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Home My WebLink AboutPermit D16-0221 - WOODSPRING SUITES - NEW HOTEL CONSTRUCTIONWOODSPRING SUITES 15637 WEST VALLEY HWY D16-0221 Parcel No: Address: Project Name: 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 DEVELOPMENT PERMIT 0005800004 Permit Number: D16-0221 15643 W VALLEY HWY WOODSPRING SUITES Issue Date: 11/3/2016 Permit Expires On: 5/2/2017 Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: Address: License No: Lender: Name: Address: NELSEN HISTORICAL TRUST 10510 NORTHUP WY #300 C/O VWC, KIRKLAND, WA, 98033 BROC HENDERSHOTT 10620 NE 9TH PL, BELLEVUE, WA, 98004 WASATCH DC BUILDERS NW LLC 10620 NE 9TH PL, BELLEVUE, WA, 98004 WASATDB846OR WEST 77 PARTNERS 10620 NE 9TH PL, BE3LLEVUE, WA, 98004 Phone: (425) 974-7080 Phone: (425) 974-7071 Expiration Date: 9/19/2018 DESCRIPTION OF WORK: DEMO EXISTING GARAGE AND BARN IN SUPPORT OF CONSTRUCTION OF NEW 110 KEY HOTEL BUILDING Project Valuation: $41,500.00 Type of Fire Protection: Sprinklers: NO Fire Alarm: NO Type of Construction: VB Electrical Service Provided by: TUKWILA Fees Collected: $1,742.22 Occupancy per IBC: R-3 Water District: TUKWILA Sewer District: TUKWILA Current Codes adopted by the City of Tukwila: International Building Code Edition: International Residential Code Edition: International Mechanical Code Edition: Uniform Plumbing Code Edition: International Fuel Gas Code: 2015 2015 2015 2015 2015 National Electrical Code: WA Cities Electrical Code: WAC 296-46B: WA State Energy Code: 2014 2014 2014 2015 Public Works Activities: Channelization/Striping: Curb Cut/Access/Sidewalk: Fire Loop Hydrant: Flood Control Zone: Hauling/Oversize Load: Land Altering: Landscape Irrigation: Sanitary Side Sewer: Sewer Main Extension: Storm Drainage: Street Use: Water Main Extension: Water Meter: Volumes: Cut: 0 Fill: 0 Number: 0 No Permit Center Authorized Signature: LajiA, R,12 Date:4 ` ✓ v 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: Print Name: , 67i— Date: //b/4 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: ***PUBLIC WORKS PERMIT CONDITIONS*** 2: 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. 3: 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. 4: Any material spilled onto any street shall be cleaned up immediately. 5: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation off-site or into existing drainage facilities. 6: 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. 7: Remove and cap all utilities prior to start of demolition of buildings. 8: Per one of the conditions of the Shoreline Substantial Development Permit (L15-0043), a professional archaeologist shall monitor construction excavation as recommended by the Cultural Resources Assessment report dated December 10, 2015. If archaeological materials are encountered during construction, work at the specific location shall stop and the City of Tukwila, Washington Department of Archaeology and Historic Preservation, and affected Indian tribes shall be notified. 9: ***BUILDING PERMIT CONDITIONS*** 10: 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. 11: 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. 12: 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). 13: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center. 14: 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. PERMIT INSPECTIONS REQUIRED Permit Inspection Line: (206) 438-9350 1700 BUILDING FINAL** 5200 EROSION MEASURES 5210 EROSION MEASURES FNL 0101 PRE -CONSTRUCTION 0101 PRE -CONSTRUCTION 1600 PUBLIC WORKS FINAL CITY OF TUK►. _LA Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Building Permit No. / - wl Project No. Date Application Accepted: 0 LI" K9 Date Application Expires: 4 (For office use o ly) 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 King Co Assessor's Tax No.: 0005800004 / 0005800002 Site Address: 15643 W. Valley Highway, Tukwila, WA 98188 Suite Number: Tenant Name: WoodSpring Suites PROPERTY OWNER Name: Broc Hendershott Name: Nelson Family Trust City: Bellevue State: WA Zip: 98004 Address: 10510 Northup Way #300 Email: broc@west77partners.com City: Kirkland State: WA Zip: 98033 CONTACT PERSON — person receiving all project communication Name: Broc Hendershott Address: 10620 NE 9th Place City: Bellevue State: WA Zip: 98004 Phone: (425) 974-7080 Fax: (425) 467-1073 Email: broc@west77partners.com GENERAL CONTRACTOR INFORMATION Company Name: TBD Address: Address: 6700 Antioch Plaza Suite 300 City: Merriam State: KS Zip: 66204 Phone: (913) 262-9095 Fax: (913) 262-9044 City: State: State: VJt& Zip: Phone: Fax: Contr Reg No.: Exp Date: Tukwila Business License No.: H:Wpplications'Forms-Applications On Line \2011 Applications\Permii Application Revised - 8-9-11.docx Revised: August 2011 bh Floor: New Tenant: ® Yes ..No ARCHITECT OF RECORD Company Name: BRR Architecture Architect Name: Rob Baker Address: 6700 Antioch Plaza Suite 300 City: Merriam State: KS Zip: 66204 Phone: (913) 262-9095 Fax: (913) 262-9044 Email: rob.baker@brrarch.com ENGINEER OF RECORD Company Name: CPH Consultants Engineer Name: Matt Hough Address: 11431 Willows Road NE - Ste. 120 City: Redmond State: WA Zip: 98502 Phone: (425) 285-2390 Fax: (425) 285-2389 Email: matt@cphconsultants.com LENDER/BOND ISSUED (required for projects $5,000 or greater per RCW 19.27.095) Name: vcA 77 ReAtets Address: IOW NC q�" kce City: %etit .e State: VJt& Zip: citr Page 1 of 4 BUILDING PERMIT INFORMATI( ,206-431-3670 Valuation of Project (contractor's bid price): $ 40,000 Existing Building Valuation: $ Describe the scope of work (please provide detailed information): Demolition of an existing Garage (approx. 877 sf) and Barn (approx. 2,035 sf) in support of construction of a new, 110 -key hotel building. Will there be new rack storage? ❑ Yes 1.. 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) 2,912 *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: 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 ❑ Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ 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 ❑ 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\201 I Applications\Permit Application Revised - 8-9-11.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 1' Floor 2"d Floor Yd 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) 2,912 *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: 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 ❑ Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ 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 ❑ 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\201 I Applications\Permit Application Revised - 8-9-11.docx Revised: August 2011 bh Page 2 of 4 PUBLIC WORKS PERMIT INFTION — 206-433-0179 Scope of Work (please provide detailed information): Demolition of an existing Garage (approx. 877 sf) and Barn (approx. 2,035 sf) in support of construction of a new, 110 -key hotel building. Call before you Dig: 811 Please refer to Public Works Bulletin #1 for fees and estimate sheet. Water District VI ...Tukwila ❑...Water District #125 O ...Water Availability Provided Sewer District VI ...Tukwila O ...Sewer Use Certificate ❑ .. Highline ❑...Valley View 0 .. Renton 0...Sewer Availability Provided ❑ .. Renton ❑ .. Seattle Septic System: O 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) 0 .. Geotechnical Report 0 ...Traffic Impact Analysis ❑ ...Bond 0 .. Insurance 0 .. Easement(s) 0 .. Maintenance Agreement(s) 0 ... Hold Harmless — (SAO) 0 ...Hold Harmless — (ROW) 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 ❑ ...Total Cut ❑ ...Total Fill cubic yards cubic yards 0 ...Sanitary Side Sewer ❑ ...Cap or Remove Utilities 0 ...Frontage Improvements ❑ ...Traffic Control ❑ ...Backflow Prevention - Fire Protection Irrigation Domestic Water ❑ .. Right-of-way Use - Profit for less than 72 hours ❑ .. Right-of-way Use — Potential Disturbance ❑ .. Work in Flood Zone ❑ .. Storm Drainage ❑ .. Abandon Septic Tank ❑ .. Curb Cut 0 .. Pavement Cut ❑ .. Looped Fire Line 37 ❑ .. Grease Interceptor ❑ .. Channelization ❑ .. Trench Excavation ❑ .. Utility Undergrounding ❑ ...Permanent Water Meter Size... WO # 0 ...Temporary Water Meter Size .. WO # ❑ ...Water Only Meter Size >I WO # ❑...Deduct Water Meter Size ❑ ...Sewer Main Extension Public 0 Private ❑ ❑ ...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: Water Meter Refund/Billing: Name: Mailing Address: City State Zip Day Telephone: City State Zip H:Wpplications\Forms-Applications On Line \2011 Applications\Permit 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 0 T: Signature:-_ Date: 7/15— / L Print Name: Broc Hendershott Day Telephone: (425) 974-7080 Mailing Address: 1062o NE 9th Place Bellevue WA 98004 City State Zip H:Applications\Forms-Applications On Line'201 1 Applications\Permit Application Revised - 8-9-1 1.docx Revised: August 2011 bh Page 4 of 4 BULLETIN A2 TYPE C PERMIT FEE ESTIMATE PLAN REVIEW AND APPROVAL FEES DUE WITH APPLICATION PW may adjust estimated fees PROJECT NAME (Po ob c('/Z/r G.g - U I *re PERMIT # i/ Co 022 I o /564.3 ()V. HWY. If you do not provide contractor bids or an engineer's estimate with your permit application, Public Works will review the cost estimates for reasonableness and may adjust estimates. 