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HomeMy WebLinkAboutPermit D17-0066 - SEGALE - VACANT HOUSE DEMOLITIONSEGALE VACANT HOUSE DEMOLITION 5563 S 178 ST D17-0066 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 3523049090 Permit Number: 5563 S 178TH ST SEGALE VACANT HOUSE DEMOLITION Issue Date: Permit Expires On: D17-0066 4/25/2017 10/22/2017 Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: Address: License No: Lender: Name: SEGALE PROPERTIES LLC PO BOX 88028 , TUKWILA, WA, 98138 BARRY BENNETT PO BOX 88028 , TUKWILA, WA, 98138 SEGALE PROPERTIES LLC PO BOX 88028 , TUKWILA, WA, 98138 SEGALPL902CQ SEGALE PROPERTIES LLC Address: PO BOX 88028 , TUKWILA, WA, 98138 Phone: (206) 396-2012 Phone: (206) 575-2000 Expiration Date: 4/3/2018 DESCRIPTION OF WORK: REMOVE STRUCTURE AND FOUNDATION OF 1,010 SQ FT SINGLE FAMILY RESIDENCE. TERMINATE AND CAP ALL UTILITIES. PUMP AND REMOVE SEPTIC TANK. Project Valuation: $11,000.00 Type of Fire Protection: Sprinklers: Fire Alarm: Type of Construction: VB Electrical Service Provided by: TUKWILA Fees Collected: $802.17 Occupancy per IBC: R-3 Water District: HIGHLINE Sewer District: NONE,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: //%/IiG(,� Date: Off%/ a.Sh7 I hearby certify that I have read and examined this permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be complied with, whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws regulating construction or the performance of work. I am authorized to sign and obtain this development permit and agree to the conditions attached to this permit. Signature: / % Date: Print Name: ,l 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: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of this requirement. 5: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the Building Official from requiring the correction of errors in the construction documents and other data. 6: ***PUBLIC WORKS PERMIT CONDITIONS*** 7: 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. 8: Any material spilled onto any street shall be cleaned up immediately. 9: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation off-site or into existing drainage facilities. 10: 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. 11: 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. 12: 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. 13: 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. 14: Applicant shall provide Seattle & King County Public Health a Report of Wastewater Tank Abondonment. Community Environment Health, 900 Oakesdale Ave SW, Renton, WA 98057-5212. (206) 296-4932 15: Applicant/Contractor shall obtain a water capping permit from Highline Water District at (206) 824-0375. 16: Prior to any demolition work the applicant or contractor shall submit to Public Works a copy of Demolition permit from Puget Sound Clean Air Agency. 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 0 CITY OF TUKWILA Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Building Permit No. 0 0 (0 0 Project No. Date Application Accepted: Date Application Expires: ca . -, „A; (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 King Co Assessor's Tax No.: 3523049090 Site Address: 5563 S. 178th St. Tukwila, WA 98188 Tenant Name: Suite Number: PROPERTY OWNER Name: Barry Bennett Name: Segale Properties LLC Address: PO Box 88028 Address: PO Box 88028 City: Tukwila State: WA City: Tukwila State: WA ' Zip: 98138 CONTACT PERSON — person receiving all project communication Name: Barry Bennett Address: PO Box 88028 Address: PO Box 88028 Phone: (206) 575-2000 Fax: City: Tukwila State: WA Zip: 98138 Phone: (206) 396-2012 Fax: Email: bbennett@segaleproperties.com GENERAL CONTRACTOR INFORMATION Company Name: Segale Properties LLC Address: PO Box 88028 City: Tukwila State: WA Zip: 98138 Phone: (206) 575-2000 Fax: Contr Reg No.: CCSEGALPL902CC Exp Date: 04/03/2018 Tukwila Business License No.: BUS -0101320 H:\Applications\Forms-Applications On Line \2011 Applications\Permit Application Revised - 8-9-1 I.docu Revised: August 2011 bh Floor: New Tenant: ❑ Yes 21..No ARCHITECT OF RECORD Name: Segale Properties LLC Address: PO Box 88028 Company Name: Architect Name: Address: City: State: Zip: Phone: Fax: Email: ENGINEER OF RECORD Name: Segale Properties LLC Address: PO Box 88028 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: Segale Properties LLC Address: PO Box 88028 City: Tukwila State: WA Zip: 98138 Page 1 of 4 fl BUILDING PERMIT INFORMATIOlW— 206-431-3670 Valuation of Project (contractor's bid price): $ 10,000 Describe the scope of work (please provide detailed information): Demolish House Remove structure and foundation of 1,010 sf single family residence Terminate and cap all utilities. Pump and remove septic tank. Will there be new rack storage? ❑ Yes Existing Building Valuation: $ 121,000 m.. 