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HomeMy WebLinkAboutPermit MI99-0197 - SCHWAFORD RESIDENCE - DEMOLITIONMI99 -0197 14836 42 °d Ave. SO. Richard Schwaford Residence 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 Parcel No: 004200 -0119 Address: 14836 42 AV S Suite No: Location: Category: DEMO Type: MISCPERM Zoning: LDR Const Type: Gas /Elec.: Units: 001 Setbacks: North: Water: 125 Wetlands: .0 South: Sewer: Slopes: .0 E VAL VUE Y Streams: Phone: Phone: 206- 523 -4441 THEIR OWN RISK. Permit No: Status: Issued: Expires: MI99 -0197 ISSUED 11/08/1999 05/06/2000 Occupancy: Not in table. UBC: 1997 Fire Protection: ast: .0 West: .0 Contractor License No: TLHABI *124KF OCCUPANT RICHARD SCHWAFORD RESIDENCE 14836 42 AV S. TUKWILA, WA 98168 OWNER MALFAIT LEON & JANET 14826 42ND AVE S. SEATTLE WA 98168 CONTACT SAM ALEXANDER 9221 ROOSEVELT WY NE. SEATTLE WA 98115 CONTRACTOR T L F ABATEMENT INC. 9221 ROOSEVELT WAY NE, SEATTLE, WA 98115 ***************************************************** * ** * ** * * *** * * * * * * * ** ** * * * * * * *** Permit Description: DEMOLISH AND REMOVE EXISTING RESIDENTIAL STRUCTURE AND FOUNDATION. HOUSE ON VALVUE SEWER AND WATER DISTRICT #125 WATER. PUBLIC WORKS ACTIVITY INCLUDES HAULING OF APPROX. 110 CU YDS OF CONSTRUCTION DEBRIS. *************** **** * * * ** * * *ik** * * * * * * *** ****** k******* * ** * * * ** * *k* * * * ** * * ** * * ** * * * *** Phone: 206- 523 -4441 Construction Valuation: $ 5,000.00 PLIBLIC WORKS PERMITS: *(Water Meter Permits Listed Separate) Curb Cut/Access/Sidewalk/CSS: N Fire Loop Hydrant: N No: Size(in): .00 Flood Control Zone: N Hauling: Y 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: ***************************************************** ** * * * * * * * * * * * * * * * ** ** * * ** * * * * ** TOTAL DEVELOPMENT PERMIT FEES: $ 76.50 **** k***** * * * * * *•k* * * * * ** * * * ** * * * * * * ** * ** Ic************ ** ** * * * * * * ** * * * * * * ** * * * * * ** * *** Eng. Appr: JJS Permit Center Authorized Signature: tiZA)--, Date: LI 8-ci9 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: Date: `e- 8'.rY This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection. CITY OF TUKWILA Address: 148.6 42 AV S Suite: Tenant: Type: Mi'SCPERM Parcel #: 004200 -0119 Permit No: MI99- -0197 Status: I'S'SUED Applied: 11/02/1999 Issued: 11/08/1999 •A k•AA:*••A *..k•A h• A• A. A. k• k• k• k• A• AA• A• AA •k•A *•Ak•A*•A•A•k*•A•k•A*A•A'k A **: A A• k• k. A' A• A.. h*• k•A *;l••A••k•k•A:l•A **A•A•k•AA* A* k!: Permit Conditions: 1. .No changes will be made to the plans unless approved by the Engineer and the Tukwila .wilding Division. 2. All permits, inspection records. and approved plans shall be available at the job Site prior to the start. of any con- struction. These .documents are to be maintained and avail- able until final: inspection approval is granted; 3. Electrical permits .shall be obtained through the Washington State Division of Labor and Industries and:all electrical work will be .inspected by that agency (248- -6630) 4. Plumbing permits shall be obtained through the Seattle-,King County. Department. of Public Health. Plumbing will be inspected by that agency, including all gas piping (296 - 4722), 5. All mechanical work shall be under separate permit issued by the City of Tukwila. 6. All :construction to be done in conformance with approved plans and requirements of the. Uniform Building Code (1997 Edition) as amended, Uni form Mechanical Code (1 997 Ed t t iOh) .' and.Wash•ington State Energy Code (1997 Edition). 7. Validity of Permit. The issuance.of a permit or approval.of plans, specifications, and computations shall not be con- strued to be a permit for., or an approval of, any violation of ,any of the provisions of the building .code or of any other ordinance of the ,jurisdiction. No permit presuming to give 'authority to violate or cancel the. provisions' of..this: code shall be valid, 8. CONTRACTOR SHALT_ notify Public Work... Utility Inspector at 206 -4`33 -0179 of cOmnencement and conpleti'on Of work at least 24 hours in advance. APPLICANT SHALL .OBTAIN A SEWER CAPPING P,ERmIT FROM VAI..VUE SEWER DISTRICT AT (206)242 -3236 ' AND WATER` •CAPPING PERMIT FROM •WATER DISTRICT #125 AT (206)242 -9547. 9. Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation off- site or into existing .storm drainage fact l •ities. 