HomeMy WebLinkAboutPermit MI98-0113 - KEIROUZ RESIDENCE - RESIDENCE DEMOLITIONCity 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:
735960 -0475
13031 33 AV S
LOT 13
DEMO
MISCPERM
LDR
DEMO
001
North:
125
.0 South:
Sewer:
Slopes:
Permit No:
Status:
Issued:
Expires:
MI98 -0113
ISSUED
07/20/1998
01/16/1999
Occupancy: DWELLING
UBC: 1994
Fire Protection: N/A
.0 East: .0 West: .0
VAL VUE
Y Streams:
Contractor License No: TERRYE *17308
OCCUPANT KEIROUZ JIHAD
13031 33 AV S, TUKWILA WA 98188
OWNER KEIROUZ JIHAD Phone: 206 - 367 -2361
13520 LINDEN AV N, #338, SEATTLE WA 98133
CONTACT JIHAD KEIROUZ Phone: 206 - 367 -2361
13520 LINDEN AV N, #338, SEATTLE WA 98133
CONTRACTOR TERRY'S EXCAVATING Phone: 206- 246 -2105
13050 10 S, SEATTLE WA 98168
**************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Permit Description:
DEMOLITION OF 1,900 SQ FT SINGLE FAMILY RESIDENCE
INCLUDING EROSION CONTROL TO PROJECT ADJACENT
PROPERTIES.
**************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Construction Valuation: $ 8,500.00
PUBLIC WORKS PERMITS: *(Water Meter Permits Listed Separate) Eng. Appr:
Curb Cut /Access /Sidewalk /CSS: N
Fire Loop Hydrant: N
Flood Control Zone: N
Hauling: N Start Time:
Land Altering: N Cut:
Landscape Irrigation: N
Moving Oversized Load: N Start 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: $ 1 46.50
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
No:
Size(in): .00
End Time:
Fill:
End Time:
Permit Center Authorized Signature:_
Date _1:1.__
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.
Signature:
Print Name: 14 -1411D .
Date: -7/ 20 /tea
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 1s suspended or abandoned
for a period of 180 days from the last inspection.
CITY OF'''IICWILA
Permit Center
6300 Southcenter Boulevard, Suite 100
Tukwila, WA 98188
(206) 431 -3670
F • STAFF USE ONLY
Project Number:
Permit Number:
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 Name/Tenant:
1 /.1.. �. �. _i
Description of work to be done:
'l -'i 0 Lm o N 6.• Ex ' s:T r iaCz ;` ck_--r-t -r -- L Ho ti sg')
Value of Constr con:
500
Site Addres : ?�
1 -31 3� ,4 "L; S
Name: _Ji NAT) V..
City State/Zip:
Ir- .I1I- L\ ,8 IAA"'
Tax Parcel Number:
'"73596,0 - c.)-47-67--d5
I�
Property Owner:
■. (MAD 1 ctiZ__
Phon6 ) -ud 61974
Address: 1,-- � 7-b 44 m
Pone:
(2- ) 367 23 (
Street Address:
1-77"-5:7_, LI 14DEN eve N .
73
City State /Zip:
,�E -'- ✓ e JA
F x #:
(€ › ) 36`7 2t 7o
P
--G) d�j 68 (W4
Fax #:
Contact Person:
,4 t-l-E.=
_.r c �Al z.
5j 33
Street Address:
f�4 `tom r:
0 Sewer
City State /Zip:
Contractor:
_
Phone:
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 BY APPLICANT) .. .
Description of work to be done:
'l -'i 0 Lm o N 6.• Ex ' s:T r iaCz ;` ck_--r-t -r -- L Ho ti sg')
Will there be storage of flammable /combustible hazardous material in the building? ❑ yes no
Attach list of materials and storage location on se. crate 8 1/2 X 11 gag er indicatin • • uantitles & Material Safet Data Sheets
■ Above Ground Tanks ■ Antennas /Satellite Dishes ■ Bulkhead/Docks ■ Commercial Reroof
RI Demolition ❑ Fence ❑ Mechanical ❑ Manufactured Housing- Replacement only
❑ Parking Lots ❑ Retaining Walls ❑ Temporary Pedestrian Protection /Exit Systems
❑ Temporary Facilities ❑ Tree Cutting
APPLICANT. REQUEST FOR MISCELLANEOUS PUBLIC WORKS PERMITS
❑ Channelization /Striping ❑ Curb cut/Access /Sidewalk ❑ Fire Loop /Hydrant (main to vault) #: Size(s).
❑ Flood Control Zone Cl Land Altering: 0 Cut cubic yards 0 Fill cubic yards 0 sq. ft.grading /clearing
Cl Landscape Irrigation ❑ Sanitary Side Sewer #: ❑ Sewer Main Extension 0 Private 0 Public
❑ Storm Drainage ❑ Street Use Cl 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: _Ji NAT) V..
' �l..1z
1
Phon6 ) -ud 61974
Address: 1,-- � 7-b 44 m
N ,
-0
3-38
City /State
/Zip
_.r c �Al z.
