HomeMy WebLinkAboutPermit D16-0286 - SOHAL RESIDENCE - GARAGE DEMOLITIONSOHAL DEMO
4018 S 148 ST
EXPIRED
04/17/17
DI 6-0286
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
0040000971
4018 S 148TH ST
SOHAL DEMO
DEVELOPMENT PERMIT
Permit Number: D16-0286
Issue Date: 10/19/2016
Permit Expires On: 4/17/2017
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
License No:
Lender:
Name:
Address:
SOHAL MOHINDER SINGH
10650 SE 213TH ST, KENT, WA, 98031
MOHINDER S SOHAL
4018 S 148TH ST, TUKWILA, WA,
98168
OWNER AFFIDAVIT
Phone: (206) 841-1431
Phone:
Expiration Date:
DESCRIPTION OF WORK:
DEMO EXISTING GARAGE
Project Valuation: $1,000.00
Type of Fire Protection: Sprinklers:
Fire Alarm:
Type of Construction:
Electrical Service Provided by: TUKWILA
Fees Collected: $151.56
Occupancy per IBC:
Water District: 125
Sewer District: VALLEY VIEW
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/Stri ping:
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:
Volumes: Cut: 0 Fill: 0
Number: 0
Water Main Extension:
iziWater Meter: N
Permit Center Authorized Signature.
fr
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:
Date: ).-/ 1 a !,6
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: Work shall be installed in accordance with the approved construction documents, and any changes made
during construction that are not in accordance with the approved construction documents shall be
resubmitted for approval.
3: 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.
4: The special inspections and verifications for concrete construction shall be as required by IBC Chapter 17,
Table 1705.3.
5: The special inspections for steel elements of buildings and structures shall be required. All welding shall be
done by a Washington Association of Building Official Certified welder.
6: Installation of high-strength bolts shall be periodically inspected in accordance with AISC specifications.
7: The special inspection of bolts to be installed in concrete prior to and during placement of concrete.
8: When special inspection is required, either the owner or the registered design professional in responsible
charge, shall employ a special inspection agency and notify the Building Official of the appointment prior to
the first building inspection. The special inspector shall furnish inspection reports to the Building Official in
a timely manner.
9: A final report documenting required special inspections and correction of any discrepancies noted in the
inspections shall be submitted to the Building Official. The final inspection report shall be prepared by the
approved special inspection agency and shall be submitted to the Building Official prior to and as a
condition of final inspection approval.
10: New suspended ceiling grid and light fixture installations shall meet the seismic design requirements for
nonstructural components. ASCE 7, Chapter 13.
11: Partition walls shall not be tied to a suspended ceiling grid. All partitions greater than 6 feet in height shall
be laterially braced to the building structure. Such bracing shall be independent of any ceiling splay
bracing.
12: Readily accessible access to roof mounted equipment is required.
13: Truss shop drawings shall be provided with the shipment of trusses delivered to the job site. Truss shop
drawings shall bear the seal and signature of a Washington State Professional Engineer. Shop drawings
shall be maintained on the site and available to the building inspector for inspection purposes.
14: Insulating materials, where exposed as installed in buildings of any type of construction, shall have a flame
spread index of not more than 25 and a smoke development index of not more than 450. Where facings
are installed in concealed spaces in buildings of Type III, IV, or V construction, the flame spread and smoke-
developed limitations do not apply to facings, that are installed behind and in substantial contact with the
unexposed surface of the ceiling, wall or floor finish.
15: Subgrade preparation including drainage, excavation, compaction, and fill requirements shall conform
strictly with the recommendations given in the soils report. Special inspection is required.
16: All construction shall be done in conformance with the Washington State Building Code and the
Washington State Energy Code.
17: Structrual Observations in accordance with I.B.C. Section 1709 is required. At the conclusion of the work
included in the permit, the structural observer shall submit to the Building Official a written statement that
the site visits have been made and identify any reported deficiencies which, to the best of the structural
observer's knowledge, have not been resolved.
