HomeMy WebLinkAboutPermit D13-103 - SEGALE DEMOLITION - DEMOLITIONSEGALE DEMOLITION
5565 S 178 ST
D13-103
City *Tukwila
•
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Inspection Request Line: 206-431-2451
Web site: http://www.TukwilaWA.aov
Parcel No.: 3523049019
Address: 5565 S 178 ST TUKW
Suite No:
Project Name: SEGALE DEMOLITION
DEVELOPMENT PERMIT
Permit Number: D13-103
Issue Date: 04/11/2013
Permit Expires On: 10/08/2013
Owner:
Name: SEGALE PROPERTIES LLC
Address: PO BOX 88028 , TUKVVILA WA 98138
Contact Person:
Name: BARRY BENNETT
Address: PO BOX 88028 , TUKWTLA WA 98138
Contractor:
Name: SEGALE PROPERTIES LLC
Address: PO BOX 88028 , TUKWILA WA 98138
Contractor License No: SEGALPL902CQ
Lender:
Name:
Address:
Phone: 206-575-2000
Phone: 206-575-2000
Expiration Date: 04/01/2014
DESCRIPTION OF WORK:
DEMOLISH AND REMOVE STRUCTURE AND FOUNDATION OF 1990 SQ FT HOME. TERMINATE AND CAP ALL UTILITIES.
REGRADE TO MATCH ADJACENT EXISTING CONTOUR AND ELEVATIONS.
PUBLIC WORKS ACTIVITIES INCLUDE EROSION CONTROL, LAND ALTERING, SEPTIC TANK ABANDONMENT, CAPPING
3/4" WATER SERVICE AT THE MAIN AND PAVEMENT RESTORATION.
HIGHLINE WATER DISTRICT.
Value of Construction: $13,000.00 Fees Collected: $885.07
Type of Fire Protection: NONE International Building Code Edition: 2009
Type of Construction: V -B Occupancy per IBC: 0022
Electrical Service Provided by: PUGET SOUND ENERGY
**continued on next page**
doc: IBC -7/10
D13-103 Printed: 04-11-2013
Public Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant:
Flood Control Zone:
Hauling:
Land Altering:
Landscape Irrigation:
Moving Oversize Load:
N Number: 0
N
Start Time:
Volumes: Cut 0 c.y.
Start Time:
Size (Inches): 0
End Time:
Fill 0 c.y.
End Time:
Sanitary Side Sewer:
Sewer Main Extension: Private: Public:
Storm Drainage:
Street Use: Profit: N Non -Profit: N
Water Main Extension: Private: Public:
Water Meter: N
Permit Center Authorized Signature:
Date:
I I- 13
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 provisions of any other state or local laws regulating
construction or the performance of work. I am authorized to sign and obtain this development permit and agree to the conditions attached
to this pe
Signature: /
Print Name:
Q/i--)c,_ toren_tosS
Date: /ii
j3
This permit shall become null axCd 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.
PERMIT CONDITIONS:
1: ***BUILDING DEPARTMENT CONDITIONS***
2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the
Building Official.
3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to
start of any construction. These documents shall be maintained and made available until final inspection approval is
granted.
4: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary
sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other
excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of
this requirement.
5: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of,
any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits
presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila
shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the
doc: IBC -7/10
D13-103 Printed: 04-11-2013
Building Official from requiring the correctly errors in the construction documents and of data.
6: ***PUBLIC WORKS DEPARTMENT CONDITIONS***
7: Contractor shall notify Public Works Inspector Mr. Dave Stuckle at (206) 433-0179 of commencement and completion of
work at least 24 hours in advance.
8: Permit is valid between the weekday hours of 7:00 a.m. and 10:00 p.m. only. Coordinate with the Public Works Inspector
for weekday work hours after 5:00 and weekend work hours.
9: Any material spilled onto any street shall be cleaned up immediately.
10: Applicant/Contractor shall obtain a water capping permit from Highline Water District at (206) 824-0375.
11: Applicant shall provide Seattle & King County Public Health a Report of Wastewater Tank Abondonment. Community
Environment Health, 900 Oakesdale Ave SW, Renton, WA 98057-5212. (206) 296-4932.
12: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation
off-site or into existing drainage facilities.
13: The site shall have permanent erosion control measures in place as soon as possible after final grading has been
completed and prior to the Final Inspection.
14: From October 1 through April 30, cover any slopes and stockpiles that are 3H: IV or steeper and have a vertical rise of
10 feet or more and will be unworked for greater than 12 hours. During this time period, cover or mulch other disturbed
areas, if they will be unworked more than 2 days. Covered material must be stockpiled on site at the beginning of this
period. Inspect and maintain this stabilization weekly and immediately before, during and following storms.
15: From May 1 through September 30, inspect and maintain temporary erosion prevention and sediment at least monthly. All
disturbed areas of the site shall be permanently stabilized prior to final construction approval.