10. The site shall have permanent erosion contro•1.measures in .place as soon as possible after final grading has been completed and prior to the Final Inspection. 12. All construction activity associated with this demolition shall be limited to within 10' of the building exterior. 13. CLEAN AND REMOVE DEBRIS FROM CITY CATCH BASIN IN AND AROUND. HAULING ROUTES. PROVIDE ADEQUATE TEMPORARY ACCESS AS NOT TO INTERFERE WITH .OTHER VEHICLE MOVEMENT OR CAUSE TRUCKS. TO. TRAVEL OVER CURETS . ALl_ VEHICLES MUST MAKE COMPLETE STOP PRIOR TO ENTERING PUBLIC RIGHT --OF -WAY. s. CITY OF 7 KWILA Permit Center 6300 Southcenter Boulevard, Suite 100 Tukwila, WA 98188 (206) 431 -3670 Project Number: Permit Number. R STAI I USE ONI Y 01q1 Miscellaneous Miscellaneous Permit Application Application and plans must be complete in order to be accepted for plan review. Applications will not be accepted through the mail or facsimile. Project Name /Tenant: 2rt•.GtArk 5c..k,,).q -Cwt 2e_5,� 4,,,c r. Valu onstru ,-- 1 OC7 Site Address : City State /Zip: I (826 L1;Vs4KI.1 . Scru7h _ ok (✓ fC%A. 58/G5 Ta c 0„ f I Property Own r: i Phone: (9 ,06 ) Phone: 1.06 s-aj_ " <( Str a Address: City State /Zip: N'-1-- �c -'SID kit 5' /!u& So, . -rukw. (I- /1(>4. c/SVR , Fax #: ( ) � �. (� Contr ctor: -- G.rr -(. A6fT/MC'�vtt iJ-.n �(,`; .o,• 7. .Ac..._ Phone: (2,06 ) 53-kt <IAf l 0 Water Street Address: City State /Zip: `7 7, ( Roo e0e. -(T- t)/4 4U. 15 . 5,2-.1P-1-el WA- !$ /(5- Fax #: (,_V6 ) 573. - </057 , 0 Metro 0 Standby Architect: Phone: ( ) Street Address: City State /Zip: Fax #: ( Engineer: w Phone: ( Street Address: ,. , City State /Zip: Fax #: ( Contact Person: ,/� A Phone :�`- LI' Street Address: City State /Zip: Fax #: ( MISCELLANEOUS PERMIT REVIEW AND APPROVAL REQUESTED: (TO BE FILLED OUT BY APPLICANT) Description of work to be done (please be specific): "—t .c 1 ;.%( 5 rU`?u(e ►`�-ytt. -Co iJeh'�c:(i5 � a.ti� Gf.,.r.cv -e e ><�� $ r � .1�r �e5. L° /i-tr 0,-,. (aprox //O Id 6 -19';5 Ad D>, 2v td. Cur,cr.ere_ Will there be storage of flammable /combustible hazardous material in the building? ❑ yes ❑ no Attach list of materials and stora :e location on se•arate 8 1/2 X 11 a er indicatin : .uantities & Material Safet Data Sheets ■ Above Ground Tanks ■ Antennas /Satellite Dishes ■ Bulkhead /Docks ■ Commercial Reroof ❑ Demolition ❑ Fence ❑ Manufactured Housing - Replacement only ❑ Parking Lots ❑ Retaining Walls ❑ Temporary Facilities ❑ Tree Cutting APPLICANT REQUEST FOR MISCELLANEOUS PUBLIC WORKS PERMITS 1 Channelization /Striping ❑ Flood Control Zone ❑ Landscape Irrigation ❑ Storm Drainage ❑ Water Meter /Exempt # Water Meter /Permanent # Water Meter Temp 11 Miscellaneous Curb cui/Access /Sidewalk ❑ Fire Loop /Hydrant (main to vault) #: Size(s): Land Altering: 0 Cut cubic yards 0 Fill_cubic yards 0 _sq. ft.grading/clearing Sanitary Side Sewer #: • • ' • ❑ Sewer Main Extension Street Use ❑ Water Main Extension 0 Private 0 Public Size(s): 0 Deduct 0 Water Only Size(s): Size(s): Est. quantity: gal Schedule: l_1 Moving Oversized Load /Hauling 0 Private 0 Public MONTHLY SERVICE BILLINGS TO: Name: (.I, , tl' . Nap: e.v f tic, Phone: 1.06 s-aj_ " <( Address :9)„ 2 ( 00 s ��� ' t. � �. (� tey /ga `t e(LZ-ep: IAA. 9 fills 0 Water 0 Sewer , 0 Metro 0 Standby WATER METER DEPOSIT /REFUND BILLING: Name: 1.1-.4 A ha e ' Phone .loG Sa3 -- </<i <t Address: 92 2 1 f2ov5 e e-(T f ,44 . City/Sta e/Zip: S�taTI'I -ei S" t��., a %`U 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 app�ic�tfonpted�� Date applica ' exp'r Applicen by: (initials) ALL MISCF1_LANLOUS PI 1 APPLICATIONS MUST BI SUBMIT ' WITH 171I 1O11OW /NC: > ALL DRAWINGS SHALL BE AT A LEGIBLE SCALE AND NEATLY DRAWN D BUILDING SITE PLANS AND UTILITY PLANS ARE TO BE COMBINED • ARCHITECTURAL DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED ARCHITECT > STRUCTURAL CALCULATIONS AND DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED STRUCTURAL ENGINEER • CIVIL/SITE PLAN DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED CIVIL ENGINEER (P.E.) ❑ Current copy of Washington State Department of Labor and Industries Valid Contractor's License. If not available at the time of application, a copy of this license will be required before the permit is issued, unless the homeowner will be the builder OR submit Form H -4, "Affidavit in Lieu of Contractor Registration ". 