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HomeMy WebLinkAboutPermit D16-0353 - HIGHLINE WATER DIST - STRUCTURE DEMOLITIONHIGHLINE WATER DIST DEMO 16032 42 AVE S D16-0353 Parcel No: Address: 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.eov DEVELOPMENT PERMIT 5379800009 Permit Number: 16032 42ND AVE S Issue Date: Permit Expires On: Project Name: HIGHLINE WATER DIST - DEMO D16-0353 1/11/2017 7/10/2017 Owner: Name: Address: HARPER CLIFTON R 16032 42ND AVE S , TUKWILA, WA, 98188 Contact Person: Name: JEREMY DELMAR Address: 23828 30TH AVE S , KENT, WA, 98032 Contractor: Name: AFFIDAVIT - DAVE STANLEY Address: License No: I!J Lender: Name: EXEMPT - GOVERNMENT ENTITY Address: Phone: (206) 592-8904 Phone: Expiration Date: DESCRIPTION OF WORK: DEMO OF EXISTING STRUCTURE Project Valuation: $25,000.00 Type of Fire Protection: Sprinklers: NO Fire Alarm: NO Type of Construction: VB Electrical Service Provided by: TUKWILA Fees Collected: $1,241.02 Occupancy per IBC: R-3 Water District: HIGHLINE 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/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: LcLLQk Date: k(H? 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 permagree to thk cgnditions attached to this permit. Signature: Print Name: j3/4,,-( Date: //l i / 7 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: From October 1 through April 30, cover any slopes and stockpiles that are 3H:1V or steeper and have a vertical rise of 10 feet or more and will be unworked for greater than 12 hours. During this time period, cover or mulch other disturbed areas, if they will be unworked more than 2 days. Covered material must be stockpiled on site at the beginning of this period. Inspect and maintain this stabilization weekly and immediately before, during and following storms. 8: From May 1 through September 30, inspect and maintain temporary erosion prevention and sediment at least monthly. All disturbed areas of the site shall be permanently stabilized prior to final construction approval. 9: Applicant shall contact Valley View District (206-242-3236) to verify if this property is connected to the Valley View District sanitary sewer system. 10: Any septic tanks in the area shall be pumped empty and removed or filled with sand. A copy of the documentation from the business that performed the pumping shall be provided to the Public Works Inspector. 11: ***BUILDING PERMIT CONDITIONS*** 12: 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. 13: 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. 14: 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. 15: 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 1600 PUBLIC WORKS FINAL CITY OF TUKJ. A. . Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Building Per><.1i No. �j 1 17J Project No. Date Application Accepted: l 9\ I, Date Application Expires: (i) IM1 1 (For office u e 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: I (032 L-12,tJD r\" E S King Co Assessor's Tax No.: Tenant Name: F\-1)\ `1 NL - ��l St PROPERTY OWNER Name: TuY1U1 *.1 51-a—IcT Address: z e zQj 301 ft -VE S City: State: 1k.1A Zip: ?56 3a CONTACT PERSON — person receiving all project communication Company Name: T D A � � -I o I �� Name: U. 77— lik y—DeL-el Poe Address: z 3e zt.3o "as City: 4.► ( State: lip Zip: 115052 Phone: 406 5/2 816 Fax: Zotc, 8z14 0806 Email: carol 3.DEZ NIS @r tbAhLINE W GENERAL CONTRACTOR INFORMATION Company Name: T D A � � -I o I �� Address: City: State: Zip: Phone: Fax: Contr Reg No.: Exp Date: Tukwila Business License No.: H:\Applications\Porms-Applications On Line \2011 Applications\Permit Application Revised - 8-9-11.docx Revised: August 2011 bh 53-7 980 - oco Suite Number: Floor: New Tenant: ❑ Yes ..No ARCHITECT OF RECORD Company Name: et.k 7..... t.. N.eth A. Company Name: xi A City: ,yr_ L- State: wA_ Zip: p&pal Architect Name: Email:—plL/oO(Or•) e_ e -j Z . or") Address: City: State: Zip: Phone: Fax: Email: ENGINEER OF RECORD: Company Name: et.k 7..... t.. N.eth A. Engineer Name: 3-pfikIJ Address: 2 2:7 2Z 2 .:TTii vie se i .z/( City: ,yr_ L- State: wA_ Zip: p&pal hone:Z- 751532(0 Fax: Phone:/42,C Email:—plL/oO(Or•) e_ e -j Z . or") 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 INFORMATIOT 106-431-3670 1 Valuation of Project (contractor's bid price): $ 2-5) OO O Describe the scope of work (please provide detailed information): Existing Building Valuation: $ fr ) - I O 1,I, 0 smeo crU Will there be new rack storage? ❑ Yes [ No If yes, a