16: Any septic tanks in the area shall be pumped empty and removed or filled with sand. A copy of the documentation from
the business that performed the pumping shall be provided to the Public Works Inspector.
doc: IBC -7/10
D13-103 Printed: 04-11-2013
110
CITY OF TUKWILA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
Building Permit No. j ( 3 103
Project No.
Date Application Accepted:
Date Application Expires: _1 ^>fj i3
(For office use only)
CONSTRUCTION PERMIT APPLICATION
Applications and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mail or by fax.
**Please Print**
SITE LOCATION
Site Address:
Tenant Name:
King Co Assessor's Tax No.: 3523049019
5565 S. 178th Street, Tukwila, WA 98188 Suite Number: Floor:
New Tenant: ❑ Yes 0 ..No
PROPERTY OWNER
Name: Barry Bennett
Name: Segale Properties LLC
Address: P.O. Box 88028
Address: P.O. Box 88028
City: Tukwila State: WA
City: Tukwila State: WA
Zip: 98138
CONTACT PERSON — person receiving all project
communication
Name: Barry Bennett
Address: P.O. Box 88028
Address: P.O. Box 88028
Phone: (206) 575-2000 Fax: (206) 575-1837
City: Tukwila State: WA
Zip: 98138
Phone: (206) 575-2000 Fax: (206)
575-1837
Email: bbennett@segaleproperties.com
GENERAL CONTRACTOR INFORMATION
Company Name: Segale Properties LLC
Address: P.O. Box 88028
City: Tukwila State: WA Zip: 98138
Phone: (206) 575-2000 Fax: (206) 575-1837
Contr Reg No.: SEGALPL902CQ Exp Date: 04/01/2014
Tukwila Business License No.: BUS -0101320
H:\Applications\Forms-Applications On Line'2011 Applications\Pertn t Application Revised - 8-9-11.docx
Revised: August 2011
bh
ARCHITECT OF RECORD
Name:
Address:
Company Name:
Architect Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
ENGINEER OF RECORD
Name:
Address:
Company Name:
Engineer Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
LENDER/BOND ISSUED (required for projects $5,000 or
greater per RCW 19.27.095)
Name:
Address:
City: State: Zip:
Page 1 of 4
BUILDING PERMIT INFORMATIO1T 206-431-3670
Valuation of Project (contractor's bid price): $ 13,000
Existing Building Valuation: $ 100,000
Describe the scope of work (please provide detailed information):
Demolish and Remove structure and foundation of 1990 square -foot home. Terminate and cap all utilities. Regrade to match
adjacent existing contour and elevations.
Will there be new rack storage? ❑ Yes
Z.. No If yes, a separate permit and plan submittal will be required.
Provide All Building Areas in Square Footage Below
PLANNING DIVISION:
Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): 41,191 Floor area of principal dwelling: 1,990 Floor area of accessory dwelling:
*Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard: Compact: Handicap:
Will there be a change in use? ❑ Yes ❑ No If "yes", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
0 Sprinklers 0 Automatic Fire Alarm 0 None 0 Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? 0 Yes ❑ No
If' yes', attach list of materials and storage locations on a separate 8-1/2 " x 11 " paper including quantities and Material Safety Data Sheets.
SEPTIC SYSTEM
0 On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health
Department.
H:\Applications\Forms-Applications On Line \2011 Applications\Petmit Application Revised - 8-9-1 I.docx
Revised: August 2011
bh
Page 2 of 4
Existing
Interior Remodel
Addition to
Existing
Structure
New
Type of
Construction per
IBC
Type of
Occupancy per
IBC
1St Floor
1,380
2"d Floor
3nd Floor
Floors thru
1
Basement
610
Accessory Structure*
Attached Garage
Detached Garage
Attached Carport
400
Detached Carport
Covered Deck
360
Uncovered Deck
80
PLANNING DIVISION:
Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): 41,191 Floor area of principal dwelling: 1,990 Floor area of accessory dwelling:
*Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard: Compact: Handicap:
Will there be a change in use? ❑ Yes ❑ No If "yes", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
0 Sprinklers 0 Automatic Fire Alarm 0 None 0 Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? 0 Yes ❑ No
If' yes', attach list of materials and storage locations on a separate 8-1/2 " x 11 " paper including quantities and Material Safety Data Sheets.
SEPTIC SYSTEM
0 On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health
Department.