0 Water
0 Sewer
0 Metro 0 Standby
WATER METER DEPOSIT /REFUND BILLING:
Name:
I 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 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:
61— / —qe
Date application expires:
/ -7s ie>
Apple taken by: (Initials) I
ALL MISCELLANEOUS PE)., IT APPLICATIONS MUST BE SUB ED WITH THE FOLLOWING:
➢ ‘4%;,414.c...911 q-` L BE 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
➢ CIVIUSITE PLAN DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED CIVIL ENGINEER
(P.E.)
CJ Copy of Washington State Department of Labor and Industries Valid Contractor'g License. "If
not available at file time of applicatibt, a copy of this Iicensewili be required beforethe
rnilt is issued, unless the homegotmeirtw,111 be the builder OR submit Form H -4,, "Affidavit
in Lieu of Cpntractor Registration ".
rh.
Building Owner /Authorized Agent If the applican4augher than the owner, registered architect/engineer, or contractor licensed;
by the State of Washington, a notarizeii1stter' (torn tlfrloroperty owner autharizing the agent to submit this permit appllcatlos and
obtain the permit will be required as part, of this submittal.
1 s •
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 AUTHO -(ZED AGENT:
SUBMIT APPLICATION AND REQUIRED CHECKLISTS FOR PERMIT REVIEW
0
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
0
Antennas /Satellite Dishes
Submit checklist No: M -1
O
Awnings /Canopies - No signage
.1
Commercial Tenant Improvement
Permit
Phone: A.,687y
Bulkhead /Dock
Submit checklist No: M -10
0
Commercial Reroof
Submit checklist No: M -6
,/6
Demolition
Submit checklist No: M -3, M -3a
El
Fences - Over 6 feet in Height
Submit checklist No: M -9
Land Altering/Grading/Pretoads
Submit checklist No: M -2
71
Loading Docks
Commercial Tenant Improvement
Permit. Submit checklist No: H -17
0
Mechanical (Residential & Commercial)
Miscellaneous Public Works Permits
Submit checklist No. M -8,
Residential only - H -6, H -16
Submit checklist No: H -9
D
El
Manufactured Housing (RED INSIGNIA ONLY)
Submit checklist No: M -5
El
Moving Oversized Load /Hauling
Submit checklist No: M -5
O J
0
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
O
Retaining Walls - Over 4 feet in height
Submit checklist No: M -1 .
J
Temporary Facilities
Submit checklist No: M -7
O
Temporary Pedestijarl Protection/Exit Systenis
Submit checklist No: M -4
0
Tree Cutting
Submit checklist No: M -2
CJ Copy of Washington State Department of Labor and Industries Valid Contractor'g License. "If
not available at file time of applicatibt, a copy of this Iicensewili be required beforethe
rnilt is issued, unless the homegotmeirtw,111 be the builder OR submit Form H -4,, "Affidavit
in Lieu of Cpntractor Registration ".
rh.
Building Owner /Authorized Agent If the applican4augher than the owner, registered architect/engineer, or contractor licensed;
by the State of Washington, a notarizeii1stter' (torn tlfrloroperty owner autharizing the agent to submit this permit appllcatlos and
obtain the permit will be required as part, of this submittal.
1 s •
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 AUTHO -(ZED AGENT:
Signature: .1:77���
Date: 5T 2 (9 S
_ w.
/
Print name: _Jit4A-1, e I i.zJ
Phone: A.,687y
1 Fax #: 3C70.4576s
Address: 13'c 2 Li ti/t,c- 1 At ve IQ
-#
333,
� City /State4
��'l1- _t_z..` C.,A- 8 133
CITY OF TUKWILA
Address: 13031 33 AV S
Suite:
Tenan t
Type: MISCPERM
Parcel #: 735960-0475
Permit No: M198-01 13
Status: ISSUED
Aool led: 06/15/1998
Issued: 07/20/1998
****4******************4*4***************4.***-144 A****4******4104*44 4*4 **,
Permit Condttions:
.. . , , •
1. Jempo'rary prosiOnHcontrol measures shall,.be-iMplemented. as
the ffrstHorder of buOnessS4,..4m.ey:gnt'.Sedimentation:,off-
s i t e or i n ti o e x: i t.i 6 c,4„A6:015,4fi*Iq90'.i3SOjiA.•..it 1 e s . . : . • „ , : .
2..
The • s i t e, s ha 1 1 . h a v e , 4!;6.-ei.7:1{4fien t e ro sronednt1icik..,..,tiie S u re s ' i n 1 -
,p 1 a c e • as soon ,as.:•.p•,,osSfb le ,:a ft 1 r f tqa 1 9 ra a il*'t:ias been
comp" ete d a ii d,,tijiWr ' 0,. the : F 0 al .(41Ls P e c € tbY' - ' -''''''''.'7•1.-.-. • ' .