1. APPLICATION BASE FEE 2. Enter total construction cost for each improvement category: Mobilization $250 (1) Erosion prevention So Water/Sewer/Surface Water /Qo 0 Road/Parking/Access A. Total Improvements /Soo 3. Calculate improvement -based fees: B. 2.5% of first $100,000 of A. '3-7 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. 4. TOTAL PLAN REVIEW FEE (B+C+D) 5. Enter total excavation volume cubic yards Enter total fill volume — cubic yards $ 3"7 Use the following table to estimate the grading plan review fee. Use the greater of the excavation and fill volumes. 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 1ST 10,000, PLUS $24.50 for each additional 10,000 or fraction thereof. 100,001 — 200,000 $269.75 for 1ST 100,000, PLUS $13.25 for each additional. 10,000 or fraction thereof. 200,001 or more $402.25 for 1ST 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 58 (1+4+5) $ Z$-7 (4) (5) The 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 01/15/16 1 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) 7. Pavement Mitigation Fee 50 $ 3-7 -. 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 p 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 8. 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. (6) (7) QUANTITY IN CUBIC YARDS RATE 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 1' 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 Last Revised 01/15/16 2 (9) 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 $ (9) 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 2177) $ F. Special Connection (TMC Title 14) $ G. Duwamish $ H. Transportation Mitigation $ L Other Fees $ Total A through I $ (10) DUE WHEN PERMIT IS ISSUED (6+7+8+9+10+11) $ 3� 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) In allation Cascade Water Alliance RCFC 01.01.2016-12. .012 6 Total Fee 0.75 $625 $.:I5 $6630 1 $1125 :. 5,012.50 $16,137.50 1.5 $2425 ', 30,025 $32,450 2 $2825 $4:,040 $50,865 3 $4425 $96,080 $100,505 4 $7825 $150,125 $157,950 6 $12525 $300,250 $312,775 Approved 09.25.02 Last Revised 01/15/16 Temporary Meter 0.75" $300 2.5" $1,500 3 Cash Register Receipt City of Tukwila DESCRIPTIONS 1 ACCOUNT I QUANTITY I PermitTRAK PAID $326.88 D16-0221 Address: 15643 W VALLEY HWY Apn: 0005800004 $326.88 PUBLIC WORKS $325.00 PERMIT ISSUANCE/INSPECTION FEE R000.342.400.00.00 0.00 $37.50 CONSTRUCTION PLAN REVIEW R000.345.830.00.00 0.00 $37.50 BASE APPLICATION FEE R000.322.100.00.00 0.00 $250.00 TECHNOLOGY FEE $1.88 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R9789 R000.322.900.04.00 0.00 $1.88 $326.88 Date Paid: Thursday, November 03, 2016 Paid By: TUKWILA HOTEL HOLDINGS LLC Pay Method: CHECK 1031 Printed: Thursday, November 03, 2016 10:15 AM 1 of 1 CRSYSTEMS Cash Register Receipt City of Tukwila DESCRIPTIONS PermitTRAK I ACCOUNT I QUANTITY I PAID $1,415.34 D16-0221 Address: 15643 W VALLEY HWY Apn: 0005800004 $1,415.34 DEVELOPMENT $1,373.84 PERMIT FEE R000.322.100.00.00 0.00 $829.90 PLAN CHECK FEE R000.345.830.00.00 0.00 $539.44 WASHINGTON STATE SURCHARGE B640.237.114 0.00 $4.50 TECHNOLOGY FEE $41.50 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R9120 R000.322.900.04.00 0.00 $41.50 $1,415.34 Date Paid: Thursday, August 04, 2016 Paid By: TUKWILA HOTEL Pay Method: CHECK 1017 Printed: Thursday, August 04, 2016 10:30 AM 1 of 1 cArMSYSTEMS INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 438-9350 x-322( (206) 431-3670 Project: lifribS1Vl/k S0/ Tytia4 of Inspection: fcbp 1rd.4L Address: S7tsu % l7 Date Called: ctiof Date Wan d: /* /7 11- Reque er: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: OL piAL. Date:21/0 7 ins ecfee must REINSPECTION FEE REQUIRED. Prior to nextp be paid at 6300 Southcenter 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) 438-9350 Project: (i,.0 2i,Jc Suit Tyke of Inspection: 1x) b) JC CAL Address: /Z37 II VALle9 Ad/ Date Called: Special Instructions: Date Wanteny, 4 /3/j 7 p.m. Request : )) Phone6No: Z6Siiq qo CO 0 Approved per applicable codes. E Corrections required prior to approval. COMMENTS: LelYS. Ap t' L pawfe& LA0ApAlc, ri-;1/4)„, AOPe2o144-L_ arw--1124 Date: 4 REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. LABS INDUSTRIAL HYGIENE SERVICES Laboratory 1 Management 1 Training i _._ _ Good Faith Asbestos And Lead Inspection 9845 NE 29th Street Tukwila, WA 98188 Prepared For Mr. Broc Hendershott West 77 Partners 10620 NE 9th PI Bellevue, WA 98004 Project Number Inspection Date Report Date Inspected By AHERA Certification Expiration Date 2016-0733 August 22, 2016 August 25, 2016 David Fiala # 156308 March 30, 2017 REVEVVED FOR; COM -2 COVPL[A CE CCT 25 2016 3UiLDCC G RECEIVED CITY OF TUKWILA OCT 1 2 2013 PERMIT CENTER TABLE OF CONTENTS 1.0 SCOPE OF WORK 3 2.0 SURVEY METHOD 4-5 3.0 LABORATORY INFORMATION 6 4.0 BUILDING DESCRIPTION 7 5.0 FINDINGS 8 6.0 CONCLUSIONS AND RECOMMENDATIONS 9-11 7.0 LIMITATIONS OF SURVEY 11 APPENDICIES A Sample Locations (Floor Plan) B Laboratory Analysis Results C AHERA Certification & Laboratory Qualifications 15643 West Valley Hwy Tukwila, WA 98188 Project Number: 2016-0733 1.0 SCOPE OF WORK A Good Faith Asbestos and Lead Inspection was conducted at the detached garage and barn located at 15643 West Valley Hwy, Tukwila, WA 98188 on August 22, 2016. David Fiala, an AHERA Certified Building Inspector and WA -Dept. of Commerce Lead Based Paint Inspector, conducted this inspection at the request of Mr. Broc Hendershott of West 77 Partners. The purpose of this inspection was to identify asbestos containing building materials and lead containing paint coatings which would be impacted by the planned demolition of the detached barn and garage. Destructive sampling methods were utilized to collect samples of suspect building materials. No soft/limited demolition was performed during this inspection. Please note that hidden materials may exist within the structure, and all suspect materials must be treated as asbestos containing until testing proves otherwise. This survey constitutes a survey of accessible suspect ACM in the project area and was conducted in accordance with: The National Emission Standards for Hazardous Air Pollutants (NESHAP) 40 Code of Federal Regulations (CFR) Part 61 requires a survey by an accredited asbestos inspector prior to demolition of a structure. This asbestos survey also satisfies the requirements for "Good Faith" inspection outlined in Washington Administrative Code (WAC) 296-62-07221(2), Identification, which requires the owner of a structure to provide contractors with a written report identifying the asbestos -containing materials expected to be disturbed during renovation or demolition. The asbestos survey section is written to comply with the AHERA asbestos sampling procedure as stated in 40 CFR 763.86. This protocol is required under the Puget Sound Clean Air Agency (PSCAA Regulation III, Article IV, rev. March 26, 2009) for all asbestos surveys prior to a building demolition. Recommendations have been included for compliance with WAC 296-155-176 "Lead in Construction". The Lead in Construction regulations are designed to protect workers from lead hazards during construction and demolition activities. A floor plan indicating locations of samples collected by NVL personnel has been included in Appendix A. NVL Laboratories, Inc. 4708 Aurora Ave N Seattle, WA 98103 Phone (206) 547-0100 • Fax (206) 634-1936 3 15643 West Valley Hwy Tukwila, WA 98188 Project Number: 2016-0733 2.0 SURVEY METHOD Asbestos Survey Method The NVL Labs field inspector is an Asbestos Building Inspector, certified under the requirements of the United States Environmental Protection Agency (EPA) Asbestos Hazard Emergency Response Act (AHERA) regulation 40 CFR 763, Subpart E. A copy of his certificate is provided in Appendix C. The AHERA Guidelines dictate the following: The inspector must determine homogenous areas, which are defined as an area of Thermal System Insulation, Surfacing Material, or Miscellaneous Material that is uniform in texture and color. Once homogenous areas have been determined, the inspector must determine whether or not material is friable or non -friable. Friable is defined as a material, that when dry, can be crushed, pulverized, or reduced to dust using hand pressure, and non -friable material is defined as a material, that when dry, cannot be crushed pulverized or reduced to