18: All food preparation establishments must have Seattle/King County Department of Public Health sign -off
prior to opening or doing any food processing. Arrangements for final Health Department inspection shall
be made by calling Seattle/King County Department of Public Health, (1-800-325-6165 ext 9-566), at least
three working days prior to desired inspection date. On work requiring Health Department approval, it is
the contractor's responsibility to have a set of plans approved by the agency on the job site.
19: Fire retardant treated wood shall have a flame spread of not greater than 25. All materials shall bear
identification showing the fire performance rating thereof. Such identification shall be issued by an
approved agency having a service for inspection at the factory.
20: Notify the City of Tukwila Building Division prior to placing any concrete. This procedure is in addition to
any requirements for special inspection.
21: Special inspection for sprayed fire-resistant materials applied to structural elements and decks is required.
Special inspections shall be based on the fire-resistance design as designated in the approved construction
documents.
22: All wood to remain in placed concrete shall be treated wood.
23: Masonry construction shall be special inspected.
24: All rack storage requires a separate permit issued through the City of Tukwila Permit Center. Rack storage
over 8-feet in height shall be anchored or braced to prevent overturning or displacement during seismic
events. The design and calculations for the anchorage or bracing shall be prepared by a registered
professional engineer licensed in the State of Washington. Periodic special inspection is required during
anchorage of storage racks 8 feet or greater in height.
25: There shall be no occupancy of a building until final inspection has been completed and approved by
Tukwila building inspector. No exception.
26: 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.
27: A Certificate of Occupancy shall be issued for this building upon final inspection approval by Tukwila
building inspector.
28: All construction noise to be in compliance with Chapter 8.22 of the City of Tukwila Municipal Code. A copy
can be obtained at City Hall in the office of the City Clerk.
29: Every occupied space other than enclosed parking garages and buildings used for repair of automobiles
shall be ventilated in accordance with the applicable provisions of the International Mechanical Code.
30: Water heaters shall be anchored or strapped to resist horizontal displacement due to earthquake motion.
Strapping shall be at points within the upper one-third and lower one-third of the water heater's vertical
dimension. A minimum distance of 4-inches shall be maintained above the controls with the strapping.
31: 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).
32: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila
Permit Center.
33: Preparation before concrete placement: Water shall be removed from place of deposit before concrete is
placed unless a tremie is to be used or unless otherwise permitted by the building official. All debris and ice
shall be removed from spaces to be occupied by concrete.
34: Prior to final inspection for this building permit, a copy of the roof membrane manufacturer's warranty
certificate shall be provided to the building inspector.
35: 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.
36: ***MECHANICAL PERMIT CONDITIONS***
37: All mechanical work shall be inspected and approved under a separate permit issued by the City of Tukwila
Permit Center (206/431-3670).
38: 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.
39: Manufacturers installation instructions shall be available on the job site at the time of inspection.
40: Except for direct-vent appliances that obtain all combustion air directly from the outdoors; fuel-fired
appliances shall not be located in, or obtain combustion air from, any of the following rooms or spaces:
Sleeping rooms, bathrooms, toilet rooms, storage closets, surgical rooms.
41: Equipment and appliances having an ignition source and located in hazardous locations and public garages,
PRIVATE GARAGES, repair garages, automotive motor-fuel dispensing facilities and parking garages shall be
elevated such that the source of ignition is not less than 18 inches above the floor surface on which the
equipment or appliance rests.
42: Type 1 Hoods, the required grease duct leakage test and (light test shall be performed by a special
inspection and testing agency in accordance with I.M.C. Chapter 5.
43: ***PLUMBING/GAS PIPING PERMIT CONDITIONS***
44: No changes shall be made to applicable plans and specifications unless prior approval is obtained from the
Tukwila Building Division.
45: All permits, inspection records and applicable plans shall be maintained at the job and available to the
plumbing inspector.
46: All plumbing and gas piping systems shall be installed in compliance with the Uniform Plumbing Code and
the Fuel Gas Code.
47: No portion of any plumbing system or gas piping shall be concealed until inspected and approved.
48: All plumbing and gas piping systems shall be tested and approved as required by the Plumbing Code and
Fuel Gas Code. Tests shall be conducted in the presence of the Plumbing Inspector. It shall be the duty of
the holder of the permit to make sure that the work will stand the test prescribed before giving notification
that the work is ready for inspection.
49: No water, soil, or waste pipe shall be installed or permitted outside of a building or in an exterior wall
unless, adequate provision is made to protect such pipe from freezing. All hot and cold water pipes
installed outside the conditioned space shall be insulated to minimum R-3.
50: Plastic and copper piping running through framing members to within one (1) inch of the exposed framing
shall be protected by steel nail plates not less than 18 guage.
51: Piping through concrete or masonry walls shall not be subject to any load from building construction. No
plumbing piping shall be directly embedded in concrete or masonry.
52: All pipes penetrating floor/ceiling assemblies and fire -resistance rated walls or partitions shall be protected
in accordance with the requirements of the building code.
53: Piping in the ground shall be laid on a firm bed for its entire length. Trenches shall be backfilled in thin
layers to twelve inches above the top of the piping with clean earth, which shall not contain stones,
boulders, cinderfill, frozen earth, or construction debris.
54: The issuance of a permit or approval of plans and specifications shall not be construed to be a permit for, or
an approval of, any violation of any of the provisions of the Plumbing Code or Fuel Gas Code or any other
ordinance of the jurisdiction.
55: The applicant agrees that he or she will hire a licensed plumber to perform the work outlined in this permit.
56: All new plumbing fixtures installed in new construction and all remodeling involving replacement of
plumbing fixtures in all residential, hotel, motel, school, industrial, commercial use or other occupancies
that use significant quantities of water shall comply with Washington States Water Efficiency ad
Conservation Standards in accordance with RCW 19.27.170 and the 2006 Uniform Plumbing Code Section
402 of Washington State Amendments
57: ***ELECTRICAL PERMIT CONDITIONS***
58: A copy of the electrical work permit shall be posted or otherwise made readily accessible to the Electrical
Inspector at each work site.
59: Approved plans shall be maintained at the construction site and shall be readily available to the Electrical
Inspector.
60: All electrical work shall be in accordance with NFPA 70 - NEC, and requirements for electrical installations,
Chapter 296-46B WAC.
61: When any portion of the electrical installation is to be hidden from view by permanent placement of parts
of the building, such equipment shall not be concealed until it has been inspected and approved by the
Electrical Inspector.
62: The issuance of an electrical work permit shall not be construed to be a permit for, or an approval of, any
violation of the provisions of the electrical code or other ordinances of the jurisdiction. Permits or related
documentation that presumes to grant this authority are therefore not valid.
63: Any change in the scope of work described by the electrical work permit shall require additional work
permits. Where approved plans have been issued, revisions to the plans and additional review may be
required.
64: Prior to permit issuance for new structure, the demolition permit must receive final inspection approval.
PERMIT INSPECTIONS REQUIRED
Permit Inspection Line: (206) 438-9350
1700 BUILDING FINAL**
CITY OF TUKr, _LA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
Building Permit No. t3tQ-'' `249
Project No.
Date Application Accepted:
Date Application Expires:
(For office use only)
CONSTRUCTION PERMIT APPLICATION
Applications and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mail or by fax.
**Please Print**
SITE LOCATION
Site Address:
Tenant Name:
PROPERTY OWNER
Name:
Name:
Address:
Address:
` (--ro 5 n
3 tr �7
City:
'�/� State:
Zip: aAo 2.
CONTACT PERSON — person receiving all project
communication
Name:
Address:
Address:
City: State:
Zip:
Phone: l�^1 oc,3 Li f I ti,S)•
Email:
Phone:
GENERAL CONTRACTOR INFORMATION
Company Name:
Address:
Company Name:
City:
State:
Zip:
Phone:
Fax:
City:
State:
Contr Reg No.:
Phone:
Exp Date:
Tukwila Business License No.:
H:Wpplications\Forms-Applications On Line \2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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King Co Assessor's Tax No.:
Suite Number: Floor:
New Tenant: 111 Yes ❑ .. No
ARCHITECT OF RECORD
Name:
Address:
Company Name:
Architect Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
ENGINEER OF RECORD
Name:
Address:
Company Name:
Engineer Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
LENDER/BOND ISSUED (required for projects $5,000 or
greater per RCW 19.27.095)
Name:
Address:
City: State: Zip:
Page 1 of 4
BUILDING PERMIT INFORMATI( 206-431-3670
Valuation of Project (contractor's bid price): $ f b€ t -s
Existing Building Valuation: $
Describe the scope of work (please provide detailed information):
)cc s r( WI, we-- l' j kl e4-, 1,-3 ' liC-cP
Will there be new rack storage? ❑ ....Yes
❑ ..No If yes, a separate permit and plan submittal will be required.
Provide AH Building Areas in Square Footage Below
PLANNING DIVISION:
Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): 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?
❑ Yes
FIRE PROTECTION/HAZARDOUS MATERIALS:
Compact: Handicap:
❑ No If "yes", explain:
O 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
O 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\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 2 of 4
Existing
Interior Remodel
Addition to
Existing
Structure
New
Type of
Construction per
IBC
Type of
Occupancy per
IBC
151 Floor
2nd Floor
3rd 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?
❑ Yes
FIRE PROTECTION/HAZARDOUS MATERIALS:
Compact: Handicap:
❑ No If "yes", explain:
O 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
O 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\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 2 of 4
PUBLIC WORKS PERMIT INF( NATION — 206-433-0179
Scope of Work (please provide detailed information):
Call before you Dig: 811
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
❑ .. Tukwila ❑ ...Water District #125
❑ .. Water Availability Provided
Sewer District
❑ .. Tukwila
❑ .. Sewer Use Certificate
❑... Highline
❑ ...Valley View 0...Renton
0 ...Sewer Availability Provided
0... Renton
0... Seattle
Septic System:
0 On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health Department.
Submitted with Application (mark boxes which apply):
0 .. Civil Plans (Maximum Paper Size — 22" x 34")
❑ .. Technical Information Report (Storm Drainage)
❑ .. Bond 0... Insurance ❑... Easement(s)
Proposed Activities (mark boxes that apply):
❑ .. Right-of-way Use - Nonprofit for less than 72 hours
❑ .. Right-of-way Use - No Disturbance
❑ .. Construction/Excavation/Fill - Right-of-way 0
Non Right-of-way 0
❑ .. Total Cut
0 .. Total Fill
cubic yards
cubic yards
0 .. Sanitary Side Sewer
❑ .. Cap or Remove Utilities
❑ .. Frontage Improvements
0 .. Traffic Control
0 .. Backflow Prevention - Fire Protection
Irrigation
Domestic Water
0 .. Permanent Water Meter Size (1)
❑ .. Temporary Water Meter Size (1)
❑ .. Water Only Meter Size
❑ .
❑.
❑ .
❑.
❑.
❑.
Geotechnical Report
.. Maintenance Agreement(s)
❑ .. Traffic Impact Analysis
❑ .. Hold Harmless — (SAO)
❑ .. Hold Harmless — (ROW)
0...Right-of-way Use - Profit for less than 72 hours
0...Right-of-way Use — Potential Disturbance
... Work in Flood Zone
❑... Storm Drainage
.. Abandon Septic Tank
.. Curb Cut
.. Pavement Cut
.. Looped Fire Line
❑ .. Sewer Main Extension Public
❑ .. Water Main Extension Public
0...Grease Interceptor
❑... Channelization
0... Trench Excavation
❑... Utility Undergrounding
WO # (2) " WO # (3)
WO # (2) " WO # (3)
WO # ❑ .. Deduct Water Meter Size
Private 0
Private 0
" WO#
" WO#
FINANCE INFORMATION
Fire Line Size at Property Line
0 .. Water 0 .. Sewer
Monthly Service Billing to:
Name:
Number of Public Fire Hydrant(s)
❑ .. Sewage Treatment
Mailing Address:
Day Telephone:
Water Meter Refund/Billing:
Name:
Mailing Address:
City
State Zip
Day Telephone:
City
State Zip
H:Wpplications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12. docx
Revised: February 2012
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Page 3 of 4
PERMIT APPLICATION NOTES —
Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject
to possible revision by the Permit Center to comply with current fee schedules.
Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation.
The Building Official may grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be
requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition).
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER OR AUTHORIZED AGENT:
Signature: Date: (r),/ l4
Print Name: 1\1 416X-- `iir7142,- Day Telephone: Q b ga / / /3/
Mailing Address:
City
H:Wpplications\Forms-Applications On Line\2012 Applications'Permit Application Revised - 2-7-12.docx
Revised: February 2012
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State
Zip
Page 4 of 4
3/1/2017
City of Tukwila
Department of Community Development
MOHINDER S SOHAL
4018 S 148TH ST
TUKWILA, WA 98168
RE: Permit No. D16-0286
SOHAL DEMO
4018 S 148TH ST
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 4/17/2017.
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 4/17/2017, 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,
Bill Rambo
Permit Technician
File No: D16-0286
'6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665
Associated Construction Corp 1
10650 SE 213th ST.
KENT, WA. 98031
Steve Randolph Owner/Operator
206-290-8493
To whom it my concern:
As the asbestos Contractor hired to evaluate property at, MOHINDER SOHAL
4018 S 148TH ST. TUKWILA, WA 98168. With proper abatement practices and
tests in place, and with laboratory results can claim this residents free of
asbestos. . Please feel free to call with any question or concerns.
Regards.
RECEIVED
OCT 0'12016
COMMUNITY
DwELol M -NT
MOHINDER SOHAL
4018 S 148TH ST
TUKWILA, WA 98168
1675 North Commerce Parkway, Weston, FL 33326 (954) 384-4446
CERTIFICATE OF BULK ASBESTOS ANALYSIS
Prepared for: MOHINDER SOHAL
Phone Number:
Fax Number:
Email Address: mssohal@yahoo.com
Project Name: MOHINDER SOHAL
Test Location: 4018 S 148TH ST
TUKWILA, WA 98168
Chain of Custody #: 973408
Date Sampled: August 15, 2016
Date Reported: August 30, 2016
(66) PP_th
Andrew Pittman, Analyst
It is certified by the signatures above that PRO-LAB/SSPTM, Inc. is accredited by the National Institute
of Standards and Technology for Polarized Light Microscopy (PLM) analysis under the EPA 600/M4-82-
020 Method. All analyses are performed using the EPA 600/R-93/116 method. The refractive index was
determined by using 'Rapidly and Accurately Determining Refractive Indices of Asbestos Fibers by using
Dispersion Staining Method', by S -C. Su. This report must not be reproduced in full, without written
approval from PRO-LAB/SSPTM, Inc. These test results apply only to the samples actually tested.
Polarized light microscopy is not always an accurate way to analyze floor tiles. When a non -detect or
very low percentage of asbestos occurs, a transmission electron microscopy analysis (TEM) may be
warranted. All samples wit be stored for a period of three months. The information contained in this
report and any attachments is confidential information intended only for the use of the individual or
entities named above. Limit of Detection (LOD) = 1%.
NVLAP Lab Code 200790-0
For more information please contact PRO -LAB at (954) 384-4446 or email info@prolabinc.com
RECEIVED
OCT 0 7 2016
COMMUNITY
DEEM -I (>1'111t IIT
Page 1 of 2
MOHINDER SOHAL
4018 S 148TH ST
1675 North Commerce Parkway, Weston, FL 33326 (954) 384-4446 TUKWILA, WA 98168
August 15, 2016 Samples
Client ID
PRO -LAB ID
LOCATION
Asbestos Mineral Percentage
COMMENTS
CH
AM
CR
AN
TR
AC
ND
081916-0579
BLACK SIDING
CAR GARAGE
0
0
0
0
0
0
ND
25% Cellulose
25% Aggregates
50% Bitumen
081916-0580
BROWN BACKING
CAR GARAGE
0
0
0
0
0
0
ND
98% Cellulose
2% Binders
CH=Chrysotile AN=Amosite
CR=Crocidolite AN=Anthophylite
TR=Tremolite AC=Actinolite
ND=None detected
Page 2 of 2
RECEIVED
OCT 0 7 2016
COMMUNITY
DEVEI 01 'MI- NT
2-111g, /s sr
FILE COPY
Permit o P (i)
Plan review appro
Approval of constri
the violation of any
of approved Field C
By:
Date:
/ L_/
RI is subject to errors and omissions.
ction documents doss not authate
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py and conditions is acknow!adA:
City of Tukwila
ILDING DIVISION
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SEPAPATE
REQUZ7D FOR:
Machan
Erpectrical
13413.umbing
0 -Gas Piping
City of Tukwil
B.UILDING DIVIS ON
REVIEWE
CODE COM
APPRO
OCT 1 9
City of T
BUILDING
FOR
LIANCE
ED
2016
kwila
!VISION
+INI.P.e..*, .•
REVISIONS
c• changes sho mrAde to the scope
of work withc! ;I: prior approval of
Tu'Kyvi/a BrPfling Division
NOT: EVSO‘vill 1.,:citliro ans-v Wan submitta!
anl may r:.:Jde add:tional pian rev'
Cash Register Receipt
City of Tukwila
Receipt Number
R9683
DESCRIPTIONS
PermitTRAK
ACCOUNT
QUANTITY
PAID
$151.56
D16-0286 Address: 4018 S 148TH ST
Apn: 0040000971
$151.56
DEVELOPMENT
$147.23
PERMIT FEE
R000.322.100.00.00
0.00
$86.50
PLAN CHECK FEE
R000.345.830.00.00
0.00
$56.23
WASHINGTON STATE SURCHARGE
B640.237.114
0.00
$4.50
TECHNOLOGY FEE
$4.33
TECHNOLOGY FEE
R000.322.900.04.00 I
0.00
I
$4.33
TOTAL FEES PAID BY RECEIPT: R9683
$151.56
Date Paid: Wednesday, October 19, 2016
Paid By: MOHINDER S SOHAL
Pay Method: CASH
Printed: Wednesday, October 19, 2016 12:07 PM 1 of 1
CRWSYSTEMS
CITY OF TUKWILA
Department of Community Development
6300 Southcenter Boulevard, Tukwila, WA 98188
Telephone: (206) 431-3670
AFFIDAVIT OF OWNERSHIP AND HOLD HARMLESS
PERMISSION TO ENTER PROPERTY
STATE OF WASHINGTON
COUNTY OF KING
The undersigned being duly sworn and upon oath states as follows:
1. I am the current owner of the property which is the subject of this application.
2. All statements contained in the applications have been prepared by me or my agents and are true and correct to the best of my
knowledge.
3. The application is being submitted with my knowledge and consent.
4. Owner grants the City, its employees, agents, engineers, .c s ori other,rr/epresentatives the right to enter upon Owner's real
property, located at 1%i/ / 4.7e,/ 8 s,. (4-7r)- 57 ; JpLL�=t..li ! et for the purpose of application review,
for the limited time necessary to complete that purpose.
5. Owner agrees to hold the City harmless for any loss or damage to persons or property occurring on the private property during the
City's entry upon the property, unless the loss or damage is the result of the sole negligence of the City.
6. Non -responsiveness to a City information request for ninety (90) or more days, shall be cause to cancel the application(s) without
refund of fees.
EXECUTED at `C' i e V + (city), iJ ,k (state), on C()cp c�� '76, ,20%'
(Print Name)
(Address)
Aa LI
(Phone Number)
(Signature)
On this day personally appeared before me t' f `Vk) v iAe' 5 . I to me known to be the individual who
, ,
executed the foregoing instrument and acknowledged that /she signed the same asi /her voluntary act and deed for the uses and
purposes mentioned therein.
SUBSCRIBED'AND�SWORN TO BEFORE ME ON THIS
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�UL
DAY OF C er , ,20I f
NOTARY P
residing at
LJC in and f \the State of Washington
('Cji,
My Commission expires on
\O 19
W:\Atplications-Handouts. Land Use\CURRENT LAND USE APPLICATIONS\Tree Removal and 1.andscane Mnri Permit -March A ,1„r„