HomeMy WebLinkAboutPermit MI99-0230 - FENTON RESIDENCE - DEMOLITION,, :e .N1..PV..,rIua«va•.+,t gbTh,�,ruu ltrraC' 4 •,.:4N+a!Ma^v�,+rsaratnY +•ro�.v,
D99 -0230
14216 34t'' Ave. So.
David Fenton
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 I PROCEEDING AT THEIR OWN RIK.
Parcel No:
Address:
Suite No:
Location:
Category:
Type:
Zoning:
Const Type:
Gas /Elec.:
Units:
Setbacks:
Water:
Wetlands:
152304 -9159
14216 34 AV S
DEMO
MISCPERM
LDR
DEMO
001
North: .0 South: .0 East: .0 West: .0
N/A Sewer: N/A
Slopes: N Streams:
Permit No:
Status:
Issued:
Expires:
MI99 -0230
ISSUED
12/28/1999
06/25/2000
Occupancy: DWELLING
UBC: 1997
Fire Protection:
Contractor License No: SAMARAH1O66LG
OCCUPANT DAVID FENTON
14216 34 AV S, TUKWILA, WA 98146
OWNER FIELD DEVELOPMENT INC
29229 18TH AVE S, FEDERAL WAY WA 98003
CONTACT DAVID FENTON
14201 42 AV 5 #115, SEATTLE, WA 98168
CONTRACTOR THE SAMARA HUBNER CONSTRUCTION C
29229 18 AV S, FEDERAL WAY WA 98003
k.k*** *** * *•k *** *** *** *** k***• k**** k**• k****• k**** k* k*• k* * * *•k * *** * ** * * * *•k* * * **•k*•k• * **k**
Permit Description:
DEMOLITION OF EXITING HOUSE AND GARAGE.
HOUSE I 684 s.f. AND GARAGE IS 396 s.f.
PER DUANE GRIFFIN, IT'S OK TO INCLUDE GARAGE UNDER
HOUSE DEMO PERMIT.
**kkk* k* k*********************************** k******* * *** * ** * *** * *k ** ***** * * ** * * * ***
Construction Valuation: $ 1,000.00
PUBLIC WORKS PERMITS: *(Water Meter Permits Listed Separate) Eng, Appr:
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:
kl ekk** k**************************************' k** k*** k** *** ** ** * * * *** * * *** * * * *k* * *k*
TOTAL DEVELOPMENT PERMIT FEES: $ 51.50
********* ***k** ******* * *** * *** **** ** ** ** ******k**** k * *** * ** *** * *** * **** * ** * *** ****
Phone:
Phone: (206)000 -0000
Phone: 206- 246 -4980
Phone: 253 -839 -2010
Permit Center Authorized Signature:'-
Date: k"
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 ott or local laws regulating construction
or the performance of work. Iir ed to sign for and obtain this
deve1opmen
Signature:
Print Name:__ _� C 1.J 0a/
Date:
P2
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 TEL WILA
Permit Center
6300 Southcenter Boulevard, Suite 100
Tukwila, WA 98188
(206) 431 -3670
Project Number:
Permit
Number: vcE9q-oao
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 enant: ,
�t- . ).moo. Lrt
Value of Con truction:
�, ovo. o�
Site Ad ress : City State/Zip:
142.14, 34 "' /v.a_ S S. tt ttJt`a. Wp 98t'4ln
T x��aa el
J
b t n
ej " i 5q
Prope Owner:
F}vt� B . FEtt1c*.L
t
Phone: (Zp(p) 24 c - 4' B o
Street Address:
14Zc� I
Md
42 � 5 . Its
City State /Zip:
. w� i liici,4
Fax it: (
)
Contr utoiler .
0 Water
Phone: 60(0) gs.4 n `
"i
Stree
ttii
1 42 5 4. I s
a
Taws ty Stt w
ax #: (
)
Architect:
Phone: (
)
Street Address:
City State/Zip:
Fax #: (
)
Engineer:
Phone: (
)
Street Address:
.. , City State /Zip:
Fax #: (
)
Contact rson:
t E �
� ,�,
Phone: (
Zp 1 246 ` 49 g(
Street Address:
t42c t
and
42— p,v�. 5. ftt5
SAcl t6 ,' Cil J tate98t i
Fax #: (
)
MISCELLANEOUS PERMIT REVIEW AND APPROVAL REQUESTED: (TO BE FILLED OUT BY APPLICANT)
Description of work to be done (lease be specific): ,
) c of 1st ,9 \r;c..
.. , ..r.4siNd Tr.s.zj..t..
i.
Scb.Y_a -FooIC Akt,�a S� 15 gp 5
Will there be storage of flammable/combustible hazardous material in the building? ❑ yes ❑ no
Attach list of materials and stora e location on se crate 8 1/2 X 11 .a.er indicatin: uantities & Material Safet Data Sheets
■ ove Ground Tanks ■ Antennas /Satellite Dishes ■ Bulkhead /Docks ■ Commercial Reroof
IJ Demolition ❑ Fence ❑ Manufactured Housing - Replacement only
❑ Parking Lots ❑ Retaining Walls ❑ Temporary Facilities ❑ Tree Cutting
APPLICANT REQUEST FOR MISCELLANEOUS PUBLIC WORKS PERMITS
❑ Channelization /Striping
❑ Flood Control Zone
❑ Landscape Irrigation
❑ Storm Drainage
❑ Water Meter /Exempt #
❑ Water Meter /Permanent #
❑ Water Meter Temp #
❑ Miscellaneous
❑ Curb cut/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 0 Private 0 Public
❑ Street Use ❑ Water Main Extension 0 Private 0 Public
0 Deduct 0 Water Only
Size(s):
Size(s):
Size(s): _ Mo Est. quantity: gal Schedule:
U ving Oversized Load /Hauling
MONTHLY SERVICE BILLINGS TO:
Name:
Phone:
Address:
City /Sta e /Zip:
0 Water
0 Sewer
0 Metro
0 Standby
WATER METER DEPOSIT /REFUND BILLING:
Name:
Phone:
Address:
City /Sta e /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 app cation irstieti9
Date p� plicai x-ir�
Applicatf by: (initials)
ALL MIS(FLLANLOt/S
MI1 APPI I( A 1IONS MUST HI SUB :D WI1 H Tll! 1 01 1 0 11/1N(,:
D ALL DRAWINGS SHALL BEAT 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
D STRUCTURAL CALCULATIONS AND DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED
STRUCTURAL ENGINEER
> CIVIUSITE PLAN DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED CIVIL ENGINEER (P.E.)
