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Permit D19-0128 - PATTON RESIDENCE - DEMO MOBILE HOME
PATTON DEMO 11545 4QTH AVE S D19-0128 Parcel No: Address: Project Name: �� �� City of Tukwila Deportment of Community Development 63VUfou,hcpnterBoulevard, Suite #1OO Tukwila, Washington g8188 Phnne:306'431'3670 Inspection Request Line: 206'438-9350 Web site: http://www.TukwilaWA.Rov 7340600182 PATr8NDEKA0 DEVELOPMENT PERMIT Permit Number: O19'01I8 Issue Date: 5/30/2019 Permit Expires On: 11/26/2819 Owner: Address: Contact Person: Name: Address: Contractor: Name: Address: License No: Lender: Name: 1153540THAVE S,TUKVV|UA,WA, 98168 ll5]540THAVE S'TUKVV|U\WA, 98168 OWNER AFFIDAVIT MATTHEVV PATTON ''' ''' Phone: (I06) 679'3157 Phone: Expiration Date: DESCRIPTION OFWORK: DEMOLISH, REMOVE MOB|LEHOK4E. PUBLIC WORKS ACTIVITIES INCLUDE CAPPING OFTHE EXISTING WATER SERVICE, EROSION [ONTRTOLSEPTIC SYSTEM ABANDONMENT PERFORMED PRIOR TVPERMIT ISSUANCE. Project Va|uatinn: $6000.00 Type of Fire Protection: Sprinklers: NO Fire Alarm: NO Type ofConstruction: V8 Electrical Service Provided by: TUKWILA Fees Collected: $651.33 Occupancy per IBC: R3 Water District: TVKVV|Lx Current Codes adopted bythe City ofTukwila: international Building Code Edition: international Residential Code Edition: International Mechanical Code Edition: Uniform Plumbing [ode Edition: International Fuel Gas Code: 015 2015 2015 3015 2015 National Electrical Code: VVACities Electrical Code: VVA[Z96'46B: WAState Energy Code: 2017 2017 017 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: Permit Center Authorized Signatu Volumes: Cut: 0 Fill: 0 Number: 0 No .,-dc-te Date:"/`"/ 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 regulati c struction or the performance of work. I am authorized to sign and obtain this development permit a e to the conditions attached to this permit. Signature: Print Name: Date;�j: ,/ 5- This permit shall become null and void if the work is not commenced within 180 days for the date of issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection. PERMIT CONDITIONS: 1: ***BUILDING PERMIT CONDITIONS*** 2: All permits, inspection record card and approved construction documents shall be kept at the site of work and shall be open to inspection by the Building Inspector until final inspection approval is granted. 3: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of this requirement. 4: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the City of Tukwila Building Department (206-431-3670). 5: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center. 6: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the Building Official from requiring the correction of errors in the construction documents and other data. 7: 1. No vegetation removal shall occur unless it is first reviewed and approved through a Shoreline Tree Removal and Vegetation Clearing Permit. 8: ***PUBLIC WORKS PERMIT CONDITIONS*** 9: Call to schedule mandatory pre -construction meeting with Scott Moore, Public Works Inspector, (206) 433- 0179. 10: 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. 11: Permit is valid between the weekday hours of 7:00 a.m. and 5:00 p.m. only. Coordinate with the Public Works Inspector for any work after 5:00 p.m. and weekends. 12: No work under this permit during weekend hours without prior approval by Public Works. Coordinate with the Public Works Inspector. 13: Any material spilled onto any street shall be cleaned up immediately. 14: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation off -site or into existing drainage facilities, 15: 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. 16: 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. 17: 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. 18: Water meter shall be returned to the Minkler Shops at (206) 433-1860 for a meter reading a minimum of every sixty (60) days. Billing for water usage shall be generated upon final return of the water meter. 