separate permit and plan submittal will be required. Provide All Building Areas in Square Footage Below 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: Compact: Handicap: Will there be a change in use? ❑ Yes ❑ No If "yes", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ Sprinklers ❑ Automatic Fire Alarm ' 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 \2011 Applications\Permit Application Revised - 8-9-11.docx Revised: August 2011 bh Page 2 of 4 Existing Interio emodel Addition to Existing Structure New Type of ': Construction per IBC Type of Occupancy per IBC 1St Floor r6p0 2"d Floor 3rd Floor Floors thru Basement I b I Q Accessory Structure* Attached Garage 2 00 J Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck 4A2t4A 230 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: Compact: Handicap: Will there be a change in use? ❑ Yes ❑ No If "yes", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ Sprinklers ❑ Automatic Fire Alarm ' 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 \2011 Applications\Permit Application Revised - 8-9-11.docx Revised: August 2011 bh Page 2 of 4 PUBLIC WORKS PERMIT INFC iATION — 206-433-0179 Scope of Work (please provide detailed information): IrJb "C)4 -1-10L-11-(0)1 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 .Valley View ❑... Sewer Availability Provided L .. Highline ❑ .. Renton ❑ .. Renton ❑ .. Seattle Septic System: LI 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): Plans (Maximum Paper Size — 22" x 34") ❑ ...Technical Information Report (Storm Drainage) ❑ ...Bond ❑ .. 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 ❑ Non Right-of-way ❑ ...Total Cut ❑ ...Total Fill cubic yards cubic yards ❑ ...Sanitary Side Sewer Nj ...Cap or Remove Utilities ❑ ...Frontage Improvements ❑ ...Traffic Control ❑ ...Backflow Prevention - Fire Protection Irrigation Domestic Water ❑ .. Geotechnical Report ❑ .. Maintenance Agreement(s) ❑ ...Traffic Impact Analysis ❑ ...Hold Harmless — (SAO) ❑ ...Hold Harmless — (ROW) ❑ .. 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 ❑ .. Pavement Cut ❑ .. Looped Fire Line .51 ❑ .. Grease Interceptor ❑ .. Channelization ❑ .. Trench Excavation ❑ .. Utility Undergrounding ❑ ...Permanent Water Meter Size... 5, WO # ❑ ...Temporary Water Meter Size.. WO # ❑ ...Water Only Meter Size WO # 0 ...Deduct Water Meter Size ❑ ...Sewer Main Extension Public 0 Private ❑ 0 ...Water Main Extension Public ❑ Private ❑ FINANCE INFORMATION Fire Line Size at Property Line Number of Public Fire Hydrant(s) ❑ ...Water ❑ ...Sewer ❑ ...Sewage Treatment Monthly Service Billing to: Name: Day Telephone: Mailing Address: Water Meter Refund/Billing: Name: Mailing Address: City State Zip Day Telephone: City State Zip H:\Applications\Forms-Applications On Line\201 I Applications\Permil 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 ' AUTHORIZED AGENT: Olt) (ANE. r�� e-1 �- Signature: V Date: raj -21311.G Print Name: "11 -C. --t^- \I DS—r1 Ale_ 01/46/13f M D^ a Telephone: Z_06 S 12 8 I6 q Mailing Address: 2-38 2.8 kJE- 5 K \AA 96632, City H:Wpplications\Forms-Applications On Line\2011 Applications\Permit Application Revised - 8-9-11.docx Revised: August 2011 bh State Zip Page 4 of 4 Cash Register Receipt City of Tukwila DESCRIPTIONS PermitTRAK I ACCOUNT I QUANTITY I PAID $619.57 D16-0353 Address: 16032 42ND AVE S Apn: 5379800009 $619.57 DEVELOPMENT $369.57 PERMIT FEE R000.322.100.00.00 0.00 $369.57 PUBLIC WORKS $250.00 BASE APPLICATION FEE TOTAL FEES PAID BY RECEIPT: R10388 R000.322.100.00.00 0.00 $250.00 $619.57 Date Paid: Wednesday, January 11, 2017 Paid By: HIGHLINE WATER DISTRICT Pay Method: CHECK 4300 Printed: Wednesday, January 11, 2017 2:07 PM 1 of 1 C. SYSTEMS Cash Register Receipt City of Tukwila Receipt Number R10171 DESCRIPTIONS PermitTRAK I ACCOUNT I QUANTITY I PAID $621.45 D16-0353 Address: 16032 42ND AVE S Apn: 5379800009 $621.45 DEVELOPMENT $592.43 PERMIT FEE R000.322.100.00.00 0.00 $210.73 PLAN CHECK FEE R000.345.830.00.00 0.00 $377.20 WASHINGTON STATE SURCHARGE B640.237.114 0.00 $4.50 TECHNOLOGY FEE $29.02 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R10171 R000.322.900.04.00 0.00 $29.02 $621.45 Date Paid: Wednesday, December 28, 2016 Paid By: HIGHLINE WATER DIST Pay Method: CHECK 4298 Printed: Wednesday, December 28, 2016 12:16 1 of 1 PM CPSYSTEMS INSPECTION NO. INSPECTION RECORD Retain a copy with permit 1/6-C3S3 PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila: WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Pr 'ect: j-�IGl me VIA+ ' /S7' T e of Inspection: 60 kt.biile;tiAt Address: /6;032 ziatb Avg Date Called: Special Instructions: `� _ e4tL Date Wante/I�/I Requester:b.ss Phone No: 2-SVZ- (..