❑
Sl1RMII APJ'II( Al ION AND IllQUUIRFI) (HI( KI ISIS [OR
AboveGround Tanks/Water'Tanks - Supported directly upon grade
exceeding 5,000 gallons and a ratio of height to diameter or width which
exceeds 2:1
PIRMII REVIEW
Submit checklist No: M -9'
•
❑
Antennas /Satellite Dishes
Submit checklist 'No: M -1 •
❑
Bulkhead /Dock• •
Submit checklist. No: M -10
❑
':Commercial Reroof.•
Submit checklist No: M -6
A.
'Demolition. • •
•Submitchecklist No: M -3
❑
',Fences - Over 6: feet in Height' ..Submit
checklist No: M -9 ,
❑
:Land Altering/Grading /Preloads
Submit checklist No: M -2
❑
Miscellaneous•Public Works Permits.
Submit checklist No: H -9
❑
• iManufacturedHousing ;(RED' INSIGNIA ONLY)•'
. Submit checklist No: .M -5
0
Moving Oversized •load /Hauling
Submit checklist No M -5 •
0
;Parking ,Lots
Submit checklist No M -4
❑
:•Retaining•Walls - Over.4 feet in height.' "
Submit checklist No: M -1
❑
- Temporary Facilities •
Submit checklist No M -7
❑
;Tree Cutting ,
Submit checklist No: M -2
❑ Current copy of Washington State Department of Labor and Industries Valid Contractor's License. If not
available at the time of application, a copy of this license will be required before the permit is issued, unless the
homeowner will be the builder OR submit Form H -4, "Affidavit in Lieu of Contractor Registration ".
Buildingpwner /Authorized Agent; if the applicant is other 'th'an'the owner, registered architect/engineer, or contractor
licensedby the State of Washington, a notarized letter from the, property owner authorizing the agent to submit this
permivapplication 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 F WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING •may ER. • 'A _ida•17iP�y
;...'__,,,�.
/
Date: D._._ 7 ,...�/.'
Signature: wh
,0
Print name: / ,
Gel
t�
A.
t 7. ///1
Phone: (a.06)c"Z (..W -9- ).
Fax #: Pob fi-1%�
Addreissio (
4.41_
o
City /State/Zip 17i K ‘psi - k.,-.74,
;,r•
9/9/99
ndrepntt.dnc
CITY OF TUKWILA
Address: 14216 34 AV 5
Suite:
Tenant:
Type: MISCPERM
Parcel it: 152304-9159
Permit No: M199-0230
Status: ISSUED
Applied: 12/14/1999
Issued: 12/28/1999
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Permit Condi tions
1. COORDINATE WITH WATER DISTRICT #125 FOR CAPPING EXISTING
WATER .SERVICE.
2. OBTAIN CAPPING PERMIT FROM VAL SEWER DISTRICT FOR SIDE
SEWER.
HYDRO-SEED EXPOSED AREAS AFTER THE 'DEMOLITION IS COMPLETE.
4. OBTAIN HAULING PERMIT FROM, CITY OF .TUKWILA IF MORE THAN 50
CUBIC YARDS OF MATERIAL IS. REMOVED FROM THE SITE.
5. No changes' will be made Lo the plans unless approved by the
Engineer 'and the Tukwi la 'Bui I ding Division.
G. Al) permtts, inspection records,; and approved plans shal.T be
avai lab 1 e at the job site prior to the start of any con-
struction. These documents are to be maintained and avail
able' unti 1 f ina 1 inspection approval is granted.
7. All construction to be done in conformance with approved
8. Val i di ty of Permi t. The issuance of a perm 1 t or approval; of'
give author i ty to violate or cancel the provisions of ,this
code shal I be val id.
.trued to be a permit for, or an approval of , any violation
plans, spec i f i cations, and computations sha 1 I not be con-.
plans and requirements of the Uniform Bui 1 di Code (1997,
Edi t ion) as amended, Uniform Mechanical Code (1991 Edition),'
of any of the provisions of the bui 1 ding code or of any
and Washington State Energy Code (1997 Edition)
other ordinance of i7,he. jurisdiction. sNo permi t presuming to
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:;x*+A**o++***+**A+k*^A+A+a+**A^+a*^*A+**a*A+**f*x+**A+»+++k+*+a+
CITY OF TUKN%LA. NA p�[\'c��, �� )KHNSM]?
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7RfiN6M1T Number: P98O0310 Amount: 51.50 I 2/28/9g'15:34
|`ovmenk Nmt.hVd: CHFC: Notation: DAVID FENTON %nit:`ULH_
Parm(t Qa: MI99-0230 Type: MISCpEUK MI8CEiLANliOUG PERMIT
Parral No 152304-9159
Site AdJroou: 14216 34 AV 6
Total Fees: , . 5 '5O ..'
[his Pavment 51.50 Total ALL Pmt�: 5�1.��O `
'
Balance: .00`
**aaA»A*A71,4a*+o+**^+^Ak^********li******AA+*******+++**AaAA+*+++*
A000uot Code Description Ambunt
000/322.100 BUILDING - HONRES
000/386.9O4 VAN:: 8UILDING SURCHAR6E
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I 99 --o23d
INSPECTION RECORD\
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 98188
PERMIT NO.
(206)431 -3670
Proj t'
p fid/.0 ,'7 Pf d rl
Type of Insction:
pe
7A/,
Address: "
/C
Date calle
Special instructions:
Date wooled:
9 —,z- c
a.
/ p.m
Requester:
,v•/tc
/------,x/74014/
Phone:
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
70
Inspector:
Date: 9 • idp
7.00 REINSPECT • N FEE REQUIRED. Pr' •r to inspection, fee must be paid
at 6300 Southcente Blvd., Suite 100. CaII o schedule reinspection.
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FILE COPY
ci that Ilia Plan Cliecic approvals 3f e
DVS and OrnISSIOfIri, appro )
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RECEIVED
CITY OF TUKWILA
DEC 1 0 1999
PERMIT CENTER
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INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 98188
m199 -OL30
PERMIT NO.
(206)431 -3670
.7rs ••wtt;:::.
Projec , t ,
(v `
-
Type of Inspection: pcu
Address:
ILfllco ;4 ire
Date called:
Special instructions:
Date wanted:
a.m.
p.m.
Requester:
Phone:
Approved per applicable codes.
COMMENTS:
Corrections required prior to approval.
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9..3A-- Kli) ioe� r calvt'.wP
9 (-)11) -Cr-LAA 1 wit.,
Inspector:
(-)v
Date: - /a I
D $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
1 Rertint Nn: 1 Date. 1
S
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 98188
PERMIT NO.
(206)431 -3670
Project:
Type of Inspection:
Address:
M24(9
/ (irk Al,ae
Date called:
I(//
VI)
Special instructions:
Date wanted:
a.m.
p.m.
Requester:
Phone:
nApproved per applicable codes.
Corrections required prior to approval.
COMMENTS:
Date: [6/0 !0 J6 1
$47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
I D......i..♦ AL.. • I rhfry
The Samara
Hubner, Inc.