dust using hand pressure. Materials normally defined as non -friable can become friable by definition if sufficiently damaged. Once friability has been determined, the materials suspected of containing asbestos are divided into one of three categories: Thermal System Insulation (TSI), Surfacing Material (SM), or Miscellaneous Material (MM). Generally speaking, TSI and SM are considered to be friable, with the exception of TSI where the structural integrity of the insulation is intact and the protective out wrap is undamaged. Once materials are divided into one of the categories, samples are collected in the following manner: Friable Thermal System Insulation: 1. Inspector shall collect three (3) randomly distributed samples; 2. Inspector shall collect a minimum of one sample of each TSI materials that appears to have been used as a patch, as long as the patch is less than six linear feet or six square feet; 3. Inspector shall collect in a manner sufficient, samples from areas of TSI applied to fittings, tees, and joints. Friable Surfacing Material: 1. Inspector shall collect samples in random manner of surfacing materials as follows: a. Collect three bulk samples from an area believed to be homogeneous (defined as a material that appears to be the same or similar and was installed at the same time) that is 1,000 square feet or less in size; b. Collect five bulk samples from an area believed to be homogeneous that is greater than 1,000 square feet in size, but Tess than 5,000 square feet in size; c. Collect seven bulk samples from an area believed to be homogeneous that is greater than 5,000 square feet. NVL Laboratories, Inc. 4708 Aurora Ave N Seattle, WA 98103 Phone (206) 547-0100 • Fax (206) 634-1936 4 • 15643 West Valley Hwy Tukwila, WA 98188 Project Number: 2016-0733 2.0 SURVEY METHOD (continued) Miscellaneous Materials: 1. Inspector shall collect samples in a manner and number sufficient to determine if the material is asbestos -containing or not. All Materials Determined to Be Non Friable: 1. Inspector shall collect samples in a manner and number sufficient to determine if the material is asbestos containing or not. In addition to these sampling requirements, the AHERA Building Inspector is required to assess the following of each material that is found to be positive for asbestos: 1. The condition of each material; 2. Accessibility; 3. Possibility for air erosion. Once the samples have been collected, they must be analyzed by an accredited laboratory, and they must be analyzed using polarized light microscopy methods, commonly referred to as EPA Method 600/R-93/116. NVL Labs collected samples and obtained analytical data for suspect asbestos -containing materials identified in the building. Once collected, each bulk sample was sealed in an unadulterated plastic bag to eliminate the possibility of cross -contamination. "Chain -of -Custody" tracking was followed to maintain sample integrity during handling and data reporting at NVL Labs. A walk-through inspection of all accessible areas of this structure was performed to identify potential asbestos -containing materials. The walk-through inspection included a review of the internal and external aspects of this structure. The locations and types of potential asbestos -containing materials were noted. Homogeneous Materials Homogeneous materials are defined as an area of asbestos -containing material or presumed asbestos -containing material which appears similar throughout in terms of color, texture, and date of material application. The report listing for homogenous materials will appear as follows: Sample Number Material Description by Layer Location Asbestos Quantity Friable ## Layer 1 is not asbestos -containing Layer 2 is asbestos -containing Location description 1. % 2. % "X" LF/ft2 Yes/No Lead Survey Method NVL Labs collected representative samples of paint from the interior and exterior of the building within the project scope. Once collected, each bulk sample was sealed in an unadulterated plastic bag to eliminate the possibility of cross -contamination. "Chain -of -Custody" tracking was followed to maintain sample integrity during handling and data reporting at NVL Labs. Sampling was representative of all layers of paint. Copies of laboratory reports and field data forms for lead paint are in Appendix B. NVL Laboratories, Inc. 4708 Aurora Ave N Seattle, WA 98103 Phone (206) 547-0100 • Fax (206) 634-1936 5 15643 West Valley Hwy Tukwila, WA 98188 Project Number: 2016-0733 3.0 LABORATORY INFORMATION Laboratory Analysis: Asbestos In accordance with 40 CFR Chapter 1 (1-1-87 edition) Part 763, Subpart F, Appendix A, asbestos samples are analyzed at NVL Labs using polarized light microscopy (PLM) with dispersion staining. If samples are not homogeneous, then sub -samples of the components are analyzed separately. All bulk samples are analyzed using EPA Method 6001R-93/116 with the following measurement uncertainties for reported % asbestos: 1%=0-3%, 5%z1-9%, 10%=5-15%, 20%=10-30%, 50%=40- 60%. Only materials containing more than 1% total asbestos were classified as "asbestos - containing" based on EPA, state, and local regulations. Findings for samples containing more than one separable layer of materials are reported for each layer. The asbestos concentration in the sample is determined by visual estimation. NVL Labs is accredited by the National Institute of Standards and Technology (NIST) under the National Volunteer Laboratory Accreditation Program (NVLAP) program for bulk asbestos fiber analysis; NVLAP Lab Code 102063-0 Laboratory Accreditation Professional accreditations for NVL Laboratories, Inc. include the following: NVL Laboratories, Inc. is currently accredited by the National Institute of Standards and Technology (NIST) under the National Volunteer Laboratory Accreditation Program (NVLAP) program for bulk asbestos fiber analysis. NVLAP Lab Code 102063-0 NVL Laboratories, Inc. is approved by the American Industrial Hygiene Association (AIHA) Asbestos Analysts Registry (AAR) program for airborne asbestos fiber analysis. AAR Counter ID 7412 NVL Laboratories, Inc. is currently accredited by the American Industrial Hygiene Association (AIHA) under the Industrial Hygiene Laboratory Accreditation Program (IHLAP). The IHLAP program is designed specifically for laboratories involved in analyzing samples to evaluate workplace exposure. IHLAP Certification Number 563 NVL Laboratories, Inc. 4708 Aurora Ave N Seattle, WA 98103 Phone (206) 547-0100 • Fax (206) 634-1936 6 15643 West Valley Hwy Tukwila, WA 98188 Project Number: 2016-0733 4.0 BUILDING DESCRIPTION General Building Type The surveyed area consists of one single store barn and one single story garage, both of wood framed construction. Primary External Components The exterior of the structures is wood siding. Foundation Type The structures has an on grade concrete/wood foundation. Roofing Material(s) The roof of the barn is rolled asphaltic sheeting. The garage has tri -tab asphaltic shingles. Window Type(s) The windows of the barn are wood framed with exterior glazing. Flooring The flooring of the structures is bare concrete and dirt. Thermal Systems With Insulation The structures have no thermal heating systems, Finishing The structures are finished with wood paneling, the barn has some drywall. NVL Laboratories, Inc. 4708 Aurora Ave N Seattle, WA 98103 Phone (206) 547-0100 • Fax (206) 634-1936 7 15643 West Valley Hwy Tukwila, WA 98188 Project Number: 2016-0733 5.0 FINDINGS Inventory of Suspect Asbestos -Containing Materials Barn Sample Number Material Description by Layer Location Asbestos Quantity ** Friable* 2016-0733-3-1 Blue painted wall paneling Barn, room 1, walls/ceilings ND 2016 -0733 -Pb -2 White paint on wood 2016-0733-3-2 Drywall with paper Barn, room 19 ND 1,500 ft2 No 2016-0733-3-3 Window glazing Barn, Exterior wood windows 2% 65 LF 4 windows No 2016-0733-3-4 1: Rolled asphaltic sheeting 2: Black mastic 3: Black mastic on wood Barn, roof 1: ND 2: ND 3: ND 300.0 0.0300 Garage Sample Number Material Description by Layer Location Asbestos Quantity "" Friable* 2016-0733-3-5 1: Rolled asphaltic sheeting 2: Black mastic Garage, flat roof 1: ND 2: ND 2016 -0733 -Pb -2 White paint on wood 2016-0733-3-6 1: Tri -tab asphaltic shingles 2 Black mastic 3: Black roofing felt Garage, pitched roof 1: ND 2: 5% 3: ND 1,500 ft2 No ND None Detected The friability of this material was determined at the time of this inspection. Subsequent activities such as demolition, renovation, or abatement may affect the friability of this material. These quantities are only an estimate of the asbestos containing material discovered on site. Accuracy of these estimates must be verified by the asbestos abatement contractor on slte. Any suspect material(s) not identified