-9/ Z Approved per applicable codes. LJ Corrections required prior to approval. COMMENTS: Date:6//o.)/ REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit 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: Ai/6110N ItARR- )/S`�— T e of Inspection: pt. - (®Yi eJ ! C,J Address: %k 3 Z. 212'ub Ave s Date Called: Special Instructions:,r. 1)0140 CALL Date Wanted: 2 / /7 ,�i-- p- m• Reques e . Phone No: , c- a- (f1Z 4d Approved per applicable codes. 0 Corrections required prior to approval. COMMENTS: Inspector: A Date: i)%7 REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. I SEPARATE PERMIT REQUIRED FOIA L Mechanicet arklectrical Lg'Plumbing (ErGas Piping of Tukwila BlP DIVISION ROT CEXISTING HOUSE TO BE yDEMOLISHED SEE •40 ;:i'NOTES THIS SHEET 11/16/2016 • • DEMOLITION PLAN HUE COPY 1-_ Permit Flo, DVP-09' Plan roviow approval is subject to orrors tend omissions. Approval of construction documents does not authorize to violation of any adopted code or emlinanco. Rocoipt of a 9rovc i Red cn •• +i is acknowloc cd: n DEMOLITION AND RESTORATION NOTES ALL EXISTING BUILDING INCLUDING BUT NOT LIMITED TO BUILDING STRUCTURES, DECKS, CONCRETE BASEMENT. BASEMENT FLOOR AND ALL OTHER BUILDING APPURTENANCES SHALL BE REMOVED. IF ANY HAZARDOUS (ASBESTOS I LEAD) A,] �FE_RRRIAL IS FOUND, IT SHALL BE D ED PROPERLY BASED ON THHE TATE ,A/N�D LOCAL REQUIREMENTS. Pro v cfe ( h Q A h rev- v- / i THE REMOVED BASEMENT SHALL BE BACKFLLED WITH TANK RUN GRAVEL' AS SPECIFIED IN T SPECIFICA S SECTION 903.19. BANK RUN GRAVEL SHALL BE PLACED IN UNWORM LAYERS NOT TO EXCEED 12 INCHES IN LOOSE THICKNESS AND COMPACTED TO90 PERCENT OF ITS MAXIMUM DRY DENSITY BASED ON THE ASTM D1557 (MODIFIED) TEST PROCEDURE. THE FINISHED GRADE SHALL BE HYDROSEEDED TO PREVENT EROSION. PROVIDE TEMPORARY MULCH TO HYDROSEEDED AREAS AS REQUIRED FOR ESTABLISHMENT AND TO PROTECT SEED FROM EROSION. I /o at,•Ly die --o tru-c.+ra� REVISIONS f�oPito •es shall hn made to the scope 67 work witho rZ p -for approval of Tukwila Building Division NOTE: Revisions will require a new plan submittal and may include additic nal plan review fee �.1 EXISING HOUSE TO BE DEMOLISHED '4 an STREET VIEW DEMOLITION PLAN PUMP STATION 8 SCALE SHOWN REVIEWED FOR CODE COMPLIAN a. t. APPROVED JAN 0 6 201 City of Tukw1'a I BUILDING DIN. RECEIVED CITY OF TUKWILA Date: ////// City of Tukwila BUILDING DIVISION FINS N® ltl)MitlY Sammy WA p171}949Cng1Y)10 oi97 DEC 2 8 2016 'ERMIT CENTER j. A -T Asbesto-Test, Inc. 1429 Ave. D. #187, Snohomish, WA 98290 425-489-4040 www.asbestotesi.com; info a,asbestotest.com ASBESTOS SURVEY House & Attached Garat'e Cad, 16032 42"d Ave. S., Tukwila, WA 98188 Page 1 of 8 November 30, 2016 B2161128 HIGHLINE WATER DISTRICT 23828 30TH AVE S KENT WA 98032 ATTN: Jeremy Delmar or Mary A. Fossos jdelmar@highlinewater.org; mfossosAhighlinewater.org 206-592-8904 (Jeremy); 206-592-8918 (Mary) IlL3 • On November 22, 2016, Asbesto-Test personnel conducted an Asbestos survey (per U.S.E.P.A./A.H.E.R.A. guidelines as designated and specified by Puget Sound Clean Air Agency and Washington State) of the house (i 16032 42"d Ave. S., Tukwila, Kiel, County Washington 98188. This survey purpose is to identify asbestos containing materials, prior to demolition. NARRATIVE OF FINDINGS BASIC CONSTRUCTION: The house is one story on a concrete basement. The siding is wood and brick. The siding vapor barrier materials were sampled. The exterior brick and mortar materials were sampled. The composition roofing materials were sampled. The torch down roofing was sampled from over the attached garage. INTERIOR CONSTRUCTION, FINISHES, AN FLOORINGS: The interior construction is wood and drywall. The drywall and taping compounds were sampled. The vinyl and tile flooring materials, with relating backings/mastics, were also sampled. The masonry tile and mortar mastic compounds were sampled. The misc. mastic materials were also sampled. INSULATION: The insulation was samledREVIEWED FOR CODE COMPLIANCE APPROVED ntinue to page 2 JAN 0 6 2017 [imtL- BBB. City of Tukwila BUILDING DIVISION RECEIVED CITY OF TUKWILA DEC 2 8 2016 PERMIT CENTER NAT -48033-1 Page 2 of 8 B2161128 November 30, 2016 Asbesto-Test, Inc. 425-489-4040 House & Attached Garaze @ 16032 42"4 Ave. S., Tukwila, WA 98188 tti ELECTRICAL SYSTEM: The electrical