3 . APPLICANT SINAI 08;TV N*,. SEWER Ap PI rIG PERMATrFROtt,YVAL VUE . .:
EWER • D IS Tf4:-,C4 v.,(20-6):..242 -3236. AND :, WATER RivT,-.P.g : CAPq,1,41a
PERMIT FiRt..10,''. WATER D1::S TR ICT,', #125 (3 e2.06),.,2429541.7i. ..,: ''''.',. ;.'•;0.. :
4. .Sewer : ar10,..-1Wat0r '140 11t.teS. shall be p 1 u 99e d,,. a t t 1161, lia ini 0,f
they a re.,,t o ' b 4',.,ie b an d .6 n e d . '1,1' '.: t1)04 die4i 1'1 he u s,e d 4,9a tn. • .1.6.:
the nett:4r' f Ls. t U re for 1 a neW;, .btli ld i n9:ii' .. they s ha 1*.b 4 ..,PW.1) rig d'':0..
, „ ...
at thetyprOperty Tine and...''.6t,:,the water meter:. res'pectlyely.
5. No Cii,an eS.'*i 11...• be made to the .;p1 ens ' tin 1 ess . a por'6.,ue it,..,.bY':.t f.Y.4.);:,,,
A r c611i eot'.6 7'' iig i n e ef‘:::: and the l'ii k w.1.,1 a •13u i 1 d i n9 • D i Vi s ;.16ny.'
6...
Al 1V.•per41t.S ill s e.c ti• on . re cO,7,. d s ., and approved. p la ns . sh41,4,,: 13*,\I
a v 0:14 Pi 1 c.;''''.6- at the tolS.`:.,S1 t,e prif‘ Vt.r t0':',%PIiej:c-s tart of a n Y; c6i2zy, :VrAt: i
s t r teC tl on ., :TheSe::dOctimentS a rte JJiib,e ;Tel-rite i ned • and ' a.i i') ..4.1'i'l:
.abWe3 until '# j'il*1-,,trisiieci6ri ',, a Ppi-OV all ii. . gr4 n t ed
7. A Vi.1:7,,•..oristrOpt i an to ht. done ..r. 1 n • L.onfprmani,..e.,5w i th appvoved.,0
p 1 An and f, r e t4 u i ic.0 nlop t*-,;6f l f.i.0-... Unj fojiiii.:1'bt; i. I'd i ng ' Code ;'.1' C194.'f,.
Edi:t i a n I'':'"'s amended . .,.'' ; ‘,......,..' ....:, :,,,,,s' ' . .. ''. • . .A`likz. ".
8. Va 1id i. ty ;0.0..:.,,: Perm i t .':',-,The,:-1ssi.i$n`ce./61:570'...'-p'elt:.Iiiit or . approval (3,
'P 1' ilYtt;t, .*061 fi:a t 106s , -. and co Iii 0i*e:.0O i).s':44)-a-.1),. not be i .Ob 0.'". '.:05';' ••'.' ':
s trued tO.;,* be.z.,i,aperml ti tor . or an „ap,pf,Toya1 -,,,Of,,4.0:V:v101#Vory,!'‘,3iff
'Of 60,, • of ' the prp V i s i on s of the i .6 0 p,cei I) si-,coape or .apf, '6i),,
0 . t h e i ' • . t'O,rd) n a n C e of the - : I ur i sd i'ai on. 1 N. O • Iiie t*i ti.,40 r es 6 plifn Vit.& , ;.,::..•,:,.::.:
9 i Ve .'04tthor it,V tcr-cviolate or i4ricpl,,he\; p'r 'a yYsi.i,on s "-"o`f. ::th .,VSVI:i.::;,:::
code . ihil, 1. : b ei.,,a 1 Vd,.,1, ,
. • , .
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4
te •
PLANR VI iteUTINtSCIP
ACTIVITY NUMBER:
PROJECT NAME:
MI98 -0113 DATE: 6 -15 -98
REIROUZ RESIDENCE
XX Original Plan Submittal Response to Incomplete Letter
Response to Correction Letter # Revision After Permit Is Issued
DEPARTMENTS:
Buildg�C�iv�n
Tit'914 s
Fir Pr�ention Plann Division
Structure ❑ Permit tord inator
DETERMINATION OF COMPLETENESS: (Tues, Thurs)
Complete Ers Incomplete ❑
Comments:
DUE DATE: 6 -16 -98
❑
Not Applicable ❑
TUES /THURS ROUTING:
Please Route n No further Review Required
Routed by Staff C (if routed by staff, make copy to master file and enter into Sierra)
REVIEWERS INITIALS: DATE:
APPROVALS OR CORRECTIONS: (ten days) DUE DATE: 7 -14 -98
Approved n Approved with Conditions ❑ Not Approved (attach comments) ❑
REVIEWERS INITIALS: DATE:
CORRECTION DETERMINATION: DUE DATE:
Approved ❑ Approved with Conditions ❑ Not Approved (attach comments) ❑
REVIEWERS INITIALS: DATE:
\PR•ROUTE.DOC
6/99
aR+
(/
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION #13
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206) 431 -3670
0i61.sc,.,'�n•;,ir.J• ' s +.. f�;l nt` 1;' 1� ";�rnwtiraTif'�.�1ncf,r+ ? {m�,r
INSPECTION RECOP)."