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 thei property owner authorizing the agent to submit this permit application and obtain the permit will be required as part of this submittal. 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING. OWNER OR AUTHORIZED AGENT: SUBMIT AIN'T I( AI ION ANI) RrQUUIRT D ( lit( I<I ISIS IOft PERM{l 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 in Antennas /Satellite Dishes Submit checklist No: M -1 ❑ Bulkhead /Dock Submit checklist No: M -10 Phone: (16 1s-2:3 Commercial Reroof Submit checklist No: M -6 Fax #: ,U6 )5-2:), „4yvc� Demolition Submit checklist No: M -3 ,C�' v/State/Zip: aiT/.e t.,),4, Fences - Over 6 feet in Height Submit checklist No: M -9 ❑ 0 Land Altering/Grading /Preloads ,. Submit checklist No: M -2 Miscellaneous Public Works Permits Submit checklist No: H -9 ❑ Manufactured Horsing (RED INSIGNIA ONLY) Submit checklist No: M -5 ❑ Moving Oversized Load /Hauling t:.•:,,.. r.; Submit checklist No: M -5 ❑ Parking Lots .1 h . Submit checklist No: M -4 0 Retaining Walls - Over 4 feet in height Submit checklist No: M -1 ❑ Temporary Facilities Submit checklist No: M -7 Tree Cutting Submit checklist No: M -2 ❑ Current copy of Washington State Department of Labor and Industries Valid Contractor's License. If not available at the time of application, a copy of this license will be required before the permit is issued, unless the homeowner will be the builder OR submit Form H -4, "Affidavit in Lieu of Contractor Registration ". 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 thei property owner authorizing the agent to submit this permit application and obtain the permit will be required as part of this submittal. 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING. OWNER OR AUTHORIZED AGENT: Signaturec 4442weCt...\ t -�^ f^..t-4, .-te,a►-...t>rw- Date :l( x —gq Print name. s �f.2�/An Phone: (16 1s-2:3 .,(l,(f41 ( Fax #: ,U6 )5-2:), „4yvc� Address :5,2o� ( 00OSeue,( c_04,� "thr ,C�' v/State/Zip: aiT/.e t.,),4, `lS 9/9/99 miscpml.doc t,*AP+*****A****A.**A.**44.**A4,N14.4.******AAAAA4*AA,*AhAlsk****4A4A CITY OF TUrWILA. w riAt5.161 - A A' A 4AAAA* * A 4," A * * A A * * A * A * A * * •A• A A * '3 91r * A A A 4, 4**-.1.*AA*A • PCIMSMIT Number t 9@00102 mr;mnt 76„50 11./08/Pil oEr:• • Pavment Method t CHICK No tat ion t TLH 011(1 FITMENT In 1..t. L» • . .PerAit NoLMI99 -0197 .Tvpr4t•MISCVERM MISCEILAAEOUSPIDOA Parcel, No: 004200-0119 Site Addreset 14836 42 J4V 3 i','W DCD 76,=50 . • I ot I Eees t ' . -2 ., 0 ...'G.,. ',tit) ' '. • :. CI-IECK 76i .50 y In ti: rit , ' ' 76.50 T o .t Et I - (.1 L 1. P in .t1 so 2 .0.76.5,0 •:,:..'•:: : • Bill :ince t ,. . 0•0:', ' .• :.•• 111) 9/99 ,1• 1% k k •h. A A A- A- A• A .4: k l',. le ..; :h. A it A. * ,'. .!, A A * A A A. .A. k 4, k .A. 1k A It k 10 't, ,I4V 14: A' 41-4, I, ..t.. 4. A A- A. A. A..* ..A * *,': : • •:'' . 04155 0097 MI4L;t:li ':';'.. oun 1: Code 0'(''322 100 000/345 „El() 000/M6.904 000'342.400 Description • BUYLDING - MORES PLON CHECK -.UTILITY.. STA1E BUILDING S1)PCNI74.0E I0611•ITEE'- UTILITY fl u 47 .; 00 1 0 0 (,) 4 115.00 OF • • „ ..1•1;e^Y,'.4.1 lAn F4A TAVAI. ,: • •:CA .fcr'Y • . AO- ., • ' . A L. A * A * it 4r i A et Iv 4, !III? OF fOKWILA, NA ( f T: 4RANSMIT .4 A A A * A A. 1, i, .4' A A A A A A Ar Al * A * A * -A A A * A A * A 4 A. A. • A* * A.A4.1./..A4*..1k4*A**A.*.wil, TRANSMIT Numbep; R9800IB2 AmotAnt: 2.000.00 11/05/99 t1:47 Payment Method: CHECK Notation: TI.J1 ADAIEMEN1 EN Itlit: 1.1LH Permit Ncia 9'() i7. 1yEle: M1SCPERM MiSCELUtNEOUS PLHMII Pdreel NO 004200-0119 Stte Addree.;s: 148U 42 AV S Total Feemt 2 ..,0?6.50 ihit, P...,:ymnt 2.000.00 1 otp.1 ALL Pmtu: 2.000.00 HAlancet 76.'30 ***A*A*.li****AAA.A4*A4*0**A*4*A****Ai*AP,kkAA******A****AA******** • Account Code Deucriptiml . Amomilt 000/3f..16.,90S BONUS/DEPOSITS ..2.000.00 • • 01.717 i 1 /AP.: •r'1 (.1.A INSPECTION RECORD( Retain a copy with permit INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd, #100, Tukwila, WA 98188 (206)431-3670 ec....c\i,k,..001.c)ro 6 c...iot • TypeoofintspectiT Ni F1 ., Address: 1 Li'53(0 - Li g.. ck v. S. ate called: h a io --q. • ' Specia , instructions: tplyvi 12-6M1;14 dews_ & Pepaik Oity Date wanted. Cgm. /4; P.m. Requester i erV RAitt T5 Phone: (Z - WO r7Approved per applicable codes. COMMENTS: Co ections required prior to approval. ////1199 6trve,o, oft zz, def2g- e/4 Inspector: o Date: $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd, #100, Tukwila, WA 98188 sir: Liuna�;'t' �•f � =, 4.,�.. • t • PERMIT NO, (206)431 -3670 Projects Q f o`fnspe o 11(A.. ( 8 Addries : !