19: Please show existing water meters and water service to each building. Per Tukwila Municipal Code, each building shall be metered separately. Any modification to existing irrigation system will require an irrigation permit. 20: 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 was submitted with permit application. 21: Water service be plugged at the water main if it is going to be abandoned. If the water service will be used again in the near future for a new building, it shall be capped capped at the property line and at the 1/2" water meter respectively. PERMIT INSPECTIONS REQUIRED Permit Inspection Line: (206) 438-9350 1700 BUILDING FINAL** 5200 EROSION MEASURES 5210 EROSION MEASURES FNL 0101 PRE -CONSTRUCTION 1600 PUBLIC WORKS FINAL 5070 SANITARY SIDE SEWER 5130 WATER METER - PERM 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. i)lq • ni Project No. Date Application Accepted: 4- 1-7- 9 Date Application Expires: 0— 17- 19 (For office use only) CONSTRUCTION PERMIT APPLICATION Applications and plans must be complete in order to be accepted for plan review. Applications will not be accepted through the mail or by fax. **Please Print** SITE LOCATION Site Address:_11545 40th Ave S Tukwila WA 98168 Tenant Name:PeL\k\ 'be-A(1'N° R P RTY OWNER Name: Matthew Patton Address: 11535 40th Ave S. City: Tukwila State: WA Zip: 98168 CONTACT PERSON — person receiving all project communication Name: Matthew Patton Address: 11535 40th Ave S City: Tukwila State: WA Zip:98168 Phone: 206) 679-3157 Fax: Email: matt@evergreenhvac.com GENERAL CONTRACTOR INFORMATION Company Name: NA Address: City: State: Zip: Phone: Fax: Contr Reg No.: Exp Date: Tukwila Business License No.: King Co Assessor's Tax No.:_7340600182 Suite Number: New Tenant: Floor: Yes X ..No ARCHITECT OF RECORD Company Name: NA Architect Name: Address: City: State: Zip: Phone: Fax: Email: ENGINEER OF RECORD Company Name: NA Engineer Name: Address: City: State: Zip: Phone: Fax: Email: LENDER/BOND ISSUED (required for projects $5,000 or greater per RCW 19.2 .095) Name: NA Address/53S— re ititAe... ‘4 CitY<Ifid,/ks State4)1 Zip: 58/A pplicationaWorms-Applicai ioiu On Line\ 2012 ApplicationsWermit Application Revised - 2-7-12.docx Revised: February 2012 Page 1 of 4 UILDING PERMIT INFORMATION06-431-3670 Valuation of Project (contractor's bid price): $ tart Describe the scope of work (please provide detailed info Existing Building Valuation: $ ion : Demolish / remove mobil home Will there be new rack storage? [I] ....Yes XI ..No If yes, a separate permit and plan submittal will be required. Provide All Building Areas in Square Footage Below Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC Ig Floor 1,152 Mobil Home R1 tad Floor Yd Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck PLANNING DIVISION: Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling. provide the following: Lot Area (sq ft): 6750 Floor area of principal dwelling: Floor area of accessory dwelling: *Provide document; 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? 0 Yes 0 No If "yes", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: 0 .......Sprinklers 0 Automatic Fire Alarm X None D....... 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 II" 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. HMpplicationsWorrns-ApplicaliansOn Linc12012 ApplicationsTermit Application Revised - 2-7-I2.doce Revised: February 2012 Page 2 of 4 • PtTBLIC WORKS PERMIT INFOQATION — 206-433-0179 Scope of Work (please provide detailed information):_ Demolish / remove mobil home Call before you Dig: 811 Please refer to Public Works Bulletin #1 for fees and estimate sheet. Water District o .. Tukwila 0 ...Water District #125 .. • Water Availability Provided Sewer District 0 Tukwila .. • Sewer Use Certificate ...Valley View 0 ...Sewer Availability Provided ... High I ine O... Renton 0... Renton 0... 