2922918th S
Federal Way, WA 98003 -3826
September 26, 2001
City Of Tukwila
Public Works Department
6200 Southcenter Blvd.
Tukwila Wa. 98168
Gentlemen:
;r, • ?Sy
�1r,
As owner of the construction company that removed the house
located @ 14216 34th St.S. Tukwila 98168, let this letter certify
that the following items were completed prior and during the
removal process.
1. Demolition permit obtained for removal of vacant house
and garage.
2. Inspection of property for asbestos.
3. Removal of linoleum in kitchen and bath, double bagged and
taken to proper disposal site per demolition permit
guidelines.
4. Septic tank located, pumped dry by Septic Tank Service,
re- filled with sand.
5. Water meter removed by Val Vue water District #125.
6. Power and cable lines removed by proper authorities.
If in any way we have failed to comply with any guidelines of the
City of Tukwila we apologize. We have been in the construction
business for over 35 years, and are knowledgeable with permitting
along with city building codes.
If further information is needed please contact the undersigned.
Sincerelyy,
Herald Hubner, President
Hubner Brothers Construction
29229 18th Ave. So.
ta
00 l 36610
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RECEIVED
CITY OF TUKWILA
DEC 1 0 1999
PERMIT CENTER
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'-` t4gency Case No.
6 L . (Q )
Agency Use Only
PUGET SOUND CLEAN AIR AGENCY
110 Union Street, Suite 500, Seattle, WA 98101 -i ,
NOTICE OF INTENT
TO PERFOP:M; e,.
SANG
Date Received
��
Agency Use Only
tr.;,
9
1.1
.TI:r 1
A. Project Type: 1 1.1§, Asbestos Removal
2. ❑ Asbestos Remo
olitiop -1
3. ❑ Demolition. No Asbestos Removal
B. Property
Owner: _/ ,
Property Owner's
Mailing'Address: /// Q/ 4i,„
Phone: - •
State: PI
C. Asbestos PLEISEPinCLEIRLY,, • I BE YOUR RETURN MAILINGLIB�L
jP.l Contractor: i , e / l! / /
Contractor / I�° t
n'
Owner /CEO. Id f Av l!6
,
\I -,, s', ~ /
Mailin : Address: - /� , � _ �/ S
,
Phone: fp v6) a y / -9,,a�
_ Fax: Fts6 )v744/- Aii-
Contractor
Job No.: t
City: /ii / Wit -D
State: W
Zip: ni! e Q
D. Site
Address:
>.J
Contact Manager or 41v�
ontact Person: �/
City:
State:0, Zip: J7
Phone: (o/a, ,214// PC3r�o�-
p. ❑ Asbestos Survey or
❑ Mat'l Presumed:
No. of
Structures:
Date Survey was
Conducted: ��-' / ` /Cf
Was Asbestos Found? O1s
❑ If No, Attach Survey
AHERA Building ANERASURVEY IS REQUIRED EFORE ALL DEMOLITION PROJECTS
Inspector Name: f02//C %-- 0'4) eeAl
Certification No.: ,c8g6/ ''8•�'
Expiration
Date: / -1 o o
Demolition
Information:
Demolition
Contractor:
No. of
Structures:
Start
Date:
❑ Training Fire (List Fire Dept. as demolition contractor below)
❑ Ordered Demolition (attach copy of Order)
PRINT jIAMZERE, ENTER V G ADDRESS IN (B.91 J ON BACK. TRAI INC BURN ENTER FIRE DEPT. HERE
G f e)2-- • ,t2 0S ' tw.f/evc /d -1
Phone: f;/(9,1 ) ��f `9g3
G. Asbestos Project
Information:
No. of Structures:
(see back if > 1)
Start
Date: _
Completion
Date:
Wk. Days: M T W Th F Sa; Su
Hours:
I r
Total Quantity to be Removed: Linear Ft. 7 AI 0 Square Ft.
Will all asbestos material QTes
removed by project. ❑ No
f Thermal System Insulation: ❑ Boiler\Furnace Ins. CrDuct Ins. Pipe Ins.
Other: urt
8urfacin: Mat'l: ❑ Fireproofing ❑ Paints ❑ Plaster ❑ Textured Coatings
Other: t•, . l-, 1 f 19T1
Misc. Mat'l: • Cement Bd. • Cement Pipe ■7' Flooring Mat'l • Roofing Mat'l
Other:
H. Asbestos/Demolition Project Categories:
1. ❑ Owner- Occupied, Single - Family Residence Asbestos Removal Project
ta Single-Family Residence Demolition Protect
Notification Waiting Period
N iN- REFUNDABLE FEE
Prior Notice
44
$25
"
2. ❑ All Other Demolitions With No Asbestos Removal Project
■
10 Days
$150
3. ❑ 10 - 259 linear feet or 48 - 159 square feet (see back of form for options)
3 Days
$150
4. • 260 - 999 linear feet or 160 - 4,999 square feet
10 Days
$300
5, ❑ 1,000 - 9,999 linear feet or 5,000 - 49,999 square feet
10 Days
$750
6. ❑ 10,000 - 49,999 linear feet or 50,000 - 99,999 square feet
10 Days
$2,000 4,
7. ❑ 50,000 - 99,999 linear feet or 100,000 - 149,999 square feet
10 Days
$5,000
18. ❑ 100,000+ linear feet or 150,000+ square feet
10 Days
$10,000
9. ❑ Emergency Asbestos Project or [f Emergenc Demolition Project
Prior Notice
10 -Day Review Period
Twice Project Fee
Twice Project Fee
70. ❑ Alternate Means of Compliance for friable materials or Demolitions
11. 13 Alternate Means of Compliance for nonfriable asbestos materials
Concurrent with Project
Twice Project Fee
I. I do hereby certify that the information contained in this notification, and supplemental data described herein, is to the best of my
knowledge accurate and comp . uF .0 •t cause or allow any asbestos project or demolition activities to begin until the appropriate
waitin • no' h; •ty psed.
Representing
//--go -sr
Date
Completeness Review
Performed By
Agency Use Only
The Puget Sound Clean Air Agency isf'• • local air pollution authority for Snohomish, King, Pierce and Kitsap Counties. The
Puget Sound Clean Air Agency's Reg...dtion III, Article 4, requires advance notir 'ion be submitted to the Agency, on.
