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Permit D15-0267 - NEWPORT BAY RESTAURANT - DEMOLITION
NEMTORT BAY IESTAURANT - DEMOLITION 17920 SOUTHCENTER PKWY D15-0267 0 City of Tukwila • Department of Community Development + 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone:206-431-3670 Inspection Request Line: 206-438-9350 Web site: http://www.TukwilaWA.gov Parcel No: 3523049123 DEVELOPMENT PERMIT Permit Number: D15-0267 Address: 17920 SOUTHCENTER PKWY Issue Date: 3/7/2016 Permit Expires On: 9/3/2016 Project Name: NEWPORT BAY RESTAURANT- DEMOLITION Owner: Name: MADISON INVESTMENTS LLC Address: P 0 BOX 1922, BOZEMAN, WA, 59771 Contact Person: Name: WILLIAM FORTUNATO Address: 1505 WESTLAKE AVE N, SUITE 305, SEATTLE, WA, 98109 Contractor: Name: ALEGIS CONSTRUCTION INC Address: 6900 SW ATLANTA ST #300, PORTLAND, OR, 97223 License No: ALEGICI894CN Phone: (206) 522-9510 Phone: (503) 970-8312 Expiration Date: 2/19/2017 Lender: Name: STOVETOP RESTAURANT GROUP Address: 9327 PIPERHILL DR SE, OLYMPIA, WA, 98513 DESCRIPTION OF WORK: DEMOLITION OF A 7,907 SQ FT RESTAURANT. ALL UTILITIES TO BE CAPPED PRIOR TO COMMENCEMENT OF WORK Project Valuation: $30,600.00 Fees Collected: $1,528.02 Type of Fire Protection: Sprinklers: YES Fire Alarm: YES Type of Construction: VB Occupancy per IBC: A-2 Electrical Service Provided by: TUKWILA FIRE SERVICE Water District: HIGHLINE Sewer District: TUKWILA SEWER SERVICE Current Codes adopted by the City of Tukwila: International Building Code Edition: 2012 National Electrical Code: 2014 International Residential Code Edition: 2012 WA Cities Electrical Code: 2014 International Mechanical Code Edition: 2012 WAC 296-466: 2014 Uniform Plumbing Code Edition: 2012 WA State Energy Code: 2012 International Fuel Gas Code: 2012 Public Works Activities: Channelization/Striping: Curb Cut/Access/Sidewalk: Fire Loop Hydrant: Flood Control Zone: Hauling/Oversize Load: Land Altering: Volumes: Cut: 0 Fill: 0 Landscape Irrigation: Sanitary Side Sewer: Number: 0 Sewer Main Extension: Storm Drainage: Street Use: Water Main Extension: Water Meter: No Permit Center Authorized Signature; i`—' ` t Date: 6 I hearby 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 permit. Signature: Date: 3 Print Name: y�lrT`A42 This permit shall become null and void if the work is not commenced within 180 days for 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 PERMIT CONDITIONS' 2: All permits, inspection record card and approved construction documents shall be kept at the site of work and shall be open to inspection by the Building Inspector until final inspection approval is granted. 3: 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. 4: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the City of Tukwila Building Department (206-431-3670). 5: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center. 6: 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 Building Official from requiring the correction of errors in the construction documents and other data. 7: 'PUBLIC WORKS PERMIT CONDITIONS' 8: The applicant or contractor must notify the Public Works Inspector at (206) 433-0179 upon commencement and completion of work at least 24 hours in advance. All inspection requests for utility work must also be made 24 hours in advance. 9: 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 any work after 5:00 p.m. and weekends. 10: Any material spilled onto any street shall be cleaned up immediately. 11: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation off -site or into existing drainage facilities. 12: 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. 13: From October 1 through April 30, cover any slopes and stockpiles that are 3H:1V 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. 14: 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. 15: Sewer and water utilities shall be plugged at the mains if they are to be abandoned. If they will be used again in the near future for a new building, they shall be capped at the property line and at the water meter respectively. PERMIT INSPECTIONS REQUIRED Permit Inspection Line: (206) 438-9350 1700 BUILDING FINAL" 5200 EROSION MEASURES 5210 EROSION MEASURES FNL 0101 PRE -CONSTRUCTION 1600 PUBLIC WORKS FINAL CITY OF TUKWILA Community Development Department • Public Works Department • Permit Center 6300 Southcenter Blvd., Suite 100 Tulnvila, WA 98188 http://www.TukwilaWA.gov Building Permit No. U J ,N Project No. Date Application Accepted: Date Application Expires: use 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 ::1 King Co Assessor's Tax No.: 352304-9123 Site Address: 17920 Southcenter Pkwy Suite Number: Floor: Tenant Name: Twin Peaks New Tenant: 0 .....Yes ❑..No PROPERTY OWNER Name: Stovetop Restaurant Group Address: 9327 Piperhill Drive SE City: Olympia State: WA Zip: 98513 CONTACT PERSON — person receiving all project communication Name: pACLAND - Seattle W1 VO A Address: 1505 Westlake Avenue N, Suite 305 City: Seattle State: WA Zip: 98109 Phone: (206) 522-9510 Fax: Email: bfortunato@pacland.com GENERAL CONTRACTOR INFORMATION Company Name: TBD Address: City: State: Zip: Phone: Fax: Contr Reg No.: Exp Date: Tukwila Business License No.: ARCHITECT OF RECORD Company Name: Architect Name: Address: City: State: Zip: Phone: Fax: Email: ENGINEER OF RECORD Company Name: pACLAND -Seattle Engineer Name: Bill Fortunato Address: 1505 Westlake Avenue N., Suite 305 City: Seattle State: WA zip: 98109 Phone: (206) 522-9510 Fes' Email: bfortunato@pacland.com LENDER/BOND ISSUED (required for projects $5,000 or greater per RCW 19.27.095) Name: Address: 9-TZ7 City: 01—YI4PZ4 State: W,4 Zip. cj � H:\Applications\Forms-Applications On Linc\2011 Applications\Permit Application Revised - 6-9-1 I.docx Revised: August 2011 bh Page I of 4 BUILDING PERMIT INFORMATION — 206-431-3670 Valuation of Project (contractor's bid price): $ 25,000 Existing Building Valuation: Describe the scope of work (please provide detailed information): Demolish existing 7,907 sf building. All utilities to be capped prior to commencement of work. Will there be new rack storage? ❑..... Yes ❑.. No If yes, a separate permit and plan submittal will be required. Provide All Building Areas in Square Footage Below Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC I' Floor 7,907 Z"d Floor P Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck 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): Floor area of principal dwelling: 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: Will there be a change in use? El ....... Yes ❑ ....... No Compact: Handicap: If "yes", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: �...... Sprinklers A....... Automatic Fire Alarm ❑ .......None ❑ .......Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ ....... Yes ....... No 1f `yes', attach list of materials and storage locations on a separate 8-112"x / / " paper including quantities and Material Safety bata Sheets. SEPTIC SYSTEM ❑ ....... On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. H:Wpplications\Forms-Applications On Line\2011 ApplicationsTermit Application Revised - 8-9-1 l.docx Revised: August 2011 Page 2 of 4 bh PUBLIC WORKS PERMIT INFORMATION — 206-433-0179 Scope of Work (please provide detailed information): N/a - Demolition only. Call before you Dig: 811 Please refer to Public Works Bulletin #1 for fees and estimate sheet. Water District m ...Tukwila ❑... Water District # 125 ❑ .. Highline El.. Renton ❑ ...Water Availability Provided Sewer District m ...Tukwila ❑ ... Valley View ❑ .. Renton ❑ .. Seattle ❑ ...Sewer Use Certificate El... Sewer Availability Provided Septic System: ❑ 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 ADDlication (mark boxes which an ❑ ...Civil Plans (Maximum Paper Size — 22" x 34" ❑ ...Technical Information Report (Storm Drainage) ❑ .. Geotechnical Report ❑ ...Traffic Impact Analysis ❑ ...Bond ❑ .. Insurance ❑ .. Easement(s) ❑ .. Maintenance Agreement(s) ❑ ...Hold Harmless — (SAO) ❑ ... Hold Harmless — (ROW) Proposed Activities (mark boxes that apply): ❑ ...Right-of-way Use - Nonprofit for less than 72 hours ❑ .. Right-of-way Use - Profit for less than 72 hours ❑ ...Right -of --way Use - No Disturbance ❑ .. Right-of-way Use — Potential Disturbance ❑ ...Construction/Excavation/Fill - Right-of-way ❑ Non Right-of-way ❑ ❑ ...Total Cut cubic yards ❑ ...Total Fill cubic yards ❑ ...Sanitary Side Sewer ❑ ...Cap or Remove Utilities ❑ ...Frontage Improvements ❑ ...Traffic Control ❑ ...Backflow Prevention - Fire Protection Irrigation Domestic Water ❑ .. Work in Flood Zone ❑ .. Storm Drainage ❑ .. Abandon Septic Tank ❑ .. Curb Cut ❑ .. Pavement Cut ❑ .. Looped Fire Line ❑ ...Permanent Water Meter Size... WO # ❑ ...Temporary Water Meter Size.. WO # ❑ ...Water Only Meter Size............ WO # ❑ ...Sewer Main Extension.............Public ❑ Private ❑ ❑... Water Main Extension.............Public ❑ Private ❑ ❑ .. Grease Interceptor ❑ .. Channelization ❑ .. Trench Excavation ❑ .. Utility Undergrounding El... Deduct Water Meter Size FINANCE INFORMATION Fire Line Size at Property Line Number of Public Fire Hydrant(s) ❑ ... Water ❑ ...Sewer ❑ ...Sewage Treatment Monthly Service Billing to: Name: Day Telephone: Mailing Address: City State Zip Water Meter Refund/Billing: Name: Day Telephone: Mailing Address: City State Zip H:\Applications\Forns-Applications On Line\20I1 ApplicationsTermit Application Revised - 8-9-1I.docx Revised: August 2011 Page 3 of 4 bh 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). 1 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 Print Name: Bill Fortunato AGENT: Mailing Address: 1505 Westlake Avenue N Date: 10/08/2015 Day Telephone: (206) 522-9510 Seattle WA 98109 City State Zip H:\Appliwtions\Forns-Applications On Line\2011 ApplicationsTermit Application Revised - 8-9-1 I.docx Revised: August 2011 Page 4 of 4 bh BULLETIN A2 TYPE C PERMIT FEE ESTIMATE PLAN REVIEW AND APPROVAL FEES DUE WITH APPLICATION PW may adjust estimated fees N6'k-46M'i AAY 1ZE6iAu9.4,r'i PROJECT NAME 1>15,w o PERMIT # b 1' - O c ;-7 (@ 1-79-1. sovTRciN-rgA PgLV If you do not provide contractor bids or an engineer's esti ate with your permit application, Public Works will review the cost estimates for reasonableness and may adjust estimates. 1. APPLICATION BASE FEE $250 (1) 2. Enter total construction cost for each improvement category: Mobilization Erosion prevention O o Water/Sewer/Surface Water 3000 Road/Parking/Access 2 , D a C) 3. 4 A. Total Improvements spa a Calculate improvement -based fees: B. 2.5% of first $100,000 of A. C. 2.0% of amount over $100,000, but less than $200,000 of A. D. 1.5% of amount over $200,000 of A. TOTAL PLAN REVIEW FEE (B+C+D) Enter total excavation volume Enter total fill volume cubic yards cubic yards Use the following table to estimate the grading plan review fee. Use the greater of the excavation and fill volumes. 9-99-(4) QUANTITY IN CUBIC YARDS RATE Up to 50 CY Free 51 — 100 $23.50 101 — 1,000 $37.00 1,001 — 10,000 $49.25 10,001 — 100,000 $49.25 for 1 10,000, PLUS $24.50 for each additional 10,000 or fraction thereof. 100,001 — 200,000 $269.75 for 1 100,000, PLUS $13.25 for each additional 10,000 or fraction thereof. 200,001 or more $402.25 for 1 200,000, PLUS $7.25 for each additional 10,000 or fraction thereof. GRADING Plan Review Fees TOTAL PLAN REVIEW FEE DUE WITH PERMIT APPLICATION (1 +4+5) $ (5) The Plan Plan Review and Approval fees cover TWO reviews: 1) the first review associated with the submission of the application/plan and 2) a follow-up review associated with a correction letter. Each additional review, which is attributable to the Applicant's action or inaction shall be charged 25% of the Total Plan Review Fee. Approved 09.25.02 Last Revised 01/01/14 BULLETIN A2 TYPE C PERMIT FEE ESTIMATE PLAN REVIEW AND APPROVAL FEES DUE WITH APPLICATION PW may adjust estimated fees 6. Permit Issuance/Inspection Fee (B+C+D) $ 140 -9-94 (6) 7. Pavement Mitigation Fee $ The pavement mitigation fee compensates the City for the reduced life span due to removal of roadway surfaces. The fee is based on the total square feet of impacted pavement per lane and on the condition of the existing pavement. Use the following table and Bulletin 1B to estimate the pavement mitigation fee. Approx. Remaining Years Pavement Overlay and Repair Rate (per SF of lane width) 20-15 (100%) $10.00 15-10 (75%) $7.50 10-7 (50%) $5.00 7-5 (33%) $3.30 5-2 (25%) $2.50 2-1 (10%) $1.00 0-1 $0.00 GRADING Permit Issuance/Inspection Fee Grading Permit Fees are calculated using the following table. Use the greater of the excavation and fill volumes from Item 5. QUANTITY IN CUBIC RATE YARDS 50 or less $23.50 51 —100 $37.00 101 — 1,000 $37.00 for 1st 100 CY plus $17.50 for each additional 100 or fraction thereof. 1,001 — 10,000 $194.50 for 1st 1000 CY plus $14.50 for each additional 1,000 or fraction thereof. 10,001 — 100,000 $325.00 for the 1st 10,000 CY plus $66.00 for each additional 10,000 or fraction thereof 100,001 or more $919.00 for 1st 100,000 CY plus $36.50 for each additional 10,000 or fraction thereof. 9. Technology Fee (5% of 6+8) Approved 09.25.02 2 Last Revised 01/01/14 (7) (8) V BULLETIN A2 TYPE C PERMIT FEE ESTIMATE PLAN REVIEW AND APPROVAL FEES DUE WITH APPLICATION PW may adjust estimated fees 10. TOTAL OTHER PERMITS A. Water Meter — Deduct ($25) B. Flood Control Zone ($52.50 — includes Technology Fee) C. Water Meter — Permanent* D. Water Meter — Water only* E. Water Meter — Temporary* * Refer to the Water Meter Fees in Bulletin Al Total A through E $ 11. ADDITIONAL FEES A. Allentown Water (Ordinance 1777) B. Allentown Sewer (Ordinance 1777) C. Ryan Hill Water (Ordinance 1777) D. Allentown/Foster Pt Water (Ord 2177) E. Allentown/Foster Pt Sewer (Ord 21.77) F. Special Connection (TMC Title 14) G. Duwamish H. Transportation Mitigation I. Other Fees DUE WHEN PERMIT IS ISSUED Total A through I $_ 0.00 (9) 0.00 (10) (6+7+8+9+10+11) $ 1 4-7 0.00 ESTIMATED TOTAL PERMIT ISSUANCE AND INSPECTION FEE This fee includes two inspection visits per required inspection. Additional inspections (visits) attributable to the Permittee's action or inaction shall be charged $60.00 per inspection. WATER METER FEE Permanent and Water Only Meters Size (inches) stallation Cascade Water Alliance RCFC 01.01.2014—12.31.2015. .'Total Fee 0.75 $625 $6005 $6630 1 $1125 $t5,,0T2.50 $16.,137.50 1.5 $2425 ,--`�30 025 $32,450 2 $2825 $48,04 $50,865 3 $4425 $96,080 $100,505 4 $7825 % $150,125 157,950 6 $125.25 $300,250 $312,775 Temporary Meter 0.75" $300 2.5" $1,500 Approved 09.25.02 3 Last