H:\Applications\Forms-Applications On Line \2011 Applications\Petmit Application Revised - 8-9-1 I.docx
Revised: August 2011
bh
Page 2 of 4
PUBLIC WORKS PERMIT INFO MATION — 206-433-0179
Scope of Work (please provide detailed information):
Call before you Dig: 811
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
❑ ...Tukwila
❑ ...Water Availability Provided
Sewer District
❑ ...Tukwila
❑ ...Sewer Use Certificate
0... Water District #125
0 .. Highline
❑ ...Valley View 0 .. Renton
❑ ...Sewer Availability Provided
❑ .. Renton
❑ .. Seattle
Septic System:
0 On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health Department.
Submitted with Application (mark boxes which apply):
❑ ...Civil Plans (Maximum Paper Size — 22" x 34")
❑ ...Technical Information Report (Storm Drainage)
❑ ...Bond ❑ .. Insurance 0 .. Easement(s)
Proposed Activities (mark boxes that apply):
❑ ...Right-of-way Use - Nonprofit for less than 72 hours
❑ ...Right-of-way Use - No Disturbance
❑ ...Construction/Excavation/Fill - Right-of-way 0
Non Right-of-way 0
0 ...Total Cut
0 ...Total Fill
cubic yards
cubic yards
0 .. Geotechnical Report
0 .. Maintenance Agreement(s)
❑ ...Traffic Impact Analysis
❑ ...Hold Harmless — (SAO)
❑ ...Hold Harmless — (ROW)
0 .. Right-of-way Use - Profit for less than 72 hours
0 .. Right-of-way Use — Potential Disturbance
❑ .. Work in Flood Zone
❑ .. Storm Drainage
0 ...Sanitary Side Sewer 0 .. Abandon Septic Tank 0 .. Grease Interceptor
..• .Cap or Remove Utilities 0 ..,Curb Cut 0 .. Channelization
0 ...Frontage Improvements 0 .. Pavement Cut 0 .. Trench Excavation
❑ ...Traffic Control 0 .. Looped Fire Line 0 .. Utility Undergrounding
0 ...Backflow Prevention - Fire Protection
Irrigation
Domestic Water
0 ...Permanent Water Meter Size... WO #
❑ ...Temporary Water Meter Size.. WO #
❑ ...Water Only Meter Size WO # 0 ...Deduct Water Meter Size
0 ...Sewer Main Extension Public 0 Private 0
❑ ...Water Main Extension Public 0 Private 0
FINANCE INFORMATION
Fire Line Size at Property Line Number of Public Fire Hydrant(s)
0 ...Water 0 ...Sewer 0 ...Sewage Treatment
Monthly Service Billing to:
Name: Day Telephone:
Mailing Address:
City State Zip
Water Meter Refund/Billing:
Name:
Mailing Address:
Day Telephone:
City
State Zip
H:\Apphcations\Fonns-Applications On Line \2011 Apphcattons\Pertnn Application Revised - 8-9-11.docx
Revised: August 2011
bh
Page 3 of 4
PERMIT APPLICATION NOTES -
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 grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be
requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition).
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 AUTHORIZED AGENT:
Signature:
Date: �3//3
Print Name: Barry Bennett Day Telephone: (206) 396-2012
Mailing Address: P.O. Box 88028 Tukwila WA 98138
H:\Applications\Fomis-Applications On Line\2011 Applications\Permit Application Revised - 8.9.1 I.docx
Revised: August 2011
bh
City State Zip
Page 4 of 4
•
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Fax: 206-431-3665
Web site: http://www.TukwilaWA.gov
Parcel No.: 3523049019
Address: 5565 S 178 ST TUKW
Suite No:
Applicant: SEGALE DEMOLITION
RECEIPT
Permit Number: D13-103
Status: APPROVED
Applied Date: 03/26/2013
Issue Date:
Receipt No.: R13-01297
Payment Amount: $326.00
Initials: WER Payment Date: 04/11/2013 02:44 PM
User ID: 1655 Balance: $0.00
Payee: SEGALE PROPERTIES
TRANSACTION LIST:
Type Method Descriptio
Amount
Payment Check 7685 326.00
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
PW BASE APPLICATION FEE
PW PERMIT/INSPECTION FEE
PW PLAN REVIEW
000.322.100
000.342.400
000.345.830
Total: $326.00
250.00
38.00
38.00
PrintPri• nd-11-9M3
• •
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Fax: 206-431-3665
Web site: http://www.TukwilaWA.gov
Parcel No.: 3523049019
Address: 5565 S 178 ST TUKW
Suite No:
Applicant: SEGALE DEMOLITION
RECEIPT
Permit Number: D13-103
Status: PENDING
Applied Date: 03/26/2013
Issue Date:
Receipt No.: R13-01137
Payment Amount: $559.07
Initials: WER Payment Date: 03/26/2013 03:13 PM
User ID: 1655 Balance: $0.00
Payee: SEGALE PROPERTIES
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 2135 559.07
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
BUILDING - NONRES
PLAN CHECK - NONRES
STATE BUILDING SURCHARGE
000.322.100
000.345.830
640.237.114
Total: $559.07
336.10
218.47
4.50
'1C'11141
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
DI3. ►03
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 r. (206) 431-367
Permit Inspection Request Line (206) 431-2451
Project:
SE_C ALL b VV\ L1T1Cry
Type of Inmos ection:
t- I %N! .41 1.
