138 Typez MISCPERt4 MISCELLANEOUS PERMIT
Parcel Na 217200-002p ,
9i•te Address:: 13013 56..AV 5.
: Tct;al Feee: 4,226.50
Thi Pament 4,. 6.50. Iota AL:L Pmts.: 4! ty
', .50
t3t-rlance; .00
**i r* A** pt**. * ** "*A * *'*1.* **dt** *14'st* Ili• 00:** *0*k'4**'* *k ***dA*A***"4A- **• *•t*
Ar...ount, Code u.esar i pt.i rin Amount
000/322.100 BUILDING -.AMU 42..00.
000/3131,. "904 STA►E `UtJILpING SURCHARGE' . 4 5()
000 /386_.908 BUILDING U,OND /DEPOSIT 4, 190.00 '
INSPECTION RECORD
Ct Retain a copy with permit
INSPECTION -Ells.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
'119g-018g
PERMIT NO.
(206) 431 -3670
Pro t: -
r
2( ..I.44._
Typ• spectiorr
,<..,,-,...1.. -,-, -i
,
y na ? /.
Address:
I72�
to Av S.
Date ca e • : j
1) -1U 9
- ---- -= '
Special instructions:
Date wanted: '
/
p.m.
Requester: --)
Phone No.:
proved per applicable codes.
El Corrections required prior to approval.
COMMENTS:
Inspector:
AIM rill
$42. • REINSPECTION SEE R QUIRE!). Prior to inspection, fee must
be paid at 6300 Southcenter Blvd., Suite 100, ,Call to schedule reinspection.
Date:
If SP CTION NO.
INSPECTION RECRD
Retain a copy with ,)1it
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
n�1�1- D12A
PERMIT NO.
(206) 431 -3670
- oject:
Am
Address•'
.4r
Type of inspection:
h mcxO
Date calla
-Special instructions:
Date��manJ �ed:
P�'`�1
U' �-1 i C \a- CI •
a.m.
p.m.
eRpquester:
thos6,1,,ds ,g,.....„2„.. �0
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
2- 49?
Inspector:
v.
Date:
IZ1i0%57 I
$42.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must
be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection,
Fk
1
INSPECTION RECORD ,�,.,
Retain a copy with permit' ( L m q'l - c g 53
INSPE�: PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
(206) 431 -3670
Project: erian
grchey.
TCypeerovf�o insp sieonp:
+ C +cnK
5(2-61Ave S
Date called y2 -8 -97
Special instructions:
Date wanted: a.m.
)2 -8_91 p.m.
Requester: Urlan Archer
Phone No.:. 2 y 8.... 2 5 5-)
n Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
W-0-2
s
eu,..w.164 12 I I
•
5W I i-PN TI
v
I Inspector:
Date: 1.4 0 ll /9 ,, 7J
$42.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must
be paid at 6300 Southcenter Blvd., Suite 100. CaII to schedule reinspection.
INSPECTION
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
INSPECTION RECORD,.
Retain a copy with perrhi! "11 g7�vl $$
PERMIT NO.
(206) 431 -3670
Pr•.i;It .'
It
Ad jy�gss��:' /
Typ= section
Date c lei: 7
m
Special instructions:
Date w7ntgd: 6.11
rr��
Reque r'rliQil
Pholyti�Qi7""
(
Approved per applicable codes. r c Jrptions required prior to approve
COMMENTS: r' ?,f N
Inspect
I /1..11/
$42.•REINSPEC SON FEE REQUIRED. Prior to inspection, fee must
be paid at 6300 Southcenter Blvd., Suite 100, Call to schedule reinspection.
Date:
OCT 15 '97 -1 :22P T 50 1 p R
1---Afency Case o. UG SOUND A111 POLLUTION, CONTROL AGENCY
110 Won Street. Ls ie 600, Seattle. WA 91101.1038
9700791
A. Protect ?roc 1 1, tJ Asbestos Removal
NOTICE OF INTENT
TO PERFORM:
2. 3 Aebeet s Removal & Densel[tien
B. Property
Owner;
operty Owner's
re wddrese:
C• A
Contractor:
5 6,d
P•2
Date Received
PSAPCA 0CT 2 3 19'
A ,rtes t.• }a del
lkton. No Asbestos Remora
Phone' (0206 a:2Y ./
cuts: /444/x.. Stute:frJf i 212: Re/
•
Ataillna I ddress:
C'
ate:
Contractor
.Sweet /CEO:
Phone: )
Fax:
Contractor
Job No.'
D. Site
Adana.: 13&L3_ _ 4
Project Manager or
Contact P,e.os :
Set
Cite
.er
E,
Aasiutoa Survey or o. of Date Survey was
Ul Mail Presumed; 13iructurte: I Conducted:
A} RA Building .,v7 iffifga.11a,Avn
In actor N ,t_; r
Peon:
la/447 Aa�tOl aund?
Sur t�Yes
� IT No, Attach 9tu�'ey
Expiration
Certification No.:
y
F, Demolition '
Intormnadont
Imo, of i Start ,
Structures. Dote: 0 . 4'
❑ Training FLe (List Fire Dept. as demolition contractor trelo.v)
Z Ordered Demolition (attach copy_ of Order)
Deno ton "' ' + r , • •. • , . • • u R . ,pq vu ' crnc •x7:: Nee!
Contractor; J Lt7 et ,a..1 --
Panne; (4c' ) c °a SS/
G. Albedo ProJeet
3nfottiPtiont
No, ofStrueturoi:
;see back if, 1)
Stan
Date:
Completion
Data:
Wk, Days: M T W Th 1, Sa Su
Hours:
Tot. tit to be Removed: Lin Pt. Square Pt.
Will l asbestos n aterta! be ill Yes
reni0yc4 l7Y- oroleet =notation? 7 No
Thermal mat 8 stem ins a opt HolloitPucaue ins. w Duct ins. - 1 Pisa lots.
other: _, .
S whelks Met : ee Fiteptcofin L��+ainta Qpleatet Q 'Ignited COatlnss
Qthot:
_
Misc. Mat'1 1 Cement lid. IS Cement Plea ZPleednt Mat'l G.1 Roofing Mat'1 7 of of
H. A4beatoe/Demolltkai Protect Categories:
t. Cd Owner•Occuple4 Residential Asbestos Removal Project
Owner.Occupied Residential Asbestos Removal & Demolition Project
Owner-Occupied P. ReildbnlapernatIon Project, No Asbestos Removal
i of ja was a
�
gigot Pus
Nfa•JFZI
S25
perlo0
Prior Notice ,
2. A110 • , • • . , . Wit be .• Re . 0.1 . Pr t
1 Days
3150
0 - ?59 NnaMr feet cc 48 • 9 square eat ,see back of form or opts a)
Days
S1
4. 260.999 linear feet or 160.4,999 csa are feet
19 Days
S3
5, is 1 000.9 99911 -, .r i.'. • - r • .'l .-
10 ys
$750
6. ' 10,000.49,DDQ 11 ear feet or 50,000.29,999 square fat
i Q Dave
$2.000 —
7. - 30.440 - 9 99 tinter feet or 100,000 149,999 souate feet
Dan
,i,400
8. • 100 000+ 1 earfe •. 1 't0- • .. efc
10 t vs
S},Q,Q�0
Twice ProiatFoe
• "' "mer_e ev As {stria ' • set er fir_ .,ty, II,, :nog on • • ect
_Prior NOtuce
10. • Alternate . Alan o ore iante fcr frig le ma als or w Demojitiots
10•Dsy p,evlew_petitsd Twice protect Pa.
Concurrent with Prefect f Twice Project Fee ,
11. glterria_s Manes of Compliance ter non able albestoi =MAIL
1. t do hereby way to: die Infonnatoe centeicad in du not Attie, , end supplemental data ditaited het dn.'.e t0 the beat 01 my kn :wledst
00c4ett and etvnpisre• 1 leap not coAc or slow art? tutastos project yr demoliCon activities to begin until the asrr:ptiste wa t'n parted has
elapsed.
$ vulture
Conrpltt :nt.0 Rs'•lek
Pee read 8y:
Darr
PSAPCA Pon No. 66.16) (Revised 10/94) AM
PAIDAMOUNT..�.._.
CK.NO.
a. £
• �,vtu
CITY OF TUKWILA
PERMIT CENTER
OCT -1? -1997 16:03 FR011 i - "D —TOX : 110RTRJEST •
TO
0I1/10011MENT Of AMERICA. INC. alv
EDTOX
NORTHWEST
October 17, 1997
248255 F.O1
tAweN 27 �•'' :.
r.><N�M to 17
?6x'1
` ""av ,t
Ms. Dixie Archer
Homeowner
13013 56th Avenue South
ukwila, Washington
ubject: Asbestos Survey Prior to Demolition
13013 56`" Avenue South, Tukwila, Washington
Med -Tox Northwest Job No. A- 4556.1
ear Ms. Archer:
roject We will forward this in
is
hould you have
any questions, please call . me at (425) 656 -2920,
ncerely,
Mu y, OHS
oject Manager
wclosure
CTIVEIALLJO$S1WS3611017974.9M
RECEIVED
CITY OF TUKWILA
OCT 171997
PERMIT CENTER
111%.-.11-0011
19032 66th Avenue S. • Suitt C 105 • Kent, WA 98032 • (206) 656.2920 FAX (206) 6,46 -2924
OCT -i7 -1997 1604 FROM 'TU —TOX NORTHWEST.