Agency - approved form no. 66 -160 (Revised7 /99), for any asbestos project involving ",erials equal to or greater in size than ,10
linear feet or 48 square feet and for any demolition project, regardless of asbestos content, involving structures with a projected
roof area greater than 120 square feet. Notices of Intent should be mailed or hand delivered to the Agency (address on reverse.
side) with the appropriate project fee. An Agency representative will review the notification, and if it is completed correctl ' """ '
' copy will be returned by mail within 3 to 5 days to the mailing address entered in box C and box J. The returned copy will:'
your valid notification. Asbestos and demolition projects involving materials and structures below the notification threshoj ,
listed above are still subject to all other' requirements of Puget Sound Clean Air Agency's Regulation III, Article 4. � � _
rr
:Yw
n.c • i • l'T
• . Demolition
. ". Contractor: i ,
IA ♦ .. i I r WIN. y/e
. f „ �N �/1 we D
�wE'-
Owner /CEO: r e !
Phone:
h d6) , G — .�._
��
y 4")./.1014
Contractor's
Job #: .k' r
9 — 0,
Mailing Address:. . f,
Cit . / '
State:b,
ZiP.9e lv
Fax:
12 ae) ,///. e,
GUIDELINES FOR SUBMITTING A NOTICE OF INTENT
Enter all applicable Information accurately and completely. Incomplete Notices of Intent will Inghed`:
;Box A., Check the appropriate project type.
Box B. Enter the legal property owner information
• Box C. Enter the asbestos contractor information, or "not applicable" (N /A) for demolition projects $.Iotg�tos-
containing materials are present. For an Owner Occupied, Single - Family Residence asbestos remove project (protect
category Hl), list the asbestos removal contractor or property owner doing the asbestos removal (include property
owner's mailing address).
:.. Box D. Enter the asbestos removal or demolition site address. For an Owner - Occupied, Single - Family Residence asbestos
removal project (project category Hl) where the property owner's mailing address differs from the site address listed In
Box D, a letter must accompany the Notice of Intent verifying that the structure located at the site address is currently,
being used as the property owners domicile. Multiple asbestos/demolition projects involving more than one structure
' (project category H2 through H8) must be submitted in accordance with the Agency Regulation I, Section 4.03(a)(7). I.
Box E. Enter the asbestos survey information or check material presumed (for asbestos projects only). An AHERA building
inspector must conduct an asbestos survey prior to any demolition project (i.e., the wrecking, razing, leveling, dismantling or
burning of a structure, making the structure permanently uninhabitable or unusable).
Box F. Enter the demolition project information. If the structure is to be used in a training fire, list the fire department
responsible for conducting the burn as the demolition contractor in Box J. If the property owner has been ordered to perform a
demolition by a government official, submit a copy of the order from the appropriate official.
Box G. Enter all asbestos project information or enter "N /A" for demolition projects with no asbestos removal required. All
multiple structure asbestos projects (project category H10 and H11) must be submitted with a work plan. map of the structures,
complete site address, type and amount of asbestos material to be removed from each structure, AHERA asbestos survey. and
work schedule.
CITY OF TUKWI tr;,•.�
nEr 1 1199
1
L.
4
Box H. Check one project category in boxes 1 through 8. The project fee includes the demolition fee. Asbestos removal
projects and demolitions with an asbestos removal involving less than 10 linear feet or 48 square feet may be filed as project
category 3. An emergency asbestos project or demolition may be requested by checking the appropriate job size category in
boxes 2 through 9 and then checking the applicable emergency box in category 9. Emergency asbestos project notifications
must be submitted with a letter from the property owner explaining the necessity for the emergency. Emergency demolition
notifications must be submitted with a letter from an authorized government official or a licensed structural engineer
documenting that the structure is in imminent danger of collapse. To request an alternative means of compliance for friable or
nonfriable materials, check the appropriate job size category in addition to the applicable box in categories 10 and 11. A work
plan must be submitted by an appropriately trained individual along with the notification.
Box I. Sign the notification certifying the accuracy and completeness of the information provided on the form.
Box J. Enter demolition contractor mailing information (on back). `
Mandatory amendments are required for changes that increase the project type, job size category, the types of asbestos
materials to be removed and work schedule changes. No fee is required for work schedule changes if the contractor is .
participating in the Agency work schedule fax program. A $50.00 processing fee is required for all other amendments.
For technical assistance, contact Tom Hudson at (206) 689 -4058, Larry Vaughn (206) 689 -4035 or Kwame Agyei (206) 689-
4054. For inquiries concerning notification and amendment status contact Anne Morgan at (206) 689 -4090.
,
J!T, Inc 11502 5t Avenue N.E. Seattle, WA 9811' (206) 440 -7367
Residential and Garage
14216 34 th Avenue South, Tukwila, WA 98146
ASBESTOS'GOOD FAITH'INSPECTIONS I1
Date: November 1, 1999
RECEIVED
CITY OF TUKWILA
DEC 1 0 1999
PERMIT � CE����•�, isna.
Requested By: David Fenton Request Date: 10/19/99
Owner: David Penton Phone: 215 -2401. 215 -2607
Pro ect Location: 14216 �4 th Avenue South, Tukwila, WA 98146_
Project Name (Description): Demolish existing house and aaraae
J/T Project #: 11199 Survey Date: 10/19/99
Per the Washington Administrative Code, asbestos standard, identification section: 296 -62- 07721, the
above identified area had a "GOOD FAITH" inspection to determine whether materials to be worked
on, removed, or disturbed during construction contain asbestos. The following indicates the
disposition of that inspection:
An inspection was performed by J/T, Inc certified AHERA Building Inspector as indicated below:
XXX Bruce Thoreen AHERA Bldg Inspector No. 538548888, exp date 1/5/2000
AHERA Mgmt Planner No. 538548888, exp date 2/27/99
AHERA Project Designer No. 99 -0211, exp date 2/5/2000
The inspection was based on the identification of work defined by the David Fenton. The covers all
interior and exterior buildings on the site.
Asbestos does not appear to be present in the work scope Identified. However, if a
worker identifies a substance that in his /her estimation contains asbestos or may
contain asbestos, then the work area must be secured from possible contamination.
Asbestos has been identified to be present in the work area. Asbestos is not •
expected to be disturbed during the course of the work. If identified asbestos must be
disturbed or if a worker identifies additional substances in the work scope that in his
estimation contains asbestos or may contain asbestos, the Owner or his /her
appointee must be contacted to determine what action must be taken.
XXX Asbestos has been identified in the work scope. A certified asbestos contractor will be
contacted by the Owner to remove or encapsulate the Identified asbestos. The
Owner will be advised when asbestos removal or encapsulation is completed. The
final report will be made available on request.
If there are any questions pertaining to the inspection or the asbestos regulations please contact
Bruce Thoreen at (206) 996 -2255 (pager).
i cerely,
ruce Tho =n
Inspector /Management Planner
J/T, Inc.
J/T, Inc
11502 5h Avenue N.E.