Address:•
655 9 ( 1 v
Date Called:
Special Instructions: cruse
Date Wanted:_ ^�
T(5 1 ?
a.m.
p
Requester:
Phone No:
)(,—•SSCp Z012
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
nNAQ� r-;/
R
pal
ECTION FEE REQUIR D. Prio to next inspection, fee must be
6300 Southcenter Blvd Suite 00. Call to schedule reinspection.
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF.TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
D1-3--103
Project:
ThEC_nALF
Type of Inspection:
PRE-
�MC
Address:
^55 GS
S 1-72S►
Date Called:
Special Instructions:
Date Wanted:
(r".)--- -% —
I
a.m.'
p -m-
Requester:
Phone No:
Jpproved per applicable codes. Corrections required prior to approval.
COMMENTS:
Inspect r: Date:
n(REI SPECTION FEE R QUIRED. Prior to next inspection, fee must be
pais at 6300 Southcente • Blvd., Suite 100. Call to schedule reinspection.
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
PsP4t3 Q ii •
Type of IDsp n Q iita_/1
A c",5 ., nS so, ri
Date Called l
/al )3
SpecialeInstructions:
Date Want�tGdn:. if? 11 (a m
l�� \ate
Requester, G/Lf/I
PhP-ti,131 - D -O I�
Corrections required prior to approval.
COMMENTS:
C...., - 0 ��aled _
rz
s"-crn•`( eot
4 ` .. '4.'.0(
Inspector:
Date: 14
(3
n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
VICII\ITY MAP
Parcel #3523049019
5565 178th Street, Tukwila, WA
changes atl h .m I'
rio(*tiO .
7' Cf -Work vttf
$ • ' Tukwila glpivi i , . ec-
t - o 71
rei!}citn.ii.Atill ro
.
. ,.• . komls,
.olude-acIdL, p41_ -...v
•Ak. ,,,. -..-- .
t *.° r,,,,, • n %
Included on bus map has been compiled by Kmg nty a sources and s subject to change vnthoumakes no representat ons or warranties. (wen or imbed, as lo accuracy. • erneknees. or to use information document is
intended for use as a survey product Kum, County shaft not be bable for any general. special indired. incedenial. or consequentv31 damages int:hiding, but not touted to, lost revenues or lost profits resulting from the use or rtuessse of the informal= contained on this map. Any sale of this map or information on this map Is
prod except by written permission of King County
4
PARCEL MAP
information included on this map has been carnpiled by County staff from a -ly sources and is su..:, !o .: ^ ..ut .. =i... • my makes no represantabms or warrant express ..-..<.., as to accuracy tom tlmeiness, or rights to the use of such information. is document is not
intended for use as e surrey product. KI County shall not be ble for any general, special, Int:Erect. incidental, or consequential damages inauding. but not limited to. lost revenues or !wt profds resulting the use or misuse of t e • otntaied on this map. My sale of this reap or Inlommahon on this map Is
hibited except by written permission of King County.
Source. King County IMAP - property Information (http./Iwrwv.metrokc.gov7GISI%MAP)
'3!ERM T CEN ►-EL.
Environmentai Seirvices . .
An Environmental Compliance Consulting Firm
Report Date: November 9, 200
Segale Properties
Attn: Barry Bennett
P.O. Box 88028
Tukwila, WA 98138
REVIEWED FOR
CODE COMPLIANCE
APPROVED
APR 10 2013
City of Tukwila
BUILDING DIVISION
WBE W2F5912535
Executive Summary
RECEIVE-
MAR 28 2013
TUKVV��
PUBLIC WORKS
RE: Asbestos & Lead Survey Report — 5565 South 178th St., Tukwila, WAS` Fr
p...__P• L - e covv,
Dear Mr. Bennett:
On November 2, 2006 under an agreement with your organization, we performed an asbestos
and lead survey on the residence at 5565 South 178Th St., Tukwila, WA. At your request, the
purpose of this survey was to ascertain the existence of asbestos containing materials
associated with any structure being demolished, as well as providing characterization and
quantities. In addition, areas where painted components are scheduled for demolition, lead
samples were taken and analyzed. This survey was performed in conformance with procedures
and methods outlined in applicable federal, state, and local regulations.
This survey was performed by an accredited AHERA Building Inspector Claude Edward
Robinson (ABII-NES-07-04; Expiration Date: September 6, 2007).
Investigating Protocol and Findinqs
All samples were homogenized, collected, processed, and analyzed for content by Polarized
Light Microscopy. AHERA protocol provides guidance for the numberof samples of each
material to be collected depending on its category and amount of material present. The goal of
AHERA is to ensure statistically reliable data and it accomplishes this by requiring or suggesting
a minimum number of samples to be collected, and in some cases: by using random sampling
techniques to determine sampling locations.