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 EROTECTION/IJAZARDOUS MATERIALS: D Sprinklers ❑ Automatic Fire Alarm ❑ None 0 Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? 0 Yes 0 No If `yes', attach list of materials and storage locations on a separate 8-1/2" x 11" paper including quantities and Material Safety Data Sheets. SEPTIC SYSTEM 0 On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health Department. H:VApplications\Fonms-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 1s1 Floor 1,010 0 2nd Floor 3`d 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: Compact: Handicap: Will there be a change in use? ❑ Yes ❑ No If "yes", explain: FIRE EROTECTION/IJAZARDOUS MATERIALS: D Sprinklers ❑ Automatic Fire Alarm ❑ None 0 Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? 0 Yes 0 No If `yes', attach list of materials and storage locations on a separate 8-1/2" x 11" paper including quantities and Material Safety Data Sheets. SEPTIC SYSTEM 0 On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health Department. H:VApplications\Fonms-Applications On Line \201 I Applications\Permit Application Revised - 8-9-11.docx Revised: August 2011 bh Page 2 of 4 PUBLIC WORKS PERMIT INFORMATION — 206-433-0179 Scope of Work (please provide detailed information): Demolish House Remove structure and foundation of 1,010 sf single family residence Terminate and cap all utilities. Pump and remove septic tank. Call before you Dig: 811 Please refer to Public Works Bulletin #1 for fees and estimate sheet. Water District ❑ ...Tukwila 0...Water District #125 0 ...Water Availability Provided Sewer District ❑ ...Tukwila ❑ ...Sewer Use Certificate 0 .. Highline ❑...Valley View ❑ .. Renton ❑ ... Sewer Availability Provided 0 .. Renton ❑ .. Seattle Septic System: ❑ On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health Department. Submitted with 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 ❑ .. 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 ❑ .. Right-of-way Use - Profit for less than 72 hours ❑ .. Right-of-way Use — Potential Disturbance ❑ .. Work in Flood Zone ❑ .. Storm Drainage ❑ ...Sanitary Side Sewer m .. Abandon Septic Tank 0 .. Grease Interceptor m ...Cap or Remove Utilities 0 .. Curb Cut 0 .. Channelization ❑ ...Frontage Improvements 0 .. Pavement Cut 0 .. Trench Excavation ❑ ...Traffic Control 0 .. Looped Fire Line 0 .. Utility Undergrounding ❑ ...Backflow Prevention - Fire Protection Irrigation Domestic Water ❑ ...Permanent Water Meter Size... 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 0 Private 0 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 n:Wpplications\Forms-Applications On Line \2011 Applications\Pennit Application Revised - 8-9-1 I.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 AN r EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THEJLAWS OF T TATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER OR AUT Signature: Print Name: Mark A. Segale, V.P. of anager Mailing Address: PO Box 88028 H:\Applications\Fomts-Applications On Line \2011 Applications\Permit Application Revised - 8-9.11.docx Revised: August 2011 bh Date: 03/28/2017 Day Telephone: (206) 575-2000 Tukwila WA 98138 City State Zip Page 4 of 4 BULLETIN A2 TYPE C PERMIT FEE ESTIMATE PLAN REVIEW AND APPROVAL FEES DUE WITH APPLICATION PW may adjust estimated fees 36-G141-- PROJECT FGj4i- PROJECT NAME r nc L 1•-n (.1 PERMIT # 1)1-7 00 4)6 S543. s,.. 118 `4` cSi 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 Erosion .revention Wat urface Water Road ' ar ing/Access A. Total Improvements 3. Calculate improvement -based fees: B. 2.5% of first $100,000 of A. 000 �000. $250 (1) C. 2.0% of amount over $100,000, but Tess 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 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 $ (5) TOTAL PLAN REVIEW FEE DUE WITH PERMIT APPLICATION (1+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 02/21/17 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) $ Z 5 (6) 7. Pavement Mitigation Fee $ The pavement mitigation fee compensates the City for the reduced life span due to removal of roadway surfaces. The fee is based on the total square feet of impacted pavement per lane and on the condition of the existing pavement. Use the following table and Bulletin 1B to estimate the p Approx. Remaining Years Pavement Overlay and Repair Rate (per SF of lane width) 50 or less 20-15 (100%) $10.00 $37.00 15-10 (75%) $7.50 1,001 — 10,000 10-7 (50%) $5.00 $325.00 for the lS` 10,000 CY plus $66.00 for each additional 10,000 or fraction thereof 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. (7) $ (8) 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 1St 1000 CY plus $14.50 for each additional 1,000 or fraction thereof. 