Date: November 1, 1999
Seattle, WA 98125
Residential and Garage
14216 34 th Avenue South, Tukwila, WA 98146
ASBESTOS GOOD FAITH INSPECTION
(206) 440 -7367
RECEIVED
CITY OF TUKWILA
DEC 1 0 1999
PERMIT' 'CENTEI
Requested By: David Fenton Request Date: 10/19/99
Owner. David Fenton Phone: 215 -2401, 215 -2607
Project Location : 14216 34 th Avenue South, Tukwila, WA 98146
Project Name (Description): Demolish existing house and garage
,J/T Project* 11199 Survey Date: 10/19/99
The following summary lists asbestos - containing materials (acm) identified in the work area:
Location Material Description Sury Date Sm I # Smpl Results
c en floor Floortile12x12(beige)(NF) 99/10/19 101p999JBT005 2% C
The following summary lists n
Location
Front Rm wall
Front Rm wall
Kitchen wall
Kitchen wall
Northeast Bedroom wall
Northeast Bedroom wall
Bathroom floor
Bathroom floor
Kitchen floor
House roof
House roof
Garage roof
Garage roof
Garage roof
Front Room ceiling
NW Bedroom ceiling
Northeast Bedroom ceiling
et
on- regulated materials sampled in the work area:
Material Description Sury Date
Joint compound 1S/10/19
Gypsum wall board
Joint compound
Gypsum wall board
Joint compound
Gypsum wall board
Floor tile12x12(mauve)(NF)
Floor tile mastic
Floor tile mastic
3 -tab roofing
3 -tab roofing
3 -tab roofing
3 -tab roofing
3 -tab roofing
Textured ceiling
Textured ceiling
Textured ceiling
Abbreviations: NAD= No Asbestos Detected
T = Tremolite Asbestos
A = Amosite Asbestos
(g) good condition
Action required at the work area is as follows:
No asbestos found at work area. No asbestos action required.
Asbestos at work area. Disturbance during construction is not expected.
XXX Asbestos at work area. Abatement is required. Refer to attached plan for ACM and sample
location.
99/10/19
99/10/19
99/10/19
99/10/19
99/10/19
99/10/19
99/10/19
99/10/19
99/10/19
99/10/19
99/10/19
99/10/19
99/10/19
99/10/19
99/10/19
99/10/19
S_m_pII##
101999JBT001
101999JBT001
101999JBT002
101999JBT002
101999JBT003
101999JBT003
101999JBT004
101999JBT004
101999JBT005
101999JBT006
101999JBT006
101999JBT007
101999JBT007
101999JBT007
101999JBT008
101999JBT009
101999JBT010
C = Chrysotlle Asbestos
ACT = Actinolite Asbestos
(F) friable, (NF) non friable
(b) bad condition
Smpl' Results
NAD
NAD
NAD
NAD
NAD
NAD
NAD
NAD
NgD
NAD
NAD
NAD
NAD
NAD
NAD
NAD
NAD
Sincerely,
ruce Thoreen
J/T, Inc.
attachment: Floor Plan
Lab data sheet
'li
At., 14 \Y is
66/ V 11
lsr
666101
66/61/01
ANtlf1S SO1S765Y
171v0 1014
:AB I$VIIO
1711VN 7111
71vO Alums
11OYOtld
Mt-966 (900 11170Yd
OIL-OD (90L) 7P Hd
•��
99196 dM 'VIIMNfIl
H1f10S 3f1N3Ad Hlb� 9I i' l
A3AWfS SOIS3SSV
rr
p
1--
OL166 VA TUV75
7N 1t1N1AY ILLS LOStI
r /6
tl.Ll1
01
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Z
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01
01
rn
01
O
W
2
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s
S.
05.1 of
ll•
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CL
W
C'
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CD
r
0
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9
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0:0 .............................................
• rua
Clayton
ENVIRONMENTAL
CONSULTANTS
4636 a Marginal Way So. Suits 213
Saute, WA 98134
(206) 763-7364
lient N'ame: David Fenton
h Location: 14216 34th Avenue South - Tukwila, WA 98168
r'
ASASTOS BULK SAMPLE DATA(
NVLAP #101106-0
Accredited Laboratory
Page 1 of 6
24$7
Regular
Log #:
Priority:
Project #:
Number of Samples:
:Contact:
Job/P0#:
LAYERED SAMPLE: NESHAP and AHERA regulations require layers be analyzed and reported separately.
LAYER 1 RESULTS: • • .
' OTHER FIBERS •
• • .
• I'.
Cellulose .. •
• .
24874.1A
• Joint Compound
• Front Room Wall
L.
White paint on white fibrous powdery material
#:
LAR #: 24874.1B
:10URCE: Wallboard
'LOCATION: Front Room Wall
OTHER MATERIALS
Filler & BindernsogNA
Paint ovrirs
Note: Joint compound
OTHER MATERIALS,
Filler & Binder
MATERIAL DESCRIPTION:
an papery layer with white chalky powder
LAYERED SAMPLE: NESHAP and AHERA regulations require layers be analyzed and reported separately.
LAYER 1 OTHER FIBERS
AMPLE #:
'04
IS #: 24874.2A
'..#-
).SOURCE: Joint Compound
LOCATION: Kitchen Wail
:MATERIAL:DESCRIPTION:
fWhitepaint on white fibrous powdery material
RESULTS:
Note: Joint compound
Cellulose
OTHER MATERIAL'S
Filler & Binder
Paint
SAMPLED BY: Bruce Thoreen DATE: 10/19/99
'• COMPANY: Clayton Environmental Consultants
RECEIVED BY: Phyllis Karr DATE: 10/20/99
ANALYZED BY: Jude Cummings
DATE: 10/21
• NVL Anoroved Signatory
••,10.74.4 •
Clayton is accredited by N1ST/NVLAP. Accreditation by NVLAP does not indicate endorsement by NVLAP or any other government agency. All bulk samplei
analyzed in accordance with method EPA/600/R-93-116 (July 1993). Analyses are crou-checked through inter and antra laboratory quality usurahce programs
. .
v't
- Clayton
.��s6 e. Marginal way so. Suits 215
ENVIRONMENTAL
"'CONSULTANTS
:4 Stank, WA 93134
(206) 763.7364
lient Name: David Fenton
ASBL,TOS BULK SAMPLE DATA(
NVLAP #101106 -0
Accredited Laboratory
b Location: 14216 34th Avenue South - Tukwila, WA 98168
LE #:
(1oi999JBT002:-
24874.2B
OURCE: Wallboard
OCATION: Kitchen Wall
ATERIAL DESCRIPTION:
LAYER 2 RESULTS:
Page i2of 6
Log #: ' 2487
Priority: Regular
Project #:
Number of Samples:
". Contact:
Job/P0#:
OTHER FIBERS'
Cellulose
OTHER MATERIALS
Filler & Binder .
CPS OF 7'<
PEF►M►'f GE■lGi', }i
an papery layer with white chalky powder
Note: Wallboard
LAYERED SAMPLE: NESHAP and AHERA regulations require layers be analyzed and reported separately.