Building materials that contain asbestos fibers in the amounts greater than 1 percent (1%) is
regulated by the Occupational Safety and Health Administration (OSHA) and Puget Sound
Clean Air Agency. RECEIVED
CITY OF TUKWILA
34004 9th Avenue South s Building A, Suite 5 F Federal Way, Washington 98003
Telephone 253) 952-6717 ♦ Facsimile (253) 927-4714 PERMIT CENTER
MAR 2 6 2013
An Environmental Compliance Consulting Firm
Suspect materials processed and found non -detect or containing < 1% for containing asbestos are listed
in the table below:
Suspect Material Inventory (Negative)
Material Homogenization Material Description
Vinyl Sheeting (VS1)
Tan Square Pattern VS with Gray Felt Backing on Unknown VS with
Green Felt Backing
Vinyl Sheeting (VS2)
Gray 12X12" Pattern VS on Unknown VS with Green Felt Backing
Wall System (WS1)
Wallboard and Joint Compound
Miscellaneous (MISC1)
Pink Insulation with Paper Backing
Miscellaneous (MISC2)
Fireplace Brick and Mortar
Vinyl Sheeting (VS4)
White with Blue Floral Pattern VS with Green Felt Backing and Tan
Mastic
Miscellaneous (MISC3)
White Furnace Duct Insulation
Slipsheet (SS1)
Black Slipsheet
Roofing Material (RM1)
Three Tab Composite Roofing with Slipsheet
Negative for ACM Table
Suspect Material Inventory (Positive)
Based on the field inspection, the homogenization of materials, and the results of the laboratory
analysis, the following materials were found to contain asbestos:
MateralD
..
Friability .. ..
Asbestos Conte t
rt
a e
Location ndSubstrat
.. �
Friable Vinyl Sheeting
(VS3)
40% Chrysotile
Approximately 80 Square Feet of Tan/Cream VS with Tan
Mastic in Basement Bathroom.
All other suspect materials associated with this structure were non -detect for containing
asbestos. The following attachment contains the laboratory analytical data for each material
collected.
Contractors should perform a site visit to validate the location, amount and difficulty of
removal for any given material.
Orion Environmental Report #064893 November 9, 2006
5555 South 178th St, Tukwila, V'A
Paae 2 of 5
An Environmental Compliance Consulting Firm
Lead
For the purpose of this investigation, lead-based paint is defined as paint or other surface
coatings (stain, shellac, or varnish) applied prior to 1978 and containing lead equal to or
exceeding 1.0 milligram(s) per centimeter or 0.5 percent lead by weight in a dried state, unless
your city or state requires a more strict interpretation. The property was tested for lead-based
paint using portions of the inspection protocol of Chapter 7 of the HUD Guidelines for the
Evaluation and Control of Lead -Based Paint Hazards in Housing (1997 Revision). HUD
guidelines were implemented for protection of residents.
In addition, Washington State's Department of Labor and Industries defines lead-based paint as
paint with any detectable concentrations of lead are regulated, thus creating the requirement for
implementing worker, and in some cases, environmental protection. Labor and Industries
guidelines were implemented for contractor and worker protection.
Also, the Washington State's Department of Ecology requires that wastes from demolition or
renovation activities that exhibit toxic characteristics be analyzed by using Toxicity
Characteristic Leaching procedure (TCLP) (40CFR 261.24). TCLP analysis is used to determine
if lead associated with constituents are below the allowable regulatory threshold, of 5.0 ppm
(milligrams/liter) of lead in leached solution. TCLP testing will be carried out when a waste
stream can be determined from the scope of work.
The purpose of this report is limited to providing the client an evaluation concerning potential
lead-based paint, specified in the report, and evident at the site at the time of the evaluation. It is
also understood that the report will pertain only to the subject property. Use of the report and
data contained therein for other purposes, is at the sole risk and responsibility of the user.
Two painted components were collected from the residence and analyzed for total lead. The
results of the investigation indicate that the structure at this property has paint with detectable
amounts of lead. Painted components meeting the criteria of Labor and Industries are noted
below:
Painted components meeting the criteria of WA Labor and Industries for Lead
Component
Substrate
Locations
Pence It Lead By Weight
Brown Paint
Wood
Exterior
0.096
White Paint
WB
Interior
0.048
The sampled components contain lead in detectable amounts. Therefore, exposure
assessments and worker protection measures must be applied.
PCB
Orion Environmental Report #064893
5565 South 178th St, Tukwila, W!A.
November 6, 200E
Page 3 of 5
An Environmental Compliance Consulting Firm
PCB
Nearly all ballasts made prior to 1979 contain PCB's. Ballasts made after July 1, 1978 that do
not contain PCB's are required to be clearly marked "No PCB's".
Exposure to leaking or damaged light ballasts of fluorescent light fixtures ballasts may be of
some concern. Particularly if electricians and maintenance technicians are not being provided
proper protective equipment when handling and removing old light ballasts that can result in
contact with PCB- contaminated surfaces.
Chlorodiphenyls are oily, viscous liquids that vary in color from dark brown to pale yellow.
Airborne exposures from leaking ballasts are of Tess concern than skin contact because the
vapor pressures. Both of the PELs for chlorodiphenyls have skin designations; therefore,
protection must be provided to prevent potential absorption in the body as a result of skin
contact. The most prominent effects from occupational exposure to PCBs have been skin and
mucous membrane effects.