10,001 — 100,000 $325.00 for the lS` 10,000 CY plus $66.00 for each additional 10,000 or fraction thereof 100,001 or more $919.00 for ls` 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 02/21/17 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 11. Total A through E $ (9) 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 I. Other Fees Total A through I $ (10) DUE WHEN PERMIT IS ISSUED (6+7+8+9+10+11) $ 25 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) Installation \ Cascade Water Alliance RCFC 01.01.2017-12.31.201 Total Fee 0.75 $625 \; $6005/ $6630 1 $1125 $15 .50 $16,137.50 1.5 $2425 025 $32,450 2 $2825 $48,6b-..„ $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 02/21/17 Temporary Meter 0.75" $300 2.5" $1,500 3 Cash Register Receipt City of Tukwila DESCRIPTIONS PermitTRAK I ACCOUNT I QUANTITY PAID $301.25 D17-0066 Address: 5563 S 178TH ST Apn: 3523049090 $301.25 PUBLIC WORKS $300.00 BASE APPLICATION FEE R000.322.100.00.00 0.00 $250.00 PERMIT ISSUANCE/INSPECTION FEE R000.342.400.00.00 0.00 $25.00 CONSTRUCTION PLAN REVIEW R000.345.830.00.00 0.00 $25.00 TECHNOLOGY FEE $1.25 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R11358 R000.322.900.04.00 0.00 $1.25 $301.25 Date Paid: Tuesday, April 25, 2017 Paid By: SEGALE PROPERTIES Pay Method: CHECK 9024 Printed: Tuesday, April 25, 2017 3:18 PM 1 of 1 CRWY TEMS Cash Register Receipt City of Tukwila Receipt Number R11163 DESCRIPTIONS ACCOUNT QUANTITY PermitTRAK PAID $500.92 D17-0066 Address: 5563 S 178TH ST Apn: 3523049090 $500.92 DEVELOPMENT $486.32 PERMIT FEE R000.322.100.00.00 0.00 $292.01 PLAN CHECK FEE R000.345.830.00.00 0.00 $189.81 WASHINGTON STATE SURCHARGE 8640.237.114 0.00 $4.50 TECHNOLOGY FEE $14.60 TECHNOLOGY FEE R000.322.900.04.00 0.00 TOTAL FEES PAID BY RECEIPT: R11163 $14.60 $500.92 Date Paid: Tuesday, March 28, 2017 Paid By: SEGALE PROPERTIES LLC Pay Method: CHECK 2229 Printed: Tuesday, March 28, 2017 2:26 PM 1 of 1 RSYSTEMS INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION (206) 431-3670 Dr7-Oo(06,' 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 438-9350 Project: Type of Inspection: rte /b se._ Detele, LA4-ton, e a.(.c/ t)e ,o 55103 5. 170 ,s--f— D e Called: 3 -)2.-2,5g--,, Special Instructions: Date Wanted: 3 ! -f3-2/-- p.m. Requester: PhoneNo: 0 Approved per applicable codes. LJ Corrections required prior to approval. COMMENTS: ewiD /A1 L (/ bpcev-r-D Inspector:! f_02 Date: _3 -13 - 20IY' REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be. paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. INSPECTION NO. INSPECTION RECORD Retain a copy with permit -14361,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: `� T. y�1 �� r 1 37 Type of Inspection: I7i�, l� i Yk F i Addre Ad ,5..5 £, /7g + Date Called: J Special Instructions: perve / &ID Date Wanted: ) 3 - 47 -201�y a..-n.'J p.m. Requester: t 04 Phone No: ``5Ft Approved per applicable codes. Corrections required prior to approval. COMMENTS: r%' ci► t 04 P ``5Ft / cF 5 ois'OrccJ ,-,--/ 76,-L Inspector: Date: 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 INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION (206) 431-3670 .b (7- 6060 I� 6300 Southcenter Blvd., #100, Tukwila: WA 98188 Permit Inspection Request Line (206) 438-9350 Project: Type of Inspection: Address: 5523 L'- /7 711 Cr, Date Called: Special Instructions: b'wi-U N T tic)o- !'Y1 o1i776 U Date Wanted: (2 57`) 7 a.m. Requester: Phone No: It Approved per applicable codes. Corrections required prior to approval. COMMENTS: Inspector: Date 5-/7 REINSPECTION FEE REQUIRED: Prior to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. 1 a (17 d • 0 0.1 ▪ O C as I .8 m .6 ora ▪ 0 • a c • co • n. c 2 b o • ' Fes. •^' `_ N ii6 ' U ▪ P O a� .0>ta' co C 6< p C. U i+�? ,..,L) >0 4) 40••�O v •h C6 : :. CO .� • 1.+ • •- O FS U' GA O O O▪ �+� : U - "C DW _ 1Z3 '� "� CL S (3)✓ N n • a - a r ,--4, .U -, at as . , ,i-, a, c•, 1 cl -,•1• QI ▪ �. T4 c9 2 cvs V) O asQa U bA •44 j `.i W ' ,I .'teacr' v) a� .)' G' , rr ig (15 �,... v.9 ow.., 0 o r , o -0s ; ..,,.v,. ..._. PERMIT CENTER a31N33 M —I cu c cu x d T A m N 0 0 cnT 0606b0£ZS£ 0. n 5563 S. 178th St., Tukwila, WA 98188 :uoilowaa asnoH co C O F 0 0 b, O m d�� <0m5 01) it m 20 An Envitonmental Compliance Consulting Firm Report Date: November 9, 2006 Segale Properties Attn: Barry Bennett P.O. Box 88028 Tukwila, WA 98138 FLE WBE W2F5912535 Executive Summary RE: Asbestos & Lead Survey Report — 5563 South 178th St., Tukwila, WA. REVIEWED FOR CODE COMPLIANCE APPROVED APR 17 2011 City of Tukwila BUILDING DIVISION Dear Mr. Bennett: On November 2, 2006 under an agreement with your organization, we performed anasbestos and lead survey on the