wiring insulation did not appear to be the kind to be ACM. The power may have been "on" at the time of the inspection, thus sampling was not safe. Any suspect electrical wiring insulation or any suspect TSI (Thermal System Insulation) found in, around, or behind any located fuse or breaker boxes should be considered to be ACM (Asbestos Containing Material), unless determined otherwise by laboratory analysis. HEATING AND VENTILATION SYSTEM: There is a gas forced air furnace in the structure. There was no relating suspect ACM located, except the flue mortar packing material that was sampled. Note: It was not possible to dismantle the furnace and ducting to locate and/or evaluate any additional suspect ACM that may be concealed, inside the unit, or associated in hidden areas. It is our opinion any further handling of the furnace systemm should be coordinated by the project manager and/or abatement contractor. If any additional relating suspect materials are located prior to and/or during any demolition or renovation, any and all additional related suspect materials should be considered to be ACM (Asbestos Containing Material), unless determined to be otherwise by laboratory analysis. Any TSI that may be present inside or outside the furnace and/or ducting system including but not limited to all gaskets, joint compounds, sealants, and/or insulations, are PACM unless tested otherwise by laboratory analysis. • There is a fireplace in the house. The fireplace brick and mortar materials were sampled. The fire brick was sampled. MISC.: The window glazing materials were sampled. ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY: None. # of structures included in survey: one house with attached garage Requested by: Jeremy Delmar WOW lae..oaAwIIS Sloe. WA,411, 701X5]773 111C(S TMsonfictdrt William R. Hutson II sadafacerep completed , lean of Percher =Wog as Asbestos Bo ss Impactor tonelln with TSCA Ike 0 / 40 CRR 743 (ANSA) aAA..wo.lo... m CreWn11 173747 Om OM Nwt7414 bps lett 7N7 William R. Hutson II Inspector, Certified A.H.E.R.A. Accred. # 155742 exp. March 2, 2017 continue to page 3 1429 Ave. D. #187, Snohomish, WA 98290 425-489-4040;f775-665-0420 • Page 3 of 8 B2161128 November 30, 2016 Asbesto-Test, Inc. 425-489-4040 House & Attached Garage A 16032 42nd Ave. S., Tukwila, WA 98188 ANY AND ALL MATERIALS IDENTIFIED AS ACM OR PACM IN THIS REPORT (AND/OR ADDITIONAL MATERIALS ASSOCIATED WITH THE STRUCTURE THAT MAY BE DISCOVERED AND LATER IDENTIFIED AS ACM OR PACM), MUST BE PROFESSIONALLY ABATED PRIOR TO DEMOLITION. ASSESSMENT AND QUANTIFICATION OF ACM FOR ABATEMENT PURPOSES AND/OR PRICING FOR REMOVAL SHOULD BE DETERMINED BY ON SITE EVALUATION, AS LISTED QUANTITIES ARE NOT GUARANTEED AND ARE AN APPROXIMATION ONLY. ANALYSIS ID SAMPLES #1-#6 ARE ASBESTOS CONTAINING MATERIALS ASBESTOS//TYPE//QUANTITY OTHER MATERIAL 1.0 FLUE MORTAR PACKING yes // chrysotile // 2% NON -FRIABLE ACM CIRCLE OF PACKING MATERIAL AROUND BASEMENT "OUT OF USE" FLUE LESS THAN 1 SQ. FT. non-fibrous materials 2.0 FLUE MORTAR PACKING yes // chrysotile // 2% NON -FRIABLE ACM CIRCLE OF PACKING MATERIAL AROUND BASEMENT "IN USE" FLUE LESS THAN 1 SQ. FT. 3.0 SHEET VINYL FLOORING yes // chrysotile // 38% FRIABLE ACM KITCHEN 2ND LAYER — COLOR: CREAM NOTE: THE ASBESTOS IS IN THE GRAY/WHITE VINYL BACKING. CANNOT BE SEPARATED FROM THE FRIABLE VINYL BACKING M ON NON -ACM GREEN SHEET VINYL AS LATER LISTED NOTE: MAY EXTEND INTO BREAKFAST AREA non-fibrous materials non-fibrous materials, cellulose THE MASTIC IS ALSO ACM AS IT ATERIAL. QUANTITIES OF ASBESTOS CONTAINING VINYL FLOORING MATERIAL (FOR ABATEMENT ASSESSMENT AND/OR PRICING FOR REMOVAL) SHOULD BE DETERMINED BY ON SITE EVALUATION. 4.0 SHEET VINYL FLOORING yes // chrysotile // 38% non-fibrous materials, FRIABLE ACM BACK BEDROOM CLOSET 2ND LAYER — COLOR: BROWN & TAN NOTE: THE ASBESTOS IS IN THE GRAY/WHITE VINYL BACKING. THE MASTIC IS ALSO ACM AS IT CANNOT BE SEPARATED FROM THE FRIABLE VINYL BACKING MATERIAL. APPROX. 15 SQ. FT. ON PARTICLE BOARD cellulose 5.0 MASTIC yes // chrysotile // 2% MASTIC IS NON -FRIABLE ACM HOLDING NAILED UP PANEL IN STAIRWELL TO BASEMENT adhesive, cellulose QUANTITIES OF ASBESTOS CONTAINING MASTIC MATERIAL (FOR ABATEMENT ASSESSMENT AND/OR PRICING FOR REMOVAL) SHOULD BE DETERMINED BY ON SITE EVALUATION. continue to page 4 1r- BBB. C_D 1429 Ave. D. #187, Snohomish, WA 98290 425-489-4040; f 775-665-0420 Page 4 of 8 B2161128 November 30, 2016 Asbesto-Test, Inc. 425-489-4040 House & Attached Garage (a� 16032 42nd Ave. S., Tukwila, WA 98188 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL 6.0 WINDOW GLAZING yes /1 chrysotile // 3% NON -FRIABLE ACM ON METAL FRAMED WINDOWS-APPROX. 