Lighting was examined in the house. One ballast was located which was clearly marked "No
PCB's".
Mercury Thermostats:
Thermostats were observed in the building and ascertained of a possible source of mercury
components. No Mercury Thermostats were found in this building.
Inaccessible Locations
ORION Environmental Services cannot make statements as to the potential presence or
absence of asbestos containing materials in inaccessible areas or areas not considered.
Disclaimer
ORION Environmental Services has conducted a survey for asbestos and metal containing
materials at the residence at 5565 South 178th St., Tukwila, WA in conformance with the
requirements established by the United States Environmental Protection Agency and the
Occupational Safety and Health Administration prior to the engagement of renovation or
demolition of the building. The sampling strategy and analytical method employed conform to
existing and enforceable standards and methods.
This Executive Summary of the investigation performed at the subject site is intended to
describe asbestos containing materials with the potential of being impacted. We represent that
our services were performed within the limits prescribed by applicable regulations and in a
manner consistent with the level of care and skill ordinarily exercised by other professional
consultants under similar circumstances. No other representation is made to the client,
expressed or implied, and no warranty or guarantee is included or intended.
Orion Environmental Report #064893 November 9, 2006
5565 South 178th St, Tukwila, WA Page 4 of 5
KlAVl�IEnwironmental Se>r
An Environmental Compliance Consulting Firm
. k5c
The opinions presented herein apply to the site conditions existing at the time of our
investigation, and interpretation of current regulations pertaining to asbestos containing
material. Therefore, our opinions and recommendations may not apply to future conditions that
may exist at the site we have not had the opportunity to evaluate. Future regulations pertaining
to these materials may impose stricter restrictions on renovation or demolition work. The
regulations should always be verified prior to any work involving these materials. The inspector
is not held responsible or liable for any repairs or replacements with regards to this property,
systems, components, or the contents therein. The acceptance of this report by the client
acknowledges the client's agreement to all of the terms and conditions of the inspection
contract.
ORION retains active copies of reports for a period of not less than one year. Retained copies
of reports, field data, field notes, laboratory test data, calculations, estimates, and other
documents prepared by ORION as instruments of service, shall remain the property of ORION.
Other than the Client, other agencies of the U.S. Federal Government, and the Owner, reports
submitted with respect to services performed under this contract may not be extended to third
parties without prior written consent.
Questions concerning this Executive Summary may be addressed the undersigned. Thank you
for the opportunity to serve you. I hope we can be of assistance to you on future projects. If
there is anything additional I can do to expedite your operation, please do not hesitate to let me
know.
Professionally Yours,
ORION Environmental Services, Inc
Building Inspector
Claude Edward Robinson
AHERA Building Inspector
ORION Environmental Services
Reviewer
Donna McNeal
AHERA Building Inspector, CEO
ORION Environmental Services
Orion Environmental Report #064893 November 9, 2006
5565 South 178th St, Tukwila, WA Page 5 of 5
n
ORIONEnvironmental Services
An Environmental Compliance Consulting Firm
Total Lead Test Report
EPA Method 7420
Client Segale Properties Date November 8, 2006
P.O. Box 88028 Page Page 1 of 1
Tukwila, WA 98138 Invoice 064898
Attn: Barry Bennett Date Received November 2, 2006
Project Number N/A
Project Name 5565 South 178th Street
Tukwila, Washington
Total Lead
Client ORION Material LOD (mg/kg) PPM % by Weight
Number Number Description (mg/kg)
5565-01 61103-96 Brown Paint — Exterior 20.8 958.3 0.096
5565-02 61103-97 White Paint — Interior 16.7 478.4 0.048
Analyst
Quality Assurance Information
Method Blank: <5.0 mg/I
Linear Regression Lower Limit: 0.990
Actual Batch Linear Regression: 0.999
Check Standard per Set: ± 0.5 mg/l
Allen Clark