TO
ASBESTOS SURVEY REPORT
Single Family Residence
13013 56th Avenue South
Tukwila, Washington
Prepared for:
Ms. Dixie Archer
13013 56`h Avenue South
Tukwila, Washington
Prepared by:
MED -TOX NORTHWEST
19032 66th Avenue South, Suite C 105
Kent, Washington 98032
Project No. A- 4556.1
October 17, 1997
2402551 P,02
`i x i .r1 It nom?'. i` 't ~ ?: t 7ji.''4'�'
ED'W0X 19032 66th Avenuo South . Sulfa C 105 • Kent. Washington • 9602.(236 ) 656.2920 • Fax (20t3) 61672924
.U.+..iwa.tyMnitLL .54e
OCT -17 -1997 16105 FROM Ft' -TOX NORTHWEST
Ms. Dixie Archer /Asbestos Survey at 13013 561" Avenue South
Med -Tox Northwest Project No. A-4556.1
October 17, 1997
Page 11
CONTENTS
TO 1 2482551 P.03
SAFI ENYEIONMUNT OF IAAIIN:A1 NR: Na
ArfiE
■
NDiNWE51
TITLE PAGE
ACRONYMS
1.0 PROJECT SUMMARY 1
1.1 Asbestos Survey Summary 1
2.0 SUMMARY OF ANALYSIS 2
3.0 RECOMMENDATIONS 2
4.0 LIMITATIONS 2
APPENDIX A
APPENDIX B
APPENDIX C
APPENDIX D
APPENDICES
Asbestos Hazard Emergency Response Act Inspector Certificate
National Voluntary Laboratory Accreditation Program Certificate
Laboratory Analytical Report - Asbestos
Summary of Materials Sampled for Asbestos
ACRONYMS
AHERA Asbestos Hazard Emergency Response Act
ACBM Asbestos- containing building material
CFR Code of Federal Regulations
EPA U.S. Environmental Protection Agency
NVLAP National Voluntary Laboratory Accreditation Program
OSHA Occupational Safety and Health Administration
PLM polarized light microscopy
N:1AC rIVE\ LUOas7Ass6\tO 197 REM
KVIL4'
C tikrta Nu. 102021
4
OCT -17-199? 16:886 FROM (' -TOX NORTHWEST
Ms. Dixie Archer /Asbestos Survey at 13013 56" Avenue South
Med -Tax Northwest Project No. A- 4556.1
October 17, 1997
Page 1
1.0 PROJECT SUMMARY
TO
2482551 P,04
W
twevinoeser Qr NIII1cA. we. . h.
/Il ED -Tox
NCRTHWEST
Med -Tox Northwest was contracted by Ms. Dixie Archer to conduct a survey to identify
asbestos - containing building material (ACBM) in a vacant single family residence located at
13013 566 Avenue South, Tukwila, Washington. The purpose of the survey was to identify
ACBM which may be impacted by future demolition activities. Our scope of work did not
include any other environmental liabilities such as lead -based paint, underground storage tanks,
or polychlorinated biphenyls, etc.
The home is a single story, wood framed construction on a concrete foundation. It has one
bedroom, one bathroom, and has always utilizes and electric heat system which is located in
the basement. According to Ms. Archer, the home has undergone many upgrades since 1995.
These include installing new linoleum flooring on hard wood floors, new aluminum windows,
and new exterior siding.
'there were no 'as- built" drawings or previous environmental studies available for review for
this survey. The recommendations and conclusions contained within this report are based on
current regulations in October, 1997.
1.1 Asbestos Survey Summary
The asbestos survey consists of a visual inspection and touching of suspect materials. Bulk
samples were collected and analyzed for asbestos by the Med -Tox Northwest laboratory.
Based on the scope of this project, the asbestos survey meets the sampling protocol for the
isolated areas of work as outlined under Asbestos Hazard Emergency Response Act (AHERA),
40 CFR 763. Med-Tox Northwest employs building inspectors that have completed the 1J.S.
Environmental Protection Agency (EPA) accredited course, and the training certificate of the
inspector is located in Appendix A.
There was no ACBM identified during our survey. We collected representative samples of
linoleum flooring and mastic, sheetrock/joint compound, acoustic ceiling tiles, composition
roofing shingles and underlying felt, and siding felt. All these materials tested negative for the
presence of asbestos. We observed fiberglass insulation in the attic of the house and in the
vicinity of the fireplace.
We did not observe any insulated piping during our survey. According to Mr. Archer, who
has done significant renovations to the home in the past, he has never encountered insulated
piping behind walls, etc. We did limited destructive sampling during the course of our survey.
N:1A C.'r! VEIALLUOBS \4S56110 i 757.R. BM
KVU
Certificate No. 102021
1
OCT -17 -199? 16107 FROM MCD -TOX NORTHWEST TO 24e2551 P.05
Ms. Dixie Archer /Asbestos Survey at 13013 56°i Avenue South
Med -Tox Northwest Project No. A -4556.1
October 17. 1997
Page 2
2.0 SUMMARY OF ANALYSIS
SAFE QIff11101M1N1 Of RMERICA SIC. ON
'M D To
EST
A total of ten out of fourteen bulk samples collected were analyzed for asbestos by polarized
light microscopy (PLM) dispersion staining EPA Method EPA/600/R- 93!116. Med -Tox
Northwest is accredited through the National Voluntary Laboratory Accreditation Program
(NVLAP) of the U.S. Department of Commerce. This accreditation does not constitute
endorsement, but rather a fording of laboratory competence. Our NVLAP participant number
is 102021 (see certificate in Appendix B).
The asbestos analytical laboratory report from Med -Tox Northwest which provides detailed
sample information is located in Appendix C. A summary of materials sampled for asbestos is
in Appendix D.
Samples with results of 1 percent or less asbestos are considered nonregulated asbestos -
containing materials by state and federal regulatory agencies.
3.0 RECOMMENDATIONS
The following site specific recommendations apply:
1. Care should be taken during the demolition process to visually ascertain additional
suspect materials are not disturbed.
2. All other suspect materials identified as a result of demolition operations should be
assumed to contain asbestos unless laboratory analysis proves otherwise.
4.0 LIMITATIONS
Asbestos surveys are not comprehensive by nature and are subject to limitations. A good faith
effort has been made to identify ACBM in or on the building prior to demolition. Med -Tox
Northwest has performed limited destructive investigation where possible and within our
limitation as a consultant. Because construction methods and material uses vary with
contractors and construction trades, suspect ACBM may exist in inaccessible locations that we
have not investigated.
Med -Tox Northwest performed this sampling consistent with the level of care and skill
ordinarily exercised by professionals currently practicing under similar conditions in the
region. No other warranty, expressed or implied, is made.
This report has been prepared fcr the exclusive use of client and its consultants for this project
only. The laboratory analyses, conclusions, and recommendations presented in this rerg�' V �A
CJ
N'1ACrIVE ALL1Oas 45561I01797.R.EM
Cuntfca;e No. ;02021
2482551 P.06
Ms. Dixie Archer /Asbestos Survey at 13013 566 Avenue South
Med -Tox Northwest Project No. A- 4536.1
October 17, 1997
Page
based on conditions encountered at the time of our survey and our experience and judgement
Med -Tox Northwest cannot be held responsible for the interpretation by others of the data
contained In this report.
C iruicate No. 1020Z
,OCT-47-i997: i6I 09 FROM ( TOX , tiORTNWEST
APPENDIX
ASBESTOS HAZARD EMERGENCY RESPONSE
ACT INSPECTOR CERTIFICATE
,..
ff r;;;:::rjb''f+.7,4.2./A,,,,. ' f'f •' ‘'.."',Iillf,,,gi:2;'.''' r --tr4s.sT:',,,l'4.1147t e•0•3::‘yi,''t 4.'7
• , ' • ' ,
A.. 1-, ';'. ■./..5:" . )7.. :P2.. fl.
(IV', • i v , „1 it:;;.. elt'1,....Ni L 10-.-1;;:4•:470\ I: ' / 0. ..4.;-4...01\ -,.:. ,■.,:%-.1.,,,'..■\ :,c-,. • ,rf!'-."-..-1.,;;:.:.1-,.::: .
ci\ +tiVi,Nalf,... e,"Abe,,...`.; .) V. ( . ,Iii+V, \l,... ,'''V .;.>1(,.• i'l t-it`i‘.',.; \cf ,,Ilc" I,' -,e/ A (C,,'11'N.,
7,/,e*..lifT3c.,Tir,..4. I '/... ."1', • ..Z4-71i.,.. ,-".1.1 Yr', • ■..i:r!'■.. ),..311.1"... ,' ;TA', ,..ff k; .■'. 4...?`,.4 -
This is to certify that
Bill Murray
has satisfactorily completed
One half-day refresher training as a
Building Inspector
in compliance with TSCA Title II
AHERA Accredited
••• 7 .
W4
Civ‘r0
1%4*
412 0043 1414)
%Wk. !ON • .1 • • " • a ...L..
• .• • • r
• \ sqt, • •
• • - .• •
\ ' •)-
".• • y
". • ,
Cert. # 97-0900
Conducted at:
Prezanc Associates
Seattle. WA
ItISN le.11,4.
APPENDIX B
NATIONAL VOLUNTARY LABORATORY
ACCREDITATION PROGRAM CERTIFICATE
OCT -17 -1997 16117 FROM CD-TOX NORTHWEST
Ms. Dixie Arcber /Asbestos Survey at 13013 56m Avenue South
Mod -Tox Northwest Project No. A- 4556.1
ND - No Detected
TO
Table D-1
Summary of Materials Sampled for Asbestos
24825551. P.14
Appendix D
hie D -1
{X X .:T 1 'v. {' :: :«4 . if i ,'''.."4" , `:e d '•f^ !, :•I : 3^' i?•if f' Y <
1 iD Hy ` .t ,'.1j , r
•:
.. `".ti'f c'elilI :M .f•� .7r'l ::1,1Pn •: f9:1!' i 2Rf.• J.:t,.. :.`L: iV• ,i1..75 Pr/4 Ii.S' +:•St , f4a l �'Cli, 1.';9 r.:)' J'[1' 1:9't {!� tr•
r ,. :.:r: .r':.,�,< :cr.s, iii. .' -':i� 1s. �4:, >,. t.:�.. Y.r i s ..F:,,6�,:d: 'ifF $:S�tJ.: ^':d' r4. • . 6 • �r ,!'.,� L ,a L;. i' �,�i � :r: y; :15': � ��•' +' r 1 z� Si "r. !'•[ $CT: {, ti:., 4,�f }.�•�'i.,,.
w�- i�e.�.... '.:{nd— °> .'.•Y �+C. :� .e�: ..i3 .y . f 5....4•..:: ...�l:yt: .... kN:;•,L,.c�C.: f.`_�sl':. ;��� . �. °�i6k <r. :. /: +;c.: : Y �>tia,
1016BM001A
Bathroom entrance, white linoleum floo ' L
ND
1016BM002A
Bathroom entrance, tan adhesive under linoleum
flooring
ND
1016BM003A
Laundry room, along east wall, white linoleum
flooring
ND
1016BM004A
Laundry room, along east wall, tan adhesive under
linoleum floo '
ND
1016BM005A
Kitchen, along north wall next to door, white
linoleum flooring
ND
1016BM006A
Living room, northeast corner, sheetrock/jolnt
. u i s a nd (co., . • •sis )
e a nahrl
ND
tA xrifg.t.