5 WINDOWS non-fibrous materials, cellulose NOTE: ANY ADDITIONAL COLORS OR KINDS OF VINYL FLOORING AND/OR TILE WITH ANY RELATING MASTICS/BACKINGS THAT WERE NOT DISCOVERED IN THIS SURVEY AND MAY LATER BE LOCATED IN THIS STRUCTURE ARE ALSO PRESUMED TO CONTAIN ASBESTOS UNLESS TESTED OTHERWISE BY LABORATORY ANALYSIS THERE WAS NO ASBESTOS DETECTED IN ANY OF THE REMAINING SAMPLES 7.0 sheet vinyl flooring NAD non-fibrous materials, kitchen surface layer — color: tan cellulose, fiberglass also in breakfast area 8.0 mastic beneath previous sample ON ACM SHET VINYL SANDWICHED HERE NAD adhesive 9.0 sheet vinyl flooring NAD non-fibrous materials, kitchen bottom layer — color: green cellulose 10.0 mastic NAD adhesive beneath previous sample 11.0 masonry tile NAD non-fibrous materials master bathroom floor -color: gray 12.0 mortar/mastic NAD adhesive, cellulose, holding previous sample listed non-fibrous materials 13.0 backer board NAD cellulose beneath previous sample 14.0 masonry tile NAD non-fibrous materials master bathroom wall over tub -color: gray 15.0 mortar/mastic NAD adhesive, cellulose, holding previous sample listed non-fibrous materials 16.0 acoustic wall board NAD cellulose bathroom walls — color: black BBB. continue to page 5 1429 Ave. D. #187, Snohomish, WA 98290 425-489-4040; f 775-665-0420 Page 5 of 8 B2161128 November 30, 2016 Asbesto-Test, Inc. 425-489-4040 House & Attached Garage (&, 16032 42n4 Ave. S., Tukwila, WA 98188 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL 17.0 mastic NAD adhesive, cellulose kitchen holding tan/pink laminate on countertop 18.0 sheet vinyl flooring NAD non-fibrous materials, hall bathroom — color: cream w/light blue design cellulose, fiberglass 19.0 mastic NAD adhesive beneath previous sample 20.0 mastic NAD adhesive, cellulose hall bathroom holding yellow laminate on vanity top 21.0 sheet vinyl flooring NAD non-fibrous materials, back bedroom closet surface layer — color: off white pattern cellulose, fiberglass 22.0 mastic NAD adhesive beneath previous sample ON ACM SHEET VINYL AS PREVIOUSLY LISTED 23.0 "squeak paper" NAD beneath hardwood floors throughout — color: brown & black cellulose, tar 24.0 drywall/taping compound/paint NAD non-fibrous materials bathroom composite cellulose, fiberglass 25.0 drywall/taping compound/paint NAD non-fibrous materials living room composite cellulose, fiberglass 26.0 drywall/taping compound/paint NAD non-fibrous materials front bedroom composite cellulose, fiberglass 27.0 drywall/taping compound/paint NAD non-fibrous materials middle bedroom composite cellulose, fiberglass 28.0 drywall/taping compound/paint NAD non-fibrous materials back bedroom composite cellulose, fiberglass 29.0 textured paint material living room 29.1 textured paint material dining room 29.2 textured paint material hallway NAD NAD NAD continue to page 6 1429 Ave. D. #187, Snohomish, WA 98290 425-489-4040; f 775-665-0420 paint, cellulose, non-fibrous materials paint, cellulose, non-fibrous materials paint, cellulose, non-fibrous materials Page 6 of 8 B2161128 ANALYSIS ID BASEMENT: November 30, 2016 Asbesto-Test, Inc. 425-489-4040 House & Attached Garage na, 16032 42nd Ave. S., Tukwila, WA 98188 ASBESTOS//TYPE//QUANTITY OTHER MATERIAL 30.0 fireplace brick @ threshold NAD non-fibrous materials 30.1 fireplace decorative brick NAD non-fibrous materials 31.0 mortar NAD non-fibrous materials, holding previous sample 1 cellulose 31.1 mortar NAD non-fibrous materials, holding previous sample 2 cellulose 31.2 mortar NAD non-fibrous materials, holding previous sample 3 cellulose 32.0 firebrick NAD non-fibrous materials from inside fireplace 33.0 acoustic ceiling tile NAD cellulose, paint hall 34.0 chimney brick NAD non-fibrous materials furnace 35.0 mortar NAD non-fibrous materials, holding previous sample 1 cellulose 35.1 mortar NAD non-fibrous materials, holding previous sample 2 cellulose 35.2 mortar NAD non-fibrous materials, holding previous sample 3 cellulose 36.0 acoustic ceiling panel NAD fiberglass, cellulose, color: white/gray paint 37.0 acoustic ceiling panel NAD cellulose, paint color: brown/white 38.0 acoustic ceiling tile NAD cellulose, paint stairwell BBB continue to page 7 1429 Ave. D. #187, Snohomish, WA 98290 425-489-4040; .f 775-665-0420 Page 7 of 8 B2161128 November 30, 2016 Asbesto-Test, Inc. 