Revised 01/01/14 L f-Zz/ /s Clear Form` ` • PermitTRAK ACCOUNT QUANTITY PAID $1,150.82 D15-0267 Address: 17920 SOUTHCENTER PKWY Apn: 3523049123 $1,150.82 DEVELOPMENT $584.80 PERMIT FEE R000.322.100.00.00 0.00 $580.30 WASHINGTON STATE SURCHARGE B640.237.114 0.00 $4.50 PUBLIC WORKS $530.00 BASE APPLICATION FEE ROOO.322.100.00.00 0.00 $250.00 CONSTRUCTION PLAN REVIEW R000.345.830.00.00 0.00 $140.00 PERMIT ISSUANCE/INSPECTION FEE R000.342.400.00.00 0.00 $140.00 TECHNOLOGY FEE $36.02 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R7843 R000.322.900.04.00 0.00 $36.02 $1,150.82 Date Paid: Monday, March 07, 2016 Paid By: ALEGIS CORPORATION Pay Method: CREDIT CARD A52382 Printed: Monday, March 07, 2016 12:33 PM 1 of 1 SYSTEMS Date Paid: Thursday, October 08, 2015 Paid By: BILL FORTUNATO Pay Method: CREDIT CARD 03802D Printed: Thursday, October 08, 2015 2:14 PM 1 of 1 / 9,' ff L�r 1�� LJ LJ SYSTEMS 41 INSPECTION RECORD Retain a copy with permit �W. ��S INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Pr . t: p �l_(,Q� Type ( pection Address: b Lk I ' V- Date Called: �.) Special Instructions: Date anted: a.m. 3 ✓�-3 p.m. Requester: Phone No: Inspector: Date: 3�z3 -1 0 REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Rim INSPECTION RECORD _ Retain a copy with permit�� O ECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Project: Typ f Inspection: - Pe Address: S C n Lt) Date Called: Special Instructions: I Dat Wanted: a.m. p.m. Requues er: PhonjN�o/ f` g Inspector: Date: 3 REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call. to schedule reinspection r` s t � I 1 1` t t '�1�� z• �t,, ys Not What �, b r d 5� It's How We Do It" F�= E [ E�ZD Asbestos and Lead Su .Project: Newport Bay Restaurant 17920 Southcenter Parkway Tukwila, WA 98188 I NE�c�D FOR CODE COMPLIANCE APPROVED UCI 21 2015 Tukwila Prepared For:,,.... — -- Madison Investments P.O. Box 1922 Bozeman, MT 59771 Project Number: SR15.2416 RECEIVED CITY OF TUKWILA OCT 0 8 2015 CENTER TABLE OF CONTENTS SECTION 1 I Inspection Report SECTION 2 1 Laboratory Results SECTION 3 1 Photographs SECTION 4 1 AHERA Certification AHERA Certified Asbestos Survey / Inspection Report 4-28-2015 Prepared For: Madison Investments Project: Asbestos Inspection Newport Bay Restaurant 17920 Southcenter Parkway Tukwila, WA 98188 A. Background On 4-22-2015, Northwest Abatement Services, Inc. performed an asbestos identification inspection which will serve as our report for all visible Asbestos Containing Building Materials located at the address listed above. The purpose of this inspection was to ascertain the presence of asbestos containing materials located in the structure and provide a report to conform to WAC 296-62- 077, PS(AA Regulation III, Section 4 and 40 CFR 763 requirements for identification of asbestos. This survey also satisfies regulatory criteria established by OSHA's Department of Labor and Washington State's Department of Labor and Industries for identifying asbestos containing materials associated with the structure for future abatement and demolition. A copy of this report may be submitted to the appropriate agencies as proof that a survey was performed prior to any renovation or demolition. A copy of this report should also be given to the contractor and/or be maintained onsite during any abatement and demolition activities. B. Sampling Methodology Suspect materials were sampled by an AHERA (Asbestos Hazard Emergency Response Act) accredited inspector. Sample locations for this survey were chosen in a non-random fashion, with emphasis being placed on obtaining samples of each type of accessible, suspect material, while minimizing damage to the material being sampled. Samples were collected by carefully removing small portions of the suspect material in a non abrasive manner. If possible, samples were collected from existing damaged areas. Friable materials are materials which can be crushed, pulverized, or reduced to powder by hand pressure. These materials were wetted with amended water prior to sampling to protect the inspector from potential exposure or accidental fiber release. PPE (personal protective clothing) will only be utilized at the inspector's discretion. A particular suspect material may be located in various separate places throughout the structure. The EPA does not require that these materials be sampled in each location. Suspect materials of the some type, age, appearance have the some date of installation, and are sampled in accordance with AHERA requirements, must provide statistically reliable data which can be extrapolated on all remaining non sampled areas. AHERA Protocol determines the number of samples of each materials to be collected, depending on it's 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. However, in every case, AHERA relies on the judgment of the inspectors who are experienced in AHERA methodology and the type of facilities being inspected. (see appendix A at end of the report) After identifying the suspect materials, bulk samples were collected and taken to an asbestos laboratory to be analyzed for the amount of asbestos and, the type of asbestos, if any. The asbestos samples were analyzed using Polarized Light Microscopy (PLM), stain dispersion staining techniques in accordance with the EPA Method 600/R-93/166, which has a reliable limit of quantification of one percent asbestos by volume. Northwest Abatement Services, Inc. Inspection Report i 1 C. AHERA Certified Inspector Information The Certified AHERA Inspector was Jeff Rogers. Certification #: BI/R-NES- 10- 10- 14-05, Expiration 10-10-2015 D. Survey Findings There were a total of twenty one suspect asbestos containing building materials (bulk samples), removed) from the structure listed above, for lab analysis. Based on the field inspection, homogenization of materials, and the results of the lab analysis, Zero of the twenty one samples tested Positive for Asbestos: Sample Number Material Asbestos Content Quantity E. Building Description The commercial structure is located at 17920 Southcenter Parkway, Tukwila, WA 98188. The structure has a concrete foundation with wood framing, partial wood exterior siding with masonry, and a mansard roof section with rolled flat roof. Note: Allsuspect.40finishes were sompledond/estedoccordin§to,411MAProtocol (See appendix A) The suspect AN (asbestos containing materials) sampled for analysis are as follows: Sample Number Material Location 1 Roofing Exterior Roof 1 A Roofing Tar Paper Exterior Roof 2 Caulking Exterior Roof Parapet 3 HVA( Caulking Exterior 3A HVAC Base Caulking Exterior 5 Vinyl Composition Tile Soda Room Floor 5A Mastic Soda Room Floor 6 Carpet Glue Dining Room/Bar Floor 7 Tile Bar Floor 7A Tile Grout Bar Ifloor 8 Ceiling Tile Bar Ceiling 8A Glue Dot Bar Ceiling 10 Drywall Soda Room l0A Joint Compound Soda Room 11 Drywall Dining Room HA Joint Compound Dining Room 12 Tile Back Kitchen 12A Tile Mastic Back Kitchen 128 Tile Grout Back Kitchen 13 Drywall Back Kitchen Office 13A Joint Compound Back Kitchen Office Northwest Abatement Services, Inc. Inspection Report 1 2 The suspect LEAD (lead containing materials) sampled for analysis are as follows: Sample Number Material Location 4 Paint (Gray) Exterior 9 Paint (White Trim) Interior 9A Paint (Gray) Interior