above should not be disturbed and should be tested immediately. The suspect material must be treated as asbestos -containing until testing proves otherwise. Inventory of Suspect Lead -Containing Paint Coatings Sample Number Material Description Location Lead in mg/kg Lead in % 2016 -0733 -Pb -1 White paint on wood Barn, exterior siding 520.0 0.0520 2016 -0733 -Pb -2 White paint on wood Barn, exterior trim 680.0 0.0680 2016 -0733 -Pb -3 White paint on wood Garage, exterior lap siding 190000.0 19.0000 2016 -0733 -Pb -4 White paint on wood Garage, exterior plywood siding 100.0 0.0100 2016 -0733 -Pb -5 Silver paint on wood Barn, interior walls 300.0 0.0300 Lead content of material analyzed Is below the Lower Detection Limit. Samples In bold contaln lead In excess of detectable levels NVL Laboratories, Inc. 4708 Aurora Ave N Seattle, WA 98103 Phone (206) 547-0100 • Fax (206) 634-1936 8 e 15643 West Valley Hwy Tukwila, WA 98188 Project Number: 2016-0733 6.0 CONCLUSIONS AND RECOMMENDATIONS The following is an inventory of asbestos -containing materials identified during the Good Faith Asbestos and Lead Inspection conducted at the subject structures 1. Window glazing (Non -friable) Sample numbers: 2016-0733-3-3 2. Tri -tab asphaltic roofing / black mastic (Non -friable) Sample numbers: 2016-0733-3-6 There is approximately 65 linear feet of asbestos containing window glazing associated with 4 exterior wood framed windows on the barn. There is approximately 1500 square feet of asbestos containing black mastic associated with the asphaltic roofing (pitched roofing portion) of the garage. Contractors should be aware that concealed suspect asbestos -containing building materials may be uncovered during the course of demolition or renovation work. Contractors should have contingency plans that include stopping work, evacuation of the immediate area and sampling by a certified AHERA Building Inspector whenever these materials are found. Concealed suspect materials may include, but are not limited to: non -fiberglass pipe or roof drain insulation; spray -applied coatings; cement board; asphalt or paper vapor barriers; floorings and adhesives. If discovered, all asbestos -containing materials that will be disturbed as a natural part of renovation and/or demolition are required to be removed and disposed of in accordance with Washington State regulations. Washington State Department of Labor and Industries and PSCAA requires that the abatement be performed using Certified Asbestos Workers under the direct on site supervision by a Certified Asbestos Supervisor. Further, NVL suggests that an AHERA inspector review this property after abatement to ensure all asbestos -containing materials have been removed by the contractor. NVL Laboratories, Inc. 4708 Aurora Ave N Seattle, WA 98103 Phone (206) 547-0100 • Fax (206) 634-1936 9 15643 West Valley Hwy Tukwila, WA 98188 Project Number: 2016-0733 6.0 CONCLUSIONS AND RECOMMENDATIONS (continued) NVL Labs, Inc. is making the following recommendations regarding asbestos: 1. A copy of this inspection report should be maintained at the site during any renovations. 2. A copy of this inspection report should be provided to the General Contractor and any Sub Contractors working on the renovation project. 3. A licensed asbestos abatement contractor must be utilized to remove any asbestos -containing materials that will be impacted by the renovations. Lead Lead -containing paint was identified in the following paint chip samples collected from the subject residence, worker protection protocols apply: • White paint on exterior wood siding (barn). • White paint on exterior wood trim components (barn). • White paint on exterior wood lap siding (Garage). • White paint on exterior plywood siding (Garage). • Silver paint on interior wood walls (barn). The Federal Occupational Safety & Health Administration's (OSHA) interim lead safety standard (29 CFR 1926.59) for the construction industry became effective on June 3, 1993. Lead exposure in construction is regulated in Washington State by WAC 296-155-176. These regulations protect workers disturbing building surfaces with lead containing paints. Paint with "any detectable level" of lead is classified as a lead containing paint by federal and state regulations and the applicable worker safety provisions must be implemented. WORKER EXPOSURE WAC 296-155-176, Lead (Pb), applies to all construction work where an employee may be occupationally exposed to Lead (Pb). Construction work includes activities such as demolition or salvage, removal or encapsulation, and renovation of materials that contain Lead (Pb). When an employee may be occupational exposed to Lead (Pb), the employer must perform an exposure assessment according to WAC 296-155-176. The exposure assessment consists of personal air monitoring to determine representative Lead (Pb) exposure levels for the work being performed. During the exposure assessment, the employer must provide the following: • As a minimum, a half mask air purifying respirators equipped with high efficiency particulate air (NEPA) filters in accordance with WAC 296-155-17613. • Appropriate personal protective clothing/equipment in accordance with WAC 296-155-17615. • A designated change area which allows for separate storage areas for work and street clothing to prevent cross contamination in accordance with WAC 296-155-17619(2). • Hand washing facilities to wash their hands and faces WAC 296-155-17619(5). • Biological monitoring in the form of blood survey and analysis for Lead (Pb) and zinc protoporphyrin levels in accordance with WAC 296-155-17621 (1) (a). NVL Laboratories, Inc. 4708 Aurora Ave N Seattle, WA 98103 Phone (206) 547-0100 • Fax (206) 634-1936 10 '15643 West Valley Hwy Tukwila, WA 98188 Project Number: 2016-0733 6.0 CONCLUSIONS AND RECOMMENDATIONS (continued) • Training to include hazard communication, safety, and the limitations, proper use, and maintenance of respirators in accordance with WAC 296-155-100. In addition to the protective equipment and hygiene requirements, the employer must attempt to reduce the levels of airborne Lead (Pb) through the use of engineering controls such as ventilation and wet methods. 7.0 LIMITATIONS OF SURVEY The purpose of this Good Faith Asbestos and Lead Survey report is to document asbestos -containing building materials and lead containing paint coatings discovered at the structure located at 15643 West Valley Hwy., Tukwila, WA 98188. The purpose of this inspection was to identify asbestos containing building materials and lead containing paint coatings which would be impacted by the planned demolition of the detached barn and garage. Destructive sampling methods were utilized to collect samples of suspect building materials. No soft/limited demolition was performed during this inspection. Please note that hidden materials may exist within the structure, and all suspect materials must be treated as asbestos containing until testing proves otherwise. This site visit consisted of a thorough visual walk-through of the building for the purpose of viewing and sampling potential asbestos -containing material. As hazardous material surveys are non- comprehensive by nature, NVL Laboratories, Inc. cannot be held liable for materials which require destructive means to access, materials which are hidden from sight (e.g. materials hidden behind walls), materials which cannot be found due to their obscure nature, or which otherwise cannot be discovered with reasonable diligence. This document is the sole property of NVL Laboratories and the property owner, or his agent, authorizing this survey. Inspected By David Fiala AHERA Building Inspector Certification # 156308 Expiration Date: March 30, 2017 Reviewed By Syed Hasan Manager Field Services AHERA Certification: # 153226 Expiration Date: September 30, 2016 NVL Laboratories, Inc. 4708 Aurora Ave N Seattle, WA 98103 Phone (206) 547-0100 • Fax (206) 634-1936 11 '1. ALB S Appendix A Sample Locations (Floor Plan) INktiLL. L ABS INDUSTRIAL HYGIENE SERVICES Laboratory 1 Management 1 Training • A / NVL Project # 2016-0733 Client West 77 Partners - Broc Hendershott Page of Location 15643 West Valley Hwy Date 8/22/2016 City Tukwila IS 12. 13 10 Made by David Fiala (Nor TO SCALE) 3-3 Phone: 206 547.0700 1 Fax 206 634.1936 1 Toll Free: 1,888.WILLABS (685.5227) 4708 Aurora Avenue North 1 Seattle, WA 98103-6516 IN/-1s7(b. L A 8 5 ,4$$$$ m,u,p.n nrn,n Appendix B Laboratory Analysis Results August 24, 2016 David Fiala NVL Field Services Division 4708 Aurora Ave. N. Seattle, WA 98103 RE: Bulk Asbestos Fiber Analysis; NVL Batch # 1617121.00 Client Project: 2016-0733 Location: 15643 West Valley Hwy. Tukwila, WA 98188 Dear Mr. Fiala, LABS INDUSTRIAL HYGIENE SERVICES Laboratory 1 Management 1 Training Enclosed please find test results for the 6 sample(s) submitted to our laboratory for analysis on 8/22/2016. Examination of these samples was conducted for the presence of identifiable asbestos fibers using polarized light microscopy (PLM) with dispersion staining in accordance with both EPA 600/M4-82-020, Interim Method for the Determination of Asbestos in Bulk Insulation Samples and EPA 600/R-93/116 Method for the Determination of Asbestos in Bulk Building Materials. For samples containing more than one separable layer of materials, the report will include findings for each layer (labeled Layer 1 and Layer 2, etc. for each individual layer). The asbestos concentration in the sample is determined by calibrated visual estimation. For those samples with asbestos concentrations between 1 and 10 percent based on visual estimation, the EPA recommends a procedure known as point counting (NESHAPS, 40 CFR Part 61). Point counting is a statistically more accurate means of quantification for samples with low concentrations of asbestos. The detection limit for the calibrated visual estimation is <1%, 400 point counts is 0.25% and 1000 point counts is 0.1% Samples are archived for two weeks following analysis. Samples that are not retrieved by the client are discarded after two weeks. Thank you for using our laboratory services. Please do not hesitate to call if there is anything further we can assist you with. Sincerely, Nick Ly, Technical Director 1.888.NVL.LABS 1.888.(685.5227) www.nvllabs.com Enc.: Sample Results Lab Code: 102063-0 page 1 of 5 NVL Laboratories, Inc. 4708 Aurora Ave N, Seattle, WA 98103 p 206.547.0100 I f 206.634.1936 NVL Laboratories, Inc. 4708 Aurora Ave N, Seattle, WA 98103 p 206547.0100 1 1206,634.1936 1 www,nvllabs.com Bulk Asbestos Fibers Analysis LABS114.4"°'\*;lb, By Polarized Light Microscopy Client: NVL Field Services Division Address: 4708 Aurora Ave. N. Seattle, WA 98103 Attention: Mr. David Fiala Project Location: 15643 West Valley Hwy. Tukwila, WA 98188 Batch #: 1617121.00 Client Project #: 2016-0733 Date Received: 8/22/2016 Samples Received: 6 Samples Analyzed: 6 Method: EPA/600/R-93/116 & EPA/600/M4-82-020 Lab ID: 16256887 Client Sample #: 2016-0733-3-1 Location: 15643 West Valley Hwy. Tukwila, WA 98188 Layer 1 of 1 Description: Brown compressed fibrous material Non -Fibrous Materials: Fine particles, Adhesive/Binder Other Fibrous Materials:% Cellulose 98% Asbestos Type: % None Detected ND Lab ID: 16256888 Client Sample #: 2016-0733-3-2 Location: 15643 West Valley Hwy. Tukwila, WA 98188 Layer 1 of 1 Description: White chalky material with paper and paint Non -Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Fine particles, Gypsum/Binder, Paint Cellulose 25% None Detected ND Lab ID: 16256889 Client Sample #: 2016-0733-3-3 Location: 15643 West Valley Hwy. Tukwila, WA 98188 Comments: Unable to analyze silver paint as a separate layer Layer 1 of 1 Description: Off-white /beige putty material with white paint and trace silver paint Non -Fibrous Materials: Calcareous particles, Binder/Filler, Paint Metallic paint Other Fibrous Materials:% None Detected ND Asbestos Type: % Chrysotile 2% Lab ID: 16256890 Client Sample #: 2016-0733-3-4 Location: 15643 West Valley Hwy. Tukwila, WA 98188 Layer 1 of 3 Description: Black asphaltic mastic Non -Fibrous Materials: Asphalt/Binder, Mastic/Binder Other Fibrous Materials:% Cellulose 7% Glass fibers 4% Asbestos Type: % None Detected ND Sampled by: Client Analyzed by: Nadezhda Prysyazhnyuk Date: 08/24/2016 Reviewed by: Nick Ly Date: 08/24/2016 Nick Ly, Technical Director Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA 600/R-93/116 and 600/M4-82-020 Methods with the following measurement uncertainties for the reported % Asbestos (1%=0-3%, 5%=1-9%, 10%=5-15%, 20%=10-30%, 50%=40-60%). This report relates only to the items tested. If sample was not collected by NVL personnel, then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories, Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government page 2 of 5 NVL Laboratories, Inc. 4708 Aurora Ave N, Seattle, WA 98103 p 206.547.0100 1 f 206.634.1936 1 www.nvllabs.com Bulk Asbestos Fibers Analysis By Polarized Light Microscopy Client: NVL Field Services Division Address: 4708 Aurora Ave. N. Seattle, WA 98103 Attention: Mr. David Fiala Project Location: 15643 West Valley Hwy. Tukwila, WA 98188 Batch #: 1617121.00 Client Project #: 2016-0733 Date Received: 8/22/2016 Samples Received: 6 Samples Analyzed: 6 Method: EPA/600/R-93/116 & EPA/600/M4-82-020 Layer 2 of 3 Description: Black asphaltic fibrous material with granules Layer 3 of 3 Non -Fibrous Materials: Asphalt/Binder, Granules, Mineral grains Description: Black asphaltic mastic (on wood) Non -Fibrous Materials: Asphalt/Binder, Mastic/Binder Other Fibrous Materials:% Glass fibers 40% Other Fibrous Materials:% Cellulose 8% Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Lab ID: 16256891 Client Sample #: 2016-0733-3-5 Location: 15643 West Valley Hwy. Tukwila, WA 98188 Layer 1 of 2 Layer 2 of 2 Description: Black asphaltic mastic Non -Fibrous Materials: Other Fibrous Materials:% Asphalt/Binder, Mastic/Binder Cellulose 6% Description: Black asphaltic fibrous material with granules Non -Fibrous Materials: Other Fibrous Materials:% Asphalt/Binder, Granules Glass fibers 37% Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Lab ID: 16256892 Client Sample #: 2016-0733-3-6 Location: 15643 West Valley Hwy. Tukwila, WA 98188 Layer 1 of 3 Description: Black asphaltic mastic Non -Fibrous Materials: Asphalt/Binder, Mastic/Binder Other Fibrous Materials:% None Detected ND Layer 2 of 3 Description: Black asphaltic fibrous material with granules Non -Fibrous Materials: Other Fibrous Materials:% Asphalt/Binder, Granules Layer 3 of 3 Description: Black asphaltic fibrous felt Non -Fibrous Materials: Asphalt/Binder Cellulose 55% Other Fibrous Materials:% Cellulose 70% Asbestos Type: % Chrysotile 5% Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Sampled by: Client Analyzed by: Nadezhda Prysyazhnyuk Date:08/24/2016 Reviewed by: Nick Ly Date: 08/24/2016 Nick Ly, Technical Director Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA 600/R-93/116 and 600/M4-82-020 Methods with the following measurement uncertainties for the reported % Asbestos (1%4-3%, 5%=1-9%, 10%=5-15%, 20%=10-30%, 50%=40-60%). This report relates only to the items tested. If sample was not collected by NVL personnel, then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except In full, without written approval of NVL Laboratories, Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government page 3 of 5 NVL Laboratories, Inc. 4708 Aurora Ave N, Seattle, WA 98103 p 206.547.0100 I f 206.634.1936 I www.nvllabs.com ASBESTOS LABORATORY SERVICES Company NVL Field Services Division Address 4708 Aurora Ave. N. Seattle, WA_981.03 Project Manager Mr. David Fiala Phone (206) 547-0100 Cell (425) 213-6779 Project Name/Number: 2016-0733 LABS NVL Batch Number TAT 2 Days Rush TAT Due Date 8/24/2016 Time 1:00 PM Email David.f@nvllabs.com Fax (206) 634-1936 1617121.00 AH _No Project Location: 15643 West Valley Hwy. Tukwila, WA 9818.8. Subcategory PLM Bulk Item Code ASB -02 . EPA 6001R-93-116. Asbestos by ELM .<...bulk> _ Total Number of Samples.,_.,-. Lab ID Sample ID Description Rush Samples A/R 1 16256887 2016-0733-3-1 NVL A 2 16256888 2016-0733-3-2 A 3 16256889 2016-0733-3-3 A 4 16256890 2016-0733-3-4 Faxed ❑ Emailed A 5 16256891 2016-0733-3-5 A 6 16256892 2016-0733-3-6 A Print Name Signature Com an Date Time Sampled by Client NVL Relinquished by Client Analyzed by Office Use Onl Print Name Signature Company Date Time Received by Shaista Khan NVL 8/22/16 1300 Analyzed by Nadezhda NVL 8/24/16 Results Called by Faxed ❑ Emailed Special Instructions: Date: 8/22/2016 Time: 1:44 PM Entered By: Shaista Khan page 4 of 5 NVL Laboratories, Inc, 4708 Aurora Ave N, Seattle, WA 98103 p 206.547.0100 1 f 206.634.1936 1 www,nvllabs.com Client NVL Laboratories Inc CHAIN of CUSTODY 1617121 SAMPLE LOG Street 4708 Aurora Ave N Seattle, WA 98103 Protect Manager Syed Hasan Project Location 15643 West Valley Hwy Tukwila, WA 98188 Phone: (425) 974-7080 Fax: (425) 467-1073 A g s NVL Batch Number Client Job Number 2016-0733 6 Total Samples Turn Around Time 0 1 Hr ❑ 6 firs ❑ 2 Hrs ❑ 1 Day ❑ 4 Hrs ,Days ❑ 3 Days ❑ 10 Days El 4 Days ❑ 5 Days Please call for TAT less than 24 Hrs Email address broc@west77partners,com Cell (206) 947-8067 ❑ Asbestos Alr '', - bestos Bulk 0 PCM (NIOSH jp%* LM (EPA/600/R-93111 7400) ❑ TEM (NIOSH 7402) 0 TEM (AHERA) 0 TEM (EPA Level 11) 0 Other BULK 6) 0 PLM (EPA Point Count) ❑ PLM (EPA Gravlmetry) 0 TEM ❑ Mold/Fungus 711S.44 n Mold Air ❑ Mold Bulk ❑ Rotometer Calibration OM METALS Det. Limit Matrix ❑ Air Filter ❑ Soil 0 Drinking water ❑ Paint Chips in % ❑ Dust/wipe (Area) ❑ Paint Chips in crr RCRA Metals All 8 0 Arsenic (As) ❑ Chromium (Cr 0 Barium (Ba) ❑ Lead (Pb) 1-1Cadmium(Cd) ❑ Mercury (Hg) . Other Metals ❑ All 3 1.:1 Copper (Cu) NI Total Total Metals • FAA • TCLP ❑ ICP (ppm) ❑ GFAA (ppb) ❑ Cr 6 • Nickel (Ni) ■ Zinc (Zn) ❑Other Types of Ana sis 0 Fiberglass n Silira 0 Nuisance Dust ❑ Other (Specify) n RRsnir hlR must Condition of Package: 0 Good 0 Damaged (no spillage) ❑ Severe damage (spillage) Seq. # 1 2 3 Lab ID Client Sample Number of -1 Comments A/R 5 6 7 3 3 -b 9 10 11 12 13 14 15 Sampled by � vt C �� VL_ (�%-, /47' &O 1,0- 812 -ib Z2-16 4 i, . Woo ;tic _1..30 Relinquished by 4,V i 9 . f ! r -:..: i".-''�� i 0 .e' % � Received by Anzed by Results Called by Results Faxed by Special Instructions: Unless requested in writing, all samples will be disposed of two (2) weeks after analysis. Results report to,'"'� `/y''� page5of5 1.888.NVL.LABS 1.888.(685.5227) www.nvllabs.com August 24, 2016 David Fiala NVL Field Services Division 4708 Aurora Ave. N. Seattle, WA 98103 RE: Metals Analysis; NVL Batch # 1617122.00 Dear Mr. Fiala, INVIUT. LABS INDUSTRIAL HYGIENE SERVICES Laboratory 1 Management 1 Training Enclosed please find the test results for samples submitted to our laboratory for analysis. Preparation of these samples was conducted following protocol outlined in EPA Method SW 846 -3051 unless stated otherwise. Analysis of these samples was performed using analytical instruments in accordance with U.S. EPA, NIOSH, OSHA and other ASTM methods. For matrix materials submitted as paint, dust wipe, soil or TCLP samples, analysis for the presence of total metals is conducted using published U.S. EPA Methods. Paint and soil results are usually expressed in mg/Kg which is equivalent to parts per million (ppm). Lead (Pb) in paint is usually expressed in mg/Kg (ppm) , Percent (%) or mg/cm2 by area. Dust wipe sample results are usually expressed in ug/wipe and ug/ft2. TCLP samples are reported in mg/L (ppm). For air filter samples, analyses are conducted using NIOSH and OSHA Methods. Results are expressed in ug/filter and ug/m3. Other matrix materials are analyzed accordingly using published methods or specified by client. The reported test results pertain only to items tested and are not blank corrected. For recent regulation updates pertaining to current regulatory levels or permissible exposure levels, please call your local regulatory agencies for more details. This report is considered highly confidential and will not be released without your approval. Samples are archived for two weeks following analysis. Samples that are not retrieved by the client are discarded after two weeks. Thank you for using our laboratory services. if you need further assistance please feel free to call us at 206-547-0100 or 1-888-NVLLABS. Sincerely, Nick Ly, Technical Director ..1.41k1V)IsAgfiZ)Nqq. page 1 of 4 NVL Laboratories, Inc. 4708 Aurora Ave N, Seattle, WA 98103 p 206.547.0100 I f 206.634.1936 NVL Laboratories, Inc. 4708 Aurora Ave N, Seattle, WA 98103 p 206.547.0100 I f 206.634.1936 1 www.nvllabs.com Client: NVL Field Services Division Address: 4708 Aurora Ave. N. Seattle, WA 98103 Analysis Report Total Lead (Pb) Attention: Mr. David Fiala Project Location: 15643 West Valley Hwy Tukwila, WA 98188 Lab ID Client Sample # Sample RL in Weight (g) mg/Kg INV. ABSL Batch #: 1617122.00 Matrix: Paint Method: EPA 3051/7000B Client Project #: 2016-0733 Date Received: 8/22/2016 Samples Received: 5 Samples Analyzed: 5 Results Results in in mg/Kg percent 16256893 2016 -0733 -Pb -1 0.1936 50.0 520.0 0.0520 16256894 2016 -0733 -Pb -2 0.1883 52.0 680.0 0.0680 16256895 2016 -0733 -Pb -3 0.1842 53.0 190000.0 19.0000 16256896 2016 -0733 -Pb -4 0.2008 49.0 100.0 0.0100 16266897 2016 -0733 -Pb -5 0.2042 48.0 300.0 0.0300 Sampled by: Client Analyzed by: Yasuyuki Hida Reviewed by: Nick Ly Date Analyzed: 08/23/2016 Date Issued: 08/24/2016 Nick Ly, Technical Director mg/ Kg =Milligrams per kilogram Percent = Milligrams per kilogram / 10000 Note : Method QC results are acceptable unless stated otherwise. Unless otherwise indicated, the condition of all samples was acceptable Bench Run No: 2016-0823-9 page 2 of 4 RL = Reporting Limit <1 = Below the reporting Limit at time of receipt. • NVL Laboratories, Inc. 4708 Aurora Ave N, Seattle, WA 98103 p 206.547.0100 1 f 206.634.1936 I www.nvllabs,com LEAD LABORATORY SERVICES Company NVL Field Services Division Address 470.8 Aurora Ave. N. Seattle, WA 98103 Project Manager Mr. David Fiala Phone (206) 547-0100 Cell (425) 213-6779 Project Name/Number:2016-0733 Subcategory Flame AA (FAA) Item Code FAA -02 _.. NVL Batch Number TAT 2 Days Rush TAT Due Date 8/24/2016 Time 1:00 PM Email David.f@nvllabs.com Fax (206) 634-1936 1617122.00 1 IL L A AK No Project Location: 15643 West Valley Hwy Tukwila, WA 98188 EPA 70.008 Lead by FAA .<..paint>_ .. Total Number of Samples Lab ID Sample ID Description 3 16256893 16256894 16256895 2016 -0733 -Pb -1 2016 -0733 -Pb -2 2016 -0733 -Pb -3 5 16256896 2016 -0733 -Pb -4 16256897 2016 -0733 -Pb -5 Print Name Signature Sampled by Relinquished by Office Use Only Received by Client Client Print Name Analyzed by Results Called by D Faxed D Emailed Special Instructions: Justin Shearer Yasuyuki Hide Rush Samples AIR Signature Company Date Time Company NVL Date: 8/22/2016 Time: 1:54 PM Entered By: Justin Shearer page 3 of 4 Date Time 8/22/16 8/23/16 NVL Laboratories, Inc. 4708 Aurora Ave N, Seattle, WA 98103 p 206.547.0100 I f 206.634.1936 I www,nvllabs.com Client NVL Laboratories Inc Street Project Manager Protect Location CHAIN of CUSTODY 1617122 Ic SAMPLE LOG 4708 Aurora Ave N Seattle, WA 98103 Syed Hasan 15643 West Valley Hwy Tukwila, WA 98188 NVL Batch Number Client Job Number Total Samples 8 2016-0733. 5 Turn Around Time 0 1 Hr ❑ 6 Hrs ❑ 2 Hrs ❑ 1 Day ❑ 4 Hrs JO Days ❑ 3 Days ❑ 4 Days 0 5 Days 0 10 Days Please call for TAT less than 24 Hrs Email address broctgwest77Dartners.com Phone: (425) 974-7080 Fax: (425) 467-1073 Cell (206) 947-8067 0 Asbestos Air 0 PCM (NIOSH 7400) 0 TEM (NIOSH 7402) CI TEM (AHERA) 0 TEM (EPA Level 11) Q Other (] PLM (EPA/600/R-93/116) © PLM (EPA Point Count) ❑ PLM (EPA Gravimetry) ❑ TEM BULK ❑ Mold Air ❑ Mold Bulk ❑ Rotometer Calibration ETALS otal Metals D TCLP Cr6 Det. Limit AA (PPM) ICP (ppm) El GFAA (ppb) ❑Other Types of Anal sis Matrix ❑ Air Filter ❑ Soil 0 Drinking water cepPaint Chips In % Dust/wipe (Area) 0 Paint Chips in crr 0 Fiberglass [_ I Nuisance Dust 0 Other (Specify) I—I Riling n Racttirsthlr f1IICt RCRA Metals QAII 8 0 Arsenic (As) Chromium (Cr 0 Barium (Ba) ead (Pb) LJ Cadmium (Cd) 0 Mercury (Hg) Condition of Package: ❑ Good ❑ Damaged (no spillage) 0 Severe damage (spillage) Other Metals All 3 0 Copper (Cu) ❑ Nickel (Ni) 0 Zinc (Zn) Se # 1 2 4 Lab ID Client Sam •le Number Comments 6 " {2137 AIR 8 9 10 11 12 13 14 15 Sampled by tfrinL.atwow Id 1' (� F � alUurautuWr..ry+sa „..41, a S/ V � V L .,....�,y_1 -16 ti �� I , -.71-1 j ., 00 12120 _LW& j T _ Relinquished by ..�-�- :►"�.�:"vi-� / 4 Received by Anajyzed .b Results Called b Results Faxed by _ Special Instructions: Unless requested in writins, all samples will be disposed of two (2) weeks after analysis. Results report to n I f , page 4 of 4 q 'N`. L A ,B S &&&&&&& 011111111 II MI i 1 Appendix C AHERA Certification & Laboratory Qualifications A • 1111trr��I 4▪ .1 AIHA Accreditation ms,t4:C,; hate+ AIHA Laboratory Accreditation Programs, LLC acknowledges that NVL Laboratories, Inc. 4708 Aurora Avenue N., Seattle, WA 98103 Laboratory ID: 101861 along with all premises from which key activities are performed, as listed above, has fulfilled the requirements of the ATMA Laboratory Accreditation Programs (AIHA-LAP), LLC accreditation to the ISO/MC 17025:2005 international standard, General Requirements for the Competence of Testing and Calibration Laboratories in the following: LABORATORY ACCREDITATION PROGRAMS 1 INDUSTRIAL HYGIENE ✓ ENVIRONMENTAL LEAD ✓ ENVIRONMENTAL MICROBIOLOGY 0 FOOD ✓ UNIQUE SCOPES Accreditation Expires: 05/01/2017 Accreditation Expires: 05/01/2017 Accreditation Expires: 05/01/2017 Accreditation Expires: Accreditation Expires: 05/01/2017 Specific Field(s) of Testing (FoT)/Method(s) within each Accreditation Program for which the above named laboratory maintains accreditation is outlined on the attached Scope of Accreditation. Continued accreditation is contingent upon successful on-going compliance with 1SO/IEC 17025:2005 and AIHA-LAP, LLC requirements. This certificate is not valid without the attached Scope of Accreditation. Please review the AIHA- LAP, LLC website (www.aihaacereditedlabs.or) for the most current Scope. Gerald &knit,. Cif! Chairperson, Analytical Accreditation Board Revision 14: 03/26/2014 crokaz„. Cheryl Q. Morton Managing Director, .41Nd Laboratory Accreditation Programs, LLC Date Issued: 04/30/2015 • • • 1 .., co id o o- (.96 3 kri .9 CN CD Ns ° ' v— •O - . '' g 0 0 4) 4 4 0 4) C) 0 %al ID .2 L. 54) k#2 . E.c .,z ..,... (1).