425-489-4040 House & Attached Garage (a, 16032 42nd Ave. S., Tukwila, WA 98188 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL COMMON AREAS: 39.0 vapor barrier NAD cellulose, tar beneath wood siding 40.0 exterior brick NAD non-fibrous materials 41.0 brick mortar NAD non-fibrous materials, holding exterior brick sample 1 cellulose 41.1 brick mortar NAD non-fibrous materials, holding exterior brick sample 2 cellulose 41.2 brick mortar NAD non-fibrous materials, holding exterior brick sample 3 cellulose 42.0 insulation NAD fiberglass, cellulose color: white 42.1 insulation NAD fiberglass, cellulose color: black 42.2 insulation NAD fiberglass, cellulose color: beige 43.0 composition roofing NAD cellulose, tar, over main house non-fibrous materials 44.0 vapor barrier NAD cellulose, tar beneath previous sample 45.0 mastic NAD cellulose, adhesive holding composition roofing ATTACHED GARAGE: 46.0 vapor barrier NAD cellulose, tar beneath wood siding on attached garage 47.0 torch down roofing NAD cellulose, tar, over garage area fiberglass, non-fibrous materials 48.0 vapor barrier NAD cellulose, tar beneath previous sample Lat8 continue to page 8 1429 Ave. D. #187, Snohomish, WA 98290 425-489-4040; f 775-665-0420 Page 8 of 8 B2161128 November 30, 2016 Asbesto-Test, Inc. 425-489-4040 House & Attached Garaze (a, 16032 42n4 Ave. S., Tukwila, WA 98188 Samples taken are listed with their corresponding analyses. If asbestos is detected, those samples containing asbestos are listed first and noted with the initials 'ACM". Some sample analyses listed may be a representative analysis of individual and separate samplings and analysis of homogenous materials, as prescribed byA.H.E.R.A. guideline. If, during demolition or renovation, any additional suspect asbestos containing materials are located [may include but not limited to: sheet vinyl flooring, tile flooring, wall or ceiling texturings or paints, concrete siding or skirting, cement pipes, cement wallboard, electrical cloth, electrical wiring insulation, thermal paper, wallboard, joint compounds, vinyl wall coverings, spackling compounds, or any other suspect TSI (Thermal System Insulation)), those materials are presumed Asbestos Containing Materials unless determined to be non -asbestos by laboratory analysis. Asbesto-Test, Inc. does not guarantee approximations of quantities of ACM, which may be listed with the analyses. It is therefore recommended professional abatement price and/or disposal quotes be obtained by inquiring as to fees per area of specific ACM material (i.e. square or linear foot, etc.), or by on site assessment. Any and all materials identified as ACM and/or PACM in this report must be abated prior to disturbance in renovation or demolition. PLM (polarized light microscopy) has been known to miss asbestos in small percentages of some samples, which contain asbestos, thus negative PLM results cannot be guaranteed. Floor tiles and wipes should be tested with SEM (scanning electron microscope) or TEM (transmitting electron microscope), to insure analytical accuracy when asbestos is reported in small percentages Analytical test method: USEPA 600/R93/116•• (PLM); WAC 296-62-07753 App. J **One percent is the USEPA regulatory limit for asbestos in bulk samples. Key: "FRIABLE"signfes "Easily Airborne' ACM signifies Asbestos Containing Material' PACM signifies Presumed Asbestos Containing Material' CAB signifies 'Concrete Asbestos Board" e signifies less than' TSI signifies Thermal System Insulation" HVAC signifies Heating Ventilating Air -Conditioning' NAD sign f es 'No Asbestos Detected' ArLynn Hammond, Pres., BSc. Analytical Chemist, AIHA proficient Inspector, certified A.H.E.R.A. accred.#158283 (Expires July 27, 2017) BBB END OF REPORT 1429 Ave. D. #187, Snohomish, WA 98290 425-489-4040; f 775-665-0420 6/5/2017 JEREMY DELMAR 23828 30TH AVE S KENT, WA 98032 City of Tukwila Department of Community Development RE: Permit No. D16-0353 HIGHLINE WATER DIST - DEMO 16032 42ND AVE S 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 7/31/2017. 