TQP Paint (Gray) Exterior Northwest Abatement Services, Inc. Inspection Report 1 3 F. Conclusion Laboratory results did not show any asbestos in the samples tested. No abatement is required unless discovery of suspect materials. Prior to any demolitionorrenovation, oflfriab/eondnon-friab/easbestos containing materials(ACM) are to he removed and disposed of in accordance with applicable federal, State andlora/regulotions /fthere is any asbestos containing materials left on site, that will not be disturbed during the repo vation or demolition process, an Asbestos Operationol and Maintenance Program (OM) is to be developed and implemented to monitor the remaining ACM. /n the a vent any suspect materials are detected during the demolition of this structure, you will need to rease all demolition activities and have these materials sampled for Asbestos. The Puget Sound Clean Air Authority requires that all materials that contain / % or more Asbestas, that these materials be rema ved by a licensed and Certified Asbestos remo vat contractor, prior to any demolition or rent? vation. The abatement contractor should pro vide the Owner with copies of all required notifications to PSCAA and the Department of Labor and Industries. A rerlifiratioa letter will need to be obtained from the abatement contractor prior to applying for o demolition permit with PSCAA. PSCAA will also want to see a copy of the asbestos survey. Although extreme thoroughness and expertise were exercised to ensure the completeness of this survey, existing conditions may have prevented the discovery of other suspect asbestos containing material. NW Abatement Services, Inc. is not responsible for materials that may be hidden from sight and cannot be discovered with reasonable diligence. Any suspect material not covered in this survey that is encountered during the renovation or demolition procedure should be verified by analysis prior to disturbance. It should be noted that this survey was conducted only to ascertain the presence of asbestos containing materials. There was no survey conducted by NW Abatement Services, Inc. to determine the presence of lead -based paint, PCB material (ballast, etc.), UST's, radon gas or any other hazardous material that may be present onsite. This report has been prepared for the sole use of our client and its representatives for this project only. The analyses, conclusions and recommendations presented in this report are based upon conditions encountered at the time of our survey only. The scope of services performed during this survey may not be appropriate for the needs of others. Re -use of this document or the findings, conclusions or recommendations presented herein, are at the sole risk of said user. NW Abatement Services, Inc. cannot be held responsible for the interpretation by others of the data contained in this report. The conclusions presented in this report were based on the results of sample analysis presented by a subcontracted, third party, analytical laboratory. Northwest Abatement Services, Inc. is not responsible for variations in analytical results or inaccuracies resulting from laboratory analysis. This survey is not intended for use as abatement plans and/or specifications. Northwest Abatement Services, Inc. recommends that professional plans and specifications be prepared for all large scale projects. No warranty, expressed or implied, is made. If you have any questions regarding this asbestos survey/inspection report, please contact us at (253) 588-0440, or FAX: (253) 588-0198. Respectfully submitted, NORTHWEST ABATEMENT SERVICES, INC. Jeff Rogers Certified AHERA Inspector DRS:initials Northwest Abatement Services, Inc. Inspection Report 1 4 Appendix A The following AHERA protocol was used in determining the number of suspect samples to collect: Surfacing materials: 1) Homogeneous area equal to or less than 1000 SF (minimum 3 samples). 2) Homogeneous area greater than 1000 SF but less than 5000 SF. (5 samples) 3) Homogeneous area greater than 5000 SF. (1 samples) Thermal Systems Insulation (TSI): 1) Homogeneous area (1 per each type of suspect materials). Miscellaneous materials: 1) Homogeneous area (1 per each type of suspect materials) Suspect Materials are divided into 3 categories: 1) Surfacing materials — AN sprayed or troweled on surfaces (walls, ceilings, and structural members) for acoustical, decorative, thermal insulation or fireproofing purposes. Examples include plaster, popcorn textured ceilings, skim coat textures, and structural fireproofing. 2) Thermal System Insulation — Insulation used to inhibit heat transfer or prevent condensation on pipes, boilers, tanks, ducts, and various other components of hot and cold water systems, and heating, ventilation, and air conditioning (HVAO systems. Examples include pipe lagging, pipe wrap; block, batt, and blanket insulation; cement and "muds" and a variety of other products such as gaskets and ropes. 3) Miscellaneous Materials — Materials not classified under surfacing materials or thermal systems insulation. Examples include: floor tile, ceiling tile, roofing felts, concrete piping, outdoor siding and fabrics, glazing putty, wall board and associated assembly component, various mastics, etc. such as floor the mastics, wall board mastics, ceiling file mastics etc. Northwest Abatement Services, Inc. Inspection Report 1 5 Sa,nAir Technologies, Laboratory Analysis Report prepared for Northwest Abatement Services, Inc. Report Date: 4/28/2015 Project Name: Newport Bay Resturant Project #: SR15-2416 SanAir ID#: 15011109 Kwa �i Texas 1�IEOrrFDlA80RATORP Virginia licensed lrnm resat SBE Mold Analysis a�» Laboratory NVLAP LAB CODE 200870.0 LABR 162952 Certification a 652931 License a LA80166 www.sanair.co SanAfr' Technologies Laboratory sa it SanAir Technologies Laboratory, Inc. 1551 Oakbridge Drive, Suite B, Powhatan, VA 23139 804.897.1177 Toll Free: 888.895.1177 Fax: 804.897.0070 Web: http://www.sanair.com E-mail: iaq@sanair.com Northwest Abatement Services, Inc. P.O. Box 39220 Lakewood, WA 98496 April 28, 2015 SanAir ID # 15011109 Project Name: Newport Bay Resturant Project Number: SR15-2416 Dear Jeff Rogers, We at SanAir would like to thank you for the work you recently submitted. The 3 sample(s) were received on Friday, April 24, 2015 via FedEx. The final report(s) is enclosed for the following sample (s): 4, 9, 9A. These results only pertain to this job and should not be used in the interpretation of any other job. This report is only complete in its entirety. Refer to the listing below of the pages included in a complete final report. Sincerely, SanAir Technologies Laboratory Final Report Includes: - Cover Letter - Analysis Pages - Disclaimers and Additional Information sample conditions: 3 sample(s) in Good condition SanAir ID Number S Air SanAir Technologies Laboratory, Inc. 1551 Oakbridge Drive, Suite B, Powhatan, VA 23139 15011109 804.897.1177 Toll Free: 888.895.1177 Fax: 804.897.0070 Web: hftp://www.sanair.com E-mail: iaq@sanair.com FINAL REPORT Name: Northwest Abatement Services, Inc. Project Number: SR15-2416 Address: P.O. Box 39220 P.O. Number: SR15-2416 Lakewood, WA 98496 Project Name: Newport Bay Resturant Collected Date: 4/22/2015 Received Date: 4/24/2015 10:15:00 AM Report Date: 4/28/2015 