residence at 5563 South 178Th St., Tukwila, WA. At your request, the purpose of this survey was to ascertain the existence of asbestos containing materials associated with any structure being demolished, as well as providing characterization and quantities. In addition, areas where painted components are scheduled for demolition, lead samples were taken and analyzed. This survey was performed in conformance with procedures and methods outlined in applicable federal, state, and local regulations. This survey was performed by an accredited AHERA Building Inspector Claude Edward Robinson (ABIII-NES-07-04; Expiration Date: September 6, 2007). Investigating Protocol and Findings All samples were homogenized, collected, processed, and analyzed for content by Polarized Light Microscopy. AHERA protocol provides guidance for the number of samples of each material to be collected depending on its category and amount of material present. The goal of AHERA is to ensure statistically reliable data and it accomplishes this by requiring or suggesting a minimum number of samples to be collected, and in some cases, by using random sampling techniques to determine sampling locations. CORREC�ON LTR# Building materials that contain asbestos fibers in the amounts greater than 1 percent (1 %) is regulated by the Occupational Safety and Health Administration (OSHA) and Puget Sound Clean Air Agency. RECEIVED CITY OF TUKWILA 34004 9:h Avenue South + Building A, Suite 5 4 Federal Way, Washington 98003APR 11 2017 Telephone (253) 952-6717 ♦ Facsimile (253) 927-4714 p «-006 PERMIT CENTER ORION Environmental Services An Environmental Compliance Consulting Firm Suspect materials processed and found non -detect or containing < 1% for containing asbestos are listed in the table below: Suspect Material Inventory (Negative) MBterial:Homogenization Material Description Vinyl Sheeting (VS1) Brown Wood Grain VS with Tan Mastic Vinyl Sheeting (VS2) White/Yellow Texture VS with Tan Mastic Vinyl Sheeting (VS3) Dark Brown Wood Grain VS with Tan Mastic Mastic (MA1) Tan Carpet Mastic Wall System (WS1) Wallboard and Joint Compound Mastic (MA2) . Tan Cove Base Mastic Mastic (MA3) Tan Mastic Associated with Wood Flooring Miscellaneous (MISC1) Gray Insulation with Paper Backing Wall System (WS2) Wall Texture with Wallboard and Joint Compound Slipsheet (SS1) Black Slipsheet Associated with Deck Slipsheet (SS2) Black Slipsheet Associated with Siding Roofing Material (RM1) Gray Asphaltic Roofing Tile with Slipsheet Roofing Material (RM2) Red Asphaltic Roofing Tile with Slipsheet Negative for ACM Table Upon completion of the field investigation, review of the field notes, and review of the laboratory data, all materials (as outlined in the suspect material table) were found to contain asbestos in amounts of less than one percent. Please note that should additional materials (not referenced in this report) be discovered as a result of remodeling or demolition, they are to be presumed asbestos containing unless subsequent sampling by an accredited inspector proves otherwise. Lead For the purpose of this investigation, lead-based paint is defined as paint or other surface coatings (stain, shellac, or vamish) applied prior to 1978 and containing lead equal to or exceeding 1.0 milligram(s) per centimeter or 0.5 percent lead by weight in a dried state, unless your city or state requires a more strict interpretation. The property was tested for lead-based paint using portions of the inspection protocol of Chapter 7 of the HUD Guidelines for the Evaluation and Control of Lead -Based Paint Hazards in Housing (1997 Revision). HUD guidelines were implemented for protection of residents. Orion Environmental Report #064892 November 9, 2006 5563 South 178th St, Tukwila, WA Page 2 of 5 Environmental Services An Environmental Compliance Consulting Firm In addition, Washington State's Department of Labor and Industries defines lead-based paint as paint with any detectable concentrations of lead are regulated, thus creating the requirement for implementing worker, and in some cases, environmental protection. Labor and Industries guidelines were implemented for contractor and worker protection. Also, the Washington State's Department of Ecology requires that wastes from demolition or renovation activities that exhibit toxic characteristics be analyzed by using Toxicity Characteristic Leaching procedure (TCLP) (40CFR 261.24). TCLP analysis isused to determine if lead associated with constituents are below the allowable regulatory threshold, of 5.0 ppm (milligrams/liter) of lead in leached solution. TCLP testing will be carried out when a waste stream can be determined from the scope of work. The purpose of this report is limited to providing the client an evaluation