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): O.. Civil Plans (Maximum Paper Size — 22" x 34") 0 .. Technical Information Report (Storm Drainage) 0 .. Bond 0...Insurance 0 Easement(s) D... Geotechnical Report 0...Maintenance Agreement(s) P.. Traffic Impact Analysis .. Hold Harmless — (SAO) 0 .. Hold Harmless —(ROW) Proposed Activities (mark boxes that anplv): Right-of-way Use - Nonprofit for less than 72 hours 0... Right-of-way Use - Profit for less than 72 hours O.. Right-of-way Use - No Disturbance 0... Right-of-way Use — Potential Disturbance Construction/Excavation/Fill - Right-of-way 0 Non Right-of-way 0 o .. Total Cut cubic yards 0... Work in Flood Zone D.. Total Fill cubic yards 0...Storm Drainage 0 .. Sanitary Side Sewer 0...Abandon Septic Tank 0... Grease Interceptor .. • Cap or Remove Utilities 0... Curb Cut 0... Channelization o .. Frontage Improvements 0... Pavement Cut 0... Trench Excavation 0 Traffic Control 0... Looped Fire Line ... Utility Undergrounding 0.. Backflow Prevention - Fire Protection 97 Irrigation ss Domestic Water 0 .. Permanent Water Meter Size (1) .. • Temporary Water Meter Size (I) o .. Water Only Meter Size O.. Sewer Main Extension Public P Water Main Extension Public 0 WO # (2)__" WO # (3) " WO # WO # (2) " WO # (3) " WO # WO # 0.. Deduct Water Meter Size Private 0 Private 0 FINANCE INFORMAT1ON Fire Line Size at Property Line Number of Public Fire Hydrant(s) .. Water 0 .. Sewer O.. Sewage Treatment Monthly Service Billing to: Name: Day Telephone: Mailing Address: City Stale Zip Water Meter Refund/Billing: Name: Mailing Address: Day Telephone: City State Zip HAApplicationaorms-Applications On Linet.2012 ApplientionsTermit Application Revised - 2-7-12.doex Revised: Fcbtuary 2012 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 HE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OW , .tis . UTHORIZED AGENT: Signature: Print Na atthew Patton Mailing Address:_ 1 1535 40th Ave S. Tukwila WA 98168 Date: r/'T %y Day Telephone:_206) 679-3157 H:WpplicationsWorms•Applications On Linei2012 ApplicalionsU'ermit Application Revised - 2-2-12.doct Revised: February 2012 Page 4 of 4 Cash Register Receipt City of Tukwila Receipt Number R17758 DESCRIPTIONS ACCOUNT QUANTITY ': PAID Pe itTRAK $273.34 D19-0128 Address: 11545 40TH AVE S Apn: 7340600182 $273.34 Credit Card Fee $7.96 Credit Card Fee R000.369.908.00.00 0,00 57.96 DEVELOPMENT $15,00 PW PERMIT ISSUANCE/INSPECTION FEE R000.342.400.00.00 0.00 5750 PW CONSTRUCTION PLAN REVIEW R000.345.830.00.00 0.00 57.50 PUB IC WQRKS $250.00 BASE APPLICATION FEE R000, 22.100.00,00 0,00 $250.00 TECHNOLOGY FEE $0.38 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R17758 R000.322.900.04,00 0.00 $0.38 - $273.34 Date Paid: Thursday, May 30, 2019 Paid By: MATTHEW PATTON Pay Method: CREDIT CARD 01732D Printed: Thursday, May 30, 2019 12:41 PM 1 of 1 7.4.1 SYSTEMS DESCRIPTIONS ACCOUNT QUANTITY PAID PermitTRAK $377.99 D19-0128 Address: 11545 40TH AVE S Apn: 7340600182 $377.99' Credit Card Fee $11.01 Credit Card Fee R000,369.908.00.00 0.00 $11,01 DEVELOPMENT $356.38 PERMIT FEE R000.322.100.00.00 0.00 $212.05 PLAN CHECK FEE R000,345.830.00.00 0,00 $137.83 WASHINGTON STATE SURCHARGE B640.237.114 0.00 $6.50 TECHNOLOGY FEE $10.60 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R17430 R000.322.900.04.00 0.00 $10.60 $377.99 Date Paid: Wednesday, April 17, 2019 Paid By: MATTHEW PATTON Pay Method: CREDIT CARD 05873D Printed: Wednesday, April 17, 2019 4:29 PM 1 of 1 YSTEMS CO TUKWILA ETRAKIT 6200 SOUTHCENTER BLVD TUKWILA, WA 98188 206-433-1870 CITY OF TUKWILA Date: 04/17/2019 04:29:23 PM CREDIT CARD SALE VISA CARD NUMBER: **********8974 K TRAN AMOUNT: $377.99 APPROVAL CD: 05873D RECORD #: 000 CLERK ID: kandace Thank you! Customer Copy 0 CO TUKWIL4 FTR4xIT 6280 SOUTHCENTER 8LVD TUKWILA, NA 98188 286'433'1870 CITY OF TVKWIL4 Date: 05/30/2019 12:48:31 PM CREDIT CARD SALE VISA CARD NUMBER: w********8974 K TRAm AMOUNT: $27].]4 APPROVAL CD; 0I732D RECORD #: 000 CLERK ID: kandace Thank you! Customer Copy INSPECTION RECORD Retain a copy with permit INSPECTION NO, PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 3670 Permit Inspection Request Line (206) 438-9350 Project 1 Type of Inspection: �' tt'�, r .aih / /17-'"/% Address: Date Called: Special Instructions: Date Wanted: aa, p.m. Requester: Phone No: TApproved per applicable codes. Corrections required prior to approval. COMMENTS: •I ns pec 71-5 Date: / 7 -- REINSPECTI©N FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspectioni. Dedicated Deconstruction LLC. 7001 Seaview Ave NW #160 Seattle, WA 98117 Ph. 206.853.7451 RECEIVED APR 17 2019 TUKWILA PUBLIC WORKS !P.rEVIEWED FOR _ JDE COMPLIANCE APPROVED MAY 24 2019 City of Tukwila BUILDING DIVISION AHERA Asbestos Survey Prepared for Mathew Patton 11545 40th Ave S. Tukwila WA 98168 Parcel Number 7 34060-0182 Project Name — 11545 Asbestos Report Inspection Date — 5/17/2018 Report Date — 5/24/2018 Inspected by AHERA Certification Expiration date Noel Stout 164665 12/6/2018 RECEIVED CITY OF TUKWILA FILE, APR 1 7 2019 ERMIT CENTER Mathew Patton 11545 40th Ave S. Tukwila WA 98168 Oizt Table of Contents 1.0 Scope of Work 2.0 Survey Methods 3.0 Building Description 4.0 Laboratory Analytical Methods 5.0 Asbestos Identification Process 6.0 Conclusions and Recommendations 7.0 Limitations of Survey Appendices as needed • Assumed material Pictures or materials with difficult description • Sample location drawing if unable to mark location on actual house. • AHERA Certifications athew Patton 11545 40th Ave S. Tukwila WA 98168 1.0 Scope of Work This asbestos survey is written to comply with the AHERA asbestos sampling procedure as stated in 40 CFR 763.86. This protocol is required under the Puget Sound Clean Air Agency (PSCAA Regulation III, Article IV, rev. July 13, 2000) for all asbestos surveys prior to a building demolition. This survey satisfies the "good faith" asbestos inspection requirements as stated in Washington Administrative Code (WAC 296-62-07221(2), "identification"). The regulation states, the owner of a structure scheduled to be renovated/demolished must provide a contractor with a written report of the Asbestos -Containing Materials (ACMs) to be disturbed during renovation/demolition. The National Emission Standards for Hazardous Air Pollutants (NESHAP), 40 CFR Part 61 requires a survey by an accredited asbestos inspector prior to demolition of a structure. Floor plan drawings locating samples taken and any pertinent photos are attached as needed based on complexity of report. 2.0 Survey Methods A walk through inspection was conducted inside and around the building to locate asbestos -containing materials (ACMs). Locations and type of potential ACMs were noted. AHERA sampling protocols were employed as required by PSCAA for buildings that are to be renovated or demolished. AHERA specifies the number of samples to be obtained and analyzed based on classification of the building material. Classifications - Surfacing material (SM)such as fireproofing, acoustical/decorative plaster that is sprayed, toweled or otherwise applied to surfaces. Ex. popcorn ceiling" - Thermal system insulation (TSI) is material applied to pipes, fittings, boilers, breeching, tanks, ducts or other interior structural components, or for other purposes. Ex. Pipe wrap and MAG - Miscellaneous material (MM) are interior building materials on structural components, structural members or fixtures, such as floor and ceiling tiles, and does not include surfacing material or thermal system insulation. Ex. Sheet flooring, gypsum wall board (GWB), cement board and mastic. - Homogenous Materials are defined as an area of presumed or asbestos containing materials that appear similar in color, texture, pattern and date of application. Under OSHA Guidelines the "3-5-7" rule is used to determine the number of samples to be taken for homogenous materials. - Surfacing Material < 1000 SF = 3 samples, between 1000 SF and 5000 SF = 5 samples and > 5000 SF = 7 samples. 3 hew Patton 11545 40th Ave S. Tukwila WA 98168 - Thermal System Insulation requires a minimum of 3 samples - Miscellaneous Material is considered to be asbestos containing if suspect and not sampled otherwise sampling protocol treats it as Surfacing Material following the "3-5-7" rule. A material is considered asbestos containing by the EPA and PSCAA, if any one sample from a homogenous area contains more than one percent (P/o) asbestos. 