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 7/31/2017, 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 Ripley Permit Technician File No: D16-0353 6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 ?Elvin" ©ORD COPY PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: D16-0353 DATE: 12/29/16 PROJECT NAME: HIGHLINE WATER DIST - DEMO SITE ADDRESS: 16032 42ND AVE S X Original Plan Submittal _ Response to Correction Letter # _ Revision # Revision # before Permit Issued after Permit Issued DEPARTMENTS: G 1\4 Building Division rpm Publ c Works 1•1 104711 Fire Prevention Structural 111 APP Planning Division dr, Permit Coordinator n PRELIMINARY REVIEW: Not Applicable ❑ (no approval/review required) REVIEWER'S INITIALS: DATE: 12/29/16 Structural Review Required DATE: APPROVALS OR CORRECTIONS: Approved Corrections Required CI (corrections entered in Reviews) Notation: DUE DATE: Approved with Conditions n Denied (ie: Zoning Issues) 01/26/17 REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg 0 Fire ❑ Ping ❑ PW 0 Staff Initials: 12/ 18/2013 CITY OF TUKWILA Department of Community Development 6300 Southcenter Boulevard, Tukwila, WA 98188 Telephone: (206) 431-3670 FAX (206) 431-3665 E-mail: tukplan @ci.tukwila.wa.us Permit Center/Building Division 206 431-3670 Public Works Department 206 433-0179 Planning Division 206 431-3670 AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION STATE OF WASHINGTON) ) ss. COUNTY OF KING ) P4vi STAN/L., [please print name] , states as follows: PERMIT NO:'/(e) _0353 1. I have made application for a permit from the City of Tukwila, Washington. 2. I understand that state law requires that all building construction contractors be registered with the State of Washington. The exceptions to this requirement are stated under Section 18.27.090 of the Revised Code of Washington, a copy of which is printed on the reverse side of this Affidavit. I have read or am familiar with RCW 18.27.090. 3. I understand that prior to issuance of a permit for work which is to be done by any contractor, the City of Tukwila must verify either that the contractor is registered by the State of Washington, or that one of the exemptions stated under RCW 18.27.090 applies. 4. In order to provide verification to the City of Tukwila of my compliance with this requirement, I hereby attest that after reading the exemptions from the registration requirement of RCW 18.27.090, I consider the work authorized under this permit to be exempt under number /3, and will therefore not be performed by a registered contractor. 5. I understand that the licensing provision of RCW 19.28.161 through 19.28.271 shall not apply to persons making electrical installations on their own property or to regularly employed employees working on the premises of their employer. The proposed electrical work is not for the construction of a new building for rent, sale or lease. I understand that I may be waiving certain rights that I might otherwise have under state law in any decision to engage an unregistered contractor to perform constructio o rk. LAURIE A. WERLE NOTARY PUBLIC STATE OF WASHINGTON COMMISSION EXPIRES MAY 29, 2018 Owne • wner's Agent* Signed and sworn to before me this j 194 day of ,20(7. NO AR PUBIC in and for the State of Washington Residing at Name as commissioned: , County 4e�r�� My commission expires: 0 , f gei fi S 18.27.090 Exemptions. The registration provisions of this chapter do not apply to: 1. An authorized representative of the United States government, the state of Washington, or any incorporated city, town, county, township, irrigation district, reclamation district, or other municipal or political corporation or subdivision of this state; 2. Officers of a court when they are acting within the scope of their office; 3. Public utilities operating under the regulations of the utilities and transportation commission in construction, maintenance, or development work incidental to their own business; 4. Any construction, repair, or operation incidental to the discovering or producing of petroleum or gas, or the drilling, testing, abandoning, or other operation of any petroleum or gas well or any surface or underground mine or mineral deposit whenperformed by an owner or lessee; 5. The sale of any finished products, materials, or articles of merchandise that are not fabricated into and do not become a part of a structure under the common law of fixtures; 6. Any construction, alteration, improvement, or repair of personal property performed by the registered or legal owner, or by a mobile/manufactured home retail dealer or manufacturer licensed under chapter 46.70 RCW who shall warranty service and repairs under chapter 46.70 RCW; 7. Any construction, alteration, improvement, or repair carried on within the limits and boundaries of any site or reservation under the legal jurisdiction of the federal government; 8. Any person who only furnished materials, supplies, or equipment without fabricating them into, or consuming them in the performance of, the work of the contractor; 9. Any work or operation on one undertaking or project by one or more contracts, the aggregate contract price of which for labor and materials and all other items is less than five hundred dollars, such work or operations being considered as of a casual, minor, or inconsequential nature. The exemption prescribed in this subsection does not apply in any instance wherein the work or construction is only a part of a larger or major operation, whether undertaken by the same or a different contractor, or in which a division of the operation is made into contracts of amounts less than five hundred dollars for the purpose of evasion of this chapter or otherwise. The exemption prescribed in this subsection does not apply to a person who advertises or puts out any sign or card or other device which might indicate to the public that he or she is a contractor, or that he or she is qualified to engage in the business of contractor; 10. Any construction or operation incidental to the construction and repair of irrigation and drainage ditches of regularly constituted irrigation districts or reclamation districts; or to farming, dairying, agriculture, viticulture, horticulture, or stock or poultry raising; or to clearing or other work upon land in rural districts for fire prevention purposes; except when any of the above work is performed by a registered contractor; ii. An owner* who contracts for a project with a registered contractor, except that this exemption shall not deprive the owner of the protections of this chapter against registered and unregistered contractors. The exemption prescribed in this subsection does not apply to a person who performs the activities of a contractor for the purpose of leasing or selling improved property he or she has owned for less than twelve months; 12.* Any person working on his or her own property, whether occupied by him or her or not, and any person working on his or her personal residence, whether owned by him or her or not but this exemption shall not apply to any person who performs the activities of a contractor on his or her own property for the purpose of selling, demolishing, or leasing the property; 13. An owner* who performs maintenance, repair, and alteration work in or upon his or her own properties, or who uses his or her own employees to do such work; 14. A licensed architect or civil or professional engineer acting solely in his or her professional capacity, an electrician certified under the laws of the state of Washington, or a plumber certified under the laws of the state of Washington or licensed by a political subdivision of the state of Washington while operating within the boundaries of such political subdivision. The exemption provided in this subsection is applicable only when the person certified is operating within the scope of his or her certification; 15. Any person who engages in the activities herein regulated as an employee of a registered contractor with wages as his or her sole compensation or as an employee with wages as his or her sole compensation; 16. Contractors on highway projects who have been prequalified as required by RCW 47.28.070, with the department of transportation to perform highway construction, reconstruction, or maintenance work; 17. A mobile/manufactured home dealer or manufacturer who subcontracts the installation, set-up, or repair work to actively registered contractors. This exemption only applies to the installation, set-up, or repair of the mobile/manufactured homes that were manufactured or sold by the mobile/manufactured home dealer or manufacturer; 18.mAn entity Wholiolds'a valid electrical contractor's license under chapter 19.28 RCW that employs a certified journeyman electrician, a certified residential specialty electrician, or an electrical trainee meeting the requirements of chapter 19.28 RCW to perform plumbing work that is incidentally, directly, and immediately aptropriate to the like:in-kind replacement of a household applikee or other small household utilization equipment that requires limited electric power and limited waste and/or water connections. An electrical trainee must be supervised by a certified electrician while performing plumbing work. * Per Washington State Department of Labor and Industries lessee has been interpreted to be equivalent to owner for purposes of exemptions.