Retain a copy with pe ...st
1,4I618 -o 113
PERMIT NO.
Project: -:!had Ke i ro u z..
Type of inspection: r' »a i
ft''
Address: 13031 33 rd Ave 8
Date called:
`� -3 -98
Special instructions:
j
.'z
Date wanted: I , 1 �¢
�-j o
('a.m.
`per
Requester . ji 1'1 as Kewo-
•1
-
Phone No.: 367- 23 6 4
Approved per as elrcabre codes.
COMMEN
Correctio - s uired prior to approval.
Inspector: ate:
9-4/-9
8-
$42.00 REINSPECTION E REQUIRED: Prior to„lnspection, fee must
be paid at 6300 Southcenter Blvd., Suite 100, Cali to schedule- reinspection.
t.' 11&z: 'i' :"'7"P !'s`' 'q*;:'q`°"= ` ! ''.`.r ..w`- :c�•y.'.*`,'^y =, iw+±�d4.YY- 1T7 'Y%",.ri: »; f, «tC
INSPECTION RECO,
Retain a copy with pe ,-.t
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
M1n8- 0 113
PERMIT NO.
(206) 431 -3670
Project: thad KeirouZ
Type of inspection: _1Qrno
Address: 13031 33ej Ave .s
f -j
Date calledi (1— 3 q p
O
Special instructions:
Date wanted:
�" 3— �i 0.
a.m.
p.m.
Requester: j--i had Ke i you z
Phone No.: 36-7... 2 .621
1
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
ct/Pti
Inspector:
Date:
[- 1 $42.00 REINSPECTION FEE REQUIRED. P rior to ins ction fee
p , must
be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
. .�rrj.r.i+:�✓I.w+Y":fi, r •: {MM.i�w*+.yMf^!.M�w
INSPECTION RECOV-
Retain a copy with
INSPECTION NO,
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
MW8 0/13
PERMIT NO
(206) 431 -3670
Project:
hacl Keirauz.
T p: of inspection: t I —'T)
, , •
Address: 1363 1 33rd Ave s
Date called: 7_28- 9, 8
Special instructions:
Date wanted: Iu� "'`
? -29 -q 8
i.
Requester: ^ �" L I Q ba f o
Phone No.:
z 3 =g52b
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
1 /z1/ �'sc Nat a ()Lie
Wu7 "V"
M1 .
Inspector:
6k/
Date: sy
$42.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must
be paid at 6300 Southcenter Blvd., Suite 100. CaII to schedule reinspection.
. .,::'.L?,!("at3Wd:r.'�lttc's;»� :•4 ::i: f,w.:n�
INSPECTION NO.
1: Y:',v1it:'�yi}iH �,;,:i•.`,,.�iv %ill1�'i1
INSPECTION RECORD eL O CI
Retain a copy with permit t9 $ -- 3
MIT NO.
(2os) as 3s o
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100,' Tukwila, WA 98188
Project: T
Type of inspection:
Address: D
Date called:
Special instructions: D
Date wanted: a
a.m.
p.m.
Requester:
Phone No.:
j
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
U
____,ZP__%2A_,..*AD ÷
11/14111_, _ Date: ei 1 �R 1 iv.
$42.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must
be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
$42.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must
be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
JUL 22 1998
'COMMUNITY •
DEVELOPMENT
CITY OF T Ul<W3,L
**.k,h4*A 44",c0 41.****-1.1tAA—kleirlrAlctor..M./e*A **A**.*1; A 4—A*-,44***4.4c4:•k:t—?1.4.9vic..81‘ is..1/44r4
TR ANSMIT iklumber : R.970()796 Amouilt 07/40/''.48 1057
Intiment Mc hod: ClIECI; Notat; ori: JIHAD ICEt11002.: ' .01.H "
.. Permit Nor MI99.-0113 Tvpe: MISCPE.RM IlISCELl. AN1.1,0119 PIIIIMIT
Si te Addess: 13031 33 AV 9
Parc el Pio: 735960-0
r 0
Loctiori: LOT 13
Tote] Fees: ' 46.50
Th is Piivmeht . 46.5() Total AL.L Pmts:
Biitl ance: , ' .00 .
1/.4...‘7%****4*.kitirie4**,■1,***A.A.o.**A*4A.***AA*014114...ktNI4A***1■AirAilvitis4PIi****"** ' .•
Account Code Descript ion '- ' ' ' Amount
.• ,.
000/322.100 IiUIL()ING . - 42.00 ,.. 4.,5.0
ST ATP' BUILDING SUR CFIAR BE . '
U3INS0 .LM1Nb3d!
6661, Nn
ViM)Ini JO
aanlaa3d
NOIS1I■ C1 OP`11G' i4f 1'ci
cnoliaW
g 6t Ct 1
31104 Alin LiI
�\J tiPiNf;i 1e ,�...
i
4-41
tNi
ta
NE 16 -23 -4
N 1- 32- 34 E
N
2
w'
w
v
71<
Jo ., a9
N _ •
1
• visysW
S
•
•
t71 js W ...
� M �pp
J J� O
O •0
JO M o
KWILIV
114‘ 40'0
'6Z JO' Jai
.
;. , 4's
.V
NE 16- 23- 4
NI- 32 -34E
7
r
• 0
D
#7114
10
N
s
.s
1-
,ti 1t N
,�,
Vr
/�
. �• •
ti41
t•-•
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` v
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0
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JUN 1 5 1998
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Fire Department'Review
Control #MI98 -0113
(510)
John W. Rants, Mayor
Thomas P. Keefe, Fine Chief
June 24, 1998
Re: Kierouz Residence - 13031 33rd Avenue South
Dear Sir:
The attached set of demolition plans have been reviewed by
The Fire Prevention Bureau and are acceptable with the
following concerns:
1. Accumulation of combustible waste material is
prohibited during the demolition phase of this project.
Remove,and properly dispose of all waste material prior to
the close of the working day and as often throughout the
day as needed.
Any overlooked hazardous condition and /or violation of the
adopted Fire or Building Codes does not imply approval of
such condition or violation.
Yours truly,
The Tukwila Fire Prevention,Bureau
cc: TFD fle
ncd
Headquarters Station: 444 Andover Park East • Tukwila, 98188 ' 'Phone (206) S7S.4404 • Fax (2O6) VS4439
JUN -04 -1998 15:42
AgencyJCase No. 0
9 2089
Agenry�Use Only
WSC INC
Pt{ OUND AIR POLLUTION CONTROL AG''VCY
• 110 Union Street, Suite 500, Seattle, WA 98101 -21;
1 NOTICE OF INTENT
TO PERFORM:
P. 01
Date Received
"Jr' Pc A JUN 05 199
Agency Use Only
A. Pro ect e: ll
1. m Asbestos Removal
2. Asbestos Removal & Demolition
Flint irrin115141,110yrrIllrerrrirni
B. Property
Owner:
Property Owner's
Mailing Address:
1
J.A.K., Inc Jihad Keirouz
13520 Linden Ave N1 #338
City: Seattle
Phone (206) 367 -2361
State: WA zip: 98133
ILCA$R Plum'L'LGAULY, MY VI7.L !E rook OMAN MAn.P GLOI(L.
C. Asbestos , Contractor
Contractor: Walker S.ecial Construction, Inc. Owner /CEO: Bill Walker
Contractor
Mailin: Address:: PO Box 469 i Phone: 206 361 -8913 Job No.:
!!' 1
City: Snohdmish State: W1A Zip: 98291.0469 Fax: (425J 806 -7383 A -480
D. Site
Address: 113031 33'd Ave S Ci . Tukwila State: WA Z'.: 98168
Project Manager •
Contact Person: Jihad Keirouz ! Phone (206 367 -2361
E. Asbestos Survey or No. of Date Survey was Was Asbestos Found? I Yes
C] Mat'! Pr anted: Structures: 11 Conducted: 5 -28 -98 ❑ If No, Attach Survey
AHERA Building j Certification Expiration
Inspector Name: Todd Rickert 1 No.:539922502 Date:1 -05 -99
F. Demolitiou No. of ' Start D Training Fire (List Fire Dept. as demolition contractor below)
Information Structures: 1 Datq: 7- 01 -98EST C] Ordered Demolition (attach co • of Order)
Demolition
Contractor:, Terry Excavating i Phone: (206) 246 -2105
G. Asbestos Pr jest No. of Structures:
Informsttio (see back if > 1)
Total Quanti tolbe Removed
Thermal System anon:
Surfacing Mat'I: I • Fireproofing
Misc.'vial'I: 111 Cement Bd.
1
Start 6.05 -98
Date:
LinearlFt S • • Ft. 305
Boilcr\Fumace (ns.
Completion 12 -31 -98
Date:
Duct Ins. ■ Pipc Ins.
Wk. Days: M T W Th F Sa Su
Hours: 7am- 3:30am
Will all asbestos material be
removej by project completion?
Other.
Paints 1 r Plaster • Textured Coatings
Cement Pipe 1 Flooring Mat'I lirRoofutg Mat'I —other
1.1. Asbestos molition Project Categories: 1 Noti cafon Waiter Proiect_Fee
1. V owner ccupicd Single Family Resider4ial Asbestos Removal Project Flagg NON - R.gFUNj)ABLE
V Single F mily Residence Demolition Project
_. I Prior Notice S25
2.13 .Fill Otb ' Demolitions With No Asbestos Removal Project 10 Days 50
3. 10 - 2591inear feet or 48 - 159 square fejet jsee back of form for options) 3 Days $150 ,74:70-3-6-i9 linear feet or 160 - 4,999 squire feet 10 Days y5300 ---1 _ 5. d 1,00O. • 999 linear feet or 5,000.49 999 feet 10 Days $750
6. O 10,000 49,999 linear feet or 50,000 - ,999 square feet 10 Days $2,000
7. la-50,000 99,999 linear feet or 100400 - 1149,999 square feet 10 Days 55.000 —�
18. 100,0 linear feet or 150 00� 0+ sguar feet — 10 Days 510,000
9 2 0 Fi er: Asbestos Pro'ect or •' • enc Demolition Pro'ect Prior Notice Twice Pro'ect Fee
10. C Altrxna Means of Com� pliance for friable materials or 0 Demolitions 10 -Day Review Period Twice Pro'ect Fee
1 1 . Aherne a Moans of C.. '•liance for aadlriable asbestos r , iaLs ` ConcuriedCl$tithtPr'o:ect Twice Pro'ect Fee
1. 1 do hereby certify that the information contained it this notification, and su, picmental data described her*, is tuu the best of my
knowledge accurate and complete. 1 shall nut cause or 'slow any asbestos project or demolition activities to be tgntil t}lq aiii@giate
wailing period tat !lapsed.
PERMIT CENTER
W�!�/.��/��r! W.g er+ n' £9ilS�uc11ga l - 06L04/9B
Sign
Representing Dag
PSAPCA r+,,.,,, tv�( 66.160 (Revised 10/96) AM
r.., ,., J.6 am-w
Completeness Review
P rfornred By:
4
/t -/' k
Armee U.se tar/4...m
n
D. Site
Address: 113031 33'd Ave S Ci . Tukwila State: WA Z'.: 98168
Project Manager •
Contact Person: Jihad Keirouz ! Phone (206 367 -2361
E. Asbestos Survey or No. of Date Survey was Was Asbestos Found? I Yes
C] Mat'! Pr anted: Structures: 11 Conducted: 5 -28 -98 ❑ If No, Attach Survey
AHERA Building j Certification Expiration
Inspector Name: Todd Rickert 1 No.:539922502 Date:1 -05 -99
F. Demolitiou No. of ' Start D Training Fire (List Fire Dept. as demolition contractor below)
Information Structures: 1 Datq: 7- 01 -98EST C] Ordered Demolition (attach co • of Order)
Demolition
Contractor:, Terry Excavating i Phone: (206) 246 -2105
G. Asbestos Pr jest No. of Structures:
Informsttio (see back if > 1)
Total Quanti tolbe Removed
Thermal System anon:
Surfacing Mat'I: I • Fireproofing
Misc.'vial'I: 111 Cement Bd.
1
Start 6.05 -98
Date:
LinearlFt S • • Ft. 305
Boilcr\Fumace (ns.
Completion 12 -31 -98
Date:
Duct Ins. ■ Pipc Ins.
Wk. Days: M T W Th F Sa Su
Hours: 7am- 3:30am
Will all asbestos material be
removej by project completion?
Other.
Paints 1 r Plaster • Textured Coatings
Cement Pipe 1 Flooring Mat'I lirRoofutg Mat'I —other
1.1. Asbestos molition Project Categories: 1 Noti cafon Waiter Proiect_Fee
1. V owner ccupicd Single Family Resider4ial Asbestos Removal Project Flagg NON - R.gFUNj)ABLE
V Single F mily Residence Demolition Project
_. I Prior Notice S25
2.13 .Fill Otb ' Demolitions With No Asbestos Removal Project 10 Days 50
3. 10 - 2591inear feet or 48 - 159 square fejet jsee back of form for options) 3 Days $150 ,74:70-3-6-i9 linear feet or 160 - 4,999 squire feet 10 Days y5300 ---1 _ 5. d 1,00O. • 999 linear feet or 5,000.49 999 feet 10 Days $750
6. O 10,000 49,999 linear feet or 50,000 - ,999 square feet 10 Days $2,000
7. la-50,000 99,999 linear feet or 100400 - 1149,999 square feet 10 Days 55.000 —�
18. 100,0 linear feet or 150 00� 0+ sguar feet — 10 Days 510,000
9 2 0 Fi er: Asbestos Pro'ect or •' • enc Demolition Pro'ect Prior Notice Twice Pro'ect Fee
10. C Altrxna Means of Com� pliance for friable materials or 0 Demolitions 10 -Day Review Period Twice Pro'ect Fee
1 1 . Aherne a Moans of C.. '•liance for aadlriable asbestos r , iaLs ` ConcuriedCl$tithtPr'o:ect Twice Pro'ect Fee
1. 1 do hereby certify that the information contained it this notification, and su, picmental data described her*, is tuu the best of my
knowledge accurate and complete. 1 shall nut cause or 'slow any asbestos project or demolition activities to be tgntil t}lq aiii@giate
wailing period tat !lapsed.
PERMIT CENTER
W�!�/.��/��r! W.g er+ n' £9ilS�uc11ga l - 06L04/9B
Sign
Representing Dag
PSAPCA r+,,.,,, tv�( 66.160 (Revised 10/96) AM
r.., ,., J.6 am-w
Completeness Review
P rfornred By:
4
/t -/' k
Armee U.se tar/4...m
n
G. Asbestos Pr jest No. of Structures:
Informsttio (see back if > 1)
Total Quanti tolbe Removed
Thermal System anon:
Surfacing Mat'I: I • Fireproofing
Misc.'vial'I: 111 Cement Bd.
1
Start 6.05 -98
Date:
LinearlFt S • • Ft. 305
Boilcr\Fumace (ns.
Completion 12 -31 -98
Date:
Duct Ins. ■ Pipc Ins.
Wk. Days: M T W Th F Sa Su
Hours: 7am- 3:30am
Will all asbestos material be
removej by project completion?
Other.
Paints 1 r Plaster • Textured Coatings
Cement Pipe 1 Flooring Mat'I lirRoofutg Mat'I —other
1.1. Asbestos molition Project Categories: 1 Noti cafon Waiter Proiect_Fee
1. V owner ccupicd Single Family Resider4ial Asbestos Removal Project Flagg NON - R.gFUNj)ABLE
V Single F mily Residence Demolition Project
_. I Prior Notice S25
2.13 .Fill Otb ' Demolitions With No Asbestos Removal Project 10 Days 50
3. 10 - 2591inear feet or 48 - 159 square fejet jsee back of form for options) 3 Days $150 ,74:70-3-6-i9 linear feet or 160 - 4,999 squire feet 10 Days y5300 ---1 _ 5. d 1,00O. • 999 linear feet or 5,000.49 999 feet 10 Days $750
6. O 10,000 49,999 linear feet or 50,000 - ,999 square feet 10 Days $2,000
7. la-50,000 99,999 linear feet or 100400 - 1149,999 square feet 10 Days 55.000 —�
18. 100,0 linear feet or 150 00� 0+ sguar feet — 10 Days 510,000
9 2 0 Fi er: Asbestos Pro'ect or •' • enc Demolition Pro'ect Prior Notice Twice Pro'ect Fee
10. C Altrxna Means of Com� pliance for friable materials or 0 Demolitions 10 -Day Review Period Twice Pro'ect Fee
1 1 . Aherne a Moans of C.. '•liance for aadlriable asbestos r , iaLs ` ConcuriedCl$tithtPr'o:ect Twice Pro'ect Fee
1. 1 do hereby certify that the information contained it this notification, and su, picmental data described her*, is tuu the best of my
knowledge accurate and complete. 1 shall nut cause or 'slow any asbestos project or demolition activities to be tgntil t}lq aiii@giate
wailing period tat !lapsed.
PERMIT CENTER
W�!�/.��/��r! W.g er+ n' £9ilS�uc11ga l - 06L04/9B
Sign
Representing Dag
PSAPCA r+,,.,,, tv�( 66.160 (Revised 10/96) AM
r.., ,., J.6 am-w
Completeness Review
P rfornred By:
4
/t -/' k
Armee U.se tar/4...m
n
1. 1 do hereby certify that the information contained it this notification, and su, picmental data described her*, is tuu the best of my
knowledge accurate and complete. 1 shall nut cause or 'slow any asbestos project or demolition activities to be tgntil t}lq aiii@giate
wailing period tat !lapsed.
PERMIT CENTER
W�!�/.��/��r! W.g er+ n' £9ilS�uc11ga l - 06L04/9B
Sign
Representing Dag
PSAPCA r+,,.,,, tv�( 66.160 (Revised 10/96) AM
r.., ,., J.6 am-w
Completeness Review
P rfornred By:
4
/t -/' k
Armee U.se tar/4...m
n
JUN -04 -1998 15:42 WSC INC P.02
The Puget Sound Air Pollution 0 ttc1 Agency (PSAPCA) requires advanc,. • notfication before any person
commences an asbestos project invol ' g"materials equal to or greater in sit . than 10 linear feet or 48 square feet and
for all demlltion projects (regardless of asbestos content) involving structures with a prof d too , titer than
120 square feet (Regulation III. Article f 4). All asbestos and demolition notifications and'n t i6iti
be submitted to PSAPCA on Agency form No.: 66 -160 (Revised 7/95) and No. 66-173 (Revised 7/95) • - •�'ely.
Asbestos and demolitiourojects " I vole' I • I,z�1: • ,: • s At .• b • w ., o . t ..: • L� . old arm
881 other_rogwrements of Regulation cle 4.
I C; 4•c nraArt Lcr. 1 f111 Z1.-A 2,..� c r.�a no f cry
Tukwila
L Demoli�'ia8 .,..
Con r•. • Terr
- -
.,. ,., ,., ..,. . , ,... ,...,• ..,,
' s Exca in •
OwnerlCEO:
...z ,,. , ..�
,_.