#' •{.-itY.;
Y. F. ;ICI' :,. f}": •, .:0,•s'tOi .,,;S1: i ,sL:r:f
• r
S, , ,• • ;0 0;
'5• i3'•:J,r• iQ:..rti:S �;!h'•:•.+..+.4.f�++k0.
eS V. :ai...7... 1A
t:1l,�.ini>!t:{I.,+ i{{ 4 11
1016BM007A Northwest corner room, at entrance, 2 -by 4-foot
acoustic cei ' 1 tile
ND
a x r` i "�
...r . .. ..: .,.f L: , •Jva )J.f' +js1 1. t :•at ':. 1 . M ?,,,,s tYif: 11, ,.,..'...-4:','. ..;:Z. .
c.441. 1 fi2r t ia, .f S .i : :•i i<:r..(P,: e .va >.f4 �(..4.: f. i:v.ki ': 3.f a7... au 7''sl.
1016BM010A Flat section over front door, composition shingle
and underlying felt
ND
1016BM012A Southeast corner of residence, composition shingle
and underi iji: felt
ND
,
:.;4"41'1..4,1e; '. .?Tl J .,r,: , (..e.,.. :, },t:.. :'s:.'r' 0:11( :4-1 i as iti;2;:1
s. : R
r i i ii't ..,. ?. ' " { 1` , • .i,..P1'Jiri'1Y
• S.e.e�cn, !1! .fs >, ;. ;..•:,riy..... a ?: s ,;...fr r ► : i.rfl �7t.. ri, ., rrS:3
.eii' v se' !• p.'t.ita; ''e.v;ij
+ }•a' a� I fi',:�';4''' .
r• <.. s,�3sa;' <.y�', r
i
1016BM013A West side of residence near damaged chimney
section sidin: felt and brown fibrous material
Ni)
N: UCTlv4MLUOLSW361OLT 7•T.ACN
TOTAL P. 14
APPENDIX D
SUMMARY OF MATERIALS SAMPLED FOR
ASBESTOS
OCT -17 -1997 16:14 FROM MED -TOX NORTH4EST
National Institute IIK
or Standards and Technology
TO
2482551 P.11
;sonEC GUIDE 25:1590
150 9002:7987
National Voluntary
Laboratory Accreditation Program
4 - -
Scope of Accreditation
• r •
::::, ; r , ,
,441, c•,r4rEs_re
Page: 1 of 1
ULK ASBESTOS FIBER ANALYSIS NVLAP LAB CODE 102021 -0
SAFE ENVIRONMENT OF AMERICA
dba Med -Tax Northwest
19032 66th Avenue S., #C -105
Kent, WA 98032
Ms. Carol Evans
Phone: 425- 656.2920 Fax: 425 -656 -2924
N LAP Code Designation
1 tA01 U.S. EPA's "Interim Method for the Determination of Asbestos in Bulk Insulation
Samples" as found in 40 CFR, Part 763, Subpart F, App. A, or the current U.S. EPA
method for the analysis of asbestos in building material.
NVLAP• 1S i 7 1.95'
Jwie 30, 1998
tflectn•e through
For the National institute of 5andards and 7ethnoiosy
Unit-Ed States Department of Commerce •
National Institute of Standards and Technology
1
a7 car., �t.._�•, i'.''T° � �, r
w ri OF
.... _......__....» ..... ...... ».. r4}s� i Coo
f C GUI) 213:1980 ...
44#
ISOU Certificate sAccreditation ion
SAFE ENVIRONMENT OF AMERICA
KENT, WA
y •4 , .
t�Y
qe
4414res of '
is recognized under the National Voluntary Laboratory Accreditation Program for satisfy
criteria established in Title 15, Part 2R5 Cod of Federal Regulations. These criteria encompass
of 1SCa/IFC Guide 25 and tltr, relevant requirements r71' 150 gt�G2 satisfactory compliance with
calibration or rest results. Accreditation is r•�•,�rclrrf liar rcl►c!cifir•; ,,F'r•��icc�s, listed n► a i • the requirements
G 1Nted o C7C: Q92-1907) e of as suppliers r:
1 tlr<. Scope of Accreditation fr►r.
BULK ASI3.ESTOS FIBER ANALYSIS
June 30, 1998
Meanie through
tiVI.AP•t51r, tl 1.9,4
for the National Institute of Standards ani/ Tech t� gy
......- »... • _._.._...._ •_. NVLAP Lab Code: 102021 -0
F
1-
CT
8
-o
•
•
OCT-17-1997 16 15
AF'PENDIX C
LABORATORY ANALYTICAL REPORT.:',,,
ASBESTOS
...,r.....,..,... w-..,- r4..n.;,rn.�ae«rm »R:.Vs•..r,.r: r:�; ;;y., ..., ..ti'C.� ...
flit) CITY OF IIUKWILA
MAY 1 2 1997
PERMIT CENTER
City of Seattle king County
Norman U. Hier. Mayor Gary Lark... Executive
Seattle -King County Department of Publics Health
Alonzo L. Plough, Ph.D., MPH, Director
December 18, 1996
Byran Archer
13013 - 56th Avenue South
Tukwila, WA 98178
Re: Decision of the King County Board of Sewage Review Application #96 -98
13013 - 56th Avenue South
Parcel Number 217200 0025 0
RECEIVED
CITY OF TUKWILA
OCT 1 7 1997
PERMIT CENTER
Dear Applicant:
The King County Sewage Review Board has considered your application for waiver of the Code of
the King County Board of Health. Title 13 (Rules and Regulations No. 3).
Waivers Requested:
13.28.070(A); Reduction of minimum design loading volume from 450 gallons per day (GPD) to
300 GPD for an on -site sewage system proposed to be sited on an approximately 10,000 square foot
lot located on a river shoreline.
13.28.030U Table B: Reduction of the standard 10 foot drainfield to property line horizontal
separation to not less than 5 feet.
I3.28.030U Table B: Reduction of the minimum 100 foot drainfield to surface water horizontal
separation to not less than 75 feet.
13.48.010 B.1: Reduction of minimum length of required 2 foot wide drainfield trench by
substituting an increased trench width of 3 feet and concurrently reducing adjacent trench sidewall
separation.
13.48.010(G): Requesting to eliminate required gravel filter material from the soil absorption
trenches and substituting the use of gravelless chambers.
13.28.070Table C: Requesting reduction of required soil absorption area by increasing the
application rate from .45 GPD to .9 GPD.
The waivers requested are associated with an on -site sewage system design proposed to serve a
replacement 2 bedroom single family residence to be constructed following the demolition of an
existing flood damaged dwelling.
Decision of the Board:
After reviewing the application and making a site visit on October 30, 1996; which included meeting
with the applicant, system designer, and Health Department representative, it is the decision of the
Board to approve the waivers requested. With the exception of the above cited code sections the
system design and subsequent system installation shall conform to all applicable requirements
of Title 13 and WAC 246 -272. This waiver is contingent upon fulfillment of the following
conditions:
Byran Archer
December 18, 1996
Page 2
NOTICE: This variance granted by the Board shall expire after two (2) years from the date of
this letter unless the on -site sewage treatment and disposal system (OSS) is installed and
approved by the health officer prior to the expiration date.
To release a building permit you must obtain approvaIhy the district sanitarian_of a revised site
•• •1 1 •I.. • ,• •1• •1 •
•.1 • •
l • 4 .
• •
Submit four complete copies of the site application revised to include theiollowing conditions and
• 1 . • 1 • :. • • • • • , •
• , . • • • • •
•„• •,
review and distribution,
1. The property owner submits a written statement to the health officer; a) agreeing to abide by
and implement conditions of this waiver and further, b) acknowledge that any unauthorized
deviation from the specifications of an approved OSS design, Title 13, WAC 246 -272,
and /or waiver conditions may invalidate any approvals granted.
2. The proposed pressure distribution systems shall be designed. constructed and tested in
accordance with the July 1996 edition of the Guidelines for the Use of Pressure Distribution
Systems, Washington State Department of Health.
3. The design shall specify a permanent barrier along the driveway to preclude vehicular
intrusion onto the soil absorption system areas and sandfilter.
4. All system pressure regulating valves and•end of lateral access points shall be located
within accessible utility boxes with covers accessible at surface grade.
5. The wastewater tanks shall be tested to ensure they are watertight after installation and prior
to approval of the system for use.
6. The wastewater tanks (septic and dosing) shall be equipped with lockable access lids
installed at grade to facilitate monitoring and maintenance of the system.
7. 'Any footing and roof drains shall be specified on the OSS design as well as the location of
and discharge point of these drains.
8. All system pressure regulating valves shall be located within an accessible utility box with a
secured cover accessible at surface grade.
9. All covers to system access and monitoring ports shall be affixed with permanent
identification markings /labels.
10. A system operation and maintenance instruction manual to include a water conservation plan
shall be prepared and submitted along with the revised design to the district office for
review.
11. The designer, builder, and owner shall hold a preconstruction conference on the site prior to
any demolition or construction activities on the lot to ensure that all individuals are aware of
necessary safeguards to preclude negative impacts of the demolition and construction project
upon the sewage system drainfield areas.
12. Adequate temporary barricades or fencing are to be specified by the designer and shall be
installed around the soil absorption system area to exclude any intrusion by equipment or
stockpiling of materials or earth during the demolition and construction process.
.,-.......,.,.... ..,..........,.........,.,,...— ,..�,.r..... «,....»....« .. .............«r.,.,.n. «mr�.nf.m unx»r ^,c!z!tr^'wn ?M•ut,9t�;y «K0:^�RUi7.�N
Byran Archer
December 18, 1996
Page 3
13. Prior to any excavation for the house foundation,. footings or slab, the designer shall verify
the actual location of the house footprint to confirm that it is located so as not to conflict
with the approved sewage system design and confirm that the required drainfield area
temporary protection barriers are in place. The designer shall submit to the health officer
written confirmation of compliance upon fulfillment of this condition.