9:46:30 AM Lead Bulk Analysis Analyst: Lane, Jennifer Test Method: SW846/3050B/7000B Sample Description pg Pb Sample Calculated Sample Sample in Sample Size (grams) RL Result Result 15011109-001 4 / Pait - Exterior <1 0.106 94.3 <94.3 <0.0094 % (Gray) Pg/g (PPm) By Weight Test Method: SW846/3050B/7000B bampie itescription pg Pb Sample Calculated Sample Sample in Sample Size (grams) RL Result Result 15011109-002 9 / Paint - Interior <1 0.1068 93.6 <93.6 <0.0094 8 Pg/g (ppm) By Weight (White Trim) Test Method: SW846/3050B/7000B bampie irescription pg 13b Sample Calculated Sample Sample In Sample Size (grams) RL Result Result 15011109-003 9A / Paint - <1 0.1116 89.6 <89.6 <0.009 % P g/g (ppm) By Weight Interior (Gray) Minimum Quantitative Limit < 0.0100% SanAir Technologies Laboratory, Inc participates in the AIHA ELPAT for environmental Lead. AIHA Lab Id: 162952 Icertification Signature: `Y.z_ Reviewed: Date: 4/27/2015 Date. 4/28/2015 Page 1 of 1 �-� SanA'r SanAir Technologies Laboratory, Inc. $a11Alr ID Number 1551 Oakbridge Drive, Suite B, Powhatan, VA 23139 15 011109 804.897.1177 Toll Free: 888.895.1177 Fax: 804.897.0070 Web: http://www.sanair.com E-mail: iaq@sanair.com FINAL REPORT Name: Northwest Abatement Services, Inc. Project Number: SR15-2416 Address: P.O. Box 39220 P.O. Number: SR15-2416 Lakewood, WA 98496 Project Name: Newport Bay Resturant Collected Date: 4/22/2015 Received Date: 4/24/2015 10:15:00 AM Report Date: 4/28/2015 9:46:30 AM DRGANISM DESCRIPTIC The descriptions of the organisms presented are derived from various reference materials. The laboratory report is based on the data derived from the samples submitted and no interpretation of the data, as to potential, or actual, health effects resulting from exposure to the numbers of organisms found, can be made by laboratory personnel. Any interpretation of the potential health effects of the presence of this organism must be made by qualified professional personnel with first hand knowledge of the sample site, and the problems associated with that site. Page 1 of 1 Disclaimer • Results relate only to the items tested • Results are not corrected for blanks • All quality control results are acceptable unless otherwise noted • SanAir Technologies Laboratory, Inc is not responsible for sample collection or interpretation made by others • This report does not constitute endorsement by AIHA/NVLAP and/or any other U.S. governmental Agencies; and may not be certified by every local, state or federal regulatory agencies Lead Exposure Limits Air 1.5 pg/m3 EPA National Ambient Air Quality Standard (Quality Time — Weight Average) 30 pg/m3 OSHA Action Level (8-hour time weighted average) 50 pg/m3 OSHA Permissible Exposure Limit (General Industry) 50 pg/m3 OSHA Permissible Exposure Limit (Construction) Dust 40 pg/ft2 HUD Clearance Level for Floors 250 pg/ft2 HUD Clearance Level for Interior Window Sills 400 pg/ft2 HUD Clearance Level for Window Troughs Water 15 ppb (pg/liter) EPA Maximum Containment Level Paint 0.5% by weight HUD definition of lead based paint 1.0 mg/cm2 5000 ppm Soil 400 ppm HUD -Play areas and high -contact areas for children Hazardous Waste 5 ppm Analyzed as "leachable" using Toxicity Characteristic Leachate Procedure (TCLP) Revision Date 10/25/2012 Page 1 of 1 Sal nAr Te3ohinol,ogi s,1! aboratory4 Analysis Report prepared for Northwest Abatement Services, Inc. Report Date: 4/24/2015 Project Name: Newport Bay Restaurant Project #: SR15-2416 SanAir ID#: 15010886 a�aa�o Texas Virginia Licensedno SBE MoldAlysl5 Loboratory NVLAP LAB CODE 200870-0 Certification I1 652931 license N LA80166 1W SanAi�r Technologies Laboratory www.sanair.com 's Air SanAir Technologies Laboratory, Inc, 1551 Oakbridge Drive, Suite B, Powhatan, VA 23139 804.897.1177 Toll Free: 888.895.1177 Fax: 804.897.0070 Web: http://www.sanair.com E-mail: iaq@sanair.com Northwest Abatement Services, Inc. P.O. Box 39220 Lakewood, WA 98496 April 24, 2015 SanAir ID # 15010886 Project Name: Newport Bay Restaurant Project Number: SR15-2416 Dear Jeff Rogers, We at SanAir would like to thank you for the work you recently submitted. The 21 sample(s) were received on Thursday, April 23, 2015 via Fed Ex. The final report(s) is enclosed for the following sample(s): 1, 1 A, 2, 3, 3A, 5, 5A, 6, 7, 7A, 8, 8A, 10, 10A, 11, 11 A, 12, 12A, 12B, 13, 13A. These results only pertain to this job and should not be used in the interpretation of any other job. This report is only complete in its entirety. Refer to the listing below of the pages included in a complete final report. Sincerely, Sandra Sobrino Asbestos & Materials Laboratory Manager SanAir Technologies Laboratory Final Report Includes: - Cover Letter - Analysis Pages - Disclaimers and Additional Information sample conditions: 21 sample(s) in Good condition Sa"ir ID Number • 'Sanair anAir Technologies Laboratory, Inc. 1551 Oakbridge Drive, Suite B, Powhatan, VA 23139 15010886 804.897.1177 Toll Free: 888.895.1177 Fax: 804.897.0070 Web: http://www.sanair.com E-mail: iaq@sanair.com FINAL REPORT Name: Northwest Abatement Services, Inc. Project Number: SR15-2416 Address: P.O. Box 39220 P.O. Number: SR15-2416 Lakewood, WA 98496 Project Name: Newport Bay Restaurant Collected Date: 4/22/2015 Received Date: 4/23/2015 10:15:00 AM Report Date: 4/24/2015 2:27:15 PM Analyst: Tallert, Jonathan G. Asbestos Bulk PLM EPA 600/R-93/116 Stereoscopic.. : SanAir ID / Description Appearance. .% Fibrous % Non -Fibrous Fibers _. - 1 / 15010886-001 Black 10% Cellulose 80% Other None Detected Roofing - Exterior Roof Non -Fibrous 10% Glass Heterogeneous Stereoscopic • Description A ComponentsAsbestosSanAir lA / 15010886-002 Black 70% Cellulose 25% Other None Detected Roofing Tar Paper - Exterior Fibrous 5% Glass Roof Homogeneous Stereoscopic• • Description A.. Fibrous .. 2 / 15010886-003 Grey 100% Other None Detected Caulking - Exterior Roof Parapet Non -Fibrous Homogeneous Stereoscopic• SanAIr ID / Description Appearance % Fibrous ..nents % Non -Fibrous Asbestos Fibers 3 / 15010886-004 Grey 100% Other None Detected HVAC Caulking - Exterior Non -Fibrous Homogeneous Stereoscopic SanAlr • Description A••- Components Asbestos 3A / 15010886-005 Various 100% Other None Detected HVAC Base Caulking - Exterior Non -Fibrous Heterogeneous Stereoscopic..AsbestosSanAir ID / Description Appearance % Fibrous % Non -Fibrous Fibers 5 / 15010886-006 Grey 100% Other None Detected Vinyl Composition Tile - Soda Non -Fibrous Room Homogeneous Stereoscopic SanAir ID / Description Appearance Components % Fibrous % Non -Fibrous Fibers 5A / 15010886-007 Yellow 100% Other None Detected Mastic - Soda Room Non -Fibrous Homogeneous Signature: �" ' Reviewed: �4/ /�" Date: 4/24/2015 Date: 4/22015 Page 1 of SanA�r SanAir Technologies Laboratory, Inc, SaaAir ID Number M. �w 1551 Oakbridge Drive, Suite B, Powhatan, VA 23139 15010886 804.897.1177 Toll Free: 888.895.1177 Fax: 804.897.0070 Web: http://www.sanair.com E-mail: iaq@sanair.com FINAL REPORT Name: Northwest Abatement Services, Inc. Project Number: SR15-2416 Address: P.O. Box 39220 P.O. Number: SR15-2416 Lakewood, WA 98496 Project Name: Newport Bay Restaurant Collected Date: 4/22/2015 Received Date: 4/23/2015 10:15:00 AM Report Date: 4/24/2015 2:27:15 PM Analyst: Tallert, Jonathan G. Asbestos Bulk PLM EPA 600/R-93/116 Stereoscopic.. Description •a- • eus % Non -Fibrous Fi• - 6 / 15010886-008 Yellow 100% Other None Detected Carpet Glue - Dining Room/ Bar Non -Fibrous Homogeneous Stereoscopic Components Fibrous• . .Fibers / 15010886-009 White 100% Other None Detected Tile - Bar Floor Non -Fibrous Homogeneous Stereoscopic Description Appearance Components 7A / 15010886-010 Grey 100% Other None Detected Tile Grout - Bar Floor Non -Fibrous Homogeneous Stereoscopic Description Appearance Fibrous Asbestos Fibers 8 / 15010886-011 White 65% Min. Wool 35% Other None Detected Ceiling Tile - Bar Ceiling Fibrous Homogeneous Stereoscopic.