/ Datballed: '11)-% Specia Instructions: (91/ 1 �at P / 4 (3V cm 64111,i1- ''� 4 )5,'fr, Pit (t:C�t Vae IA 4--, Date wanted ���?�� i� P.m. Requester: Zt( - IN A*1 t Phone: �d�- 52�- 4P1 pproved per applicable codes. Q Corrections required prior to approval. COMMENTS: r/ Inspector: Date: r 847.00 REINSPECTION FEE ' UIRED. rior to inspection, fee must be paid at 6300 Southcenter Blvd., Su e 100. Call to schedule reinspection. (vnrezi.,t r.l.,. I date JI INSPECTION RECORD Retain a copy with permit 1 t INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION " 6300 Southcenter Blvd, #100, Tukwila, WA 98188 PERMIT NO. (206)431-3670 rojet:- rc i.....—.1t.....,,,..„, Typ1-51n.spe_ tiorryE. r. IL: Address: L2 AV s Date callIdir. ii-3.., <IC\ Special instructions: Date wanted: \ , P.m. Requesterso.... Phonei q iS- cl3e9 (--.5' Approved per applicable codes. LJ Corrections required prior to approval. COMMENTS: oft Insp Hp 5ait7947 $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. ' ' D u, 103 P 3 0 -) �! p 7 ) Sr r v !s ° r Q) p P c -t r> P U 7 S rgS U.` m _3 6 G) T1 m 0 -ti ( ". ' 7 1 1 L RECEIVED CITY OF TUKWILA ._...g - NOV 2 1999 p PERMIT CENTER NTER ../„ 0 c tp 1° i A•AII 7 0: 44 Pagel al IN#990728 Jrtly 24, 1999 ASBESTO ASIBESTO..TEST I N C O R P O R A T E D "GOOD FAiTJI" ASBESTOS SURVEY 14836 421°d Ave. S.. Seattle, WA Richard Swallbrd 14240 411' Ave. S. Seattle, WA 98168 Ph: 206 -433 -8890 PAGE— .02 _ Note: This house was occupied at the time of the survey, thus destructive sampling was somewhat limited, 1f there is any additional located suspect ACM prior to or during demolition (such as, but not limited to, those materials listed on page 2), that was not discovered in this survey, the materials) should be PACM unless tested otherwise by laboratory analysis. INTRODUCTION On July 23, 1999, Asbesto -Test personnel conducted a "good iisith" asbestos survey (per U.SE.P.A.%A- H.E.RA. guidelines as designated and specified by Puget Sound AU Pollwdow Control Agency) of the sin a l A. ern. : ed 1483. Ord v y le K w C u W in ton. This survey purpose is to identify any Asbestos Containing Materials that may be present and will•require professional removal prior to renovation or demolition of the structure. NARRATIVE OF FINDJNG RABIC CONSTRUCTION (including siding and roofing rypes): The one -story wood frame house is on a concrete basement. The exterior CAB siding was sampled along with the composition roofing and underlying materials. There was no additional relating suspect ACM located. ATTIC/Mr/U.1. INSULATION: There was no relating suspect ACM located. PLUMBING SYSTEM: There was no relating suspect ACM located, ELECTRICAL SYSTEM: The electrical wiring insulation is of newer vintage and was not sampled. Any additional suspect ACM electrical wiring insulation or any suspect TSI (Thermal System Insulation) found in, around or behind any located fuse or breaker boxes should be considered to be ACM ( Asbestos Containing Material), unless determined otherwise by laboratory analysis. MISC.: The window putty material was sampled, CONTINUE' TO PAGE 2 RECEIVED CITY OF TUKWILP NOV 2 1999 8 3 1 t!1 ST. SE • SNOHOMISH. A 99296 • ( ) 499 -4040 • Seattle (206) 523 -S117 Pager (206) 699411iF CENTER : �f.;:..:.y.':i[Yil��:'r.Vt.7lY. ;YW.tti$•acr'M1iM1,a;.. •.aYM:: sAn.rv: Page 2of4 IN#990728 WW.LUVA!Ny.Mrt row a July 24, 1999 Asbeslo -Test, Inc. (425) 489 -4040 /4836 42' Ave. S., Seattle, WA "INTERIOR CONSTRUCTION, FINISHES, AND FLOORINGS: The inside of the house is wood frame with drywall, The drywall /taping compounds were uniformly sampled, Vinyl and/or tile flooring materials with relating backings and/or mastics were sampled per each homogenous area. The acoustic ceiling tile was sampled from the living room area. HEATING AND VENTILATION SYSTEM: The heating system, is a gas forced air furnace located in the basement. The relating flue mortar packing material was sampled, along with the TSI panels above the ducting along the basement ceiling. it was not possible to dismantle the furnace and ducting to locate and/or evaluate any additional suspect ACM that may be concealed, inside the unit, or associated in hidden areas. It is our opinion any further handling of the furnace system should be coordinated by the project manager and /or abatement contractor. If any additional relating suspect materials are located prior to and /or during any demolition or renovation, any and all additional related suspect materials should be considered to be ACM (Asbestos Containing Material), unless determined to be otherwise by laboratory analysis. ADDITIONAL STRUCTURES INCLUDED IN SURVEY: hione. PAGE 83 *Some sample analyses listed may be a representative analysis of individual and separate samplings and analysis of homogenous materials, as prescribed byA.H.I.R.A. protocol, Samples taken are listed nn the following pagers), with their corresponding analyses. Jf asbestos is detected, those samples containing asbestos are listedf►rst and noted with the initials "ACM ", If, during demolition or renovation, any additional hidden or covered suspect materials similar to those identified in the survey are located [may include hut not limited to: sheet vinyl flooring, tale flooring, wall or ceiling texturings or paints, concrete siding or skirting, cement pipes, cement wallboard, electrical cloth, electrical wiring insulation, thermal paper, wallboard, Joint compounds, vinyl wall coverings, spackling compounds, or any other suspect at (Thermal System Insulation)J, they should be treated as Asbestos Containing Materials unless determined to be non- asbestos by laboratory analysis, Nate; Asbesto•Test, Inc, does not guarantee approximations of quantities of ACM, which may be listed with the analyses. It is therefore recommended professional abatement price and/or disposal quotes be obtained by inquiring as to fees per area of specific ACM material (i.e. square or linear foot, etc,), or by on site assessment. Owner- Occupied, Single - Fancily Residence means any non - multiple unit building containing space for uses such as living, sleeping, preparation of food, and eating that is currently used by one family who mvns the property as their domicile. This term includes houses, mobile homes, trailers, detached garages, houseboats, and houses with a "mother -in -law apartment" or "guest room". This term does not include rental property or multiple family units, nor does this term include any mixed -use building, structure, or installation that contains a residential unit, it of structures included in survey: one house Requested by: Stan Nachtrieb ArLynn H. Schneider, B,Sc. Inspector, certified A.H.E.R.A. aecsed.#CLAY5327 (Expire& 8/04/99) CONTINUE TO PAGE .3 RECENED CITY OF TUKWILA NOV 021999 PERMIT CENTER a 0:44 4894040 ASBESTO Page 3 of4 INii 990728 ANALYSIS ID July 24,1999 Asbesto -Test, Inc. (425) 489-4040 14816 42' Ava 5., Seattle; WA ANALYSIS R6SUI,TS: PO�SITII' -, .4MPLE5 #14g ASBESTOS /!l'YPE/fOUANTITY OTIIIEM MATERIAL 1) CAB aiding yea // chrysolite // 15 -20% non - fibrous material on exterior of house Approx. 1875 sq. ft. 2) '01 panels above beat ducting yes /1 chrysotilo // 45-50% in basement between heat ducts and basement ceiling Joists ACM Approx. 40 sq. fl (approx, above 18 lin.it, x2'wide rectangular ducts) - inspector was not able to determine exact uanlllies as additional material may be concealed from view. ,LIN4L PSIS RESULT;- NO ASEESTO.Q DETECTED 1N ANY OF TIIE REMAINING S ACM non- fibrous material, cellulose 3) composition roofing & underlying materials 4) drywall taping compounds representative of 5 samplings throughout 5) sheet vinyl flooring bathroom- color: white w /black design 6) linoleum flooring living room - color: brown painted white 7) linoleum flooring bedroom - color: gold NAD NAD NAD NAD NAD non- fibrous materials, tar, cellulose, fiberglass non - fibrous materials, cellulose, fiberglass morn- fibrous materials, cellulose, fiberglass non - fibrous materials, cellulose, tar non - fibrous materials, cellulose, tar 8.0) the flooring NAD non- fibrous materials 12" x12" tile - laundry area - color: white design 8, I) tannic (clear) NAD adhesive RECEIVED CRY OF TUKWILA NOV 021999 PERMIT CENTER Page 4of4 IN #990728 ANALYSIS 1 &__ . I ..r'YJ CrG CF rtl .n. July 24, 1999 Asbesto -Test, Inc (425) 4894040 )4$36 42"AAye. S.. Seattle, WA ASBPTOSIITYPE/ /QU,ANTITY 9.0) We flooring NAD 12" x12" tilt - kitchen area - color: off white pattern 9.1) mastic (clear) NAD 10) flue mortar packing NAD circle of packing material around furnace exhaust entry into brick chimney 11) windmv putty 12) acoustic ceiling the liv. room NAD NAD QTHER TER1AL non - fibrous materials adhesive non - fibrous materials, fiberglass noo- fibrous materials, cellulose cellulose analytical test method: USEPA 600/R93/116*. (PLM) /Jai ACM signifies "Asbestos Containing Material" PACM signifies "Presumed Asbestos Containing Material" CAB signifies "Concrete Asbestos Board" signifies "less than" TSI signifies "Thermal System insulation" HVAC signifies "heating Ventilating Air - Conditioning" NAD signifies "No Asbestos Dotected" " *One percent is the USEPA regulatory limit for asbestos in bulk samples. PLM has been known to miss asbestos in small percentages of some samples, which contain asbestos, thus negative P{.M results camnot be guaranteed. Floor tiles and wipes should be tested with SEIVM or TEM, to insure analytical accuracy when reported in small percentages, Asbesto -Test, Inc. claims responsibility for sample content only. End of Report ArLynn, H. Schneider Analytical Chemist, B.Sc. AMA round robin proficient RECEIVED CITY OP TUKWIIA NOV 021999 PERMIT CENTER •11/05;99 FRI 11:34 FAX 522 4099 11/801. ON X21 /XZ] 90:Tl Ad 88/90/TT TLH ABATEMENT t ' fool CERTIFICATE OF INSURANCE Issued Dote: 11ror9g • Marsh USA Inc. 1215 Fourth Avenue, Suite 2300 Seattle, Washington 98161 THIS CERTIFICATE is ISSUED AS 4 NUTTER OF INPQRMATION ONLY AND CONFERS NO RIE TTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY. THIS CERTIFICAT* DOES NOT AMEND, MORN% OR ALTER THE COVISRAOg AFFORDED BY THE POLIO= LISTED HEREIN_ Companies Affording Coverage Comma LIME A National Union fire Insyrarlce Co. TLH 9221 Seattle, .�I"�•^ 11 NoTWITh5TANDING TO may LIMITS Abatement, Inc. Roosevelt Way NE WA 98115 ,�:• .-+... 1, , . ^. �� ., ..�_k V . �...... . UTED Ifeim NAVE bow am= on cowo om army coNTRACT sin mums LNTSD HEREIN la CLAIMS. Lama 13 Commerce and Indus ITis. Co. eolIPAINV LATTER C � .411. ♦ .. .. •i ra nom, ;1 . To THU INSURED NAMED IMMO FOR THE POLICY PERIOD INDICA l'• , OR TONER bOCUSMITN WITH REPS= TO west (HS C=ATIFICATE MAY SE rssUSD SUlstecr To ALL ma TDIMs, CONDInowe aND isCLUsatia or SUCH POLICIES. 1 V TO c8RTIFV THAT POUCH'S OP IN.uRaNCI ANT REQUIRSMEMT. TERM esRTAIN. THi INSURANCE APPOR!D my SHOWN MAY HAVE SEEN REDUCED BY PAID Co typo of Inatome* Pdrey Numb ' Effective Data ExpfreUcgr Date I eta A General Liability ®Cornmvrciai General Liability []Claims Made (EOccur. MI7780147 12/31/98 12/31/99 Sensor Agensgetat $ 2,000,000 Produare•Cernp/oq Agg $ 2,000,000 Personal a Ada Injury $ INCLUDED Each Ocr urrence ; $ 1,000,000 Fbe Damage Om one fire) $ 100,000 1 Med. epansa (Any area S 9 OOo wean) ' ■ Owner's Contract Prot. ASBESTOS AND LEAD ABATEMENT :, WASHINGTON STOP GAP /81,000,000 LIMIT 13 Automobile Liability Any Auto CA7663976 12131/98 12!31/99 Combined Single Unit $ 2,000,000 Bodily Injury (Per Pinyon) $ Bodily Injury (Pa• s0dsnq $ Property Demo 1 $ PoLLUT10N LIABIUTY - SUDDEN 9 ACCIDENTAL • M Owned Autos • Scheduled Autos ®HIred Autos ®Nor1 -Owned Autos Garage Liability [ Any Auto DGKLL Auto Ony ■eaen AFIdent $ Oro Than Auto only $ *soh Amdanl I $ AMrasera ' $ i Excess Liability ©Umbrella Form each ooamenes ? $ AO PIVa , $ ■ Other Than Umbrella Form Workers' Compensation and Employers Liabil swrAofy Limits ; $ Each Aa ILISAI Dlasu1 -PcBay Lgit 3 Grease •g.a, Empoye. $ Other 1 , Description of Operatlona /LocationsdVehle/es/Special items RE: ABATEMENT AT 14836 42ND AVE SOUTH, TUKWILA, WA RICHARD SCHWAFORD AND•THE CrTY OF TUKWILA ARE ADDI- TIONAL INSUREDS AS RESPECTS ABOVE PROJECT. JOB #R146 Certificate Holder 1 RICHARD SCFiWAFORO 1493642ND SOUTH 1035 4 TUKWILA, WA AVE. E. SOUTH 98188 Cancellation. 3HOII D ANY OP THE POUCIES Tlsi11OP, THE INIURER 11°Tlea TO T1 CERTIFICATE SHALL IMPOSE NOOEUGATIONORLMELEYOFASTOUND ITS RiH -03C, Br JUDITH LISTED NoRIIN ea CweaLCD BBFOR! THa WI ATgN DATE Opossum =MOUSE WILL liana* TO MAIL Wan rs 4 HOLDER NAMED Now. BUT FAILIia! TOM AIL SUCH NOTIC= UPONTNaINISURED APPORDNs • OR ISSUER OVUM To. . +1, 1. C Crk (XI O5 CD Cr' 0 r" X > Cc) • 59, M . 