Laboratory Analyst
Reviewed By
Donna McNeal
Laboratory Director
Leading Environmental Compliance Consulting Into the 21St Century
34004 9`'' Avenue South • Building A, Suite 5 • Federal Way, Washington 98003-6740
Seattle (253) 874-8118 • Tacoma (253) 952-6717 • Facsimile (253) 927-4714 ♦ email ORION6717@aol.com
WBE W2F5912535
n r`
ORION
Environmental Services
An Environmental Compliance Consulting Firm
Polarized Light Microscopy Test Report
EPA Method 600/R-98/116
Client Segale Properties
P.O. Box 88028
Tukwila, WA 98138
Attn: Barry Bennett
Project Number
Project Name
Client
Number
5565 -Ola
5565-0l b
5565-02a
5565-02b
5565-03a
5565-03 b
5565-04a
5565-04b
5565-05a
5565-05b
N/A
5565 South 178th Street
Tukwila, Washington
Orion
Number
61103-57a
Stereo Scope Exam
Tan Square Pattern Vinyl
Sheeting w/ Gray Felt
Backing
Homogeneous
61103-57b Vinyl Sheeting w/ Green
Felt Backing
Assoc. w/ 5565-01 a
61103-58a Gray Square Pattern Vinyl
Sheeting
Homogeneous
61103-58b Vinyl Sheeting w/ Green
Felt Backing
Assoc. w/ 5565-02a
61103-59a Joint Compound
Assoc. w/ 5565-03b
61103-59b Wallboard
Homogeneous
61103-60a
61103-60b
61103-61a
Joint Compound
Assoc. w/ 5565-04b
Wallboard ,
Homogeneous
Joint Compound
Assoc. w/ 5565-05b
61103-61b Wallboard
Homogeneous
Date
Page
Invoice
Date Received
November 7, 2006
Page 1 of 3
064893
November 2, 2006
Sample Asbestos Other
Treatment Percent Type Fibers
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
Cellulose
Cellulose
Cellulose
Cellulose
Cellulose
Cellulose
Cellulose
Cellulose
Cellulose
Cellulose
34004 9th Avenue South • Building A, Suite 5 • Federal Way, Washington 98003-6740
Seattle (253) 874-8118 • Tacoma (253) 952-6717 • Facsimile (253) 927-4714 • email ORION6717@aol.com
WBE W2F5912535
ORIONEnvironmental Services
An Environmental Compliance Consulting Firm
Polarized Light Microscopy Test Report
EPA Method 600/R-98/116
Client Segale Properties
P.O. Box 88028
Tukwila, WA 98138
Attn: Barry Bennett
Project Number
Project Name
Client
Number
5565-06
5565-07a
5565-07b
5565-08
5565-09a
N/A
5565 South 178th Street
Tukwila, Washington
Orion
Number
61103-62
61103-63a
61103-63b
61103-64
61103-65a
5565-09b 61103-65b
5565-09c 61103-65c
5565-10 61103-66
5565-11 61103-67
5565-12a 61103-68a
Stereo Scope Exam
Tan / Cream Pattern
Vinyl Sheeting w/ Non -
Separable Tan Mastic
Homogeneous
Pink Insulation
Homogeneous
Paper Insulation Backing
Assoc. w/ 5565-07a
Fireplace Brick Mortar
Homogeneous
White w/ Blue Floral
Pattern Vinyl Sheeting
Homogeneous
Tan Mastic
Assoc. w/ 5565-09a
Green Felt Backing
Remnants
Assoc. w/ 5565-09a
White Furnace Duct
Insulation
Homogeneous
Building Paper
Homogeneous
3 -Tab Roofing
Homogeneous
Date
Page
Invoice
Date Received
November 7, 2006
Page 2 of 3
064893
November 2, 2006
Sample Asbestos Other
Treatment Percent Type Fibers
40 Chrysotile Cellulose
- ND
ND
ND
ND
Chloroform ND
ND
ND
ND
ND
Fiberglass
Fiberglass
Cellulose
Cellulose
Cellulose
Cellulose
Fiberglass
Cellulose
Cellulose
Fiberglass
34004 9`h Avenue South • Building A, Suite 5 • Federal Way, Washington 98003-6740
Seattle (253) 874-81 18 • Tacoma (253) 952-6717 • Facsimile (253) 927-4714 • email ORION6717@aol.com
WBE W2F5912535
ORION Environmental Services
An Environmental Compliance Consulting Firm
Polarized Light Microscopy Test Report
EPA Method 600/R-98/116
Client Segale Properties
P.O. Box 88028
Tukwila, WA 98138
Attn: Barry Bennett
Project Number N/A
Project Name 5565 South 178th Street
Tukwila, Washington
Client
Number
5565-12b
Analyst
Orion
Number Stereo Scope Exam
61103-68b Building Paper
Assoc. w/ 5565-12a
Date
Page
Invoice
Date Received
November 7, 2006
Page 3 of 3
064893
November 2, 2006
Sample Asbestos Other
Treatment Percent Type Fibers
ND Cellulose
Dup: Laboratory QA/QC Duplicate; M; Mastic [(a), (b), (c), etc.]: Sample layers numbered from front to back.
Comments: For layered samples, each component has been analyzed separately. ND means non -detect for
asbestos fibers by EPA Method 600/R-98/116.
Disclaimers: PLM has been known to miss asbestos in a small percentage of samples that contain asbestos.
Thus negative PLM results cannot be guaranteed.
This report may only be reproduced in full with written approval of ORION Environmental Services.
Orion samples are analyzed according to EPA Method 600/R-98/116 by AIHA Bulk Asbestos Analytical Testing
Program (102911) proficient analysts.
Reviewed By
Donna McNeal Allen Clark
Laboratory Director, CEO
Laboratory Analyst
Leading Environmental Compliiance Consulting Into the 2P Century
34004 9`'' Avenue South • Building A, Suite 5 • Federal Way, Washington 98003-6740
Seattle (253) 874-81 18 • Tacoma (253) 952-6717 • Facsimile (253) 927-4714 • email ORION6717@aol.com
WBE W2F5912535
•.-.._. :.. ...: .:....}. :. .,. ...«.. .: .... Y...., .n. ..A.,-vJut...). r.....t. . v )... l l.y��}.Ib t.A.. 1.� ..i .. .- -.�
.•¢• r �r..,. a �s+a; �) a:vur,a.,. u�:. \... 1•;�^:�-�...... wt c., ••..0 a\.t. \..:. w�.
..: .^� :'eau ... .... :.
``
i
BUILDING INSPECTOR — INITIAL
This is to certify that
Claude Ed rwaRobinson
d
has successfully completed all requirements necessary to obtain accreditation as an
AHERA Building Inspector
in accordance with the Toxic Substance Control Act Title (Section 206) and 40 CFR 763
This training was completed on: September 5th — September 7th 2006
Accreditation Number: AB ES -07-04
Valid Through: September 6, 2007 _
Donna McNeal
Nowicki Environmental Services Inc.
34004 9th Avenue South, Suite 12
Federal Way, WA 98003
(253) 927-5233
1 '�
• _ •
PER GOtD COPY
PLAN REVIEW/ROUTING SLIP
ACTIVITY NUMBER: D13-103
PROJECT NAME: SEGALE DEMOLITION
SITE ADDRESS: 5565 S 178 ST
X Original Plan Submittal
Response to Correction Letter #
DATE: 03-26.13
Response to Incomplete Letter #
Revision # After Permit Issued
T6S. „
v•v•iib
S� l (4 00.2i,t5
Bull ing Division Fire Prevention 1111
Public WorkG Structural
0
Planning Division
Permit Coordinator
DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 03-28-13
Complete Incomplete ❑
Not Applicable
El
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED:
LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg 0 Fire 0 Ping 0 PW 0 Staff Initials:
TUES/THURS ROUTING:
Please Route
Structural Review Required
REVIEWER'S INITIALS:
❑ No further Review Required
DATE:
APPROVALS OR CORRECTIONS:
DUE DATE: 04-25-13
Approved n Approved with Conditions1)d Not Approved (attach comments) n
Notation:
REVIEWER'S INITIALS:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections:
Bldg 0 Fire 0 Ping 0 PW 0 Staff Initials:
Documents/routing slip.doc
2-28-02
Contractors or Tradespeople P 'nter Friendly Page
•
General/Specialty Contractor
A business registered as a construction contractor with Lal to perform construction work within the scope of
its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of
account and carry general liability insurance.
Business and Licensing Information
Name SEGALE PROPERITIES LLC UBI No. 602023533
Phone 2065752000 Status Active
Address Po Box 88028 License No. SEGALPL902CQ
Suite/Apt. License Type Construction Contractor
City Tukwila Effective Date 2/18/2010
State WA Expiration Date 4/1/2014
Zip 981382028 Suspend Date
County King Specialty 1 General
Business Type Limited Liability Company Specialty 2 Unused
Parent Company
Other Associated Licenses
License
Name
Type
Specialty
1
Specialty
2
Effective
Date
Expiration
Date
Status
LAPIALP055MZLA
PIANTA LIMITED
PARTNERSHIP
Construction
Contractor
General
Unused
7/9/1995
4/1/2001
Archived
SEGALBP151M5
SEGALE BUSINESS
PARK
Construction
Contractor
General
Unused
7/25/1985
7/9/1995
Archived
LAPIAL'008J8
LA PIANTA LLC
Construction
Contractor
General
Unused
4/28/2000
4/1/2010
Inactive
Business Owner Information
Name
Role
Effective Date
Expiration Date
SEGALE, MARIOA
Agent
02/18/2010
Amount
SEGALE, MARIO A
Partner/Member
02/18/2010
13DLS31006
Bond Information
Page 1 of 2
Bond
Bond Company Name
Bond Account Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Bond Amount
Received Date
1
SAFECO INS CO OF AM
6115146
02/18/2010
Until Cancelled
$12,000.00
03/28/2002
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information
Insurance
Company Name
Policy Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Amount
Received Date
5
Alaska National
Insurance Co
13DLS31006
04/01/2013
04/01/2014
$1,000,000.00
03/28/2013
4
Alaska National
Insurance Co
12DLS31006
04/01/2012
04/01/2013
$1,000,000.00
03/30/2012
3
Alaska National
Ins Co
11DLS31006
04/01/2011
04/01/2012
$1,000,000.00
03/29/2011
2
ALASKA
NATIONAL
INSURANCE
COMP
10DLS31006
04/01/2010
04/01/2011
$1,000,000.00
03/31/2010
1
ALASKA
NATIONAL
INSURANCE
COMP
09DLS31006
02/18/2010
04/01/2010
$1,000,000.00
03/31/2009
Summons/Complaint Information No unsatisfied complaints on file within prior 6 year period
httns://fortress.wa. aov/lni/bbin/Print.asnx
04/11/2013