• Description.. .Fibers8A / 15010886-012 Cream 100% Other None Detected Glue Dot - Bar Ceiling Non -Fibrous Homogeneous Stereoscopic• • s • • - - ..Asbestos- • • • •us Fibers 10 / 15010886-013 White 10% Cellulose 90% Other None Detected Drywall - Soda Room Non -Fibrous Homogeneous Stereoscopic SanAlr ID / Description Appearance ComponentsAsbestos % Fibrous % Non -Fibrous Fibers 10A / 15010886-014 White 100% Other None Detected Joint Compound - Soda Room Non -Fibrous Homogeneous Certification Signature: �" ' Reviewed:�-- Date: 4/24/2015 Date: 4/24/2015 Page 2 of 3 � SanAir ID Number ! SanAir SanAir Technologies Laboratory, Inc. 1551 Oakbridge Drive, Suite B, Powhatan, VA 23139 15010886 804.897.1177 Toll Free: 888.895.1177 Fax: 804.897.0070 Web: http://www.sanair.com E-mail: iaq@sanair.com FINAL REPORT Name: Northwest Abatement Services, Inc. Project Number: SR15-2416 Address: P.O. Box 39220 P.O. Number: SR15-2416 Lakewood, WA 98496 Project Name: Newport Bay Restaurant Collected Date: 4/22/2015 Received Date: 4/23/2015 10:15:00 AM Report Date: 4/24/2015 2:27:15 PM Analyst: Tallert, Jonathan G. Asbestos Bulk PLM EPA 600/R-93/116 Otureuswpic Lomponenis ASDesios SanAir ID / Description Appearance % Fibrous % Non -Fibrous Fibers Drywall - Dining Room Non -Fibrous Homogeneous SanAir ID / Description Stereoscopic Appearance Components % Fibrous % Non -Fibrous Asbestos Fibers 0•. Other Joint Compound - Dining Room Non -Fibrous Homogeneous anAir ID / Description Stereoscopic Appearance Components % Fibrous % Non -Fibrous Asbestos Fibers • • 0•. Other Tile - Back Kitchen Non -Fibrous Homogeneous SanAir ID / Description Stereoscopic Appearance Components % Fibrous % Non -Fibrous Asbestos Fibers ..: Other None Detected Tile Mastic - Back Kitchen Non -Fibrous Homogeneous 12B / 15010886-019 Black 100% Other None Detected Tile Grout - Back Kitchen Non -Fibrous Homogeneous Stereoscopic Components SanAir ID / Description Appearance % Fibrous % Non -Fibrous Fibers 13 / 15010886-020 White 10% Cellulose 90% Other None Detected Drywall - Back Kitchen Office Non -Fibrous Homogeneous Stereoscopic Components AppearanceSanAir ID / Description 13A / 15010886-021 White 100% Other None Detected Joint Compound - Back Kitchen Non -Fibrous Office Homogeneous Certification Signature: � Reviewed: A,`�''�` Date: 4/24/2015 Date: 4/24/2015 Page 3 of 3 Disclaimer The final report cannot be reproduced, except in full, without written authorization from SanAir. Fibers smaller than 5 microns cannot be seen with this method due to scope limitations. The accuracy of the results is dependent upon the clients sampling procedure and information provided to the laboratory by the client. SanAir assumes no responsibility for the sampling procedure and will provide evaluation reports based solely on the sample and information provided by the client. This report may not be used by the client to claim product endorsement by NVLAP or any other agency of the U.S. government. For NY state samples, method EPA 600/M4-82-020 is performed Polarized- light microscopy is not consistently reliable in detecting asbestos in floor covering and similar non -friable organically bound materials. Quantitative transmission electron microscopy is currently the only method that can be used to determine if this material can be considered or treated as non -asbestos containing. NY ELAP lab ID 11983 0 SURVEY PHOTOS 17920 Southcenter Parkway, Tukwila, WA SURVEY PHOTOS 17920 Southcenter Parkway, Tukwila, WA h t Lem a A w•v �$ tjQ 1. I AHERA BUILDING INSPECTOR REFRESHER CERTIFICATE This is to certify that Jeff Rogers has attended and satisfactorily completed all requirements to maintain accreditation as an AHERA Building Inspector in accordance with the Toxic Substance Control Act Title (Section 206) and 40 CFR 763. Accreditation No. 13I/R-NES-10-10- 5 Course Date: October 10, 2014 Valid through: October 10, 2015 Donna McNeal NOW Environmental Services, Inc. 34004 — 9t' Avenue South, Suite # 12 Federal Way, Washington 98003 (253)927-5233 i A ga,t f I !� Ir�pau•F •� V1 City of Tukwila Department of Community Development - Jack Pace, Director March 7, 2016 WILLIAM FORTUNATO 1505 WESTLAKE AVE N SUITE 305 SEATTLE, WA 98109 RE: Application No. D15-0267 NEWPORT BAY RESTAURANT - DEMOLITION 17920 SOUTHCENTER PKWY Dear WILLIAM FORTUNATO: Allan Ekberg, Mayor Permit application D15-0267 for the work proposed at NEWPORT BAY RESTAURANT - DEMOLITION (17920 SOUTHCENTER PKWY) has not been issued by the City of Tukwila Permit Center. Per the International Building, Residential, and Mechanical Codes as well as the Uniform Plumbing Code and/or the National Electric Code, every permit application not issued within 180 days from the date of application shall expire and become null and void. Currently your application has a status of APPROVED and is due to expire 04/22/2016. If you still plan to pursue your project, you are hereby advised to do one of the following: 1) If the plan review is completed for the project and your application is approved, you may pick up the application before the date of expiration. At the time of permit issuance the expiration date will automatically be extended 180 days. -or- 2) If the plan review is not completed submit a written request for application extension (7) seven days in advance of the expiration date. Address your extension request to the Building Official and state your reason(s) for the need to extend your application. The Building Code does allow the Building Official to approve one extension of up to 90 days. If it is determined that your extension request is granted, you will be notified by mail. In the event that your permit is not issued, we do not receive your written request for extension, or your request is denied your permit application will expire and your project will require a new permit application, plans and specifications, and associated fees. Thank you for your cooperation in this matter. Sincerely, --V�x '-�J Bill Rambo Permit Technician File No: D15-0267 Tukwila City Hall • 6200 Southcenter Boulevard • Tukwila, WA 98188 • 206-433-1800 • Website: TukwilaWA.gov Approved Transaction Page l of l pseleana%r.org Puget Sound Clean Air Agency Notification Case #: 201504273 This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)). Fee Amount Paid $65.00 Credit Card Transaction # AXOFDA67D421 Transaction Date 10/07/15 Owner's Name Stovetop Restaurant Group Phone (303) 501-9272 Project Street Address 17920 Southcenter Parkway City Tukwila Zip 98188 Contact Person Brad Clawson Phone (303) 501-9272 Mailing Address 9327 Piperhill Drive SE Olympia, WA 98513 This project includes a demolition. Demolition