- Holmes
Mailing
Address:
13050
1
10th Alive So
Phone:
(206 )
2 4 6- 210 5
Contractor's
Job 4h
A -480
I'
City: burien
1
State: WA
Zie: 98168
Fax:
GUIDELINES FOR SIUBMITTING AN ASOESTOSIDEMOLITION NOTIFICATION
The PSA$A notification form must be tilted to submit a notif ration for an asbestos project, a combined asbestos or demolition
project andla drmolisian project where no asbestos removal is man' ed prior to demolition. After receiving a complete notification
with the ap ropriare project fee, PSAPCA will review the form and return a copy to the asbestos and/or demolition contractor by
mail in 3 5 days. The returned copy will be your validated notification.
Step 1. deck the appropriate uotific atioli box on the top of the form to designate the type of notification being submitted and
enter the legal property owners informed* in Box A.
Step 2. Enter the asbestos contractor infcirmacion in Box B and the demolition connector information in Box I (above).
Step 3. Eater the site address for all notifications in Box C. Attach a reap for multi - structure projects.
Step 4. Enter the asbestos survey information for all demolitions in Box D and agaelgsogyAgmluzlaimujgAzggic
Step 5. Enter the demolition project information in Box E. and check the appropriate box if the demolition is a training fire (a
copy of I fire district permit must be utached): an ordered demolition by a city or state official (a copy of the order must be
lunched).
Step 6. Elimr asbestos project information in Box F.
Step 7. Check one project category in Bin G 1- 6. The project fee for categories 1- 6 includes the demolition fee. Demolition
projects with an asbestos removal involving less than 10 linear feet or 48 square feet may file u project dory No. 3. In
�suiddicioon�t checking a project category bin 1- 6. an emergency asbestos or demolition project may be requested by checking the
aapprro�l,..ry -/'1Tc bbloA�}l�� category `# 7�.�i -� 1�] l -•t ^. 111 1 •.- . rl M,•. • - •l . • ,t•J1, . .1 {b•. -.1 •J:JI _, •!.h.
nrcluit Y• �Q�.a wiLL11K1�blio 11 -q• •1• .,1 • , - 1• •-•!1.4-•• -fl• • � • • • .- .•Iu ^1 1.1 "1 , ifn7 • •1
• •H•' • .4 d /111` rol • • —• -• t.,, .1401,. -11 •/ 1 ;•-f • •.1 11 -,•1• 1 ' 4
11 1.,. 4.1..1
• 1,
•• H•11 !
II
••••• 11 c• •.•. • • •• :_! 1 • -1V ' • • I an -•,• •n• � I. To request an alternative meant of compliance for friable
or nonfri -lilt materials, a determination Of noe friabillcy must be attached in accordance with Regulation M. secdon 4.06(b) or for
demolid • • procedures check the approptiaro box in category *8 or 09.
Step 8. lease certify the accuracy and completeness of the Mformadon provided by signing and dating the notification in Box IL
Mandy • ry amendments to the notification are required for changes that increase the project category, champs the typea,of.'
a s b e s t o s • • - t o be removed and w o r k schedule changes. No fez is requiredfor work schedule changes if the for is
particip • • .gin the Agency work schedule fax program. A twenty-five dollar processing fee is required for all other anundsaeacs.
For • 'cal assistance. contact Tom Hudson at (206) 689 -4058. Lucy Vaughn (206).689 -4035 or Kwamc Agyei (200 689 -
4054. 4. F r inquiries concerning notification and amendment status contact Anne Morgan (206) 689-4090
PSAPCA No.: 66-160 (Ravissd 7195) TJH
07/20/98 07:58
f
206 2403561 'i 001 •
STASI OF
WASHINGTON
r, -4C-7—""."‘r r, t---- zr r, -c -a- r, -1C-- -"JP^
MASTER LICENSE SERVICE
REGISTRATIONS AND LICENSES
ORGANIZATION TYPE
SOLE PROPRIETORSHIP
TERRY LEE HOLMES
TERRY'S EXCAVATING
13050 10TH S
SEATTLE WA 9e16e
—REGISTRATION
UNEMPLOYMENT INSURANCE
REGISTERED TRADE NAMES:
TERRY'S EXCAVATING
4'
UNIFIED BUSINESS ID 0: 600 466 462
BUSINESS ID 0: 001
LOCATION: 0001
The above et been Weed Ihe buineemvabsions aImamWed
011P OF UCaNaMa. WINO FOOMINIONIOMOON.
F.O. SON SON OLVAMIA pa>! 713401
MOS AT
ANCC
DEPARTMENT OF LABOR AND INDUSTRIES
REGISTERED AS PROVIDE) BY LAW AS
CONST COET1' SPECIALTY RN
. *EGIBTRATION DENIM
CCM TII RY1f173O8 09/29/1998
EFPECTIVE ATE 09/28/1983
TERRY'S EXCAVATING
13090 10T11 8
SMA?TL1 NA 98160
Fi:sau000 (W97)