14. The property owners are to file a covenant on the property with the Department of Records
and Elections which is binding on the owners, heirs, assignees or successors, and which
includes the following:
a. No garbage grinder shall be installed until public sewers are available.
b. A copy of the system as -built drawing as well as the user operation and maintenance
instructions for the sewage system shall be recorded onto the property deed records
prior to final approval of the installed system for use and prior to issuance of a
certificate of occupancy.
c. An agreement to engage a certified on -site sewage system designer, professional
engineer or other qualified individual to conduct a sewage system operation and
preventative maintenance inspection six (6) months after the initial installation,
then annually thereafter.
The monitoring is to be in accordance with the inspection /monitoring criteria
established for sandfilter and pressure distribution systems as contained in the
guidelines issued by the Washington State Department of Health.
d. An inspection report, which is to include water use figures as well as confirmation of
proper effluent dose volumes and frequencies shall be submitted to the Health
Department District Office immediately upon completion and not later than January
31st for each preceding year.
e. Decks shall not extend over any portion or part of the on -site sewage system.
f. A statement advising that the level of sewage treatment provided and future
reliability of the sewage system is enhanced by regular system maintenance and
reduced wastewater loading and therefore, water conservation and regular
maintenance is necessary.
A statement describing the waivers granted and an agreement that the building
will be constructed and maintained as a single family residence with not more
than two (2) bedrooms.
h. No landscape irrigation system (underground sprinkler systems) shall be installed
over or within ten feet (10') of either the primary or reserve soil absorption system
areas.
g.
i. The lot area designated for primary and reserve drainfield will be utilized only for
the soil absorption components of the on -site sewage system. There shall be no
structure or impervious surfaces constructed, removal or addition of soil, nor shall
there be any parking of vehicles within this area.
A statement agreeing not to protest any utility local improvement district project
for the extension of public sewers which would specifically provide service to the
subject nronerty.
At the time of as -built submission, the property owner shall specify in writing the individual
engaged to complete the six (6) month system performance inspection.
John P. Nordin, Chairman
King County Sewage Review Board
James Henriksen, Secretary
JPN:jha
cc: Alder Square District Service Center
Attn: Gale Yuen/Peppe Olyano
Robin Owen, Designer
Charolette Ohashi, Office of the King County Executive
Jeff Ing, Office of the Director of Public Health
RECEIVED
CITY OF TUKWILA
CITY OF TUKWILA 0 0 1' 1 7 1997
ELEVATION CERTIFICATE MAY 1 2 i997 EVA MTFR
FEDERAL EMERGENCY MANAGEMENT AGENCY
PERMIT NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate aoes not provide a waiver of the flood insurance purchase requirement. This form is used only to
provide elevation information necessary to ensure compliance with applicable community floodplatn management ordinances. to
cetermine the proper Insurance premium rate. and%or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMA).
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
BUILDING OWNER'S NAME
1D arf.ate..Va-
POUCY NUMBER
r.cc 1 ADDRESS (Inctuainq Aot.. Unit. Suite anaror eloq. Nurnoerl OR P.O. ROUTE AND BO)( NUMBER
13d 3 Sly
TnEA DESCRIPTION (lot ana BIocA Nur'foars. etc.)
G.T
t_Z
COMPANY NAIC NUMBER
CITY
w.\ Lk
"t'(LI�GT
STATE
WA
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
P (... 11►
ZIP CODE
?rc.,ce the following from the proper FIRM (See Instructions):
i • COMMUNITY NUMBER
2. PANEL NUMBER
J. SUFFIX
A. GATE OF FIRM INDEX
5. FIRM ZONE
E. BABE FL0o0 ELEVATION
on AO Zone, use a>•otn►
53o 33 C032t.�
Slip OF frpSD
.D
C\ — Zck—es
AE- w %�
1'3.?
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): NGVD' 29 ._:Other (describe on back)
n. For Zones A or V; where no BFE is provided on the FIRM, and the community has established a BFE for this building site, Indicate
:re come nity;s . g3FE: feet NGVD (or other FIRM datum -see Section B. Item 7),
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevatipn C.enificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best
cescribes Iht;l subject building's reference level
2(a). FIRM Zones.A1 .A30, AE, AH, ana A (witn BFE). The top of the reference level floor from the selected diagram Is at an elevation
of t0 1..feet NGVD (or other FIRM datum -see Section B, Item 7).
FIRM Zones Vt .V30, VE, and V (with BFE). The bottom 01 the lowest horizontal structural member of the reference level from
the selected djagram, is at an elevation of feet NGVD (or other FIRM datum -see Section B. Item 7).
(c). FIRM Zone A,(without BFE). The floor used as tne reference level from the selected diagram is feet above — or
ee :ow (check one tne nignest grade aajacent to the building.
FtRet Zone AO. The Iloor used as the reference level from the selected diagram is _ feet above ._ or below _ (check
:Jr :a) the highest grade aajacent to the building. If no flood depth number is available, is the building's lowest floor (reference
cvei) elevated in accoraance with the community's lloodplain management ordinance? Yes _... No _Unknown
::c,cate the elevation datum system used in determining the above reference level elevations: ,X NGVD '29 .._ Other (describe
-:;.101 Comments on Page 2). (NOTE: 11 the elevation datum used in measuring the elevations is different than that used on
:,;e FIRM (see Section 8, Item 7), then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: X Yes _. _ No (See Instructions on Page 4)
The reference level elevation is based on: X. actual construction _ construction drawings
NOTE: Use of construction orawings is only valid if the building does not yet have the reference level Iloor in place, in which
:ase tnrs certificate will only be valid for the building during the course of construction. A post-construction Elevation Certificate
,',ii be required once construction is complete.)
Tne elevation of the lowest grade immediately aajacent to the building ,s: k b feet NGVD (or other FIRM datum see
Section B. Item 7). gie 41 1-0' faili
SECTION 0 COMMUNITY INFORMATION
:rte community orficial resoonsiote for verifying meeting elevations specifies that the reference level indicated in Section C. Item •
ezt :rte - lowest floor" as oeline° an the community's tloodplaln management orainance. the elevation of the building's 'lowest
•
SECTION E CERTIFICATION
Tn,s certll,cauon is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to cenity elevation
;nlormatlon when the elevation Information for Zones A1—A30, AE, AH. A (with 8FE),V1— V30,VE. and V (with BFE) is required.
Community officials wno are authorized by local law or ordinance to provide Hoodplain management information, may also sign the
certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an
owner's representative may also sign the certification.
Reference level diagrams 6. 7 and 8 • Distinguishing Features —lf the cenitier is unable to certify to breakawaylnon•breakaway wall,
enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not
induced in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered.
1 certify rear the information in Sections 8 and C on This certificate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishaole by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME
R•oocs�� 1. \..>.At,7iea
TITLE
0
LICENSE NUMBER (or Aix Seal)
SIGN
Copies shout
COMPANY NAME
CITY
STATE
GATE PHONE
4— )A•-9G Z~ 35- -1M(12
ZIP
be made of this Certificate for: '1) community official, 2) insurance agent/company, and 3) building owner. `
COMMENTS'
ON
SLAB
ZONES
ZONES
WITH
BASEMENT
REPINING
4.tVn
ON PILES.
PIERS. OR COLUMNS
A V
ZONES ZONES
AU MINCE
ttvu
•000
ntvarca
'r,e clagrams aoovo Illustrate the points at wnicn the elevations should be measured in A Zones and V Zones.
c,,:vaaons :or all A Zones snould be measureo at the top of the relerence level floor.
:evasions for all V Zones snould be measureo at the bottom of the lowest horizontal structural member.
1414 Of
■
LEGEND
SPECIAL FLOOD HAZARD AREAS INUNDATED
BY 100-YEAR FLOOD
ZONE A No base flood elevations determined.
ZONE AE
ZONE AH
Base flood elevations determined.
Flood depths of 1 to 3 feet (usually areas of
ponding); base flood elevations determined.
ZONE Ae Flood depths of 1 to 3 feet (usually sheet
flow on sloping terrain); average depths
determined. For 1 alluvial fan flood.
ing, velocities also determined.
ZONE A99 To be protected from 100.year flood by
Federal flood protection system under
construction; no base elevations determined.
ZONE V Coastal flood with velocity hazard (wave
action); no base flood elevations deter.
mined.
ZONE VE Coastal flood with velocity hoard (wave
action); base flood elevations determined.
FLOODWAY AREAS IN ZONE AE
OTHER FLOOD AREAS
ZONE X Areas of 500-year flood; areas of
100-year flood with average depths
of less than 1 foot or with drainage
areas Icss than 1 square mile; and
areas protected by levees from 100•
year flood.
OTHER AREAS
ZONE X Areas determined to be outside 500•
year flood plain.
ZONE Areas in which flood hazards are
undetermined.
rR f
i
I �•
(EL 987)
Flood Boundary
Fioodway Boundary
Zone D Boundary
Boundary Dividing Special Flood
Hazard Zones, and Boundary
Dividing Areas of Different
Coastal Base Flood Elevations
Within Special Flood Hazard
I,nnes.
Base Flood Elevation Line; Ele-
vation in Feet*
Cross Section Line
Base Flood Elevation in Feet
Where Uniform Within Zone*
RM7x Elevation Reference Mark
inced to the National Geodetic Vertical Datum of 1929
NOTES
is for use in administering the National Flood Insurance Program:
trot necessarily identify all areas subject to flooding, particularly
al drainage sources of small size, or all planimetric features outside
Flood Hazard Areas.
special flood hazard (100•year flood) include Zones A, A1.30, AI..
A99, V. V1.30 AND VE.
FLOODING SOURCE
FLOODWAY
BASE 11000
WATER SURFACE ELEVATION
CROSS SEC IION
DISIAIICEI
WID111
(IL 1)
SICIIUN
AlllA
(SUIIAIt
fElI)
MEAN
VELOCITY
(IIEII'ER
SECOND)
REGULATORY
WIIIIOUI Willi
IIOOI)WAY FLOODWAY
01E1tNGVD)
INCREASE
Green River
(Without Levees)
A
3.90
450
9,977
1.2
8.2
8.2
8.2
0.0
0
4.38
443
8,939
1.3
8.3
8.3
8.3
0.0
C
4.80
500
9,357
1.3
8.3
8.3
8.3
0.0
O
5.21
800
13,904
0.9
8.3
8.3
8.3
0.0
E
5.42
400
4,953
2.4
8.3
8.3
8.3
0.0
F
5.68
260
3,626
3.3
8.5
8.5
8.5
0.0
C
5.98 •
290
4,571
2.6
8.7
8.7
8.7
0.0
II
6.20
400
4,679
2.6
8.8
8.8
8.8
0.0
I
6.25
200
2,726
4.4
8.8
8.8
8.8
0.0
J
7.62
213
2,432
5.3
9.9
9.9
9.9
0.0
K
8.12
250
2,668
4.8
11.4
11.4
11.4
0.0
L
8.47
290
3,555
3.6
12.3
12.3
12.3
0.0
M
8.86
190
2,464
5.2
13.0
13.0
13.0
0.0
N
8.97
186
2,363
5.4
13.3
13.3
13.3
0.0
0
9.06
165
2,051
6.2
13.5
13.5
13.5
0.0
.....99
9.24
188
2,883
4.4
14.2
14.2
0.0
9.48
134
2,645
4.8
14.4
14.4
1
0.1
R
10.63
176
2,654
4.8
17.5
17.5
17.6
0.1
S
10.79
163
3,247
3.9
18.1
18.1
18.2
0.1
T
10.87
163
2,735
4.7
18.3
18.3
18.4
0.1
U
10.92
216
3,576
3.6
18.6
18.6
18.8
0.2
V
11.18
150
2,571
4.7
19.4
19.4
19.5
0.1
W
11.48
140
2,576
4.7
20.0
20.0
20.2
0.2
X
11.68
180
2,884
4.2
20.3
20.3
20.6
0.3
Y
11.83
175
2,568
4.7
20.6
20.6
21.0
0.4
1Miles Above Mouth
1
A
B
1
E
FEDERAL EMERGENCY MANAGEMENT AGENCY
KING COUNTY, WA
FLOODWAY DATA
.- .. -r-■• •.•/ 11• 1ITLIA /IT I Cl/CCCtt
Approximate
Site Address:
Applicant'
Name
I
Designer
Seattle•: King County Dek ; tment of Public Health
Site Application for On -Site Sewage Disposal SystemCIRECEIVEt, H 0:2;C ,
Y OF
(Submit 5 copies of application with 4 copies of plans) TUKV{II(A Oepartment Use Only
Activity Number
13013 56TH AVE S.
ARCHER BRYAN
Last
R. A. OWEN
First
Street Address
I City-Zip Code I
Street Address 1
City -Zip Code I
ATTACH A DETAILED ROUTE/
DIRECTION MAP FOR LOCATING
PCRMITC RTHE PROPERTY.
13013 56TH AVE S.
TUKWILA 98178 ( phone ° 248-2551
5594 S. LANGSTON RD
SEATTLE 98178 1 phone 772- 4740
PROPERTY INFORMATION:
Parcel #: ,2 1 7 2 0,0 , — , 0, 0,2 ,5 1 Section: 1 1 i 4 1 Township: 12 :3 1
Subdivision Name: I EAST RIVERTON GARDEN TRACTS 2Nq Lot: 1 t 5 1
Property Size: 10 0 9 9, 7, 3 1 sq. ft. Acreage' I 0 .2 3 I
Distance from property line to nearest sewer: 13 31 01+1 ft. • Within ULID? I N I (Y ?N)
Water Supply L p' (IP) I - Individual P • Public (More than One Connection)
Public Water Supply Name: 1 CITY OF TUKWILA 1 ID# 1 . . i . i I
Sensitive Area: L N J (Y ?N) If yes, specify L__J (L,W,O) (L = Landslide W = Wetlands 0 = Other)
Range: i0 4
Block:
SYSTEM INFORMATION:
New System L�
Type of Building 1 S F
Type of System Proposed:
Repair Design L'._J Detailed Plans Attached: (4 sets)' U (Y /N)
l SF = Single Family MF = Multiple Family COMM . Commercial INST = Institutional
D G. Gravity GP - Gravity with pump M- Mound
PO . Pressure Distribution SF : Sand Filter HT a Holding Tank CT a Composting Toilet E - Experimental 0 - Other
Dates Soils Logged: 10, 8 12 ,1 I Soil Logs Data Attached :(Min. allot) U (Y /N)
Depth to Watertable or Restrictive Layer: 1 2 t8 1 inches Maximum Slope in Drainfield /Reserve Area- Q....21_1
SURVEYED FLOOD ELEV.
CALCULATIONS:
Number of bedrooms: L I Total Gallons /Day (450 minimum): I .3 I i I gal. Soil Texture Type (1 -5): 5 !
Application Rate: .1 ;9 1 gal /sq ft/day Total Absorption Area: I 3 3 1 sq. ft
Total Drainfield Length: 11 1 2 3 ft. Septic Tank Size: 1 1 0, 0 ,0 1 gal.
Pump Chamber Size (if needed) 1 9 9 0, 1 gal. Trench Depth (min/max): 11 2 I / tr inches
I understand that failure to comply with the Code of King County Board of Health Title 13 may result in the disapproval of the sewage system being proposed in this
application. Non - compliance may at tion ' Designer's Certificate of Competency and/or appropriate legal action by the Health Department.
Designer's Signature: �t i� K.C.ID# ` P q
0, 3,21 Date 1/17/97
FOR HEALTH DEPARTMENT USE ONLY ? r SYSTEM MUST BE INSTALLED BY A KING
APPROVED J�" /,tlaie/ - - -. BY• '. * /// /�j,�'1 : • / / / ." ' > >�' -S ��C S f�`' �J /OTHERWISE PROVIDED BY CODE UNLESS
Jf L //
Comments /Conditions: / v�.y<e'.(7t -') rf )j)�t, ,.t.vi "/) .2 Lt. i i ye":)1 V PLC cc:4: < !� ' // 1�r,'J
`(- ) -/, er'f. /1:/ "l'7 !... . / ,!v•- /c .''I,(/ /!`tr.C(_ .,- fi.e- ircal-, Ll�_c.j /Y)J/. �• '.'.r�
`._ //) ) ...',c.;.-,._' L.i .:f -'/) , Lt. . 'N.: , ( “Lk_.` C. c".. cit.-:t. ,-.)...47-' - 2..:./ J L1.. -.c :_
APPROVAL OF THIS DESIGN-APPLICATION IS BASED SOLELY ON INFORMATION PROVIDED IN XHIS APPLICATION AND DOES NOT CONSTITUTE PERMISSION TO BEGIN
CONSTRUCTION OF THE PROPOSED SEWAGE DISPOSAL SYSTEM OR ANY OTHER IMPROVEMENT THHE OF SITETUKW. It THIS q APPROVAL SHALL NOT BE CONSIDERED AN MEM
ASSURANCE. EITHER EXPRESSED OR IMPLIED, THAT DEVELOPMENT PERMITS FOR THE SITE
TY
THIS APPLICATION EXPIRES TWO YEARS FROM DATE OF APPROVAL.
DISAPPROVED BY.
OCT 1 7 1997
oats)
See attached Site Deficiency Sheet. MIX 1 ..Ol PERMITCPNTP
JAN 2 1 19.9 ??
wi r,ro
crIt I��r
SEWAGE DISPOSAL SIGN
SAND FIL i ER - GRAVELLESS P.D. LRAINFIELD
FOR:
BRYAN ARCHER
13013 56TH AVE S
TUKWILA WA 98178
SHEET 2 OF 11
DATE: 1/17/97
SITE: ADDRESS: 13013 56TH AVE S. PARCEL # 217200 -0025
INSTALL: 1000 GALLON SEPTIC TANK - - WITH ACCESS RISER & LOCKING COVER AT SURFACE
1000 GALLON PUMP CHAMBER & PUMP WITH ACCESS RISER & LOCKING COVER AT SURFACE
BOTH TANKS TO BE WATERTIGHT TESTED AFTER INSTALLATION.
20 FT. X 20 FT. SAND FILTER (PER WASHINGTON STATET.R.C. GUIDELINES, DATED JUNE, 1996 )
PROGRAMMABLE DOSE TIMER AND COUNTER REQUIRED. (IN PUMP CONTROL PANEL)
112 X 3 FT. GRAVELLESS CHAMBER DRAINFIELD, PER WASHINGTON STATE GUIDELINES DATED
MAY, 1995, USING PRESSURE DISTRIBUTION , PER STATE GUIDELINES DATED JULY 1996.
PROVIDE FILL MATERIAL (MAXIMUM 10% ORGANIC CONTENT) AS REQUIRED FOR 12 INCHES
MINIMUM CHAMBER COVER
A PERFORMANCE MONITORING CONTRACT (IN COMPLIANCE WITH STATE HEALTH DEPT
GUIDELINES) MUST BE IN EFFECT PRIOR TO APPROVAL OF STUB -OUT INSPECTION, AND
ACQUISITION OF INSTALLATION PERMIT.
ANY SOIL LOSS. OR DOWN SLOPE CUTS, (IN DRAINFIELD
OR RESERVE AREA) MAY INVALIDATE THIS DESIGN
RESULTING IN DENIAL OF INSTALLATION PERMIT
INSPECTION SCHEDULE:
STUBOUT INSPECTION : TO BE REQUESTED BY INSTALLER.
(PLUMBING STUB MUST BE INSTALLED AND EXPOSED.)
ASBUILT AND
PRESSURE TESTS:
FINAL INSPECTION:
PRESSURE TESTING TO BE CONDUCTED, BY INSTALLER, IN THE PRESENCE
OF THE DESIGNER AND HEALTH DEPARTMENT SANITARIAN.
AFTER PUMP CONTROL PANEL IS COMPLETELY WIRED & OPERATIONAL
WATER, (IN PUMP CHAMBER SF TO DF) TO BE JUST BELOW "PUMP ON" LEVEL
TO CONFIRM SPECIFIED DOSE VOLUME (48HR NOTICE: 772 -4740 - FAX: 772 -0481)
DESIGNER TO RECEIVE WRITTEN NOTICE TO INSPECT, AND SIGNED BACKFILL.
CERTIFICATION, AFTER ALL SPECIFIED COVER MATERIAL IS IN PLACE.
( BY MAIL OR FAX)
INSTALLER TO PROVIDE SIEVE TEST CONFIRMATION OF C -33 SAND SPECIFICATION
THE ABOVE INSPECTIONS, AND ANY ADDITIONAL INSPECTIONS, WILL BE CHARGED
TO THE OWNER, OR BUILDING CONTRACTOR, AT THE CURRENT HOURLY RATE.
ALL CHARGES WILL BE BILLED AFTER FINAL INSPECTION, AND PRIOR TO
'SUBMITTING ASBUILT FOR HEALTH DEPARTMENT APPROVAL.
RARCLL # 217200 -0025
LOT 5 EAST RIVERTON
GARDEN TRACTS 2ND
DELINEATES FLOOD WAY
AND FLOOD FRINGE
SAND FILTER
LATERAL ELEV: 15.5
PUMP ELEV: 11
DRAINFIELD
TRENCH BOTTOM
ELEV: 14.7
LATERAL ELEV: 15.7
EL
16
ui
DUWAMISH RIVER,
(HIGH WATER) ELEV: 13.7
SHEET 3 OF 11
M. HIGH WATER
ELEV: 06
TOP OF BANK 40' MINIMUM
16
k 37'7"
2 B.R. RESIDENCE
PLUMB
ELEV: 15
42
1;i
I('
4sss
IsI'
I!
1
PARKING
f -- -28 RESV --�
HT-28 RESV --i
8' TYP
F=28 RESV --1
1-- -28 RESV
5
',20 X:20
•
ND FILTER;:
PUMP
ELEV: 10
J
8'TYP
�- -28
5
50
26
27'
NOTE
ON SITE PRE - CONSTRUCTION
MEETING REQUIRED.
SEE ADDENDUM "B"
PUMP & FILL EXISTING SEPTIC TANK
+' yra 4'
••". 1Ni i Y
•
RESERVE DRAINFIELD
AREA REQUIREMENT
30' EXISTING
1.8ASEMENT
EXCAVATION
32'
1 EL
16
1
r3,_AND FILTER DETAIL
21 " X 67 ' PUMP CHAMBER
(ORENCO SYSTEMS)
.4--SLOPE
2" CHECK VALVE
AND UNION
2" PVC TRANSPORTTO DF
-SLOPE
SHEET 4 OF 11
FINAL GRADE
TOP OF LINER
FILTER FABRIC \44 12" COVER
6"
--ORIGINAL GRADE
9" 11/2" GRAVEL
1" PVC LATERAL
I
PUM
'HT REDU
P All11111111 .t
4,11111Eff
TirtitA
fir A
ON/OFF IDANTOFF -
v---111110ME
AEON
PVC MANIFOLD .
gigh
1/2" EXTERIOR PLYWOODOS
r
SUPPORT FRAME
'ATO I •
Arrapraild .Lijfl! ii
VI I 11111:
1111111111111111111111111!11111111111111111111
iii 111111111111111101;0111111111111111111111'"Illimi`
IL-11
411
"1111111111111111111111111111111111111111111111111111111111111111111111111111111111.
4" PERF, PVC
UNDERDRAIN
1'4-36*
1111111111111111111110111111:: IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
30 MIL PVC LINER
(ORENCO SYSTEMS)
Le:11111111111111111111111111111111
11111111111111111111111111111111111111111.2-
■•■••■■■■1
24" C-33 SAND
4" PEA GRAVEL
10" 1 1/2" GRAVEL
4" BEDDING SAND
PVC LINER TO EXTEND
6" ABOVE ORIGINAL
SURFACE LEVEL ON
UPSLOPE "SIDE.
TRANSPORT ONES
IN AND OUT OF SAND
FILTER TO CROSS
OVER THE TOP OF
PVC LINER
11111111111111111111111111111111111
11111111111111111111111111111111111111a
%d1O Vi;y:,:+.rra.ct, +r U»:bu∎61,0,a...o + v..,.... ....,u.,n uuaw....: snw: N•• M. we.w1,,,, v.>.••,...,.. r.. a.» nm.+.-... 4,..... m...,,,. v+....Nw........„.. .w „.,+•:,n..w.- r.,,nx..vrmvvvit iron••. ...w.1,40uea...atrMliMTINFVMJF? J�
SANDILTER UNDERDRAIN DETAi
SHEET 5 OF 11
4 IN. PERF. PVC
(TYPICAL)
SAND FILTER PRESSURIZED BED
FLOW
APPLICATION RATE
ABSORPTION AREA
FILTER DIMENSION
480 GAL PER DAY
1.2 GAL PER SQ FT PER DAY
400 SQ FT
20 X 20 FT SQUARE
DISTRIBUTION NETWORK
MANIFOLD DIAMETER
MANIFOLD LENGTH
LATERAL DIAMETER
LATERAL LENGTH
LATERAL SPACING
NUMBER OF LATERALS
TRANSPORT DIAMETER
TRANSPORT LENGTH
ORIFICE DIAMETER
ORIFICE SPACING
ORIFICES PER LATERAL
TOTAL ORIFICES
RESIDUAL HEAD
FLOW PER ORIFICE
FLOW PER LATERAL
SYSTEM DISCHARGE
3 INCHES
16.5 FEET
1 INCH
19 FEET
3.3 FEET (39.6 INS.)
6
2 INCHES
50 FEET
1/4 INCH (0.25 INS.)
3 FEET (36 INS.)
7
42
2 FEET (24 INS.)
1.04 GAL PER MIN
7.28 GAL PER MIN
43.68 GAL PER MIN
. �...<,. e. w. rvw«. wn,r,�iaurxnx =ir.:v:,1r,5=.2ax �? �fiJ' xzl.;.;; h7 ,4'1. ".!Rt�W;M�b'•"•'�7:�xriir:
MONIT ^RING PORT / AERATOR DET'L
(SAND FILTER)
SURFACE
4 - 4" MONITORING PORT W/ EASILY REMOVABLE VENTED CAP
EFFLUENT DISTRIBUTION LATERAL •
SHEET 6 OF 11
4 INCH PERFORATED AERATION PIPE
BOTTOM OF GRAVEL INFILTRATION BED
AO
BOTTOM OF SAND FILL
OPEN TO SAND / GRAVEL
INTERFACE
SIEVE
C - 33 SAND SPECIFICATIONS
PARTICLE SIZE
% PASSING (BY WEIGHT)
3/8 IN.
9.5 MM
100%
NO. 4
4.75 MM
95 - 100%
NO. 8
2.36 MM
80 - 100%
NO. 16
1.18 MM
50 - 85%
NO. 30
0.6 MM
25 - 60%
NO. 50
0.3 MM
10 - 30%
NO. 100
0.15 MM
2 - 10%
NO.200
0.075 MM
0 -3%
THE SAND SHALL HAVE NOT MORE THAN 45% PASSING ANY ONE SIEVE AND
RETAINED ON THE NEXT CONSECUTIVE SIEVE (OF THOSE SHOWN ABOVE)
THE FINENESS MODULUS SHALL NOT BE LESS THAN 2.3 NOR MORE THAN 3.1
THE FINENESS MODULUS IS DEFINED AS : THE SUM OF THE CUMULATIVE
PERCENTAGES RETAINED IN THE SIEVE ANALYSIS, DIVIDED BY 100,
(FOR THE SIEVE SIZES SHOWN ABOVE)
SIEVE TEST RESULTS, CONFIRMING ABOVE SPECIFICATIONS, MUST BE PROVIDED, BY INSTALLER ,
ono Al 1 en Kin 1 icen ins eMIJenMrCn TOCATI1ACMT /Aril IIUn enlnina R .iNn FIITFR SVSTPMS PRIOR
dk iiG JrS.tin,+f'iu.w.Y ♦va• ■v.. Nen.• nn
SURFACE
.1v+! .n:.0- gHM�it� AGX6K:. Y!' 15Y+' 7i: �Y�YLFi}( i�f�1 :"{i:�.i�{i.l�v�MI.YiJ',�'.�� (,'J'a��tl �•
r EFFLUENT PUMP SHEET 7 OF 11
SAND FILTER - PRESSURE DISTRIBUTIC .4 NETWORK
LOCKING COVER
2' DISCHARGE
CHECK VALVE
Ati
36" MAX.
TO SAND
FILTER
uuununuuuuuuuuuuuuuuu
REDUNDANT
OFF
CONC. BLOCK
1 }if€f € €€111dt11111d111141 €#itr,€fii €f1E141€4 l'€;i€€ INIIR f€ i MI#11 € €fil'ifiPiififitiiiiti4 - i41€1
r
i
PUMP CONTROL PANEL (ORENCO SYSTEMS
OR EQUAL) WITH PROGRAMMABLE DOSE
TIMER & COUNTER.
ABLE TO CONTROL BOTH PUMPS
PUMPS & ALARMS ON SEPERATE CIRCUITS.
ALL WIRING TO BE COMPLETE & OPERATIONAL
PRIOR TO PRESSURE TEST.
DOSE: 120 GAL.
COARSE SAND (ASTM C -33) @ 4 DOSES PER DAY
FLOW: 480 GAL X .25 = 120 GALLONS
PUMP CHAMBER
MINIMUM CAPACITY:
PUMP SCREEN
MINIMUM SPECS:.
• SUBMERSIBLE
EFFLUENT PUMP:
DOSE CYCLE
DURATION:
DRAW DOWN
PER DOSE:
SPECIFICATIONS
1000 GALLONS. (DOSE: 120 GAL + ONE DAY FLOW: 480 GAL) = 720 GAL
1/8 INCH MESH (NON - CORROSIVE MATERIAL), MINIMUM SURFACE AREA: 12 SQ. FT.
NOT TO INTERFERE WITH FLOAT SWITCHES, EASILY REMOVABLE FOR CLEANING.
1/2 HP (GOULDS MODEL 3885 - WEO5H OR EQUAL)
2.75 MINUTES : (120 GAL DOSE 0 43.68 GPM )
CHAMBER SIZE
GAL PER INCH
DRAW DOWN
750 GALLON
15.6
7.7 INCHES
1000 GALLON
20.8
5.8 INCHES
1100 GALLON
22.9
5.2 INCHES
15 FT
FEET
90
80
70
60
50
40
30
20
10
SAND FILTER
PRESSURE NETWORK PUMP
SHEET 8 OF 11
SELECT: 1/2 HP PUMP
CAPACITY: 67 GAL PER MIN.
FRICTION LOSSES
1.85
F = (L) X (Q/K)
GPM
A
B
C
D
E
F
G
1
CL. 200 PVC
GPM/TABLE K
YX 1.85 -
X LENGTH -
/3 -
X NO. OF LAT.
LOSS (FEET)
2
GOULDS -
MODEL 3885
X 100 FT -
3
2" TRANSPORT
0.1386
0.0258
2.58
NA
NA
2.58
4
43.68/873.3-
X 16.5 FT. -
5
3" MANIFOLD
0.05
0.0039
0.0647
0.0216
NA
0.02
6
7.28/66.5 -
X 19 FT m
7
1" LATERAL
0.1095
0.0167
0.3173
.....,WE15H
X 6 - .6348
0.64
8
9
RESID. HEAD
2
10
1.5
HP
1 1
ELEV. LIFT
10
12
1 3
1----WE10H
TOTAL DYNAMIC HEAD
15.24
1 HP
-WEIH
7/10
-1
HP
1
l
i
~WEOSH
1/2 HP
I
-WEO3M
3/10 HP
11111
III.
NEL
7L.
111E
■M
10 20 30 40 50 60
70 80 90 100 110 12(
SELECT: 1/2 HP PUMP
CAPACITY: 67 GAL PER MIN.
FRICTION LOSSES
1.85
F = (L) X (Q/K)
GPM
A
B
C
D
E
F
G
1
CL. 200 PVC
GPM/TABLE K
YX 1.85 -
X LENGTH -
/3 -
X NO. OF LAT.
LOSS (FEET)
2
43.68/315.2-
X 100 FT -
3
2" TRANSPORT
0.1386
0.0258
2.58
NA
NA
2.58
4
43.68/873.3-
X 16.5 FT. -
5
3" MANIFOLD
0.05
0.0039
0.0647
0.0216
NA
0.02
6
7.28/66.5 -
X 19 FT m
7
1" LATERAL
0.1095
0.0167
0.3173
0.1058
X 6 - .6348
0.64
8
9
RESID. HEAD
2
10
1 1
ELEV. LIFT
10
12
1 3
TOTAL DYNAMIC HEAD
15.24
24
2" CL 200 PVC
.TRANSPORT
aY
3 "CL 200 PVC MANIFOLD
GRAVLLESS (CHAMBER) DRA.4Y =IELD
28 X 3 FT. INFILTRATOR (TYPICAL)
1 INCH CL. 200 PVC
6"
10 - 7/32INCH ORIFICES ON 36 INCH CENTERS -;1P-
SHEET 9 OF 11
8' TYP
1 INCH VALVE (TYP.)
USE BALL VALVES (INSTALLED AS SHOWN) TO ADJUST RESIDUAL HEAD TO AN
EQUAL MINIMUM OF TWENTY FOUR INCHES.
SYSTEM DISCHARGE
24 INCH RESIDUAL HEAD
TOTAL: 40 (7/32 ") ORIFICES @ .80 GPM = 32 GALLONS PER MINUTE.
:ry
SAND FILTEP TO PRESSURE DRAINF'cLD DOSE SHEET 10 OF 11
7 X VOLUME OF MANIFOLD & LATERALS PLUS VOLUME OF TRANSPORT PIPE
(IF IT DRAINS BETWEEN DOSES) OR 50% OF DAILY FLOW IN SOIL TYPES
3 & 4 (2 DOSES PER DAY) OR 25% OF FLOW IN SOIL TYPES 1 & 2 (4 DOSES)
DAILY FLOW: 300 GAL. = 150 GAL
2.
SELECT LARGER DOSE:
150 GAL
20FT X 20FT SAND FILTER VOID VOLUME: = 75 GALLONS PER VERTICAL INCH
20' X 20' X 7.48 GAL X 30%
12"
- 74.8 GALLONS
DRAW DOWN = 2 INCHES
PER DOSE
VALVE BOX
1"
VALVE
TYPICAL 36 IN. WIDE INFILTRATOR LATERAL
FINISHED GRADE
36INCH WIDE INFILTRAROR
12" COVER
ORIFICES (AT DESIGNED SPACING) DRILLED AT 12 0 -CLOCK
1 INCH CL. 200 PVC LATERAL
28 FT.
4 INSPECTION
PORT
TEST HOLE
UP
A 12"
MANIF[)I n
TRENCH BOTTOM
A
B
C
D
E
F
1
CL 200 PVC
DIAMETER
GAL. PER FT.
X LENGTH =
X 7 -
GALLONS
2
3
MANIFOLD
3 INCH
@ .417
X 24 - 10
X 7 - 70
70
4
LATERAL
1 INCH
@.058
X 112_ - 6.5
X 7 - 45.5
46
5
6
TRANSPORT
2 INCH
@ .189
N. A.
XXXXXXXXXXX
0
7
8
TOTAL DOSE =
116
DAILY FLOW: 300 GAL. = 150 GAL
2.
SELECT LARGER DOSE:
150 GAL
20FT X 20FT SAND FILTER VOID VOLUME: = 75 GALLONS PER VERTICAL INCH
20' X 20' X 7.48 GAL X 30%
12"
- 74.8 GALLONS
DRAW DOWN = 2 INCHES
PER DOSE
VALVE BOX
1"
VALVE
TYPICAL 36 IN. WIDE INFILTRATOR LATERAL
FINISHED GRADE
36INCH WIDE INFILTRAROR
12" COVER
ORIFICES (AT DESIGNED SPACING) DRILLED AT 12 0 -CLOCK
1 INCH CL. 200 PVC LATERAL
28 FT.
4 INSPECTION
PORT
TEST HOLE
UP
A 12"
MANIF[)I n
TRENCH BOTTOM
9 FT,
FEET
90
80
70
60
50
40
30
20
10
SI F-ILTR TO P.D. DRAIN
PRESSURE NETWORK PUMP
WE15H
1.5 HP,
1 1
El OH
1 HP
1 1
WE07H
7/10 HP
Ni
lift.„_•1_111
SHEET 11 OF 11
GOULDS -
MODEL 3885
WE05H
1/2 HP
WE03M
3/10 HP
,■■01__
,,11111111110
■►i■ M
10
20 30 40 50 60
•
80
100
SELECT: 1/2 HP PUMP CAPACITY: 72 GAL PER MIN.
FRICTION LOSSES
F = (L) X (Q/K) 1.85
110 120 GPM
A
B
C
D
E
F
G
1
2
CL. 200 PVC
GPM /TABLE K
32/315.2=
YX 1.85 =
X LENGTH =
/3 =
X NO. OF LAT.
LOSS FEET
3
4
2" TRANSPORT
0.1015
32/873.3
0.0145
X 40 = .581
NA
NA
0.6
5
6
3" MANIFOLD
0.0366
8/66.5
0.0022
�...
X 24 = .052.9
0.0176
NA
0.02
7
1." LATERAL
0.1203
0.0199
X 28 = .5567
0.1856
X 4 = .7423
1
8
9
RESID. HEAD
2
10
1 1
ELEV. LIFT
5
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EACH PRESSURE DISTRIBUTION LATERAL (IN SAND FILTER & DRAINFIELD) IS TO BE FITTED
WITH A RISER, AS SHOWN, AFTER PRESSURE TESTS HAVE BEEN CONDUCTED, AND
PRIOR TO PLACEMENT OF FINAL COVER
PLUG IN SLEEVE
BACKFILL
MATERIAL
PVC HOSE OR LONG
SWEEP ELBOW
UNDISTURBED SOIL.
THREADED CAP OR PLUG
fCC'
� / nPrPC
ADDENDUM "A"
x\AS
■
�00o
OdoO O
°g°0
o0DO 0��--
•
INFILTRATIVE SURFACE
MONITORING /CLEANOUT PORT
(EXAMPLE)
6" PVC
LAST ORIFICE; WITH ORIFICE
SHIELDS IF ORIFICE ORIENTATION
IS UPWARD •
6" - 24"
PRESSURE LATERAL AS
SPECIFIED
DRAIN ROCK; 6" MIN.
BELOW PIPE
6" PVC WITH DRAIN HOLES;
EXTEND TO BOTTOM OF GRAVEL
TO MONITOR PONDING
PARCEL # 955820 -0080
'r ADDENDUM
At
PROVISIONAL REQUIREMENTS FOR VARIANCE APPROVAL
BY KING COUNTY SEWAGE REVIEW BOARD
A PRECONSTRUCTION CONFERENCE, WITH DESIGNER, BUILDER, AND OWNER, SHALL
BE HELD, ON SITE, PRIOR TO ANY SITE PREPARATION OR CONSTRUCTION, OR
DEMOLITION, TO INSURE THAT ALL INDIVIDUALS ARE AWARE OF NECESSARY
SAFEGUARDS TO PRECLUDE NEGATIVE IMPACT ON THE SEWAGE DISPOSAL AREAS.
ADEQUATE TEMPORARY BARRICADES, OR FENCING SHALL BE INSTALLED SO AS
TO EXCLUDE ANY TRAFFIC OR MATERIAL STOCKPILING IN THE PRIMARY OR
RESERVE DRAINFIELD AREAS, PRIOR TO ANY CONSTRUCTION ACTIVITY. DESIGNER
IS TO BE NOTIFIED FOR INSPECTION AND VARIFICATION.OF THIS REQUIREMENT.
PRIOR TO ANY EXCAVATION THE BUILDING FOOTPRINT LOCATION IS TO BE VERIFIED
(BY, THE DESIGNER) AS COMPATABLE WITH THE SEWAGE DISPOSAL DESIGN.
WRITTEN CONFIRMATION OF THIS, AND COMPLIANCE WITH THE BARRICADE
REQUIREMENT, WILL BE SUPPLIED TO THE HEALTH DEPTARTMENT BY THE
DESIGNER.
AT THE TIME OF ASBUILT SUBMISSION, THE PROPERTY OWNER SHALL SPECIFY, (IN
WRITING) THE INDIVIDUAL ENGAGED TO PERFORM THE SYSTEM MONITORING, AND
PERFORMANCE INSPECTIONS.
City of Tukwila
Department of Community Development
MEMORANDUM
John W. Rants, Mayor
Steve Lancaster, Director
LAURIE ANDERSON, FINANCE
FROM WENDY BULL, PERMIT CENTER
DATE: DECEMBER 15, 1997
SUBJECT: RELEASE BOND /DEPOSIT
Please release the $4,180.00 bond /deposit to BRYAN AND DIXIE ARCHER.