concerning potential lead-based paint,. specified in the report, and evident at the site at the time of the evaluation. It is also understood that the report will pertain only to the subject property. Use of the report and data contained therein for other purposes, is at the sole risk and responsibility of the user. Three painted components were collected from the residence and analyzed for total lead. The results of the investigation indicate that the structure at this property has paint with detectable amounts of lead. Painted components meeting the criteria of Labor and Industries are noted below: Painted components meeting the criteria of WA Labor and Industries for Lead Component .S ibstrate Locations, PercentiL:ead' BypWelght7 Green&Peach Paint Wood Exterior 0.343 Light Green Paint WB Interior 0.007 White Paint WB Interior 0.001 The sampled components contain lead in detectable amounts. Therefore, exposure assessments and worker protection measures must be applied. Orion Environmental Report #064892 November 9, 2006 5563 South 178th St, Tukwila, WA Page 3 of 5 Environmental Services An Environmental Compliance Consulting Firm PCB Nearly all ballasts made prior to 1979 contain PCB's. Ballasts made after July 1, 1978 that do not contain PCB's are required to be clearly marked "No PCB's". Exposure to leaking or .damaged Tight ballasts of fluorescent light fixtures ballasts may be of some concern. Particularly if electricians and maintenance technicians are not being provided proper protective equipment when handling and removing old light ballasts that can result in contact with PCB- contaminated surfaces. Chlorodiphenyls are oily, 'viscous liquids that vary in color from dark brown to pale yellow. Airborne exposures from leaking ballasts are of less concern than skin contact because the vapor pressures. Both of the PELs for chlorodiphenyls have skin designations; therefore, protection must be provided to prevent potential absorption in the body as a result of skin contact. The most prominent effects from occupational exposure to PCBs have been skin and mucous membrane effects. Lighting was examined in the house. Three ballasts were located which were clearly marked "No PCB's". Mercury Thermostats: Thermostats were observed in the building and ascertained of a possible source of mercury components. No Mercury Thermostats were found in this building. Inaccessible Locations ORION Environmental Services cannot make statements as to the potential presence or absence of asbestos containing materials in inaccessible areas or areas not considered. Disclaimer ORION Environmental Services has conducted a survey for asbestos and metal containing materials at the residence at 5563 South 178th St., Tukwila, WA in conformance with the requirements established by the United States Environmental Protection Agency and the Occupational Safety and Health Administration prior to the engagement of renovation or demolition of the building. The sampling strategy and analytical method employed conform to existing and enforceable standards and methods. This Executive Summary of the investigation performed at the subject site is intended to describe asbestos containing materials with the potential of being impacted. We represent that our services were performed within the limits prescribed by applicable regulations and in a manner consistent with the level of care and skill ordinarily exercised by other professional consultants under similar circumstances. No other representation is made to the client, expressed or implied, and no warranty or guarantee is included or intended. Orion Environmental Report #064892 November 9, 2006 5563 South 178th St, Tukwila, WA Page 4 of 5 ORION EnvironmentalServices An Environmental Compliance Consulting Firm The opinions presented herein apply to the site conditions existing at the time of our investigation, and interpretation of current regulations pertaining to asbestos containing material. Therefore, our opinions and recommendations may not apply to future conditions that may exist at the site we have not had the opportunity to evaluate. Future regulations pertaining to these materials may impose stricter restrictions on renovation or demolition work. The regulations should always be verified prior to any work involving these materials. The inspector is not held responsible or liable for any repairs or replacements with regards to this property, systems, components, or the contents therein. The acceptance of this report by the client acknowledges the client's agreement to all of the terms and conditions of the inspection contract. ORION retains active copies of reports for a period of not less than one year.. Retained copies of reports, field data, field notes, laboratory test data, calculations, estimates, and other documents prepared by ORION as instruments of service, shall remain the property of ORION. Other than the Client, other agencies of the U.S. Federal Government, and the Owner, reports submitted with respect to services performed under this contract may not be extended to third parties without prior written consent. Questions concerning this Executive Summary may be addressed the undersigned. Thank you for the opportunity to serve you. I hope we can be of assistance to you on future projects. If there is anything additional I can do to expedite your operation, please do not hesitate to let me know. Professionally Yours, ORION Environmental Services, Inc Building Inspector Claude Edward Edward Robinson AHERA Building Inspector ORION Environmental Services Reviewer Donna McNeal AHERA Building Inspector, CEO ORLON Environmental Services Orion Environmental Report #064892 November 9, 2006 5563 South 178th St, Tukwila, WA Page 5 of 5 ORIONEnvironmental Services An Environmental Compliance Consulting Firm Total Lead Test Report EPA Method 7420 Client Segale Properties Date November 8, 2006 P.O. Box 88028 Page Page 1 of 1 Tukwila, WA 98138 Invoice 064897 Attn: Barry Bennett Date Received • November 2, 2006 Project Number N/A Project Name 5563 South 178th Street Tukwila, Washington Client ORION Number Number Total Lead Material LOD (mg/kg) PPM % by Weight Description (mg/kg) 5563-01 61103-93 Green & Peach Paint—Exterior 35.7 3,426.7 0.343 5563-02 61103-94 Light Green Paint— Interior 31.3 71.7 0.007 5563-03 61103-95 White Paint — Interior 23.8 8.878 0.001 Analyst Quality Assurance Information Method Blank: <5.0 mg/1 Linear Regression Lower Limit: 0.990 Actual Batch Linear Regression:. 0.999 Check Standard per Set: ± 0.5 mg/1 Allen Clark Laboratory Analyst Reviewed By Donna McNeal Laboratory Director Leafing Environmenta(Comphance Consulting Into the 21" Century 34004 9th Avenue South • Building A, Suite 5 • Federal Way, Washington 98003-6740 Seattle (253) 874-8118 • Tacoma (253) 952-6717 • Facsimile (253) 927-4714 ♦ email ORION6717@aol.com WBE W2F5912535 n � ORIONEnvironmental Services An Environmental Compliance Consulting Firm Polarized Light Microscopy Test Report EPA Method 600/R-98/116 Client Segale Properties P.O. Box 88028 Tukwila, WA 98138 Attn: Barry Bennett Project Number Project Name N/A 5563 South 178th Street Tukwila, Washington Client Orion Number Number Stereo Scope Exam Date Page Invoice Date Received November 7, 2006 Page 1 of 3 064892 November 2, 2006 Sample Asbestos Other Treatment Percent Type Fibers Cellulose 5563-01a 61103-39a Brown Wood Grain Pattern ND Vinyl Sheeting Homogeneous 5563-01b 61103-39b Tan Mastic Chloroform ND Cellulose Assoc. w/ 5563-01a 5563-02a 61103-40a White / Yellow Textured ND Cellulose Vinyl Sheeting Homogeneous 5563-02b 61103-40b Tan Mastic Chloroform ND Cellulose Assoc. w/ 5563-02a 5563-03a 6110341a Dark Brown Wood Grain ND Cellulose Pattern Vinyl Sheeting Homogeneous Chloroform ND Cellulose Chloroform ND Cellulose ND Cellulose ND Cellulose ND Cellulose ND Cellulose ND Cellulose 5563-03b 5563-04 5563-05a 5563-05b 5563-06a 5563-06b 5563-07a 61103-41b Tan Mastic 61103-42 61103-43a 61103-43b 61103-44a Joint Compound 61103-44b Wallboard Homogeneous 61103-45a Joint / Compound 34004 9th Avenue soouthw` Si do gbA, Suite 5 • Federal Way, Washington 98003-6740 Seattle (253) 874-8118 • Tacoma (253) 952-6717 • Facsimile (253) 927-4714 • email ORION6717@aol.com Assoc. w/ 5563-03a Tan Carpet Mastic Homogeneous Joint Compound Assoc. w/ 5563-05b Wallboard Homogeneous Assoc. w/ 5563-06b WBE W2F5912535 n � ORIONEnvironmental Services An Environmental Compliance Consulting Firm Polarized Light Microscopy Test Report EPA Method 600/R-98/116 Client Segale Properties Date November 7, 2006 P.O. Box 88028 Page Page 2 of 3 Tukwila, WA 98138 Invoice 064892 Attn: Barry Bennett Date Received November 2, 2006 Project Number N/A Project Name 5563 South 178`h Street Tukwila, Washington Client Orion Sample Asbestos Other Number Number Stereo Scope Exam Treatment Percent Tyne Fibers 5563-07b 61103-45b Wallboard ND - Cellulose Homogeneous 5563-08 61103-46 Tan Cove Base Mastic Chloroform ND Cellulose Homogeneous 5563-09 61103-47 Tan Flooring Mastic ,Chloroform ND Cellulose Homogeneous 5563-10 6110348 Gray Insulation ND Cellulose Homogeneous 5563-11a 61103-49a Texture - ND Assoc. w/ 5563-11 c. 5563-11b 61103-49b Joint Compound ND Cellulose Assoc. w/ 5563-11 c 5563-1lc 61103-49c Wallboard ND Cellulose Homogeneous 5563-12a 61103-50a Texture - ND Assoc. w/ 5563-12c 5563-12b 61103-50b Joint Compound ND Cellulose Assoc. w/ 5563-12c 5563-12c 61103-50c Wallboard - ND Cellulose Homogeneous 5563-13a 61103-51a Texture ND Assoc. w/ 5563-13c 5563-13b 61103-51b