SAMPLE #:
r
jd1B M: 24874.3A
=SOURCE: Joint Compound
'LOCATION: Northeast Bedroom Wall
:MATERIAL DESCRIPTION:,
,White paint on white fibrous powdery material
AMPLE #:
LAB .00 24874.38
;,SOURCE: Wallboard
OCATION: Northeast Bedroom Wall
101999JBT003;
?MATERIAL DESCRIPTION:
1( Tan papery layer with white chalky powder
LAYER 1 RESULTS: OTHER FIB RS
Note: Joint compound
LAYER 2 RESULTS:
Note: Wallboard
Cellulose
OTHER MATERIALS
Filler & Binder
Paint
OTHER FIBERS
Cellulose
OTHER MATERIALS';.
Filler & Binder
Arci
SAMPLED BY: Bruce Thoreen DATE: 10/19/99
COMPANY: Clayton Environmental Consultants
RECEIVED BY: Phyllis Karr DATE: 10/20/99
ANALYZED BY: Jude Cummings DATE: 10/21
Labo ory anater - N _ • paved Simeon/
Clayton is accredited by NIST/NVLAP. Accreditation by NVLAP does not indicate endorsement by NVLAP • r any other government agency. All bulk umpl
analyzed in accordance with method EPA/600/R- 93.116 (July 1993), Analyses are cross - checked through inter and antra laboratory quality assurance progrsms,
verification. The percent values reported above are based on a calibrated visual estimates by volume unless verification by Point Counting is indicated. Teat
Clayton
ENVIRONMENTAL
CONSULTANTS
4636 E. Marginal Way So. Suite 215
Seattle, WA 98134
(206) 763.7364
ASB -t;TOS BULK SP.MPLE DATA
NVLAP #101106.0
Accredited Laboratory
Client Name: David Fenton
Job Location: 14216 34th Avenue South - Tukwila, WA 98168
Page 3 of 6
Log #: 24874
Priority: Regular 13
Project #:
Number of Samples: 8
Contact:
Job/PO #:
•
.1
1\
LAYERED SAMPLE: NESHAP and AHERA regulations require layers be analyzed and reported separately.
LAYER 1 RESULTS:
SAMPLE #: (101999JBT004 ) , , OTHER FIBERS
LAB #: 24874.4A : ... Cellulose
,SOURCE: 12"X12" Floor Tile No Asbestos 'Detected:: t
LOCATION: Bathroom Floor ASBESTOS TYPE `
PERCENT::
MATERIAL DESCRIPTION:
Mauve vinyl
Note: I2 "x12" Flour rile (mauve)
l/
SAMPLE #:
LAB #: 24874,4B
,SOURCE: Floor Tile Mastic
LOCATION: Bathroom Floor
(101999JBT004
MATERIAL DESCRIPTION:
Tan and black mastic
LAYER 2 RESULTS:
No Asbestos .Detected
ASBESTOS TYPE 0 PERCENT,'.
' 2
OTHER MATERIALS %
Aggregate 20
Asphalt Fitter 0 T, KW11.A 78
:i.
BEC ,1999
pESaMI'I cesIEFF
OTHER FIBERS
%
Cellulose 3
Glass Fiber 2
OTHER MATERIALS %
Fine drains 20
Filler & Binder 75
1
Note: Mastic
I\
LAYERED SAMPLE: NESHAP and A111ERA regulations require layers be analyzed and
SAMPLE #: (1O1999JBT005 )
LAB #: 24S74.5 :1
SOURCE: 12 "X12" Floor Tile
LOCATION: Kitchen Floor
MATERIAL DESCRIPTION:
Tan vinyl
LAYER 1 RESULTS:
:.1
Asbestos Containing Material (ACM)
ASBESTOS TYPE PERCENT'
Chrysutile 2
reported separately.
OTHER FIBERS
Cellulose
OTHER MATERIALS
Aggregate 20
Vinyl Filler and Binder 77
Note: 12 "x12" Flour tile
t 1
SAMPLED BY: Bruce Thoreen
DATE: 10/19/99 ANALYZED BY: Jude Cummings
COMPANY: Clayton Environmental Consultants
RECEIVED BY: Phyllis Karr DATE: 10/20/99
DATE: 10/21/99
Laboratory M•nauer- NVLAP Any oved Silmatory
Clayton is accredited by NIST/NVLAP. Accreditation by NVLAP does not indicate endorsement by NVLAP or any other government agency. All bulk samples are
analyzed in accordance with method EPA/600 /R- 93.116 (July 1993). Analyses are cross - checked through inter and intra laboratory quality assurance programs for
on vn1 .•c r..n „r„ -,1 nh „v . nr,• 1 , ..,I „n ,.nlihrntad view,I .•ei.nvunc by vnlun„, nnincc vnrifientinn by Pnint rnnuntinv lc indiented. Teat ret"It_a
• Clayton
ENVIRONMENTAL
CONSULTANTS
4636 E. N1arginal Way So. Suite 215
Seattle. WA 98134
1 :06) 763.7364
ASI °L7'0S BULK S. ti'vIPLL DATA(
NVLAP #101106-0
Accredited Laboratory
Page 4 of 6
Log #: 24874
Priority: Regular B
Project #:
Number of Samples: 8
CIient Name: David Fenton Contact:
Job Location: 14216 34th Avenue South - Tukwila, WA 98168 Job/PO #:
SAMPLE #: (101999JBT005 LAYER 2 RESULTS:
/ r
LAB #: 24874.513
SOURCE: Floor Tile Mastic No Asbestos Detected . ;.
LQCATION: Kitchen Floor ASBESTOS'1'YPE PERCENT
MATERIAL DESCRIPTION:
Tan mastic
Note: ,Mastic
OTHER FIBERS
Cellulose
3
OTHER MATERIALS %
Fine grains ( 15
Filler & Binder : 82
LAYERED SAMPLE: NESHAP and AHERA regulations require layers be analyzed and reported separately.
SAMPLE #: (101999JBT006 LAYER 1 RESULTS: OTHER FIBERS
LAB #: 24874.6A Cellulose
SOURCE: 3 Tab Rooting Shingle No Asbestos Detected.' Glass Fiber
LOCATION: House Roof ASBESTOS 'TYPE PERCENT
MATERIAL DESCRIPTION:
Tan and orange pebbles on black fibrous asphaltic
material
;Yore: 3 -tab roofing
agCE UKv40.,
G ►N .Q:.. .
(-• A \999.