The demolition work was signed off by the building inspector on
DECEMBER 11, 1997. The original transaction was Receipt #6570 for
$4226.00 (less $46.50 for the permit fee) PERMIT NO. M197 -0188.
Please return the check to the permit center and the applicant will pick it up
there.
Thank you!
Building Official
),s-V/ 5/?7
Date
TO:
FROM:
DATE:
SUBJECT:
City of Tukwila
Department of Public Works
John W. Rants, Mayor
NOTIFICATION OF UTILITY PERMIT ACTION
Permit Center
Public Works Engineering
October 24,1997 D `r fie
Rrch-er 5F-
13013 56th Avenue South
Permit No.: M197 -0188
Contact Person: Bryan Archer
Phone: (206) 248 -2551
Ross A. Earnst, P. E., Director
THE FOLLOWING PUBLIC WORKS PERMITS HAVE BEEN APPROVED FOR ISSUANCE
IN ACCORDANCE WITH TI•IE PLANS APPROVED ON OCTOBER 24, 1997:
Water Service Cap
Septic Abandonment
PERMIT FEE
No Fee
No Fee
TOTAL: No Fee
Two copies of the confirmed Utility Permit Application and plans are attached for inclusion in the
permit file.
JJS /sal
CF: Development File (with copy of application and plans)
PW Utilities Inspector (with copy of application and plans)
Finance Department (with a copy of application)
rrnifCcorQt. Copy
PLAN REVIEW / ROUTING SLIP
ACTIVITY NUMBER MI-97 -0188
PROJECT NAME ARCHER. BRYAN
DEPARTMENT:
BUILDING �SION
ttrlk
DATE 10/17/97
FIRE PREVENTION
AM i APPS:
STRUCTURAL
rn�
PLANNING DIVISION
(ire com, u ,
PERMIT COORDINATOR
DETERMINATION OF COMPLETENESS: (T,Th)
COMPLETE " NOT COMPLETE El
COMMENTS �
DUE DATE 10/21/97
NOT APPLICABLE ❑
TUES /THURS ROUTING: PLEASE ROUTE ❑ NO FURTHER REVIEW REQUIRED ❑
ROUTED BY STAFF ❑ (If routed by staff, make copy to master file & enter Sierra.)
REVIEWERS INITIAL DATE
APPROVALS OR CORRECTIONS: (ten days) DUE DATE 11/4/97
APPROVED El APPROVED W/ CONDITIONS ❑
REVIEWERS INITIAL
DATE
NOT APPROVED (attach comments) ❑
CORRECTION DETERMINATION:
APPROVED
DUE DATE
APPROVED W/ CONDITIONS ❑ NOT APPROVED (attach comments) ❑
REVIEWERS INITIAL DATE
(Certification of occupancy required. __ )
CITY OF TUKWILA
Department of Community Development
Building Division - Permit Center
6300 Southcenter Boulevard, Tukwila, WA 98188
Telephone: (206) 431 -3670
REVISION SUBMITTAL
DATE: /0 /Py f 97 PLAN CHECK/PERMIT NUMBER: /MM2 97 --
PROJECT NAME: v. c Are % v�
PROJECT ADDRESS: /&1, s`G ,d , $�.
CONTACT PERSON: y PHONE: P» D S S /
REVISION SUMMARY:
4
—-L ,
RECEIVED
SHEET NUMBER(S)
CITY OF TUKWILA
OCT 2 1997
"Cloud" or highlight all areas of revisions and date revisions.
SUBMITTED TO:
PERMIT CENTER
Bldg.
Planning
CITY USE ONLY
Fire
Public Works
4
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PLAN REVIEW / ROUTING SLIP
ACTIVITY NUMBER MI -97 -0188
PROJECT NAME
DEPARTMENT:
BUILDING DIVISION
PUBLIC WORKS
ARCHER, BRYAN
DATE 10/17/97
FIRE PREVENTION PLANNING DIVISION* E]
STRUCTURAL E PERMIT COORDINATOR El
DETERMINATION OF COMPLETENESS: (T,Th)
- COMPLETE
COMMENTS •
NOT COMPLETE
DUE DATE 10/21/97
NOT APPLICABLE Ei
TUES /TRURS ROUTING: PLEASE ROUTE fl NO FURTHER REVIEW REQUIRED E
ROUTED BY STAFF n (If routed by staff, make copy to master file & enter Sierra.)
REVIEWERS INITIAL
DATE 16/2/A 7
APPROVALS OR CORRECTIONS: (ten days)
APPROVED
REVIEWERS INITIAL
APPROVED W/ CONDITIONS ❑.
DUE DATE .11/4/97
NOT APPROVED (attach comments) EI
DATE O /ZO?
CORRECTION, DETERMINATION:
DUE DATE
APPROVED APPROVED W/ CONDITIONS 111 NOT APPROVED (attach comments) 0
REVIEWERS INITIAL
DATE
(Certification of occupancy, required.
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PLAN REVIEW / ROUTING SLIP
ACTIVITY NUMBER MI-97-0188
PROJECT NAME ARCHER. BRYAN
DEPARTMENT:
BUILDING DIVISION
PUBLIC WORKS
DATE 10/17/97
FIRE PREVENTION 111 PLANNING DIVISION ❑
STRUCTURAL
PERMIT COORDINATOR ❑
DETERMINATION OF COMPLETENESS: (T,Th)
COMPLETE ❑ NOT COMPLETE ❑
COMMENTS
DUEDATE 10/21/97
NOT APPLICABLE ❑
TUES /THURS ROUTING: PLEASE ROUTE ❑ NO FURTHER REVIEW REQUt ED
�`
ROUTED BY STAFF El (If routed by staff, make copy to master file & enter Sierra.) �
REVIEWERS INITIAL '5j )
DATE 10 .7 ). . .7
1
1
APPROVALS OR CORRECTIONS: (ten days)
DUEDATE 11/4/97 •
APPROVED ❑ APPROVED W/ CONDITIONS ❑ NOT APPROVED (attach comments) ❑
REVIEWERS INITIAL
DATE
CORRECTION. DETERMINATION:
APPROVED ❑
REVIEWERS INITIAL
DUEDATE
APPROVED W/ CONDITIONS 111 NOT APPROVED (attach comments) ❑
DATE
(Cerdfication of occupancy, required. )
1
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PLAN REVIEW / ROUTING SLIP
ACTIVITY NUMBER MI -97 -0188
PROJECT NAME
DEPARTMENT:
BUILDING DIVISION
PUBLIC WORKS
ARCHER. BRYAN
DATE 10/17/97
FIRE PREVENTION PLANNING DIVISION ir
STRUCTURAL PERMIT COORDINATOR Q
DETERMINATION OF COMPLETENESS: (T,Th)
• COMPLETE NOT COMPLETE n
COMMENTS
DUE DATE 10/21/97
NOT APPLICABLE
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TUES /THURS ROUTING:
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ROUTED BY STAFF [1 (If routed by staff, make copy to master file & enter Sierra.)
REVIEWERS INITIAL
DATE ( °121.
APPROVALS OR CORRECTIONS: (ten days)
DUEDATE 11/4/97
APPROVED El APPROVED W/ CONDITIONS k-- NOT APPROVED (attach comments) El
REVIEWERS INITIAL
-
DATE
‘1012-1, feCT
CORRECTION. DETERMINATION:
DUE DATE
APPROVED ri APPROVED W/ CONDITIONS p NOT APPROVED (attach comments) 0
REVIEWERS INITIAL
DATE
(Certification of occupancy. required. )
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PLAN REVIEW / ROUTING SLIP
ACTIVITY NUMBER M! 3 - o /
PROJECT NAME
0.-cHurz, A y4i
DEPARTMENT:
BUILDING DIVISION E1
PUBLIC WORKS
DATE /0(/ ./ ?
FIRE PREVENTION �J PLANNING DIVISION 0
STRUCTURAL PERMIT COORDINATOR ❑
DETERMINATION OF COMPLETENESS: (T,Th)
DUE DATE r0 / /(9
- COMPLETEl NOT COMPLETE El NOT APPLICABLE
COMMENTS (,.)1 L'1 // J 854-pc 4 lei -o-- ch
TUES /THURS ROUTING: PLEASE ROUTE EL NO FURTHER REVIEW REQUIRED 0
ROUTED BY STAFF El (If routed by staff, make copy to master file & enter Sierra.)
DATE , ( '�'-
REVIEWERS INITIAL
APPROVALS OR CORRECTIONS: (ten days)
APPROVED W/ CONDITIONS JJ
APPROVED Ei
REVIEWERS INITIAL
CORRECTION DETERMINATION:
DATE
DUE DATE / lG/ -
NOT APPROVED (attach comments) Q
DUE DATE
APPROVED LJ APPROVED WI CONDITIONS Fl NOT APPROVED (attach comments) Q
REVIEWERS INITIAL
DATE
(Certifcadoo of occupancy *squired. )
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ACTIVITY NUMBER 141-97-0188
PROJECT NAME ARCHER. BRYAN
DATE 10/17/97
DEPARTMENT:
BUILDING DIVISION ❑ FIRE PREVENTION ❑
PUBLIC WORKS III STRUCTURAL ❑
PLANNING DIVISION ❑
PERMIT COORDINATOR ❑
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DETERMINATION OF COMPLETENESS: (T,Th)
• • • COMPLETE
COMMENTS •
•
NOT COMPLETE
DUEDATE 10/21/97
NOT APPLICABLE ❑
TUES /THURS ROUTING: PLEASE ROUTE, NO FURTHER REVIEW REQUIRED E
ROUTED BY STAFF ❑ (If routed by staff, make copy to master file & enter Sierra.)
REVIEWERS INITIAL DATE fehtiVi
APPROVALS OR CORRECTIONS: (ten days)
DUEDATE 11/4/97 •
APPROVED n APPROVED W/ CONDITIONS ES NOT APPROVED (attach comments) 0
REVIEWERS INITIAL
Ga- DATE (0 /22'V`Z 7
CORRECTION. DETERMINATION: DUE DATE
APPROVED ❑ APPROVED W/ CONDITIONS ❑ NOT APPROVED (attach comments) ❑❑
REVIEWERS INITIAL DATE
(Certification of occupancy, requited. )