Joint Compound ND Cellulose Assoc. w/ 5563-13c 5563-13c 61103-51c Wallboard ND Cellulose Homogeneous 34004 911' Avenue South ♦ Building A, Suite 5 • Federal Way, Washington 98003-6740 Seattle (253) 874-8118 • Tacoma (253) 952-6717 • Facsimile (253) 927-4714 • email ORION6717@aol.com WBE W2F5912535 n ORIONEnvironmental Services An Environmental Compliance Consulting Firm Polarized Light Microscopy Test Report EPA Method 6001R-981116 Client Segale Properties P.O. Box 88028 Tukwila, WA 98138 Attn: Barry Bennett Project Number N/A Project Name 5563 South 178th Street Tukwila, Washington Date November 7, 2006 Page Page 3 of 3 Invoice 064892 Date Received November 2, 2006 Client Orion Sample Asbestos Number Number Stereo Scone Exam Treatment Percent Type 5563-14 61103-52 Deck Building Paper Homogeneous 5563-15 61103-53 Siding Building Paper Homogeneous 5563-16 61103-54 Gray Asphalt Roofing Tile Homogeneous 5563-17 61103-55 Gray Asphalt Roofing Tile - ND Homogeneous 5563-18a 61103-56a Red Asphalt Roofing Tile - ND Homogeneous 5563-18b .61103-56b Building Paper ND Assoc. w/ 5563-18a Dup: Laboratory QA/QC Duplicate; M; Mastic [(a), (b), (c), etc.]: Sample layers numbered from front to back. Comments: For layered samples, each component has been analyzed separately. ND means non -detect for asbestos fibers by EPA Method 60018-98/116. Disclaimers: PLM has been known to miss asbestos in a small percentage of samples that contain asbestos. Thus negative PLM results cannot be guaranteed. This report may only be reproduced in full with written approval of ORION Environmental Services. Orion samples are analyzed according to EPA Method 600/R-98/116 by ATHA Bulk Asbestos Analytical Testing Program (102911) proficient analysts. ND ND Analyst Other Fibers Cellulose Cellulose Cellulose Cellulose Cellulose Cellulose Donna McNeal Reviewed By Allen lark Laboratory Director, CEO Laboratory Analyst 340(14 9`1' Avenue c [h • Butidinglk, SQite 5• F deral W y W n ngto 198003-6740 Seattle (253) 874-8118 • Tacoma (253) 952-6717 • Facsimile (253) 927-4714 ♦ email ORION6717@aol.com WBE W2F5912535 City of Tukwila Allan Ekberg, Mayor Department of Community Development - Jack Pace, Director r September 20, 2017 Barry Bennett Segale Properties PO Box 88028 Tukwila, WA 98138 RE: Request for Extension #1 Permit Number D17-0066 Dear Mr. Bennett, This letter is in response to your written request for an extension to Permit D17-0066. The Building Official, Jerry Hight, has reviewed your letter and considered your request to extend the above referenced permit. It has been determined that the City of Tukwila Building Division will be granting an extension to the permit through April 22, 2018. If you should have any questions, please contact our office at (206) 431-3670. Sincerely, Rachelle Ripl Permit Technician File: Permit No. D17-0066 Tukwila City Hall • 6200 Southcenter Boulevard • Tukwila, WA 98188 • 206-433-1800 • Website: TukwilaWA.gov SEGALE PROPERTIES A. LIMITED L1 -ABILITY COMPANY COMMERCIAL • INDUSTRIAL • AGRICULTURAL • NATU--RA.L RESOURCES September 14, 2017 City of Tukwila Attn: Building Official 6300 Southcenter Blvd. Tukwila, •WA 98188 Re: Permit No. D17-0066 Extension . Dear Building Official, . - RECEIVED :. CITY OF TUKWILA SEP i 8 2017 PERMIT CENTER Segale Properties would like to request an extension for Permit Number D17-0066. It is currently set to expire on October 22, 2017. We have scheduled the demolition work for this fall and plan to be done by early spring of 2018. Thank you for your consideration in this matter. Very truly yours, SEGALE PROPERTIES LLC Barry Bennett Request for Extension # Current Expiration Date: 0 2 ' Extension Request: ri Approved for days ❑ Denied (provide explanation) Signature/Initials J PO BOX '880'2'8 • TUKWILA, WA 98138 • 5811 SEGALE PARK DRIVE C • TUKWILA, WA 98188 P 2'06157-5.20.00. • F 206.'575.1837 • www.segaleproperties.com 8/31/2017 City of Tukwila Department of Community Development BARRY BENNETT PO BOX 88028 TUKWILA, WA 98138 RE: Permit No. D17-0066 SEGALE VACANT HOUSE DEMOLITION 5563 S 178 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 10/22/2017. 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 10/22/2017, 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: D17-0066 6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 April 06, 2017 Q Q City of Tukwila Department of Community Development BARRY BENNETT PO BOX 88028 TUKWILA, WA 98138 RE: Correction Letter # 1 DEVELOPMENT Permit Application Number D17-0066 SEGALE VACANT HOUSE DEMOLITION - 5563 S 178 ST Dear BARRY BENNETT, 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 (206)-431-3677 if you have questions regarding these comments. Provide asbestos survey and/or PSAPCA mitigation results. . 