1
U'1'r1ER MATERIALS
Aggregate
Asphalt Filler & Binder
5
15
10
70
SAMPLE :: 001999JBT006
LAB #: 24874.6B
SOURCE: 3 Tab Rooting Shingle
1.00ATIQN: house Roof
MATERIAL DESCRIPTION:
Tan pebbles on black fibrous asphaltic material
LAYER 2 1S LILTS:
r
No rlsbestos Detected
ASBESTOS TYPE ' PERCENT:
OTHER FIBERS
Cellulose
%
l0
OTHER MATERIALS %
Aggregate 15
Asphalt Filler & Binder 75
Nunn 3 -tab roofing
I
SAMPL.EI BY: Bruce Thoreen
DATE: 10/19/99 ANALYZED BY: Jude Cummings
CO,NIPANY: Clayton Environmental Consultants
RECEIVED 13Y: Phyllis Karr DA'L'E: 10/20/99
✓l.
.�C
Laboratory a aver • NVLA
DATE: 10/21/99
nnroved Sianatory
Clayton i; :,..rcdited by NIST /NVLAP. Accreditation by NVLAP does not endorsement by NVLAP or any other government agency. All bulk samples are
analyze.: in accordance with method EPA/60:J/K•93-116 (Jule 1993). Analyses ate cross- checked through inter and Ultra laboratory quality assurance programs for
verilic:,. • The nercent value; rennrted ah..•.■• :Ire hated nn n celihr:ue 1 vtut .1 oc,'matee by vnhnne unlace varificntinn by Point (' 11 ntino ie inrtiontad Tect ramdtc
.Y'
Clayton
ENVIRONMENTAL
CONSULTANTS
4636 E. Nix ginal Way Su. Suite 215
Seattle, WA )B134
12061 763.7364
AS STOS BULK S2rAMPLE DATA(
NVLAP #101 IOt)-U
Accredited Labor•:,tury
Page 5 of 6
Log #: 24874
Priority: Regular B
Project #:
Number of Samples: 8
Client Name: David Fenton
Contact:
Job Location: 14216 34th Avenue South - Tukwila, WA 98168 Job /PO //:
1
SAMPLE #:
(101999JBT006
LAB #:, 24S74.6C
SOURCE: 3 Tab Rooting Shingle
LOCATION: House Roof
MATERIAL DESCRIPTION:
Red pebbles on black fibrous asphaltic material
LAYER 3 RESULTS:
No Asbestos Detected
ASBESTOS'I'YPE PERCENT
Note: 3 -tab roofing
\ J
LAYERED SAMPLE: NES1L P and AHI RA regulations require layers be analyzed and reported separately.
OTHER FIBERS
Cellulose
Synthetic
OTHER MATERIALS
A�_ r %,Sate
Asphalt Filler & Binder
15
3
10
72
J
SAMPLE #: C101999JBT007 LAYER 1
LAB #: 24874.7A
SOURCE: 3 Tab Rooting Shingle No A.,bestos Detected •
LOCATION: Garage Roof ASBESTOS 'TYPE PERCENT
It r :SULTS:
MATERIAL DESCRIPTION:
Tan, gray and white pebbles an black fibrous
asphaltic material
0.
t\,t,': 1-Mb roofing
O'1'1-1ER FIBERS
C'el l t.lose 15
OTHER MATERIALS
Aggregate 15
Asphalt Filler & Binder 70
J
SAMPLE #: C101999JBr1'007
j-AB #: 24S74.713
SOURCE: 3 Tab Rooting Shingle
LOCATION: Garage Roof
MATERIAL DESCRIPTION:
Gray pebbles• on black fibrous asphaltic material
LAYER2 k:' :SULTS:
No Asbestos Detected
ASBESTOS 'TYPE : PERCENT '?
Vote: 3 -tab roofing
OTHER FIBERS
Cellulose
20
OTFIER MATERIALS
Aggregate 10
Asphalt Filler & Binder 70
I
SAMPLED I3Y: Bruce Thoreen DATE: 10/19/99 ANALYZED BY: Jude Cununin s DATE: 10/21/99
CON1PANY: Clayton Environmental Consultants
RECEIVED LAY: Phyllis Karr DATE: 10/20/99
Laboratory lanauer • NVLAP An oved Sianatory
Clayton :Iedited by NIST /NVLAP. Aecic'Jitatiun by NVLAP does not indicat•_ endorsement by NVLAP or any other government agency. All bulk samples are
analyzed in aeeurdance with method EPA/6UUiR -93 -116 (July 1993). Analyses ale Bross- checked through inter and antra laboratory quality assurance programs for,
vnrifiraii.,It -I•h,• n.•rrwnl vnlurc rwnnrt.a1 nhnvn hncnrt nn ti rnlihrn twri vicunl r... n.it .c by vnlumw unlwce vnr: llnnlinn Lv Pnint (•nt,ntlnn it in.Iinnr.a TA./..e .1*.
Clayton
ENVIRONMENTAL
CONSULTANTS
4636 E. Marginal Way So. Suite 215
Seattle. WA 98134
(206) 763.7364
�:, ?`.'r.�ff.'?xs •.MinXr.`.,-;; r.� n,+, ,.::.vr- ,^,•e.,;. ^.rc^ erv...141rrw•,:ea;:
:: •: vlir, t•,,:q,t�^ : Kn r �tr�..y,4�tHn „emr.
ASISTOS BULK SAMPLE DATA
NVLAP #101IU1, -0
Accredited Laba,..tory
Client Name: David Fenton
Job Location: 14216 34th Avenue South - Tukwila, W:s, 98168
Page 6 of 6
Log #: 24874
Priority: Regular B
Project #:
Number of Samples: 8
Contact:
Job/PO #:
SAMPLE #: (101999JBT007 LAYER 3 kESULTS:
r
LAB #: 24874.7C
SOURCE: 3 Tab Roofing Shingle , 'No :'ISbestos> Detected.