- 0) 'e• , L• .'.1* t. 0 CU LIZI P'; IA 8 't A . cg 0• • rj) .o 0 g § 06 • ....1.. ,e 2. cA. 4 . , w v) c:). +4. z: (1) ea ,.... %,.. g • 8 A 4 >. .e co o E Zu ...'.a.).4' o '8 A z ..= QS g t Z CD 0 ott) CD E G (t) E & .0. - 2 1:▪ 1 co 4) e (13 8 0 co El.? (0 g ' . g a National Voluntary Laboratory Accreditation Program �ge S O''Arle 0 SCOPE OF ACCREDITATION TO ISO/IEC 17925:2005. NVL Laboratories, Inc, 4708 Aurora Avrsnue N, Seattle, WA 98103 Mr. Nghiep Vi Ly 1thone; 206.547.'0100 Tnx:.206-634-1936 tltnil; niold (! nv11nbS,CUII] http://www,nvllnbL.com ASBESTOS FIBER ANALYSIS NVLAP LAB CODE 1020634 I311lk Asbestos Analysis l /�1U1 81'A 600/M4.82.020: interim Method for the 'Determination of Asbestos in Bull; Insolation Samples 1 ii//t03 IPA 600/lk-93/116: Method for the Determination of Asbestos in l3u1k "Building Materials For the Nat o! y VolittttJ( , /fwtivu 2015-09.25 through 201649-30 �irvr'ol ••� oatbdltitkin.Program Page 1 of 1 STATE OF WASHINGTON Department of Commerce Lead -Based Paint Program Has fulfilled the certification requirements of Washington Administrative code (WAC) 365-230 and has been certified to conduct lead-based paint activities pursuant to WAC 365-230-200 as a: Y 4/3/2017 City of Tukwila Department of Community Development NICK BLAYDEN 10620 NE 9TH PL BELLEVUE, WA 98004 RE: Permit No. D16-0221 WOODSPRING SUITES TUKWILA 15643 W VALLEY HWY Dear Permit Holder: Allan Ekberg, Mayor Jack Pace, Director In reviewing our current records, the above noted permit has not received a final inspection by the City of Tukwila Building Division. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and/or the National Electric Code, every permit issued by the Building Division under the provisions of these codes shall expire by limitation and become null and void if the building or work authorized by such permit has not begun within 180 days from the issuance date of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work has begun for a period of 180 days. Your permit will expire on 5/2/2017. Based on the above, you are hereby advised to: 1) Call the City of Tukwila Inspection Request Line at 206-438-9350 to schedule for the next or final inspection. Each inspection creates a new 180 day period, provided the inspection shows progress. -or- 2) Submit a written request for permit extension to the Permit Center at least seven(7) days before it is due to expire. Address your extension request to the Building Official and state your reason(s) for the need to extend your permit. The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is determined that your extension request is granted, you will be notified by mail. In the event you do not call for an inspection and/or receive an extension prior to 5/2/2017, your permit will become null and void and any further work on the project will require a new permit and associated fees. Thank you for your cooperation in this matter. Sincerely, Rachelle • ipley Permit Technician File No: D16-0221 6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431=3670 • Fax 206-431-3665 City of Tukwila Department of Community Development September 28, 2016 BROC HENDERSHOTT 10620 NE 9TH PL BELLEVUE, WA 98004 RE: Correction Letter # 1 DEVELOPMENT Permit Application Number D16-0221 WOODSPRING SUITES - 15643 W VALLEY HWY Dear BROC HENDERSHOTT, Allan Ekberg, Mayor Jack Pace, Director This letter is to inform you of corrections that must be addressed before your development permit can be approved. All correction requests from each department must be addressed at the same time and reflected on your drawings. I have enclosed comments from the following departments: BUILDING DEPARTMENT: KC ELLIS at if you have questions regarding these comments. • Provide a copy of the asbestos survey. Please address the comments above in an itemized format with applicable revised plans, specifications, and/or other documentation. The City requires that two (2) sets of revised plan pages, specifications and/or other documentation be resubmitted with the appropriate revision block. In order to better expedite your resubmittal, a 'Revision Submittal Sheet' must accompany every resubmittal. I have enclosed one for your convenience. Corrections/revisions must be made in person and will not be accepted through the mail or by a messenger service. If you have any questions, I can be reached at (206)433-7165. Sincerely, Rachelle Ripley Permit Technician File No. D16-0221 6300 Southcenter Boulevard Suite #100 • Tukwila Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 ?ERMIT COORD COPY . PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: D16-0221 DATE: 10/18/16 PROJECT NAME: WOODSPRING SUITES SITE ADDRESS: 15643 W VALLEY HWY Original Plan Submittal Revision # before Permit Issued X Response to Correction Letter # 1 Revision # after Permit Issued DEPARTMENTS: 10 WO it\21 Building Division 8111 Public Works n Fire Prevention Structural Planning Division ❑ Permit Coordinator PRELIMINARY REVIEW: Not Applicable n (no approval/review required) REVIEWER'S INITIALS: DATE: 10/20/16 Structural Review Required DATE: APPROVALS OR CORRECTIONS: DUE DATE: 11/17/16 Approved Corrections Required ❑ Approved with Conditions ❑ Denied (corrections entered in Reviews) (ie: Zoning Issues) Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg 0 Fire ❑ Ping ❑ PW ❑ Staff Initials: 12/18/2013 ?ERMIT COORD COPY PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: D16-0221 DATE: 08/05/16 PROJECT NAME: WOODSPRING SUITES SITE ADDRESS: 15643 W VALLEY HWY X Original Plan Submittal Revision # before Permit Issued Response to Correction Letter # Revision # after Permit Issued DEPARTMENTS: Building Division DR'M Ain/6 $.10. 1(9 Public Works El AM Alk, t.4I( Fire PreventionTil Structural Planning Division ❑ Permit Coordinator ❑ PRELIMINARY REVIEW: Not Applicable ❑ (no approval/review required) DATE: 08/09/16 Structural Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved Corrections Required ❑ Approved with Conditions ❑ Denied (corrections entered in. Reviews) (ie: Zoning Issues) Notation: DUE DATE: 09/06/16 REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg Fire ❑ Ping ❑ PW ❑ Staff Initials: Wa 12/18/2013 City of Tukwila REVISION SUBMITTAL Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206-431-3670 Web site: htto://www.TukwilaWA.gov Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Date: I0/12/ 2016 Plan Check/Permit Number: D16-0221 RECEIVED ❑ Response to Incomplete Letter # CITY OF TUKWILA ® Response to Correction Letter # 1 OCT 1 2 2016 ❑ Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner PERMIT CENTER ❑ Deferred Submittal # Project Name: WOODSPRINGS SUITES__ Project Address: 15643 W VALLEY HWY Contact Person: cyo(\ Sc 10\e Phone Number: WS) `18" - o'iM2 Summary mary of Revision: P1S\0es"ko5 StAtvey �uc Qeow Qee.1i o.S Cectue$te‘• Sheet Number(s): "Cloud" or highlight all areas of revision including date o V/' Received at the City of Tukwila Permit Center by: O Entered in TRAKiT on C:\Users\Rachelle-R\L csktop\Revision Submittal Fo m.doc Revised: August 2015 relvi'si`on W WASATCH DC BUILDERS NW LIQ A Washington State Department of Labor & Industries Page 1 of 2 Hot Espanol Contact Search L&I Safety & Health Claims & Insurance A -Z Index Help My L&:I Workplace Rights Trades & Licensing WASATCH DC BUILDERS NW LLC Owner or tradesperson Principals Nielson, Michael James, MANAGER West77 Partners LLC, MANAGER Doing business as WASATCH DC BUILDERS NW LLC WA UBI No. 603 591 156 10620 NE 9th PI BELLEVUE, WA 98004 425-974-7071 KING County Business type Limited Liability Company Governing persons LLC WEST77 PARTNERS MICHAEL NIELSON; License 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. WASATOB846OR Effective — expiration 09/19/2016— 09/19/2018 Bond ................. Western Surety Co Bond account no. 62697583 $12,000.00 Received by L&I Effective date 09/19/2016 09/15/2016 Expiration date Until Canceled Insurance ...._..._.... _..... _ _... Ironshore Specialty Ins Co $1,000,000.00 Policy no. AGS0100700 Received by L&I Effective date 10/13/2016 10/12/2016 Expiration date 10/12/2017 Insurance history Savings No savings accounts during the previous 6 year period. Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=603591156&LIC=WASATDB846OR&SAW= 11/03/2016 HOCK 1TOP1281502 SURVEY DATA EXISTING BOUNDARY, TOPOGRAPHIC, AND PLANIMETRIC INFORMATION SHOWN ON THIS PLAN AND OTHERS IN THIS SET WERE USED AS A BASIS FOR DESIGN AND REPRESENT FIELD SURVEY DATA AND MAPPING PREPARED BY TRIAD ASSOCIATES (JOB NO. 14-184), AS PROVIDED BY THE PROJECT OWNER, AND DOES NOT REPRESENT WORK BY CPH CONSULTANTS. THE FOLLOWING SURVEY DATA WAS PROVIDED WITH THE TOPOGRAPHIC MAP BY TRIAD ASSOCIATES: PARCEL DESCRIPTION ALL THAT PORTION OF THE FOLLOWING DESCRIBED PARCEL "B" , LYING WEST OF A LINE ( "DIVISION LINE") DESCRIBED AS FOLLOWS; BEGINNING AT A POINT ALONG THE SOUTH LINE MEASURED 170.07 FEET FROM THE SOUTHEAST CORNER OF SAID PARCEL . THENCE NORTH A DISTANCE OF 226.13 FEET, MORE OR LESS TO A POINT ON THE NORTH LINE MEASURED 140.22 FEET FROM THE NORTHEAST CORNER OF SAID PARCEL 13", AND THE TERMINUS OF SAID DESCRIBED LINE. PARCEL "8" THAT PORTION OF THE HENRY MEADER DONATION CLAIM NO 46 IN SECTION 24, TOWNSHIP 23 NORTH, RANGE 4 EAST, W.M., BEGINNING AT THE INTERSECTION OF THE MONUMENTED LINE OF STATE ROAD 181 (ALSO KNOWN AS WEST VALLEY HIGHWAY) BEING 72 FEET WESTERLY, MEASURED AT RIGHT ANGLES TO THE EASTERLY MARGIN OF SAID STATE ROAD RIGHT -OF -WAY, WI77-I THE MO9NUMENTED LINE OF SUCH 15817-i STREET. BEING 28 FEET SOUTH, MEASURED AT RIGHT ANGLES TO THE NORTHERLY RIGHT-OF-WAY LINE OF SAID SOUTH 158TH STREET, THENCE NORTHERLY ALONG THE MONUMENTED LINE OF SAID STATE HIGHWAY 181, 32.17 FEET, THENCE SOUTH 86'04'17" WEST, 60.13 FEET TO THE WEST MARGIN OF THE STATE HIGHWAY 181 RIGHT-OF-WAY, WHICH IS THE POINT OF BEGINNING, THENCE SOUTH 8604'17" WEST, 220 FEET, THENCE SOUTH 8604'17" WEST APPROXIMATELY 458 FEET TO THE EAST BANK OF THE GREEN RIVER. THENCE NORTHERLY ALONG THE EAST BANK TO A POINT THAT BEARS SOUTH 852100" WEST FROM A POINT ON THE MONUMENTED LINE OF THE SAID STATE HIGHWAY 181 7 -IAT IS 261.51 FEET NORTH FROM THE INTERSECTION OF THE MONUMENTED LINES OF STAT HIGHWAY 181 AND *(SUCH] 1587H STREET, WHICH INTERSECTION IS MENTIONED IN INE PARAGRAPH ABOVE, THENCE NORTH 852100" EAST TO 17 -IE WESTERLY MARGIN OF STATE HIGHWAY 181 RIGHT-OF-WAY WHICH IS 78 FEET WEST OF THE MONUMENTED LINE OF STATE HIGHWAY 181, THENCE SOUTHERLY ALONG THE WEST MARGIN OF ME RIGHT-OF-WAY, APPROXIMATELY 233 FEET TO THE POINT OF BEGINNING. EXCEPT THAT PORTION ADJOINING THE GREEN RIVER, CONDEMNED BY STATE OF WASHINGTON IN KING COUNTY SUPERIOR COURT CAUSE NO. 592029, TOGETHER WITH A STRIP OF LAND 10 FEET IN WIDTH LYING SOUTHERLY AND SOUTHEASTERLY OF AND IMMEDIATELY ADJOINING THE *(ACCESS AND UTILITIES EASEMENT] FIRST ABOVE DESCRIBED; SITUATE IN THE CITY OF TUKWILA, COUNTY OF KING, STATE OF WASHINGTON, TOGETHER WITH AN EASEMENT FOR ACCESS. AND UTILITIES PURPOSES OVER THE SOUTHERLY 36.30 FEET OF THAT PORTION OF PARCEL "B" LYING EAST OF THE DIVISION LINE DESCRIBED ABOVE. *NOTE: CONTAINS SCRIVENER ERROR *(SUCH] SHOULD READ "SOUTH" *(ACCESS AND UTILITIES EASEMENT] SHOULD READ "EXCEPTED PORTION" BASIS OF BEARING HELD A BEARING OF NORTH 07'43'01" WEST ALONG MONUMENT CENTERLINE OF WEST VALLEY HIGHWAY FROM THE FOUND MONUMENT IN CASE AT ENGINEERING STATION 156+15.10 TO THE FOUND SURFACE MONUMENT AT THE INTERSECTION WITH SOUTH 158TH STREET. HORIZONTAL DATUM NAD 83/2011 WA STATE PLANE NORTH VERTICAL DATUM NA VD 88 BENCHMARKS ORIGINAL BENCHMARK: TOP OF 3" USGS BRASS DISK MONUMENT STAMPED 1)408" SET VERTICALLY ON THE SOUTHERLY FACE OF THE 5TH SUPPORT COLUMN (FOR 1-405 OVERPASS) NORTH OF THE SOUTHERLY MOST SUPPORT COLUMN ALONG THE CENTERLINE OF THE WEST VALLEY HIGHWAY. (NOT SHOWN HEREON) ELEV. = 33.19 TBM "A" SET CHISELED 7" ON THE NORTHEAST BASE BOLT OF A TRAFFIC SIGNAL POLE IN 77IE SOUTHWEST QUADRANT FOR THE INTERSECTION OF WEST VALLEY HIGHWAY AND SOUTH 158TH STREET (LONGACRES WAY) ELEV. = 29.60' TBM 'B" SET CHISELED SQUARE ON THE TOP NORTHWESTERLY CORNER ON THE NORTH END OF THE MOST WESTERLY PARKING ISLAND IN BEST WESTERN PARKING LOT SOUTH OF SITE ELEV. = 25.49' 5 OHWM ZONING TUC ti WF +4 100 -YR FEMA FLOODPLAI APPROX. ELEV. =22.6 (ZN: A l WF - FOUND 4" CONC. MON. MA "R/W) ON SIDE 7.6 ABOVE GRADE. USED TOP CENTER MON. (12/5/14 PTCI. OF SW 1/4 SEC 24, TWP 23N, R4E W.M. 100 -YR FEMA FLOODPLAIN APPROX. Ej.EV. =18.0 (ZONE o i QQ OGP Q = ZONING WC FOUND 1/2" 014,- REBAR 4REBAR 0.8' N. OF I( (12/10/14) 8"DEC 10"C 6"C\ w RECORD OF SURVEY VOL. 33 PG. 296 -�ANI -0005-807775-w SSMr --i SS 9158 12"DEC FH # HEDGE 12"DEC II Imo._ 12"DEC -12"DEC 12"DEC • u 12"DEC�' LS EXTRUDEDj 85 SDCO � , •r �2.DE �.-- „``` i�r �j91�.d;�� I =c� �� H WFN C SS TAL 4"C l W LINE HENRY MEADER DLC NO 46 LINE ESTABLItHED FROM STATE OF WASHINGTON PLAT F RIGHT OF WAY FOR STA TE IGHWAY NO. 1 GREEN RIVER NTERCHANGE URBA/V \2S w SS w SS SS w N8519'2� N85'19'29"E 140.22' 1 CI CP SSMH #7252 - "E 78.11' S. END 4' CLFNC AT N. END 4' I BFNC / HOUSE -co\j"o t'Ltt" N (i) 78' w WV-.� / co GATE z m. rn i c w 0 EJB / \ \ \ -26- " - 26- / \� EA VE 4r7• 10' EASEMENT REC. Na 6551841 ` uRTSD/Cn0 / O/ ^.y bj • 26.5 / GATE - /- BWFNC CONT. S. GENERAL NOTES 1. PRIMARY CONTROL POINTS AND ACCESSIBLE MONUMENT POSITIONS WERE FIELD MEASURED UTILIZING GLOBAL POSITIONING SYSTEM (GPS) SURVEY TECHNIQUES USING LEICA SYSTEM 500 AND 1200 EQUIPMENT. MONUMENT POSITIONS THAT WERE NOT DIRECTLY OBSERVED USING GPS SURVEY TECHNIQUES WERE TIED INTO THE CONTROL POINTS UTILIZING LEICA ELECTRONIC TOTAL STATIONS FOR THE MEASUREMENT OF BOTH ANGLES AND DISTANCES. THIS SURVEY MEETS OR EXCEEDS THE STANDARDS SET BY WAC 332-130-090. 2. THE INFORMATION DEPICTED ON THIS MAP REPRESENTS THE RESULTS OF A SURVEY MADE ON DATE INDICATED AND CAN ONLY BE CONSIDERED AS INDICATING THE GENERAL CONDITION EXISTING AT THAT TIME 3. PARCEL DESCRIPTION AND BOUNDARY ARE BASED ON EXECUTOR'S DEED RECORDED UNDER RECORDING NUMBER 20001020000740 RECORDS OF KING COUNTY, WASHINGTON 4. WETLAND FLAGS, WETLAND BUFFER, AND ORDINARY HIGH WAY WATER LINE SHOWN HEREON ARE FROM A RECORD OF SURVEY BY TRIAD ASSOCIATES RECORDED UNDER RECORDING NUMBER 20000418900004 RECORDS OF KING COUNTY, WASHINGTON. 5. SANITARY SEWER AND STORM DRAINAGE FACILITIES HAVE BEEN ASBUILT THROUGH FIELD MEASUREMENTS OF THE LOCATION OF THE ACCESS STRUCTURES, THE TOP ELEVATION OF THE STRUCTURES, AND THE INVERT ELEVATIONS OF ANY PIPES ENTERING OR LEAVING THE STRUCTURES. IT IS STANDARD PRACTICE TO SHOW THE PIPES CONNECTING THESE STRUCTURES AS STRAIGHT LINES. THIS IS ONLY AN ASSUMPTION AND THE ACTUAL LOCATION OF THE PIPING MUST BE VERIFIED IN THE FIELD BY THE CONTRACTOR PRIOR TO ANY CONSTRUCTION. 6. U11LITY LOCATIONS SHOWN ON THIS SURVEY DRAWING ARE BASED UPON FIELD LOCATION OF EXISTING UTILITY STRUCTURES, FIELD LOCATION OF CONDUCTIBLE UNDERGROUND UTILITIES BASED ON PAINT MARKS OR 077-IER MARKINGS ESTABLISHED BY A UTILITY LOCATE SERVICE AND UTILITY LOCATIONS BASED ON UTILITY MAPS PROVIDED BY PSE AND CITY OF TUKVI'LA. OTHER UNDERGROUND UTILITIES MAY EXIST. NO SUB -SURFACE EXPLORATION WAS DONE TO VERIFY UTILITY ROUTINGS THE ROUTING OF ALL BURIED UTILITIES SHOULD BE CONFIRMED WITH THE UTILITY PURVEYOR AND EXPOSED IN AREAS CRITICAL TO DESIGN. 7. RECORDS OF UNDERGROUND TELECOMMUNICATIONS/FIBER OPTIC LINES WITHIN THE ADJACENT RIGHTS OF WAY ARE NOT ALWAYS AVAILABLE OR DISCLOSED TO THE PUBLIC AND LOCAL JURISDICTIONS. ROUTING COULD NOT BE VERIFIED. REFERENCES 1. RECORD OF SURVEY VOL. 33 OF SURVEYS, PAGE 296, KING COUNTY, WASHINGTON. 2. RECORD OF SURVEY VOL. 62 OF SURVEYS, PAGE 198, KING COUNTY, WASHINGTON. 3. RECORD OF SURVEY VOL. 137 OF SURVEYS, PAGE 33, OF KING COUNTY, WASHINGTON. RECORDED UNDER RECORDING NO. 8210259006 RECORDS OF RECORDED UNDER RECORDING NO. 8809129004 RECORDS OF RECORDED UNDER RECORDING NO. 20000418900004 RECORDS S87'19'50'W 11.5 r*16 F SDMH #9232 0 #9233 FOUND 1/2" REBAR W/ CAP LS #5524 0.3' N X 0.2' E (12/17/14) S87'19'50"W 15.58' S16 34'09"E FOUND 4" X 4" CC. 0' MON. CENTER OF �5 BELOW GRADE 0.3' X 0.5' E (12/17/14) _.. ENCLOSURE.... • ..... - • •E .. TBM 13" ELEV. = 25.49 - /- - - - - - - - - - - - - - - - - - _ - - - - - - - 30' WIDEREC. NOS SEMENT 9111260669 TPN 0005800030• FOUND 1/2" REBAR W/ CAP LS #5524 0.1' N X 0.5' E (12/17/14) 20' WIDE .ACCESS REC. N0. I NT 2 EASEMENT 9111260 SPOT WESTERN 11 - =26 - / I CLFNC � NT40'8 (SSC) :7 43'Q1."E:':�� GATE 16"C 14"DEC B 6"C GATE 8"DEC 6 "DEC - 22"C 18"F TS - -- D EASEMENT••• ........ • ...... .:-.. ........................REC. N0: ODNDT/2 REBAR W/ CAP LS #5524 0.2' N X 0.1' E (12/17/14) / EXTRUDED CURB ZONING TUC us3S SF GMAGS = 877 SF 0 7151 29.58 TBM-A 8152 29.54 TBM-A ::..:: .•....X=WALK.' 2 LTJ U a FOUND PUNCH IN 2" SASS SURFACE MON STAMPED 'ILS #10671) (12/5/14) 398.69' (MEAS.) S. 158TH ST. AAPPt . GB::.*....::. L . . 0 WV-\:\ 0 cn coc N SEP R,1` T PE , iE,/iii ELEV. = 29.60' p1.. REQU D FOR: Permit No TBM A" iVicchanical zEr Electrical )3"PIurnbing ,Gas Piping City kv,r ..f of TLl.�L ! ala Cillll_F l°.' 1 Di E COPY Plan review approval is t ubject to errors and omissions. Approval of construction documents does not authorize the violation of any adopt ; d code or ordinance. Receipt of approved Field Copy a d c.nditions is acknowledged: By: Date: ///0 6 City of Tukwila BUILDING DIVISION REVIEWED FOR CODE COMPLIANCE APPROVED REVISIONS No changes shall be made to the scope of work without prior approval of Tukwila Building Division :