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 206-431-3655. Sincerely, Bill Rambo Permit Technician File No. D17-0066 6300 Southcenter Boulevard Suite #100 • Tukwila Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 °PERMIT COORD COPY; PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: D17-0066 DATE: 04/11/17 PROJECT NAME: SEGALE VACANT HOUSE DEMOLITION SITE ADDRESS: 5563 S 178 ST Original Plan Submittal Revision # before Permit Issued X Response to Correction Letter # 1 Revision # after Permit Issued DEPARTMENTS: 114,11 Building Division c Public Works ❑ Fire Prevention Structural Planning Division ❑ ❑ Permit Coordinator PRELIMINARY REVIEW: Not Applicable ❑ (no approval/review required) DATE: 04/13/17 Structural Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 05/11/17 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 0 Ping 0 PW 0 Staff Initials: 12/18/2013 9ERM1T COORD COPY ° PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: D17-0066 DATE: 03/28/17 PROJECT NAME: SEGALE VACANT HOUSE DEMOLITION SITE ADDRESS: 5563 S 178 ST X Original Plan Submittal Response to Correction Letter # Revision # before Permit Issued Revision # after Permit Issued DEPARTMENTS: Co>M jZ Building Division 111 �lcWor isjC P NPr Fire Prevention Structural Istkooe_s Planning Division ❑ Permit Coordinator PRELIMINARY REVIEW: Not Applicable (no approval/review required) DATE: 03/30/17 Structural Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved DUE DATE: 04/27/17 ❑ Approved with Conditions ❑ Corrections Required (corrections entered in Reviews) Denied (ie: Zoning Issues) Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: `-10v( Departments issued corrections: Bldg Fire 0 Ping 0 PW ❑ Staff Initials: 12/18/2013 Date: 4/10/17 0 City of Tukwila 0 Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206-431-3670 Web site: http://www.TukwilaWA.gov REVISION SUBMITTAL Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Plan Check/Permit Number: DI7-0066 ❑ Response to Incomplete Letter # ❑X Response to Correction Letter # 1 ❑ Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner ❑ Deferred Submittal # Project Name: Segale Vacant House Demolition S 178th Project Address: 5563 S. 178th St. Tukwila, WA 98188 Contact Person: Barry Bennett Phone Number: 206-396-2012 Summary of Revision: 1.) Attached documentation providing Asbestos & Lead Report from Orion Environmental Services. RECEIVED CITY OF TUKWILA APR 1 1 2017 PERMIT CENTER Sheet Number(s): N/A "Cloud" or highlight all areas of revision including dato revision C Received at the City of Tukwila Permit Center by: N.—Entered in TRAKiT on s 1 ` L 1 W:\Pennit Center\TemplatesWonns\Revision Submittal Form.doc Revised: August 2015 SEGALE PROPERITIES LLC Home Espanol Contact Safety & Health Claims & Insurance CoWashington State Department of Labor & Industries Search L&I Page 1 of 2 A -Z index Help - My L&1 Workplace Rights Trades & Licensing SEGALE PROPERITIES LLC Owner or tradesperson Principals SEGALE, MARIO A, PARTNER/MEMBER SEGALE, MARIO A, AGENT Doing business as SEGALE PROPERITIES LLC • UBI No. 602.023 533 PO BOX 88028 TUKWILA, WA 98138-2028 206-575-2000 KING County Business type Limited Liability Company Governing persons LISA M ATKINS TINA A COVEY; DEVELOPMENT METRO LAND; TERESA NADEAU; NITA L SEGALE; Verify the contractor's active registration ,'cense / certification (depending on trade) and any past violations. Construction Contractor License specialties GENERAL License no. SEGALPL902CQ Effective — expiration 02/18/2010— 04/03/2018 Bond SAFECO INS CO OF AM Bond account no. 6115146 Active. Meets current requirements. $12,000.00 Received by L&I Effective date 03/28/2002 02/18/2010 Expiration date Until Canceled Insurance Alaska National Insurance Co $1,000,000.00 Policy no. 17DLS31006 Received by L&I Effective date 03/31/2017 04/01/2017 Expiration date 04/01/2018 Insurance history Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602023533&LIC=SEGALPL902CQ&SAW= 4/18/2017 SEGALE PROPERITIES LLC Savings No savings accounts during the previous 6 ye.. eriod. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period, but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID Account is current. 878,961-02 Doing business as SEGALE BUSINESS PARK Estimated workers reported Quarter 4 of Year 2016 "51 to 75 Workers" L&I account representative T3 / KAYLENE MONIER (360)902-6627 - Email: BRKB235@Ini.wa.gov IWorkplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Inspection results date 12/09/2014 Inspection no. 317552669 Location 196th St and Southcenter Pkwy. Tukwila, WA 98188 Violations Page 2 of 2 © Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington. { Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602023533&LIC=SEGALPL902CQ&SAW= 4/18/2017