10/06/99 WED 12:17 FAI 522 4099 Agency Use Only ;.1 t} �� Case No.: Amendment No.: TLH ABATEMENT PSAPCA APPS ooi PUGET SOUND AIR POLLUTION CONTROL AGENCY' 110 UNION STREET, SUITE 500 SEATTLE, WA 98101 -2038 (206) 689 -4090 FAX (206) 343 -7522 Contractor: Mailing Address: City: Seattle Agency Use Only OCT 61999 Date Received NOTIFICATION AMENDMENT ASBESTOS PROJECT tal DEMOLITION PROJECT "—`rcrssrimmuzo rxn wtuxsroux iuApTilan✓u uam �-- TLH Abatement, Inc. Owner /CEO: Timothy P. Ozog 9221 Roosevelt Way NE State: WA Zip: 98115 Phone: (206) 523 -4441 Fax: (206) 522 -4099 ALL AMENDMENTS REQUIRE A SSO FEE, EXCEPT WORK SCHEDULE CHANGES FOR CONTRACTORS PARTICIPATING DI TB WORK SCHEDULE FAX PROGRAM. THE FEE MUST BE ATTACHED TO EACH AMENDMENT, UNLESS THE CONTRACTOR IS PARTICIPATING IN THE PRE- APPROVED BILLING PROGRAM. ANY AMENDMENT THAT CHANGES THE PROJECT TYPE OR PROJECT CATEGORY IS SUBJECT TO THE NEW NOTIFICATTON PERIOD AND MUST BE ACCOMPANIED BY THE APPROPRIATE PROJECT CATEGORY FEE. PLEASE ENTER CURRENT NOTIFICATION INFORMATION BELOW: AGENCY CASE #: 9903458 PROJECT CATEGORY 1 CONTRACTOR JOB # R146 JOB SITE ADDRESS: 14836 42ND AVE SOUTH TUKWILA, WA 98168 PLEASE ENTER AMENDMENT CHANGES BELOW: Q NEW PROJECT TYPE: ❑ NEW JOB SITE ADDRESS: ❑ NEW DEMOLITION STARTING DATE: ❑ MULTIPLE STRUCTURE PROJECT:(Attach map, site addresses, type and amount of asbestos material & work schedule) El NEW PROJECT STARTTNG DATE: COMPLETION DATE: 1115 99 ❑ NEW WORK SCHEDULE DAYS: M T W TH F SA SU; WORK SHIFT HOURS: ADDITIONAL QUANTITY TO BE REMOVED: SQUARE FT LINEAR FT NEW FOOTAGE TOTALS: SQUARE FT LINEAR FT ❑ NEW TYPE OF MATERIAL TO BE REMOVED (PLEASE INCLUDE THE QUANTITY FOR EACH TYPE): C ADD1TIONAL INFORMATION (ATTACH ADDITIONAL SHEET IF NECESSARY): 1 DO HEREBY CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICAITON AND SUPPLEMENTAL DATA DESCRIBED HEREIN IS. TO THE BEST OF MY KNOWLEDGE, ACCURATE AND COMPLETE. 10/6/99 SIGNATURE C_ ) DATE CONTRACTOR : TLH Abatement, Inc. _ TELEPHONE: (206) 523 -4441 FAX: (206) 522-4099 /Ind AM Oftlft Oft 046 AGLNCY USE ONLY REVIEWED BY CITY OF TUKWILA 09/22/99 WED 10:54 FAX 522 41:89 TLh ABATEMENT Agency Case No. fi`'7 f'r u Agency Use Only LProject Type: I 1. ❑Asbestos Removal 2. ® Asbestos Removal & Demolition 1 3. ❑ Demolition, No Asbestos Removal B. Property 444 PSAPCA APPS i) 001 'UGET SOUND AIR POLLUTION CONTR(',,y kGENCY I t0 Union Street, Suite 500, Seattle, WA 98101 -2038 NOTICE OF INTENT TO PERFORM: • PSAPCA RSEN 19gci Date Received Owner: RICHARD SCHWAFORD rirroperty Owner's MaijingAddress: C. Asbestos Contractor: 14240 41ST AVE SO. Mailing Address: City: Seattle ' D. Site Address: 14836 42ND AVE SOUTH project t inager or Contact Person: City: TUKWILA PLEASE PRm =au, rtes WILL aF, t.otm nerummAtav6 r tdtl TLH Abatement, Inc. 9221 Roosevelt Way NE State: WA ip: 98115 E, ® Asbestos Survey or o, of n Mat'I Presumed: Struc res: AHERA Building AN AHEM SWIM IeRRQUIRED1Fo let.uia6AoMIONPaevr.Crx ns . ector a e: ARLYNN H SCHNEIDER Phone: (206) 433 -8890 State: WA—TZip: Contractor Owner/CEO: Timothy P. Ozog Phone: (206) 523 -4441 Fax: (206) 522-4099 J Contractor Job No.: R146 r SEP 2 3 City: 'TUKWILA 1 urvey was F. Demolition No, of Start Information Structures: 1 Date: 10!4/99 Demolition PRAT M CIIFR'. EATER MARINO AIJUIffSSINBOX ON AMU' Contractor: TLH Abatement. Inc. G • sbestos Project I No, of Structures; Start Completion Work Days: ,formation: { (see back if> 1) 1 Date: 10/4199 I Date: 10/11/99 Hours: C � � Wil1 all asbestos Qjc be aterial Yes m Total Qty. to be Removed: 0 Linear Ft. 1915 Square Ft. removed by project completion? El No Thermal System Insulation ❑ Boller\Furnance Ins. ❑ Duct Ins; ❑ Pipe Ins. Other: Duct Paper Surfacing Mat'1: ❑ Fireproofing I_. Paints: ❑ Plaster 0 Textured Coatings Other: Misc. Mat's [ Cement Bd. ❑ Cttnent Pipe ❑ Flooring Mat') ['Roofing Mat'I Other: State: WA hone: Zip: 98168 7/23/99 as s estos Found? ® 'Yes ❑ If No, Attach Survey Expiraton Certification No.: C1.AY5327 la . e: 8/4/99 1. p Tia—nttag Ftre (List Fire Dept es demob= contractor a ow 2. ❑ Ordered Demolition (attach copy of Order) Phone: (206) 523 -4441 J 1. Asbestos/Demolition Project Categories: 1. ® Owner - Occupied, Single - Fancily Residence Asbestos Removal Project Single - Family Residence Demolition Project 2, ❑ All Other Demolitions With No Asbestos Removal Project 3. ❑ 10.259 linear feet or 48 - 159 square feet (see back of form for options) 4. ❑ 260 - 999 linear feet or 160.4,999 square feet 5. ❑ 1,000 - 9,999 linear fcct or 5,000.49,999 square feet 6. ❑ 10,000 - 49,999 linear feet or 50,000 - 99,999 square feet 7. 0 50,000 - 99,999 linear feet or 100,000. 149,999 square feet 8. ❑ 100,000+ linear fed or 150,000+ square feet 9. ❑ Emergency Asbestos Project or Ei Emergency Demolition Project !0, ❑ Altematc Means of Compliance friable materials or ❑ Dcmolidons 11. ❑ Alternate Means of Compliance nonfriablc asbestos material Notification Waiting Perio4NON- REFUNDABLE FEIN Prior Notice 525 u 11 10 Days 3 Der 10 Drys 10 Days 10 Days 10 Days 10 Days Prior Notice 10-Day Review Period Concurrent with Project S150 5150 5300 5750 52,000 55,000 $ 10,000 Twice Project Fee Twice Project Fee Twice Project Fee 1 I do hereby certify that ttre Information contained in dria noufication, and supptemeatal date described herein is, to the the bat of my knowledge accurate and complete. t shall not cause or allow any asbestos project err domoliton activida to babin um+I the appropriate waling period has elapsed. Completeness Rrview Perforated by: NED TLH Abatement, Inc. Repreneniing PC•PCA Pnrrn'NM AA.16r1/Qewi.ed 111/961 • i1 IIP/C 41111% 9/21/9 Dare — w t` Use Only Date: November 18, 1999 To: Laurie Anderson Finance Dept. From: Jan Illian Public Works c, �v�. rP�. rtR 'aTM°>�tamrt.+�ka.�avcx�c�+nr- ^;.fir rna.^r,:wae��v!wroe: REFUND REQUEST Subject: Refund of Hauling Deposit T.L.H. Abatement (Schwaford Residence) Receipt No: 8607 Date: 11/08/99 Amount: $2,000.00 Permit # MI99 -0197 Laurie, Public Works hereby authorizes release of the above cash deposit of $2,000.00 to T. L. H. Abatement. The project has been completed and final inspection was on 11- 12 -99. T.L.H. Abatement & Demolition 9221 — Roosevelt Way NE Seattle, WA 98115 Cc: Development file TO: FROM: DATE: City of Tukwila John W Rants, Mayor Department of Public Works NOTIFICATION OF UTILITY PERMIT ACTION Permit Center Public Works Engineering November 5, 1999 SUBJECT: Schwaford SFR Demo 14836 42 "d Ave S. Permit No.: MI99 -0197 Contact Person: Sam Alexander Phone: (206)523 -4441 James R Morrow, P.E., Director THE FOLLOWING PUBLIC WORKS PERMITS HAVE BEEN APPROVED FOR ISSUANCE IN ACCORDANCE WITH THE PLANS APPROVED ON November 5,1999: Hauling PERMIT FEE $ 25.00 Two copies of the confirmed Utility Permit Application and plans are attached for inclusion in the permit file. Also attached are copies of Certificate of Insurance, $ 2000 Permit Bond and 5 copies of haul route map. JJS /jjs Attachments a/s CF: Development File (with copy of application/plans /haul route map) PW Utilities Inspector (with copy of application/plans & haul permit documents) PERMIT COORD COP* PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: MI99- 0197DATE: 11 -3 -99 PROJECT NAME: SCHWAFORD, RICHARD XXOriginal Plan Submittal Response to Incomplete Letter # Response to Correction Letter # _ Revision # _ After Permit Is Issued DEPA TMENTS: Buil.in•'P!vision /14-g7 Public yyor_"ks /k6) h i5�tili I I-� Fire Prevention Structural Plah'riing Division si Permit Coordinator DETERMINATI N OF COMPLETENESS: (Tues., Thurs.) Complete Incomplete DUE DATE: 11 -4 -99 Not Applicable n Comments: TUES /THURS ROU ING: Please Route Structural Review Required n No further Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: (ten days) Approved Approved with Conditions DUE DATE 12-2-99 Not Approved (attach comments) n REVIEWER'S INITIALS: DATE: CORRECTION DETERMINATION: DUE DATE Approved Approved with Conditions n Not Approved (attach comments) ❑ REVIEWER'S INITIALS: DATE: \PRROUTE.DOC DLtuch And !jieipItcy Ceriilicatc DEPARTMENT OF LABOR AND INDUSTRIES REGISTERED AS PROVIDED BY LAW AS CONST CONT GENERAL REGIST. #;;;: EXP DATE; CC01 _' •.`TLHABI *124KF ` 12/,31/1'999 EFFECTIVE DATE 05'/06/1988. T L H ABATEMENT INC ' 9221 ROOSEVELT WAY N E SEATTLE WA 98115-2841 I•n2 .IP 2.t10U (8/97) .,25.1 15.1.000 i8/97) Detach And Display Certificate (REGISTERED AS PROVIDED BY LAW AS I CONST CONT GENERAL • REGIST. # EXP. DATE CC01 TLHABI *124KF.12 /31/1999 EFFECTIVE DATE • 05/06/1988 T L H. ABATEMENT INC 9221 ROOSEVELT WAY N :E. SEATTLE.WA 98115 - 2841..• Signature Issued by DEPARTMENT OF LABOR AND INDUSTRIES IA T CI a _ es% ci -ms Please Remove And Sign Identification Card Before Placing In Billfold