3.0 Building Description Unfinished double wide mobile home blocked up on concrete pad. Till Plywood siding and corrugated aluminum. Building Number 1 Basement Garage 0 Year Built 1974 Unfinished 1/2 0 Year Renovated 0 Unfinished Full 0 Stories 1 AGLA 1,152 Living Units 1 Attached Garage 0 Grade Average Bedrooms 2 Condition Average Full Baths 1 1st Floor 1,152 3/4 Baths 0 2nd Floor 0 1/2 Baths 0 Upper Floor 0 Heat Source Electric Finished Basement 0 Deck Area SoFt 0 Total Finished Area 1,152 Open Porch SciFt 150 Total Basement 0 4.0 Laboratory Analytical Methods and Results Samples were analyzed using polarized light microscopy (PLM) with dispersion staining. If samples are not homogenous, then sub -samples of the components are analyzed separately. All bulk samples are analyzed using EPA Method 600/R-93/116 with the following measurement uncertainties for reported % asbestos (1% = 0-3%. 5 %_> 1-9%, 10% = 5-15%, 20% = 10-30`1/0, 50% = 40-60%). For each layer of materials, the lab report will include findings for each layer (labeled Layer: 1, Layer: 2, etc.). The asbestos concentration in the sample is determined by visual estimation. a hew Patton 11545 40th Ave S. Tukwila WA 98168 TRIANGLE ENVIRONMENTAL SERVICE CENTER. INC. 13509 East Boundary Road, Smite B, Midlolhian, VA 23112 SO4-739-1'751 • fax: 804-739-1753 BULK ASBESTOS SAMPLE ANALYSIS SUMMARY marl- : Dedicated Decoustmciion, LLC 7001 Seaview Ave. NW #160-241 Seattle; WA 98117 CLIENT JOB/ #: JOB SITE: 11545 40th Ave. S. WA 98168 TESC LOGIN #: 180522K DATE OF RECEIPT: 05(22/2018 DATE OF ANALYSIS: 05122(2018 DATE OF REPORT: 0522/2018 ANALYST- B Trimmer TESC SAMPLE # CLIENT SAMPLE ID & GROSS DESCRIPTION [SMALL° % ASBESTOS NON ASBESTOS % FIBERS 1 1 / White powder, brown fibers 90% Cellulose NON FIBROUS % MATERIALS 10% 2 2 / Yellow, white lino., gay fibers NAD 20% Cellulose 80% 3 3 I Brown fibers NM/ 98% Cellulose 2% 4 4 / Black tar -like NAD 10% Fibergl 90% Total Sample/Layers Analyzed: 4 Samples are analyzed in accordance with "Interim Method for the Determination of Asbestos in Bulk Insulation Samples", EPAi600.,R-93-116, July 1993 (EPA-600144-82-020, Dec 1982), or the current 1.7S EPA method for the analysis of asbestos in building material. None Detected: not detected avor below the detected limit of method (Reporting limit: 1% Asbestos), Glass fiber is analyzed for quality control blank. TESC recommends by point count or Transmission Electron Microscopy (TEM), for materials regulated by the EPA NESHAP (National Emission Standards for Hazardous .Air Pollutants) and found to contain less than ten percent (<10°O) asbestos by Polarized Light Microscopy (PLM). Both services are atMlable for an additional fee. This report must not be reproduced except in full with approval of Triangle Environmental Service Center, Inc. This test report relates only to the item(s) tested_ NVLAP Lab Code: 200794-0 Reviewed By Authorized Signatory: [LEGEND NAD=No Asbestos Detected, Lino.=Linoleum, JC=Joint Compound) Feng Jiang, AfS Savior Geologist, Laboratory Director Dattlong Fang, Senior Gooiogi:t May 22, 2018 Page 1 of 1 5 athew Patton 11545 40th Ave S. Tukwila WA 98168 5.0 Asbestos Asbestos findin s: cv cli E o v) Description Class- Material type — color- pattern — friable or not if blank Location Floor -room- area Asbestos Type -% Qty SF/LF 1 MM- Tile backer board floor — fiber grey bathroom NAD 25 2 MM- Sheet vinyl flooring — ornate yellow pat. bedroom NAD 130 3 MM- Acoustic ceiling panels — 16"x11' white Ceiling NAD 1058 4 MM- Composite roofing shingles b lack Roof NAD 1152 Assumed asbestos containing materials: - None 6.0 Conclusions and Recommendations The following is a summary of the asbestos -containing materials over 1%© that will require abatement; either by assumption or lab results. 