Start Date 11/02/15 Completion Date 11/24/15 Demolition will be completed by a demolition contractor Demo Contractor TBD Contractor Job # Contact Phone Mailing Address (1) I certify that the information I have provided is to the best of my knowledge true and accurate. (2) I understand that I must file an Amendment to this Notification if: • The type of project has changed. The project types are asbestos and demolition. • The quantity of friable asbestos to be removed meets a larger project category. • The project's start or completion date has changed. (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Create Another Notification View History If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. Loa Out RECEIVED CITY OF TUKWILA OCT 082015 PERMIT CENTER https:Hsecure.pscleanair.org/Asbestos/Approved.aspx 10/7/2015 PERMIT COORD COPY PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: D15-0267 DATE: 10/08/15 PROJECT NAME: NEWPORT BAY RESTAURANT - DEMOLITION SITE ADDRESS: 17920 SOUTHCENTER PKWY X Original Plan Submittal Revision # before Permit Issued Response to Correction Letter # DEPARTMENTS: c, on ( IS—� r kBu Tildin ivis g Xuvwor"ks I jt4l� PRELIMINARY REVIEW: Not Applicable ❑ (no approval/review required) REVIEWER'S INITIALS: APPROVALS OR CORRECTIONS: Approved ❑ Corrections Required ❑ (corrections entered in Reviews) Notation: REVIEWER'S INITIALS: Revision # after Permit Issued A-�\ lil - 10-I3-/s- L$ A' jo-13-I6- Fire Prevention of Planning Division N Structural ❑ Permit Coordinator DATE: 10/13/15 Structural Review Required ❑ DATE: DUE DATE: 11/10/15 Approved with Conditions ❑ Denied ❑ (ie: Zoning Issues) DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: 12/18/2013 ALEGIS CONSTRUCTION INC Page 1 of 2 Safety & Health 4DWashington State Depaftent of Lab©r & Industries ALEGIS CONSTRUCTION INC Owner or tradesperson Principals JONES, BARRIE GLYN, PRESIDENT PRICE, MICHAEL RAY, VICE PRESIDENT PRICE, MARK ALLAN, SECRETARY EVERTON, ROBERT K, TREASURER Doing business as ALEGIS CONSTRUCTION INC HOITIC Espanol Contact. Claims & Insurance 6900 SW Atlanta St. Bldg 2, suite 110 PORTLAND, OR97223 603-970-8312 WA UBI No. Business type 603 073 077 Corporation Governing persons BARRIE GLYN JONES DANIEL ANTHONY FINNEGAN; JASON WYNECOOP; MICHAEL RAY PRICE; License A-L Index Help My L&I Workplace Rights Trades & Licensing Verify the contractor's active registration / license / certification (depending on trade) and any past violations. Construction Contractor Active. .................................................. _................. _.. Meets current requirements. License specialties GENERAL License no. ALEGIC1894CN Effective — expiration 02/10/2011— 02/19/2017 Bond Travelers Cas and Surety Co of America $12,000.00 Bond account no. 106017187 Received by L&I Effective date 02/12/2014 01/12/2014 Expiration date Until Canceled Bond history Insurance Valley Forge Ins Co $1,000,000.00 Policy no. 5086230808 Received by L&I Effective date 06/30/2015 06/28/2016 Expiration date https://secure.lni,wa.gov/verify/Detail.aspx?UBI=603073077&LIC=ALEGICI894CN&SAW= 3/7/2016 a 0 0 L 0 N 0 0 0 Cn Lv 0 n r- i Cn QD N n U 0 64 hi x 0 0 n EROSION CONTROL NOTES 1. THE DESIGN SHOWN IS BASED UPON THE ENGINEER'S UNDERSTANDING OF THE EXISTING CONDITIONS. THE PLAN DOES NOT REPRESENT A DETAILED FIELD SURVEY. THE EXISTING CONDITIONS SHOWN ON THIS PLAN SHEET ARE BASED UPON THE SURVEY PREPARED BY GEODIMENSIONS, DATED SEPTEMBER 8, 2015. THE CONTRACTOR IS RESPONSIBLE FOR VERIFYING FIELD CONDITIONS PRIOR TO BIDDING THE PROPOSED SITEWORK IMPROVEMENTS. IF CONFLICTS ARE DISCOVERED, THE CONTRACTOR SHALL NOTIFY THE OWNER PRIOR TO INSTALLATION OF ANY POR11ON OF THE SITEWORK WHICH WOULD BE AFFECTED. IF CONTRACTOR DOES NOT ACCEPT EXISTING SURVEY, INCLUDING TOPOGRAPHY AS SHOWN ON THE PLANS, WITHOUT EXCEPTION, HE SHALL HAVE MADE, AT HIS OWN EXPENSE, A TOPOGRAPHIC SURVEY BY A REGISTERED LAND SURVEYOR AND SUBMIT IT TO THE OWNER FOR REVIEW. 2. CAUTION - NOTICE TO CONTRA THE CONTRACTOR IS SPECIFICALLY CAUTIONED AT THE LOCATION AND/OR ELEVATION OF EXISTING U1ILITIES AS SHOWN ON THESE PLANS IS BASED ON RECORDS OF THE VARIOUS UTILITY COMPANIES AND, WHERE POSSIBLE, MEASUREMENTS TAKEN IN THE FIELD. THE INFORMATION IS NOT BE RELIED ON AS BEING EXACT OR COMPLETE. THE CONTRACTOR MUST CALL THE APPROPRIATE UTILITY COMPANY AT LEAST 48 HOURS BEFORE ANY EXCAVATION TO REQUEST EXACT FIELD LOCATION OF UTILITIES. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO RELOCATE ALL EXISTING UTILITIES WHICH CONFLICT WITH THE PROPOSED IMPROVEMENTS SHOWN ON THESE PLANS. 3. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO THE MOST CURRENT APPLICABLE LOCAL, STATE, AND FEDERAL STANDARDS. 4. THE CONTRACTOR SHALL BE RESPONSIBLE AT ALL TIMES FOR PREVENTING SILT -LADEN RUNOFF FROM DISCHARGING FROM THE PROJECT SITE. FAILURE BY THE CONTRACTOR CAN RESULT IN A FINE. THE DESIGNATED TEMPORARY CONTACT PERSON NOTED ON THIS PLAN MUST BE AVAILABLE FOR CONTACT BY TELEPHONE ON A 24 HOUR BASIS THROUGHOUT CONSTRUCTION AND UNTIL THE PROJECT HAS BEEN COMPLETED AND APPROVED BY THE GOVERNMENTAL AGENCY WITH JURISDICTION. 5. THE IMPLEMENTATION OF THE ESC PLANS AND THE CONSTRUCTION, MAINTENANCE, REPLACEMENT AND UPGRADING OF THESE ESC FACILITIES IS THE RESPONSIBILITY OF THE CONTRACTOR FROM THE BEGINNING OF CONSTRUCTION UNTIL ALL CONSTRUCTION IS COMPLETED AND APPROVED BY THE GOVERNMENTAL AGENCY WITH JURISDIC11ON AND THE SITE IS STABILIZED. 6. THE BOUNDARIES OF THE CLEARING LIMITS SHALL BE CLEARLY FLAGGED AND INSPECTED BY THE LOCAL JURISDICTION PRIOR TO ANY CLEARING OR CONSTRUCTION TAKING PLACE. DURING CONSTRUCTION, NO DISTURBANCE BEYOND THE FLAGGED CLEARING LIMITS SHALL BE PERMITTED. THE FLAGGING SHALL BE MAINTAINED BY THE OWNER AND/OR CONTRACTOR UNTIL ALL CONSTRUCTION IS APPROVED. 7. THE EROSION AND SEDIMENTA11ON CONTROL FACILITIES SHOWN ON THIS PLAN ARE TO BE CONSIDERED ADEQUATE BASIC REQUIREMENTS FOR THE ANTICIPATED SITE CONDITIONS. DURING CONSTRUCTION, DEMA11ONS FROM THIS PLAN MAY BE NECESSARY IN ORDER TO MAINTAIN WATER QUALITY. 8. ALL EROSION AND SEDIMENTATION CONTROL MEASURES SHALL BE INSPECTED BY THE CONTRACTOR ON A FREQUENT BASIS AND IMMEDIATELY AFTER EACH RAINFALL, AND MAINTAINED AS NECESSARY TO INSURE THEIR CONTINUED FUNCTIONING. ALL SEDIMENT MUST BE REMOVED FROM SILT FENCES, STRAW BALES, SEDIMENT PONDS, ETC. PRIOR TO THE SEDIMENT REACHING 1/2 ITS MAXIMUM POTENTIAL DEPTH. 9. AT NO TIME SHALL CONCRETE, CONCRETE BYPRODUCTS, VEHICLE FLUIDS, PAINT, CHEMICALS, OR OTHER POLLUTING MATTER BE PERMITTED TO 17. ALL AREAS DISTURBED DURING CONSTRUCTION WHERE PERMANENT LANDSCAPING WILL NOT BE PROVIDED WITHIN THE NUMBER OF DAYS SPECIFIED BELOW SHALL BE HYDROSEEDED, OR OTHERWISE STABILIZED, AS REQUIRED. STRAW MULCHING OR PLASTIC SHEETING ARE ACCEPTABLE ALTERNATIVES TO TEMPORARY HYDROSEEDING DURING PERIODS OF LOW GROWTH: WEST OF THE CASCADE MOUNTAIN CREST DURING THE DRY SEASON (MAY 1 - SEPT. 30): 7 DAYS DURING THE WET SEASON (OCTOBER 1 - APRIL 30): 2 DAYS 18. SLOPE STABILIZATION. CUT AND FILL SLOPES SHALL BE CONSTRUCTED IN A MANNER THAT WILL MINIMIZE EROSION. ROUGHENED SOIL SURFACES ARE PREFERRED TO SMOOTH SURFACES. INTERCEPTORS SHOULD BE CONSTRUCTED AT THE TOP OF LONG, STEEP SLOPES WHICH HAVE SIGNIFICANT AREAS ABOVE THAT CONTRIBUTE RUNOFF. CONCENTRATED RUNOFF SHOULD NOT BE ALLOWED TO FLOW DOWN THE FACE OF A CUT OR FILL SLOPE UNLESS CONTAINED WITHIN AN ADEQUATE CHANNEL OR PIPE SLOPE DRAIN. WHEREVER A SLOPE FACE CROSSES A WATER SEEPAGE PLANE, ADEQUATE DRAINAGE OR OTHER PROTEC11ON SHOULD BE PROVIDED. IN ADDITION, SLOPES SHOULD BE STABILIZED IN ACCORDANCE WITH ITEM (17) ABOVE. 19. STORM DRAIN INLET PROTECTION. ALL STORM DRAIN INLETS MADE OPERABLE DURING CONSTRUCTION SHALL BE PROTECTED SO THAT STORM WATER RUNOFF SHALL NOT ENTER THE CONVEYANCE SYSTEM WITHOUT FIRST BEING FILTERED OR OTHERWISE TREATED TO REMOVE SEDIMENT. 20. DUST ON THE SITE SHALL BE CONTROLLED PER LOCAL JURISDICTIONAL AIR QUALITY REQUIREMENTS. THE USE OF MOTOR OILS AND OTHER PETROLEUM BASED OR TOXIC LIQUIDS FOR DUST SUPPRESSION OPERA11ONS IS PROHIBITED. DEMOLITION NOTES � v I t � ► ► I EXISTING AND wv k PROPOSED ACCESS Wv N ' POINT t d :t o 15. EXISTING TRANSFORMER L3 3 AND ELECTRICAL ts' �' JUNCTION TO REMAIN - 0 WIN uV 4 v I 1V 8751027" ftft I ► 1 1. ► I I I I /V 0'3 c� 8 W 12� EMOVE EXISTING SIDEWALK FROM / EDGE OF NORTH/SOUTH SOUTHCENTER PARKWAY SIDEWALK EAST _ ' a I -EXISTING GREASE WASTE LINE TO BE CAPPED PRIOR TO - a DEMOLITION 0 K SS �J ,L�J C��Ciii�;zl 9 .kurn`bing 00--3 Piping of a REVISION No changes shall 1:�n r^.^u to the stop of work with ;r t � licr CKII Okfa,1 of Tulki liksa Suit'ding r isvisione twi l r lqi;.'m o r• , l`,n subm' al and may i�..;!udw � drlition�.l p,sn r u� feEs I FILE � Y Permit No. � Plan review approval is subject to errors and cno,'s ''ons. Approval Pf wnstruction documents does not authorize the violation of any adopted coda or ordinan^r?. Receipt Of approved Field Copy and conditions is acknowledged: By: < :_ Date: City of Tukwila BUILDING DIVISION CATCH BASIN TO RECEIVE INLET PROTECTION. TO BE INSTALLED PRIOR TO DEMOLITION ASS` 5' REQUIRED REAR YARD SETBACK l TCH BASIN TO RECEIVE INLET OTECTION. TO BE INSTALLED IOR TO DEMOLI11ON w DISCHARGE TO THE TEMPORARY OR PERMANENT DRAINAGE SYSTEM, OR TO DEMOLITION 1 , o < D DISCHARGE FROM THE PROJECT SITE. TEMPORARY SEEDING - WITHIN 14 DAYS AFTER CONSTRUCTION ► " a. /z 10. THE CONTRACTOR PERFORMING THE WORK SHALL MAINTAIN A SET OF THE ACTIVITY CEASES ON ANY PARTICULAR AREA, ALL DISTURBED }- T� l �� a_ a a v EMOVE EXISTING SIDEWALK FROM APPROVED CONSTRUCTION DRAWINGS ON SITE AT ALL TIMES WHILE GROUND WHERE THERE WILL NOT BE CONSTRUC110N FOR LONGER EXISTING CONCRETE PATIO AND p 4 d ---� -4: / 9 �� SOUTH EDGE OF THE BUILDING CONSTRUCTION IS IN PROGRESS. TRELLIS TO BE REMOVE �ONCRETE PaTlo . / _ �3 .s THAN 21 DAYS MUST BE SEEDED WITH FAST -GERMINATING -� •W/.WOOD° TRELLIS • Q o° 4 Co .. �m EXTENDED TO EXISTING CURB. 11. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR PERFORMING THE TEMPORARY SEED AND PROTECTED WITH MULCH. ►4 �' I ► 3 Ec a EXISTING CURB TO REMAIN UNLESS WORK TO OBTAIN ALL NECESSARY PERMITS FROM THE LOCAL JURISDIC11ON LL Q � I ► 3 DEC NOTED. PRIOR TO COMMENCING ANY WORK WITHIN THE PUBLIC RIGHT-OF-WAY. PERMANENT SEEDING - ALL AREAS AT FINAL GRADE MUST BE EXISTING FIRE �� o (btSDI--�'�--SD 3" Ec 3" D c a / 12. THE CONTRACTOR PERFORMING THE WORK SHALL BE RESPONSIBLE FOR SEEDED WITHIN 14 DAYS AFTER COMPLETION OF THE MAJOR ,s.c�- EXISTING EDGE . . COL W HYDRANT TO REMAIN. A I ► vr. ---dn PROVIDING ADEQUATE TRAFFIC CONTROL AT ALL 11MES DURING CONSTRUCTION ACTIVITY. �., w v I I OF BLDG - p1 CONSTRUCTION ALONGSIDE OR WITHIN ALL PUBLIC ROADWAYS. I (�)CO °° •. 'tr f. 13. THE APPROVED "TEMPORARY EROSION AND SEDIMENTATION CONTROL Z 15' REQUIRED FRONT va PLAN" MUST BE IMPLEMENTED PRIOR TO ANY SITE WORK. SEE THE PLANS W YARD SETBACK Cn a 1 29 P�� Know what's below. AND DETAILS FOR FURTHER INFORMATION. Q I - f i i c , c - v o�� / Call before you dig. 14. THE CONTRACTOR SHALL NOTIFY THE OWNER AND THE ENGINEER IN THE plans have been reviewed by the Public = 30 EXISTING U11LI1Y CORRIDOR 'orks De art;nent for conformance with current PER SHORT PLAT L99-0053 EVENT OR DISCOVERY OF POOR SOILS, GROUNDWATER OR DISCREPANCIES City standards. acceptance is subject to errors and (POWER, TELEPHONE, FIBER Rr �5 I RECEIVED IN THE EXISTING CONDITIONS AS NOTED ON THE PLANS. c / of 15. MAXIMUM SLOPES SHALL BE 2:1 HORIZ: VERT FOR FILL SLOPES, AND 2:1 omissions which do not authorize violations ib Q OPTICS �� CITY OF TUKWILA adopted standards or ordinances. The responsibility ��^^ HORIZ: VERT FOR CUT SLOPES. for the adequacy of the design rests totally with the Go U �5 ( c \\ OCT 0, 8 2015 16. ALL'XREAS DISTURBED DURING CONSTRUCTION WHERE PERMANENT designer. Additions, deletions or revisions to these I �� \ ,,, �o RIM29. 5 SMH / 1 LANDSCAPING WILL NOT BE PROVIDED WITHIN 60 DAYS SHALL BE drawings after this date will void this acceptance Q _ HYDROSEEDED, OR OTHERWISE STABILIZED, AS REQUIRED. STRAW MULCHING and will require a resubmittal of revised drawings \� \` ° / PERMIT CENT PROPOSED OR PLASTIC SHEETING ARE ACCEPTABLE ALTERNATIVES TO TEMPORARY for subsequent approval. FREESTANDING SIG SC GRAPHIC SCALE HYDROSEEDING DURING PERIODS OF LOW GROWTH. �� C (� s MH 20 � 10 20 40 80 Final acceptance is subject to field inspection by EXISTING PEDESTRIAN p < `� ��� R� =31.63 the Public 'Works utilities inspector. ACCESS TO REMAIN Date: s• ��. IN FEET ) l co to j \ o� � �' �s � I / 1 inch = 20 ft. Q -a I 1. DEMOLITION NOTES ARE FOR CLARIFICATION ONLY AND ARE SHOWN FOR THE CONTRACTOR'S BENEFIT. THESE NOTES ARE NOT INTENDED TO BE COMPREHENSIVE. THE CONTRACTOR SHALL REMOVE OR RELOCATE ALL EXISTING ON -SITE IMPROVEMENTS NECESSARY TO ACCOMMODATE THE PROPOSED CONSTRUCTION. 2. CONTRACTOR IS TO REMOVE ALL EXISTING SURFACE IMPROVEMENTS AND DEBRIS WITHIN THE LIMITS OF WORK UNLESS OTHERWISE NOTED. ALL DEBRIS FOUND ON SITE SHALL BE DISPOSED OF IN ACCORDANCE WITH APPLICABLE STATE CODES. 3. CONTRACTOR TO PROTECT EXISTING FEATURES WHICH ARE TO REMAIN. 4. ABANDONED PIPES LOCATED OUTSIDE PROPOSED BUILDING PAD LIMITS WITH AN EXCESS OF 3' COVER MAY BE DECOMMISSIONED AND ABANDONED IN PLACE, PROVIDED THAT THESE ABANDONED UTILITIES ARE GROUTED AND CAPPED. EXISTING SUBSURFACE IMPROVEMENTS AND_ DEBRIS WITHIN THE PROPOSED BUILDING PAD AREA, INCLUDING 10' BEYOND FOUNDATIONS, SHALL BE REMOVED. 5. CONTRACTOR SHALL ADJUST ALL EXISTING MANHOLE RIMS, DRAINAGE STRUCTURES, VALVE BOXES, VAULT LIDS AND UTILITY ACCESS STRUCTURES TO FINISH GRADE WITHIN AREAS AFFECTED BY PROPOSED CONSTRUCTION. EXISTING ELECTRICAL JUNCTION TO REMAI z rV 0 0 0 EXISTING RAMP AND BOLLARDS TO BE REMOVED I EXISTING EDGE OF BLDG (TYP.)------- 30' EXISTING UTILITY CORRIDOR PER SHORT PLAT L99-0053 (POWER, TELEPHONE, FIBER OPTICS). EXISTING UTILITIES TO REMAIN AND TO BE PROTECTED - EXISTING TREES ALONG SOUTHCENTER PARKWAY TO REMAIN UNLESS OTHERWISE NO A] EXISTING GAS TO BE CAPPED PRIOR TO i t L tS .:8 � t, 3 f S ) e � 4 t � .�� ,. ,� i,^^ ,. ,..4a. „Zef,,, .v,.;, .,,., �,., �„�.„ _. .,,. ...,, ...�... ... ...... .:. mt ,v,. �J _c �£. , r. # t s �.., ..., ,. ,. ., ,,. 7,�•, �-' .h.' u,. ,J,# , 3,.4 t tir .af we G C ANK BF 10/7/2015����' DEMO PERMIT LR R - c y k �v 70 "� WFF 10-492 001�t4NAL�� is " 1505 Westlake Ave. N. T (206) 522-9510 Suite 305 F (206) 522-8344 _ Seattle, WA 98109 wlvw.PAcLAND.COM 0 -I-EXISTING ADA RAMPS/SIGNS TO BE REMOVED SO EDGE OF PROPO' BLDG (TYP.) E REVit WED FOR CODE C OMPHIANCE AP ROV D OCT 21 2 15 City f Tuk i!a UILDI G DI ISION DEMOLITION/ESC PLAN' D-loo