LOCATION: Caragc Root' ASBESTOS "TYPE PERCENT.:
MATERIAL DESCRIPTION:
Black fibrous asphaltic material
,Vote: Roofing felt
:.1
OTHER FIBERS
Cellulose 25
OTHER MATERIALS %
Asphalt Filler & Binder 75
SAMPLE #: C01999JBT008
J_AB #: 24874.8
SOURCE: Textured Ceiling
LOCATION: Front Room Ceiling
MATERIAL DESCRIPTION: LAVEREli •,
Off-white paint en off white powdery material
RESULTS:
i
'Layers l il,mogenized for Analysis
No Asbestos Detected
ASBESTOS TYPE :::: PERCENT
Note: Textured cell;:,,
OTI -IER FIBERS
ti
Cellulose
OTHER MATERIALS %
Filler & Binder
Paint
84
15
J
1
/
r
SAMPLED BY: Bruce Thoreen DATE: 10/19/99
COMPANY: Clayton Environmental Consultants
RECEIVED 13Y: Phyllis Karr DATE: 10/20/99
ANALYZED BY: Jude Cummings
DATE: 10/21/99
1
Clayton is accredited by NIST/NVLAP. Accreditation by NVLAP does not indicutz endorsement by NVLAP or any other government agency. All bulk samples are
analyzed in accordance with method GPA/600/R•93.116 (July 1993), Analyses a: cross- checked through inter and infra laboratory quality assurance programs for
verification. The percent values reported above are based on a calibrated visual :,:unates by volume unless verification by Point Counting is indicated. Test results
. •Clayton
ENVIRONMENTAL
CONSULTANTS
4636 E. Marginal Way So. Suite 213
Seattle, WA 95134
(206) 763.736.1
7
..rk 4•1 ^,
ASIC TOS BULK SAMPLE DATA(
NVLAP 111011uo -u
Accredited Laborn fury
Client Name: David Fenton
Job Location: 14216 34th Avenue South, Tukwila, WA
i
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Page 1 of 1
Log #: 24887
Priority:
Project #:
Number of Samples:
Contact:
Job/PO #:
Regular B
2
SAMPLE #:
LAB #: 2487,1
SOURCE: Textured Ceiling
LOCATION: NW Bedroom Ceiling
C 01999JBT009
MATERIAL DESCRIPTION: LAYERED
Off -white paint on off - white non fibrous material
RESULTS:
Layers H :,nogenized,for.Analysis ;..:
NU rl - ibestoS Detected
ASBESTOS t'YPE PERCENT:. •
,';ate: Texnrre
OTHER FIBERS
Cellulose
OTHER MATERIALS
Filler & Binder
Paint
89
10
SAMPLE #: C 01999JBT010
LAB a: 2•1SS7.2
SOURCE: Textured Ceiling
LOCATION: NE Bedroom Ceiling
MATERIAL DESCRIPTION: LAVERI• :I)
Off-white paint (Et off- white nun fibrous 'tatterlul
RESULTS:
Layers 1lr+mogenized for Analysis;
:No ..l:ibestos Detected
,ASBESTOS 1'YPE PERCENT:':?
Note: Texture
SAMPLED 131': Bruce '1ltorcc11
COMPANY: Clayton Environmental Consultants
RECEIVED BY: Bruce Thoreen
DATE: 10/19/99
DATE: 10/9/99
OTHER FIBERS
Cellulose
OTHER MATERIALS
Filler & Binder
Pail.
ado
89
10
J
ANALYZED BY: Jude Cununings DATE: 10/25/99
Laboratory anaaer - NVI.AP Approved Sistnatgly
Clayton is accredited by NIST /NVLAP, Accreditation by N \'LAP does not indie:,w endorsement by NVLAP or any other government agency. All bulk samples are
analyzed in accordance with method EPA,' iOO /R•93.116 (July 1993). Analyses : eross•clrecked through inter and intra laburatory quality assurance programs for
verification. The percent values reported ab+,t c are based on a calibrated visual c •itnates by volume unless verification by Point Counting is indicated. Test results
City of Tukwila
Steven M. Mullet, Mayor
Department of Community Development Steve Lancaster, Director
September 5, 2001
Mr. David Fenton
14201 42nd Ave. S., #115
Tukwila, WA 98168
RE: Permit Status M199 -0230
Site Address: 14216 34th Ave. S, .
Dear Mr. Fenton:
In reviewing our current permit files, it appears that your permit for demolition of existing house
and garage issued on December 28, 1999, has not received a final inspection as of the date of this
letter by the City of Tukwila Building Division.
Per the Uniform Building Code and /or Uniform Mechanical Code, every permit issued by the
building official under the provision of this code shall expire by limitation and become null and
void if the building or work authorized by such permit is not commenced within 180 days from
the date of such permit, or if the building or work authorized by such permit is suspended or
abandoned at any time after the work is commenced for a period of 180 days.
Based on the above, if a final inspection is not called for within ten (10) business days from the
date of this letter, the Permit Center will close your file and the work completed to date will be
considered non - complying and not in conformance with the Uniform Building Code and /or
Mechanical Code,
Please contact the Permit Center at (206) 431 -3670 if you wish to schedule a final inspection.
Thank you for your cooperation in this matter.
Sincerely,
KCCtA.LjU (t ' , rt,ji 1,)
Kathryn A. Stetson
Permit Technician
Xc: Permit File No. MI99- 0230.':::
Dunne Griffin, Building Official
Mr. Fenton,
I have reviewed the materials you gave me. I have filled out a Building Permit
application for you. Please check it over for accuracy. If it is okay, please sign and date
it on the reverse side.
There are a couple of items that need to be completed before your permit can be
approved:
1. Since there is asbestos in the residence (kitchen floor), the flooring must
be removed by a certified asbestos abatement contractor before demolition
can begin. This certified contractor must file an application to perform an
asbestos project with Puget Sound Air Pollution Control Agency. A
certified contractor will know the procedures.
2. You need to get an approval from Puget Sound Air Pollution Control
Agency — requires you to submit a separate permit to them. Their address
is 110 Union Street, Suite 500, Seattle. Part of their approval will be the
removal of the aforementioned asbestos.
3. The City requires a bond in an amount equal to the demolition cost, plus
10 %, and it must be posted prior to issuance of the permit. The demolition
cost is the cost to demolish the structures, not the asbestos removal
because the asbestos removal must be completed prior to demolition of the
structures.
4. We need four copies of the site plan. The checklist identifies the
requirements of the site plan.
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THE SAMARA HUBNER CONSTRUCTION INC..
29229 18T11 AVE. S.
FEDERAL WAY, WA. 98003
253- 839 -2010 (OFFICE)
TAX ID #: - -91- 1354045
REG: # SAMARAH1066LG
EXPIRES: JUNE 7T11, 2000
PMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: MI99 -0230
PROJECT NAME: FENTON RESIDENCE -DEMO.
XX Original Plan Submittal
DATE: 12 -10 -99
Response to Incomplete Letter #
Response to Correction Letter # Revision # _:After Permit Is Issued
DEPARTMENTS:
Bui ?g Divisi
Public Works
A (A' int), IZ -/�-9�
Fire Prevention
Structural
Planning Division
n
nPermit Coordinator
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
DUE DATE: 12 -16 -99
Incomplete n Not Applicable
Comments:
TUES /THURS ROUTING:
Please Route [—I/Structural Review Required n No further Review Required
n
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS: (ten days) DUE DATE 1 -13 -2000
Approved n Approved with Conditions
Not Approved (attach comments)
REVIEWER'S INITIALS: DATE:
CORRECTION DETERMINATION: DUE DATE
Approved n Approved with Conditions n Not Approved (attach comments)
REVIEWER'S INITIALS: DATE:
WRROUTE.DOC
Ch
* * *VIEW CONTRACTOR BOND /SAVINGS INFORMATION * * *
* * *VIEW PRINCIPAL OWNER(S) FOR THIS LICENSE* * *
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