4 samples were tested and none came back containing asbestos. All 4 samples are marked on location in black marker with the corresponding sample #. No assumed asbestos containing materials were detected. All asbestos -containing materials that will be disturbed as a natural part of the intended scope of work are required to be removed and disposed of in accordance with Washington State regulations. Washington State Department of Labor and Industries and PSCAA require that the abatement be performed using Certified Asbestos Workers under the direct on -site supervision of a Certified Asbestos Supervisor. Further, it is advised by Dedicated Deconstruction to have an AFIERA inspector present during demolition to ensure that any potentially asbestos -containing materials uncovered during demolition be dealt with properly. 7.0 Limitations of Survey The purpose of this survey report is to document asbestos -containing materials. athew Patton 11545 40th Ave S. Tukwila WA 98168 The site visit consisted of a thorough visual walk-through of the building for the purpose of viewing and sampling potential asbestos -containing materials. As hazardous material surveys are non -comprehensive by nature, Dedicated Deconstruction cannot be held liable for materials which require destructive means to access, materials hidden from sight (ex. behind walls), materials which cannot be found due to their obscure nature, or which otherwise cannot be discovered with reasonable diligence. This report has been prepared for the exclusive use of the owner listed on this report and as it applies to the exclusive scope of work to be done. Use or reliance upon this report by third parties or altered scope is at their own risk This document is the sole property of Dedicated Deconstruction and the property owner, or agent, authorizing this survey. Certificate of 'Completion This is to certify that Noel P. Stout has satisfactorily completed 4 hours of efresher training as an AHERA Biding Inspector to comply with the uaining requirements of TSCA Title II, 40 CFR 763 (AHERA) • 164665 Certificate Number ARGUS wir m TRAINING•CONSULTING n wlicrnacon aximkra Dec 6, 2017 Expires in 1 year. Date(s) of Training Exam Score: N/A 11 appropriate: Instructor ARGUS PACIFIC. INC / I 900WEST NICKERSON ST.SUITE 315 I SEATTLE.WASHINGTON 98119 / 206.285.3373 /ARGUSPACIFIC.COM •-• -1.TY 'Cr?' J• I, f1-1 I 71 Mathew Patton 11545 40th Ave S. Tukwila WA 98168 City of Tukwila Department of Community Development 10/1/2019 MATTHEW PATTON 11535 40TH AVE S TUKWILA, WA 98168 RE: Permit No. D19-0128 PA 1 ION DEMO 11545 40TH 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 11/26/2019. Based on the above, you are hereby advised to: I) 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 11/26/2019, 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: DI9-0128 6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 City of Tukwila Department of Community Development April 23, 2019 MATTHEW PATTON 11535 40TH AVE S TUKWILA, WA 98168 RE: Correction Letter # 1 DEVELOPMENT Permit Application Number D19-0128 PATTON DEMO - 11545 40TH AVE S Dear Matthew, 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: PW DEPARTMENT: Joanna Spencer at 206-431-2440 if you have questions regarding these comments. 1) Property is still on septic system. Please show on plan location of the septic tank. The septic tank shall be pumped empty by a septic pumping company and pumping receipt submitted to the Public Works Inspector. Septic info can be obtained from King County Wastewater Program office, 14350 SE Eastgate Way, Bellevue, WA 98007, phone 206 477-8050. 2) On your plan show location of the existing 1/2" water meter. 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. Kandace Nichols Permit Technician File No. D19-0128 6300 Southcenter Boulevard Suite #100 • Tukwila Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 5ERMIT COORD COP,( PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: D19-0128 DATE: 05/17/19 PROJECT NAME: PATTON DEMO SITE ADDRESS: 11545 40T11 AVE S Original Plan Submittal Revision # before Pe!mit Issued X Response to Correction Letter # 1 Revision # after Permit Issued DEPARTMENTS: Building Division V) kW Public Works Fire Prevention Structural C r PRELIMINARY REVIEW: Not Applicable (no approval/review required) Planning Division Permit Coordinator DATE: 05/21/19 • Structural Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved Corrections Required P (corrections entered in Reviews) DUE DATE: 06/18/19 Approved with Conditions E Denied (ie: Zoning Issues Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg 0 Fire D Ping 0 PW 0 Staff Initials: 12/18/2013 PERMIT COORD COPY PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: D19-0128 PROJECT NAME: PATTON DEMO SITE ADDRESS: 11545 40TH AVE S X Original Plan Submittal Response to Correction Letter DATE: 04/17/19 Revision # Revision # before Permit Issued after Permit Issued DEPARTMENT : pt,\ 1,0N1 Building Division Public Works Fire Prevention Structural PRELIMINARY REVIEW: Not Applicable (no approval/review required) REVIEWER'S INITIALS: lanning Division Permit Coordinator • DATE: 04/18/19 Structural Review Required DATE: APPROVALS OR CORRECTIONS: Approved Corrections Required (corrections entered in Reviews) Approved with Conditions Denied (ie: Zoning Issues DUE DATE: 05/16/19 Notation: REVIEWER'S INITIALS: DATE: dr,.•e:' Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg 1:j Fire 1] Ping E] Staff Initials: 12/18/2013 Date: 5 Li City of Tukwila 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: D19-0128 Response to Incomplete Letter # Response to Correction Letter # 1 Revision # after Permit is Issued Revision requested by a City Building Inspector or Plans Examiner Deferred Submittal # Project Name: Patton Demo Project Address: 11545 40th Ave S Contact Person: Matthew Patton Summary of Revision: RECEIVED CITY OF TUKWILA MAY 1 7 2019 PERMIT CENTER Phone Number: (206) 679-3157 Plan now shows location of water meeter & demolished & in -filled 1000gal septic tank. Copy of pumping report & King County Abandonment Report, included. Sheet Number(s): "Cloud" or highlight all areas of revision includi dat of visi Received at the City of Tukwila Permit Center by: El Entered in TRAKiT on WAPermit Center (Rachelle)\Kandace Revision Submittal Form.doc Revised: August 20t5 CITY OF TUKWILA Department of Community Development 630o Southcenter Boulevard, Tukwila, WA 98188 Telephone: (206) 431-367o FAX (206) 431-3665 E-mail: tukpl an ci .tukwila.wa.us Permit Center/Building Division 206 431-367o Public Works Department 206 433-0179 Planning Division 206 431-367o AFFIDAVIT IN LIEU OF CONTRACI'OR REGISTRATION STATE OF WASHINGTON) ) ss. COUNTY OF KING ee/Itmace, [please print name] , states as follows: PERMIT NO: -D c) 1. I have made application for a permit from the City ofTukwila, 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 migh h se have under state law in any decision to engage an unregistered contractor to perform construe liti\voN4S\ Signed and sworn to before me this 304- day of , 20 / 9 . NOTARY PUBLIC in and for the State of Washington Residing at Name as commissioned: , County 71-Werde, My commission expires: 0 18.27.090 Exemptions. The registration provisions of this chapter do not apply to: i. 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 when performed 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 46.7o RCW who shall warranty service and repairs under chapter 46.7o 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; io. 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; l , 18. An entity who holds 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 1948 RCW to perform plumbing work that is incidentally, directly, and immediately appropriate to the like -in -kind replacement of a household appliance or other small household utilizationequipment that requires limited electric power and lipited 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. W C W 2 1 W K W W 2 lJ G L u d1.0 Off v) Ln � ui z W 0 wC�, 0 o g o v- �- WLn L a � �' ,a z W o05 �m �m 05 a 0 3 0 t D.1 PERMIT SET DAIS: 4/17/19 ISSUED FOR CONSTRUCTION DATE: ---- AS BUILT DATE. 11545 40TH AVE S DEMO PLAN DEMO PLAN DWG BY: JV CKD BY: MG/ ---- JOB NO.: ---- SHEEr: