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HomeMy WebLinkAboutPermit D07-137 - MEDICA RESIDENCE - RESIDENCE DEMOLITIONThis record contains information which is exempt from public disclosure pursuant to the Washington State Public Records Act, Chapter 42.56 RCW as identified on the Digital Records Exemption Log shown below. D07 -137 Medica 10802 East Marginal Way South RECORDS DIGITAL D- ) EXEMPTION LOG THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION Page # tode Exemption = Brief Explanatory DeSctiptiop �t�tutel ule The Privacy Act of 1974 evinces Congress' intent that Personal Information — social security numbers are a private concern. As such, individuals' social security numbers are Social Security Numbers redacted to protect those individuals' privacy pursuant 5 U.S.C. sec. DR1 Generally — 5 U.S.C. sec. to 5 U.S.C. sec. 552(a), and are also exempt from 552(a); RCW 552(a); RCW disclosure under section 42.56.070(1) of the 42.56.070(1) 42.56.070(1) Washington State Public Records Act, which exempts under the PRA records or information exempt or prohibited from disclosure under any other statute. Redactions contain Credit card numbers, debit card Personal Information — numbers, electronic check numbers, credit expiration 21 DR2 Financial Information — dates, or bank or other financial account numbers, RCW RCW 42.56.230(4 5) which are exempt from disclosure pursuant to RCW 42.56.230(5) 42.56.230(5), except when disclosure is expressly required by or governed by other law. MEDICA 10802 EAST MARGINAL WY S D07 -137 Cityif Tukwila Parcel No.: 0323049046 Address: 10802 EAST MARGINAL WY S TUICW Suite No: Tenant: Name: MEDICA Address: 10802 EAST MARGINAL WY S , Owner: Name: MEDICA MARIA Address: 3014 28TH AVE W , SEATTLE WA 98199 Phone: Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us Contact Person: Name: JERROD STAFFORD Address: 3006 NORTHUP WY #303 , BELLEVUE WA 98004 Phone: 425 889 -1180 Contractor: Name: GREGCO EXCAVATING LLC Address: 3401 139 AV NE , LAKE STEVENS WA 98258 Phone: 425 334 -7307 Contractor License No: GREGCEL949CB DESCRIPTION OF WORK: TEAR DOWN AND DEMOLISH 2080 SF SFR. Public Works activities include SEPTIC ABANDONMENT. Water Meter has been turned -off in 2006 due to customer request. doc: IBC -10/06 DEVELOPMENT PERMIT * *continued on next page ** Permit Number: D07 - 137 Issue Date: 04/25/2007 Permit Expires On: 10/22 /2007 Expiration Date: 02/02/2008 Value of Construction: $3,500.00 Fees Collected: $499.19 Type of Fire Protection: International Building Code Edition: 2003 Type of Construction: VB Occupancy per IBC: 0022 D07 -137 Printed: 04 -25 -2007 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Fire Loop Hydrant: N Number: 0 Size (Inches): 0 Flood Control Zone: Hauling: N Start Time: End Time: Land Altering: Volumes: Cut 0 c.y. Fill 0 c.y. Landscape Irrigation: Moving Oversize Load: Start Time: End Time: Sanitary Side Sewer: Sewer Main Extension: Private: Public: Storm Drainage: Street Use: Profit: N Non - Profit: N Water Main Extension: Private: Public: Water Meter: Permit Center Authorized Signature: governing this work will be compile Signature: Print Name: doc: IBC-10 /06 City o .iTukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us N Permit Number: D07 -137 Issue Date: 04/25/2007 Permit Expires On: 10/22 /2007 Date: (){ ( Z a I hereby certify that I have read and ed this permit and know the same to be true and correct. All provisions of law and ordinances , whether specified herein or not. The granting of this permit does • - presume to give au • • to violate or cancel the provisions of any other state or local laws regulating construction or the perfo - • e work. au o sign and obtain this development permit. Date: This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection. D07 -137 Printed: 04 -25 -2007 Parcel No.: 0323049046 Address: 10802 EAST MARGINAL WY S TUICW Suite No: Tenant: MEDICA 1: ** *BUILDING DEPARTMENT CONDITIONS * ** fir►' City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 - 431 -3665 Web site: http: / /www.ci.tukwila.wa.us PERMIT CONDITIONS Permit Number: D07 - 137 Status: ISSUED Applied Date: 04/13/2007 Issue Date: 04/25/2007 2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the Building Official. 3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to start of any construction. These documents shall be maintained and made available 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: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the Cityof Tukwila Permit Center. 6: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building Department (206 - 431 - 3670). 7: 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. 8: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * ** 9: The applicant must notify the City Utility 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. 10: Any material spilled onto any street shall be cleaned up immediately. 11: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation off-site or into existing drainage facilities. 12: 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. 13: 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. 14: 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. doc: Cond -10/06 D07 -137 Printed: 04 -25 -2007 City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us 15: 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 City Utilities Inspector. 16: Applicant shall coordinate septic abandonment with King County Public Health, Eastgate Environmental Health Office, phone (206)296 -4932. doc: Cond -10/06 * *continued on next page ** D07 -137 Printed: 04 -25 -2007 I hereby certify that I have read these conditions and will comply with them as outlined. 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 provision of any other work or local laws regulating construction or the performance of work. Signature: Print Name: doc: Cond -10/06 City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us X --iz..4t0 Date: g U D07 -137 Printed: 04 -25 -2007 CITY OF TUKWILA Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.cltukwila.wa.us Building Permit No. a) /0 Mechanical Permit No. Plumbing/Gas Permit No. Public Works Permit No. Project No. (For office use only) GENERAL CONTRACTOR INFORMATION — (Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5)) 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 City State 0 3a30y 9o QQ King Co Assessor's Tax No.: Site Address: vO� � , At1 tk( kt! S� Suite Number: Floor: Tenant Name: V PCk1 C GL l /� L New Tenant: ❑ Yes ❑ ..No Property Owners Name: LAST /��t/G/1 * *i I✓A P v ' ties s n £ C Mailing Address: 3006 /Jo /No a WA" /3 30 3 etkdot 144 Firm y City State Zip CONTACT PERSON - who do we contact when your permit is ready to be issued Name: I CM cTAKIN2 A o✓ FJt P EL Cc k-Ly Day Telephone: 9 2 5 ,� - It 0 Mailing Address: 3D0 (c / i t k ✓0 WA-t At- 3,63 Qe lle.� W vT �Z� y LL __ Zip E -Mail Address: J e��edL () M C ke y d ee• co" Fax Number: y2s "' O-. • 9 373 Company Name: ) C) A ��CC/g thi -bAr y 4 �Grei Ce 1 94( dig Mailing Address: 3'40 6 9 + 1/4, /7� ,3 , L40- � S - 5 1/V4 9 1 Z S$' State Zip Contact Person: Day Telephone: N 2S' 32 ' t' as E -Mail Address: Fax Number: i t 2 S 6 0 7- T Exp Date: Contractor Registration Number: ARCHITECT OF RECORD - All plans must be wet stamped by Architect of Record Company Name: Mailing Address: Iv`4�t G /c0f J Al Crialircs t, City Company Name: Mailing Address: City Contact Person: Day Telephone: E -Mail Address: Fax Number: Q :\Applications\Forms-Applications On Line\3 -2006 - Permit Application.doc Revised: 9-2006 bh State Zip City Contact Person: Day Telephone: E -Mail Address: Fax Number: ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Record State Zip Page 1 of 6 BUILDING PERMIT INFORMATION - 206- 431 -3670 Valuation of Project (contractor's bid price): $ 4' Scope of Work (please provide detailed informatio c-ird[i}',li(° c) $ to Will there be new rack storage? ❑ Yes Q:Upplications\Forms- Applications On Linel3 -2006 - Permit Application.doc Revised 9-2006 bh t'4a t ea. t . Dees 1 4 (5 Existing Building Valuation: $ ❑.. No If yes, a separate permit and plan submittal will be required. Provide All Building Areas in Square Footage Below PLANNING DIVISION: Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq ft): Floor area of principal dwelling: Floor area of accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Compact: Handicap: Will there be a change in use? ❑ Yes ❑ No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ Sprinklers ❑ Automatic Fire Alarm ❑ None ❑ Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes ❑ No If "yes', attach list of materials and storage locations on a separate 8 - 1/2 "x 11" paper including quantities and Material Safety Data Sheets. SEPTIC SYSTEM ❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. Page 2 of 6 Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC 1" Floor 2n Floor 3r Floor Floors thru 2 ,,��„ ; 7 f �[/ a Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck BUILDING PERMIT INFORMATION - 206- 431 -3670 Valuation of Project (contractor's bid price): $ 4' Scope of Work (please provide detailed informatio c-ird[i}',li(° c) $ to Will there be new rack storage? ❑ Yes Q:Upplications\Forms- Applications On Linel3 -2006 - Permit Application.doc Revised 9-2006 bh t'4a t ea. t . Dees 1 4 (5 Existing Building Valuation: $ ❑.. No If yes, a separate permit and plan submittal will be required. Provide All Building Areas in Square Footage Below PLANNING DIVISION: Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq ft): Floor area of principal dwelling: Floor area of accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Compact: Handicap: Will there be a change in use? ❑ Yes ❑ No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ Sprinklers ❑ Automatic Fire Alarm ❑ None ❑ Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes ❑ No If "yes', attach list of materials and storage locations on a separate 8 - 1/2 "x 11" paper including quantities and Material Safety Data Sheets. SEPTIC SYSTEM ❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. Page 2 of 6 PUBLIC WORKS PERMIT INFORMATION — 206 - 433 -0179 .Scope of Work (please provide detailed information): De at • (t - e4 t Sill s-f is ovt s 1 it 1 q Molt /hip A l y w!w- A taut 1 Please refer to Public Works Bulletin #1 for fees and estimate sheet. 1 Water District ❑ ...Tukwila ❑...Water District #125 ❑ ...Water Availability Provided Sewer District ❑ ...Tukwila ❑ ...Sewer Use Certificate ❑ ...Permanent Water Meter Size... ❑ ...Temporary Water Meter Size .. ❑ ...Water Only Meter Size ❑ ...Sewer Main Extension Public _ ❑ ...Water Main Extension Public _ ❑ ... ValVue ❑ ... Sewer Availability Provided Proposed Activities (mark boxes that apply): ❑ ...Right -of -way Use - Nonprofit for less than 72 hours ❑ ...Right -of -way Use - No Disturbance ❑ ... Construction /Excavation/Fill - Right -of -way Non Right -of -way ❑ ...Total Cut cubic yards ❑ ...Total Fill cubic yards ❑ ...Sanitary Side Sewer ❑ ...Cap or Remove Utilities El ...Frontage Improvements ❑ ...Traffic Control ❑ ...Backflow Prevention - Fire Protection Irrigation Domestic Water El . ❑ ❑ • • ❑ . » Q:\Applications\Forms- Applications On Line\3 -2006 - Permit Application.doc Revised: 9-2006 bh Call before you Dig: 1- 800 -424 -5555 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) El .. Geotechnical Report ❑ ...Bond El .. Insurance ❑ .. Easement(s) ❑ .. Maintenance Agreement(s) . Abandon Septic Tank . Curb Cut . Pavement Cut . Looped Fire Line ❑ .. Highline El .. Renton WO # WO # WO # Private Private El .. Renton ❑ .. Seattle El .. Right -of -way Use - Profit for less than 72 hours El .. Right -of -way Use — Potential Disturbance ❑ .. Work in Flood Zone ❑ .. Storm Drainage ❑ .. Grease Interceptor El .. Channelization El .. Trench Excavation ❑ .. Utility Undergrounding ❑ ...Deduct Water Meter Size ❑...Traffic Impact Analysis ❑ ...Hold Harmless — (SAO) ❑ ...Hold Harmless — (ROW) » FINANCE INFORMATION Fire Line Size at Property Line ❑ ...Water ❑ ...Sewer Monthly Service Billing to: Name: Mailing Address: Water Meter Refund/Billing: Name: Mailing Address: Number of Public Fire Hydrant(s) ❑ ...Sewage Treatment Day Telephone: City State Zip Day Telephone: City State Zip Page 3 of 6 Unit Type: Qty Unit Type: Qty Unit Type: Qty Boiler /Compressor: Qty Fumace<100K BTU Air Handling Unit >10,000 CFM Fire Damper 0 -3 HP /100,000 BTU Furnace>100K BTU Evaporator Cooler Diffuser 3 -15 HP /500,000 BTU Floor Furnace Ventilation Fan Connected to Single Duct Thermostat 15 -30 HP /1,000,000 BTU Suspended/Wall/Floor Mounted Heater Ventilation System Wood/Gas Stove 30 -50 HP /1,750,000 BTU Appliance Vent Hood and Duct Emergency Generator 50+ HP /1,750,000 BTU Repair or Addition to Heat/Refrig/Cooling System Incinerator - Domestic Other Mechanical Equipment Air Handling Unit <10,000 CFM Incinerator — Comm/Ind Company Name: MECHANICAL PERMIT INFORMATION - 206 - 431 -3670 .MECHANICAL CONTRACTOR INFORMATION Id Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Contractor Registration Number: Expiration Date: Valuation of Mechanical work (contractor's bid price): $ Scope of Work (please provide detailed information): Use: Residential: New .... ❑ Replacement .... ❑ Commercial: New .... ❑ Replacement .... ❑ Fuel Type: Electric ❑ Gas.... El Other: Indicate type of mechanical work being installed and the quantity below: Q:\Applications\Forms- Applications On Line\3 -2006 - Permit Application.doc Revised: 9 -2006 bh Page 4 of 6 Fixture Type: Qty Fixture Type: Qty Fixture Type: Qty Fixture Type: Qty Bathtub or combination bath/shower Drinking fountain or water cooler (per head) Wash fountain Gas piping outlets Bidet Food -waste grinder, commercial Receptor, indirect waste Clothes washer, domestic Floor drain Sinks Dental unit, cuspidor Shower, single head trap Urinals Dishwasher, domestic, with independent drain Lavatory Water Closet Building sewer or trailer park sewer Rain water system — per drain (inside building) Water heater and/or vent Additional medical gas inlets/outlets — six or more Industrial waste pretreatment interceptor, including its trap and vent, except for kitchen type grease interceptors Repair or alteration of water piping and/or water treating equipment Repair or alteration of drainage or vent piping Medical gas piping system serving one to five inlets/outlets for specific gas PLUMBING AND GAS PIPING PERMIT INFORMATION - 206- 431 -3670 . PLUMBING AND GAS PIPING CONTRACTO INFORMATION Av 4 Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Contractor Registration Number: Expiration Date: Valuation of Plumbing work (contractor's bid price): $ Valuation of Gas Piping work (contractor's bid price): $ Scope of Work (please provide detailed information): Building Use (per Int'l Building Code): Occupancy (per Int'l Building Code): Utility Purveyor: Water: Sewer: Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below: Q:Wpplications\Forms- Applications On line n -2006 - Permit Application.doc Revised: 9-2006 bh Page 5 of 6 PERMIT APPLICATION NOTES — Applicable to all permits in this application 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. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER OR AUTH ENT: Signature: ) u Print Name: jetI � STS io Mailing Address: Building and Mechanical Permit 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). Date Application Accepted: 0 3 /C Plumbing Permit The Building Official may grant one extension of time for an additional period not exceeding 180 days. The extension shall be requested in writing and justifiable cause demonstrated. Section 103.4.3 Uniform Plumbing Code (current edition). 30,00 Aleta hav 1441 # 363 Date Application Expires: � 00) 6/ Q:\ Applications\Forms- Applications On Line\3.2006 - Permit Application.doc Revised: 9 - 2006 bh TJ Date: I/ • S• 6 t Day Telephone: '0.5'' Q [ • rl gD F City State Zip Staff Initials: hw Page 6 of 6 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 1 10,000, PLUS $24.50 for each additional 10,000 or fraction thereof. 100,001— 200,000 $269.75 for 1 100,000, PLUS $13.25 for each additional 10,000 or fraction thereof. 200,001 or more $402.25 for 1 200,000, PLUS $7.25 for each additional 10,000 or fraction thereof. BULLETIN A2 TYPE C PERMIT FEE ESTIMATE PLAN REVIEW AND APPROVAL FEES DUE WITH APPLICATION PW may adjust estimated fees PROJECT NAME H ea t e 6�1/tQ (d �M o PERMIT # i) — 1 3-7 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 $250 (1) 2. Enter total construction cost for each improvement category: Mobilization Erosion prevention Water /Sewer /Surface Water Road/Parking/Access A. Total Improvements 3. Calculate improvement -based fees: B. 2.5% of first $100,000 of A. C. 2.0% of amount over $100,000, but less than $200,000 of A. D. 1.5% of amount over $200,000 of A. 4. TOTAL PLAN REVIEW FEE (B +C +D) $ Z2- SO (4) • 5. Enter total excavation volume cubic yards Enter total fill volume cubic yards Use the following table to estimate the grading plan review and permit fee. excavation and fill volumes. GRADING Plan Review and Permit Fees TOTAL PLAN REVIEW AND APPROVAL FEE DUE WITH PERMIT APPLICATION (1 +4 +5) $ 2 - S O 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 Jan. 2006 1 2 2 . so QUANTITY IN CUBIC YARDS RATE 50 or less $23.50 51 -100 $37.00 101 -1,000 $37.00 for 1 100 CY plus $17.50 for each additional 100 or fraction thereof. 1,001 - 10,000 $194.50 for 1 1000 CY plus $14.50 for each additional 1,000 or fraction thereof. 10,001 - 100,000 $325.00 for the 1 10,000 CY plus $66.00 for each additional 10,000 or fraction thereof 100,001 or more $919.00 for 1 100,000 CY plus $36.50 for each additional 10,000 or fraction thereof. Approx. Remaining Years Pavement Overlay and Repair Rate (per SF of lane width) 20 -15 (100 %) $10.00 15 -10 (75 %) $7.50 10 - (50 %) $5.00 7 -5 (33 %) $3.30 5 -2 (25 %) $2.50 2 -1 (10 %) $1.00 0 -1 $0.00 8. GRADING Permit Review Fee Approved 09.25.02 Last Revised Jan. 2006 2 BULLETIN A2 TYPE C PERMIT FEE ESTIMATE PLAN REVIEW AND APPROVAL FEES DUE WITH APPLICATION PW may adjust estimated fees 6. Permit Issuance/Inspection Fee (B +C +D) $ ( 7. Pavement Mitigation Fee $ ( 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 Grading Permit Fees are calculated using the following table. Use the greater of the excavation and fill volumes from Item 5. $ (8) WATER METER FEE Permanent and Water Only Meters Size (inches) Installation Cascade Water Alliance RCFC 01.01.2006 - 12.31.2006 Total Fee 0.75 $600 $4648 $5248 1 $1100 $11620 $12720 1.5 $2400 $23240 $25640 2 $2800 $37184 $39984 3 $4400 $74368 $78768 4 $7800 $116200 $131790 6 $12500 $232400 $244900 Approved 09.25.02 Last Revised Jan. 2006 BULLETIN A2 TYPE C PERMIT FEE ESTIMATE PLAN REVIEW AND APPROVAL FEES DUE WITH APPLICATION PW may adjust estimated fees 9. TOTAL OTHER PERMITS A. Water Meter — Deduct ($25) B. Flood Control Zone ($50) C. Water Meter — Permanent* D. Water Meter — Water only* E. Water Meter — Temporary* * Refer to the Water Meter Fees in Bulletin Al Total A through E $ (9) 10. ADDITIONAL FEES A. Allentown Water (Ordinance 1777) $ B. Allentown Sewer (Ordinance 1777) $ C. Ryan Hill Water (Ordinance 1777) $ D. Special Connection (TMC Title 14) $ E. Duwamish $ F. Transportation Mitigation $ G. Other Fees $ Total A through G $ (10) DUE WHEN PERMIT IS ISSUED (6 +7 +8 +9 +10) $ 2 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 $47.00 per inspection. 0.75" 2.5" $300 $1,000 Temporary Meter 3 Receipt No.: R07 -00577 Initials: LAW User ID: 1632 TRANSACTION LIST: Type Method Description ACCOUNT ITEM LIST: Description BUILDING - NONRES PLAN CHECK - NONRES STATE BUILDING SURCHARGE City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us Parcel No.: 0323049046 Permit Number: D07 -137 Address: 10802 EAST MARGINAL WY S TUKW Status: PENDING Suite No: Applied Date: 04/13/2007 Applicant: MEDICA Issue Date: Payee: EAST MARGINAL WAY PROPERTIES LLC Payment Check 10906 203.19 Account Code Current Pmts 000/322.100 000/345.830 000/386.904 RECEIPT Total: $203.19 Payment Amount: $203.19 Payment Date: 04/13/2007 03:13 PM Balance: $0.00 Amount 120.42 78.27 4.50 7155 04/17 9710 TOTAL 203.19 rtnr.: Rar..int -(1R PrintA.rt 04 -13 -2007 Parcel No.: 0323049046 Permit Number: D07 -137 Address: 10802 EAST MARGINAL WY S TUKW Status: APPROVED Suite No: Applied Date: 04/13/2007 Applicant: MEDICA Issue Date: Receipt No.: R07 -00676 Initials: JEM Payment Date: 04/25/2007 01:00 PM User ID: 1165 Balance: $0.00 Payee: EAST MARGINAL WAY PROPERTIES, LLC TRANSACTION LIST: Type Method Description Payment Check 10914 296.00 ACCOUNT ITEM LIST: Description PW BASE APPLICATION FEE PW PERMIT /INSPECTION FEE PW PLAN REVIEW City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us Account Code Current Pmts 000/322.100 000/342.400 000/345.830 RECEIPT Payment Amount: $296.00 Amount 250.00 23.00 23.00 Total: $296.00 7523 04/25 9716 TOTAL 296.00 doc: Receiot -06 Printed: 04 -25 -2007 COMMENTS: 1-G ' 4 --1 A( 6eV 0,ar k'T Date Called i id: kt „-,,i . , i L (/_j ? Id., (2? W 3 ......_ oe p.m. Requester: p -e_r . .,_,A.ro t , tA , :5 i 4 - 0 A-4 (-t>%C.- • ' p(” f, j7 t) if e. f Aiv, ') S Ae 0 OA e Akr r ef v o(f)\E C--,Ar 0 Projet: , blf A icA Type of Inspection: e'A1-1 Eu ,(AL- Address: 1080'7-- E, AA[1:Ad LAJ Date Called i id: Special Instructions: ( 2 D ki' A tte.AJI ad 4. ....liervolowwww•Fp.. 25 - 3J1 - (9)40 /- W 3 ......_ oe p.m. Requester: Phone No: 1 1180 INSPECTION RECORD Retain a copy with permit INSPEcTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION g 6304 Southcenter Blvd., #100, Tukwila, WA 981 88 (206)431-3670 oved per applicable codes. Corrections required prior to approval. 60'1 -I3') Date3 tf__ o r ID $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call the schedule reinspection. !Receipt No.: 'Date: 'vl Project , C L A " , Type of Inspection: p Address: V 17 it CA.-.) try Date Called: lqiql Lq Special Instructions: Date Wanted: i k (-, a.m. p.m. Re quester: / i‘ i Phone No: SSA INSPECTION RECORD Retain a copy with permit D07 X37 INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Approved per applicable codes. Corrections required prior to approval. COMMENTS: I b L [ Il C for . � d() (J'F f n 1.�.�s (L€ c u IL / 1. I q t-ki/LA) ( — lit, r Inspector: U‹l Date: tql_0/0 ID $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call the schedule reinspection. 'Receipt No.: 'Date: Customer Name Phone # Send Bill (Acct #) Service I # ( 4e - DcD (k-00. Expires SI,t Truck #. �1 PRODUCTS / SERVICES CODE PRICE AMOUNT Tank Delivery: Truck Time Mileage, Hole Bottom Septic Tank Pumping: Tank Liquid Level: normal high )( low Start Inches° Stop Inches0 Tank Size ,rjid Gallons Pumped —1 1 Septic Tank: Sludge Scum 1st Comp. / 2nd Comp. Pump Chamber / Draw Down Timer On 0(f Counter Baffles Intact O yes O no replaced ATU O yes Ono Risers Diameter Height 1st Comp. 2nd Comp. Pump Chamber 0/M Pumpers Report attached 0/M Pumpers Report left on -site Terms: net 10 days. 1.5% per month delinquenci charge on past due accounts. Signature /l C DRAWING iifa,. U.evot f caC w ,206 -P31 -3665 More work to follow O yes 17 no Explanation L , ! Sub -Total Tax Total Date • Drain Cleaning • Septic Locating • Vactor Trucks • Plumbing - 'Sewer Line Video, • High Velocity Jetting Date TERMS AND CONDITIONS REPRESENTATIONS AND DISCLAIMERS 1. SEPTIC TANKS ::Nbrthwest Cascade, Inc. NOrtlit'CasCade;Int. is not responsible for damage to tank caused by improper excavation or back fill of tank Customer assumes all responsibility-from damage inside the pioPerty line to property or persons. -') - 2. DELIVERY OF MATERIAL Our drivers will _., make every effort to place Material where H• v-- 'rrl customer; designates, and the customer assumes all responsibility for damages inside the curb or to i - property or persons _ ,.'. . , 10 3. MATERIALSMEWS LIEN NOTICE - Signature of this truck; invoice will be considered your notice of our intent to lien this project if necessary. TERMS All charges not paidby the 10th of the month shall be subject to 1.5% delinquency charge on all past due accounts. • • MAINTENANCE RECORD Projec : �C� (« Type of Inspection: p (' 44 Addrress: /0 X10,2 Z. rn COS Date Called: o`>// dei7 Special Instructions: �e► "� D Date Wanted: Ol /l /d�� a.m. P.m, Requer: (A7'0 P12‘)//,..S Phone No: L /a5 - h�/ - / /d- o kV" INSPECTION NO. INSPECTION RECORD Retain a copy with permit CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 PERMIT NO. (206)431 -3670 Approved per applicable codes. Corrections required prior to approval. COMMENTS: l 01 Mir) f it Inspector: Gfi r ate: 7W I El $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be . paid at 6300 Southcenter Blvd., Suite 100. Call the schedule reinspection. Receipt No.: 'Date: D n SAFETY • TRAINING • INDUSTRIAL HYGIENE n April 11, 2007 Mr. Jarrod Stafford McConkey Development 3006 Northup Way, Suite 303 Redmond, Washington 98004 Dear Mr. Stafford, AU GUS RE: 10801 Marginal Way Asbestos Building Sampling At your request, on April 7, 2007, Argus Pacific, Inc. (Argus Pacific) collected bulk samples of building materials for asbestos analysis of the single family residential structure located at 10801 Marginal Way in Tukwila, Washington. The inspection was conducted by EPA certified AHERA Building Inspector Paul McGee (Argus Pacific), #1025595 (exp. February, 2008). This inspection and report is intended to meet the requirements of the Washington Sate Department of Labor and Industry's (L &I) requirement for a "good faith inspection" found at WAC 296 -62 -07722 and the Puget Sound Clean Air Agency's (PSCAA) requirement for an "Asbestos Survey" found at PSCAA Regulation III, Article 4. Scope of Work The purpose of this study was to identify asbestos in building materials expected to be impacted by the demolition of this structure. A total of 31 samples were taken at various locations throughout the 10801 Marginal Way Building, as directed by Jarrod Stafford of McConkey Development. Suspect asbestos containing materials were sampled according to 40 CFR 763.86 by an EPA certified AHERA building inspector. Each sample was collected and stored in a heavy -duty, self - sealing plastic bag and delivered to NVL Laboratories, Inc. in Seattle, WA. Samples were analyzed via Polarized Light Microscopy (PLM) according to US EPA Method 600/M -4-82 -020. RECEIVED CITYOFTUKWRA APR 13 2007 PERMITCENTER 10801 Marginal Way Asbestos Building Sampling Inspection Page 1 of 6 ArgusPacific, Inc. PO4.-- 1* SAMPLE ID MATERIAL ` SAMPLE RESULT QUANTITY, : SAMPLE LOCATION MC- AC1-01 Acoustical ceiling 25% Chrysotile 170 SF R2, Ceiling, i' E of W wall MC- ACI-02 Acoustical ceiling 26% Chrysotile 170 SF (quantity Included in MC- ACt -01) R2, Ceiling, 1' W of E wall 14C- AC1-03 Acoustical ceiling 29% Chrysotile 170 SF (quantity Included In MC- AC1 -01) R3, Ceiling, SW corner MC- AC2 -01 Acoustical ceiling 32% Chrysotile 150 SF R1, Ceiling, NW corner MC- AC2 -02 Acoustical ceiling 31% Chrysotile 150 SF (quantity Included In MC- AC2 -01) R1, Ceiling, SE corner MC- AC2-03 Acoustical ceiling 33% Chrysotile 150 SF (quantity Included In MC- AC2 -01) R1, Ceiling, 1' E of W wall MC- COP1 -01 Construction paper ND Exterior N wall, under siding MC- GWB1 -01 Li: Drywall mud (white) L2: Gypsum wallboard (white) ND (all layers) Basement, stairway, W wall MC- GWB1 -02 Li: Drywall mud (white) Basement, ceiling, 7' W of E wall ARGUS INV IV SAFETY • TRAINING • INDUSTRIAL HYGIENE Results Detectable concentrations of asbestos were found in the following samples: • Acoustical (popcorn) ceiling • Vinyl Floor Sheet Backing The following materials are assumed to contain asbestos: • Electrical panels (2) • Gaskets 10801 Marginal Way Asbestos Building Sampling ArgusPacific, Inc. A summary of suspected asbestos- containing materials, sample locations and analytical results is reported in Table 1 below. Laboratory reports and a floor plan with sample locations are included as attachments. Table 1. Suspected asbestos - containing materials list including sample results, 10801 Marginal Way, April 7, 2007 Inspection Page 2 of 6 ARGUS D II SAFETY • TRAINING • INDUSTRIAL HYGIENE 10801 Marginal Way Asbestos Building Sampling ArgusPacific, Inc. Inspection Page 3 of 6 L2: Gypsum wallboard (white) , MC- GWB1 -03 Gypsum wallboard (white) Basement, ceiling, 6' W of E wall MC- GWB2 -01 Gypsum wallboard ND (all layers) Basement, ceiling, 2' N of S wall MC- GWB2 -02 Gypsum wallboard Basement, ceiling, 2' E of W wall MC- GWB2 -03 Gypsum wallboard Basement, ceiling, 10' E of W wall MC- LC1 -01 Li: Leveling compound U: Sandy material (grey) L3: Joint compound (white) L4: Foam (white) ND (all layers) R2, W wall -floor interface, 7' N of S wall, MC- OTH1 -01 Sealant for penetration ND Stairway to basement, W wall, wall penetration MC -PL1 -01 MC -PL1 -02 MC -PL1 -03 MC -PL1-04 MC -PL1 -05 Plaster ND R4, N wall R1. N wall R2, N wall R5, W wall R3, S wall MC-R01-01 Roof Li: Shingle L2: Roofing felt ND (all layers) Roof, 4' E of W edge, 6' N of S edge MC-R01-02 Roof Li: Shingle L2: Shingle L3: Shingle L4: Shingle Roof, 3' E of W edge, 15' S of N edge MC-R01-03 Roof Li: Shingle L2: Roofing felt Roof, 1' W of E edge, 6' N of S edge MC- VCB1 -0i 1: Vinyl cove base 2: Mastic (tan) ND (all layers) R4, S wall MC- VCB2 -01 1: Vinyl cove base 2: Mastic (brown) ND (all layers) R6, E wall MC- VFS1 -01 Li: Vinyl floor sheet (tan) 1.2: backing (beige) L3: Fibrous ND (all layers) R6, floor ARGUS D II SAFETY • TRAINING • INDUSTRIAL HYGIENE 10801 Marginal Way Asbestos Building Sampling ArgusPacific, Inc. Inspection Page 3 of 6 AIR G LJS sr SAFETY • TRAINING • INDUSTRIAL HYGIENE n Notes: ND indicates that no detectable concentration of asbestos was found in sample. 10801 Marginal Way Asbestos Building Sampling ArgusPacific, Inc. Inspection Page 4 of 6 material (white) L4: Vinyl (beige) L5: Fibrous material (black) MC- VFS2 -Oi Vinyl floor sheet Li: Vinyl floor sheet (tan) U: Backing (grey, fibrous) L3: Vinyl L4: fibrous material (black, asphaltic) L1: ND L2: 43% Chrysotile L3: ND L3: ND 170 SF R4, floor MC- WPG1 -01 Window putty glazing (tan) ND Exterior of R1, E wall window MC- WPG2 -01 Window putty glazing (grey) ND Exterior of R3, W wall window MC- WPG3 -01 Window putty glazing (tan) ND Exterior of R4, E wall window MC- WPG4 -01 Window putty glazing (grey) ND Exterior of RI, E wall window Gaskets Assumed Throughout unit Electrical panels Assumed 2 Basement AIR G LJS sr SAFETY • TRAINING • INDUSTRIAL HYGIENE n Notes: ND indicates that no detectable concentration of asbestos was found in sample. 10801 Marginal Way Asbestos Building Sampling ArgusPacific, Inc. Inspection Page 4 of 6 Eri a SAFETY • TRAINING • INDUSTRIAL HYGIENE Conclusions and Recommendations ACM and non -ACM materials were identified in the Auburn Car Lot Building located at 10801 Marginal Way. It is important to note that any materials not identified in this report that are discovered during construction activities must be treated as asbestos- containing materials until they are sampled and shown not to contain asbestos Please note that this inspection does not replace professionally developed asbestos abatement plans, specifications, or bidding documents and cannot be used as a contract document or any portion of a contract document set. 10801 Marginal Way Asbestos Building Sampling Inspection Page 5 of 6 ArgusPacific, Inc. A SAFETY • TRAINING • INDUSTRIAL HYGIENE n Limitations APG TS Asbestos inspections are intrinsically non - comprehensive and subject to many limitations, including those presented below. Our assessment has considered risks pertaining to asbestos; however, this inspection is limited to only those locations and materials sampled. This inspection was not designed to identify all potential concerns or to eliminate all risks associated with demolition, material removal, construction, or transferring of property title. Evaluation of other risks not specifically described in the Scope of Work have not been included; for example: structural integrity; engineering loads; electrical; mechanical; radon gas; slope stability; building settlement; and evaluation of toxic and hazardous substances in, or in contact with, soil and groundwater. No warranty, expressed or implied, is made. This asbestos inspection was performed in preparation for removal of asbestos- containing materials in accordance with State of Washington and PSCAA laws and regulations. Argus Pacific is not responsible for materials that are hidden from sight, materials hidden behind walls, materials that cannot be found with reasonable diligence, or materials that require destructive means to access. Materials that are suspected to exist in wall cavities and other hidden spaces are assumed to be asbestos containing until these areas can be inspected by an AHERA- certified building inspector. Argus Pacific has performed the services set forth in the Scope of Work in accordance with generally accepted industrial hygiene practices in the same or similar localities, related to the nature of the work accomplished, at the time the services were performed. The hazardous building materials and conditions presented in this report represent those observed on the dates we conducted the asbestos inspection. This inspection is intended for the exclusive use of McConkey Development for specific application to the referenced property. This inspection is not intended to replace construction or demolition plans, specifications, or bidding documents. This report is not meant to represent a legal opinion. We appreciate the opportunity to be of service to you. Please contact me at (206) 285 -3373 if you have questions regarding this material, or if you require additional information. Sincerely, Reviewed by, 1 00 MA- Paul D. McGee Industrial Hygiene Technician Argus Pacific, Inc. Attachments 1) Field drawing with sample locations 2) Laboratory Analytical Results 3) Inspector Certifications John Terrill Project Manager Argus Pacific, Inc. iDR JoI 4i 'Tar if 10801 Marginal Way Asbestos Building Sampling Inspection Page 6 of 6 ArgusPacific, Inc. wfritpli In-7/1:4P&I-e• U ?NE ittc- Rol- 03 • NVL Laboratories, Inc. l 4708 Aurora Ave. N., Seattle, WA 98103 #102063 Tel: 206.547.0100, Fax: 206.634.1936 www.nvllabsbs.com Bulk Asbestos Fibers Analysis com Client: Argus Pacific, Inc. Address: 1900 W. Nickerson St, Suite 315 Seattle, WA 98119 Attention: Mr. Paul McGee Project Location: N/A • Lab ID: 27040185 Client Sample #: EC-AC1 -01 Location: N/A Layer 1 of 1 Description: White lumpy foamy material with paint Non - Fibrous Materials: Other Fibrous Materials:% Binder/Filler None Detected ND • Lab ID: 27040186 Client Sample #: MC -AC1 - 02 Location: N/A Layer 1 of 1 Lab ID: 27040187 Location: N/A Layer 1 of 1 Description: White lumpy foamy material with paint Non - Fibrous Materials: Other Fibrous Materials:% Binder /Filler None Detected ND Client Sample #: MC AC1 - 03 Description: White lumpy foamy material with paint Non- Fibrous Materials: Other Fibrous Materials:% Binder/Filler None Detected ND Lab ID: 27040188 Client Sample #: MC AC2 • Location: N/A Layer 1 of 1 Description: White lumpy foamy material with paint Non - Fibrous Materials: Other Fibrous Materials:% Binder/Filler None Detected ND Lab ID: 27040189 Client Sample #: MC Location: N/A Layer 1 of 1 By Polarized Light Microscopy Description: White lumpy foamy material with paint Non - Fibrous Materials: Other Fibrous Materials:% Binder /Filler None Detected ND Batch #: 2705783.00 Client Project #: 438507 Date Received: 04 /06/2007 Samples Received: 31 Samples Analyzed: 31 Method: EPA/600R- 93/116 Asbestos Type: % Chrysotile 25% Asbestos Type: % Chrysotile 28% Asbestos Type: % Chrysotile 29% Asbestos Type: % Chrysotile 32% Asbestos Type: .% Chrysotile 31% Sampled by: Client Analyzed by: Jason Stuhr Date: 04 /10/2007 DRAFT Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using EPA 600/R - 93/116 Method with the following measurement uncertainties for the reported % Asbestos (1 % =0-3 %, 5 %=1 -9 %, 10 % =5 -15 %, 20 % =10 -30%, 50%=40 -60 %). This report relates only to the Items tested. If sample was not collected by NVL personnel, then the accuracy of the results Is limited by the . methodology and acuity of the sample collector. This report shall not be reproduced except In full, without written approval of NVL Laboratories, Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government. Page 1 of 9 Attention: Mr. Paul McGee Project Location: N/A Layer 1 of 1 Lab ID: 27040191 Location: N/A Layer 1 of 1 Lab ID: 27040192 Location: N/A Layer 1 of 2 Layer 2 of 2 NVL Laboratories, Inc. ab ■ 4708 Aurora Ave. N., Seattle, WA 98103 Tel: 206.547.0100, Fax: 206.634.1936 www.nvllabs.com Bulk Asbestos Fibers Analysis #102063 / Client: Argus Pacific, Inc. Address: 1900 W. Nickerson St., Suite 315 Seattle, WA 98119 Lab ID: 27040190 Client Sample #: MC .Location: N/A Description: White lumpy foamy material with paint Non - Fibrous Materials: Binder /Filler Client Sample #: MC COP1 - 01 Description: Black asphaltic fibrous material Non - Fibrous Materials: Asphalt/binder Client Sample #: MC GWB1 - 01 Non - Fibrous Materials: Binder /Filler Description: White chalky material with paper Non - Fibrous Materials: Gypsum/binder By Polarized Light Microscopy Description: White compacted powdery material with paint Lab ID: 27040193 Client Sample #: MC GWB1 - 02 Location: N/A Layer 1 of 2 Description: White compacted powdery material with paint Layer 2 of 2 Other Fibrous Materials:% None Detected ND Other Fibrous Materials:% Cellulose 90% Other Fibrous Materials:% Cellulose 20% Non- Fibrous Materials: Other Fibrous Materials:% Binder /Filler Cellulose Description: White chalky material with paper Non- Fibrous Materials: Other Fibrous Materials:% Gypsum/binder Cellulose 22% Batch #: 2705783.00 Client Project #: 438507 Date Received: 04 /06/2007 Samples Received: 31 Samples Analyzed: 31 Method: EPA/600R- 93/116 Asbestos Type: % Chrysotile 33% Asbestos Type: % None Detected ND Other Fibrous Materials:% Asbestos Type: % Cellulose 2% None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % 2% None Detected ND Asbestos Type: % None Detected ND Sampled by: Client Analyzed by: Jason Stuhr Date: 04 /10/2007 DRAFT Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using EPA 600/R - 93/116 Method with the following measurement uncertainties for the reported % Asbestos (1 % =0-3 %, 5 % =1 -9 %, 10 % =5 -15 %, 20%= 10 -30%, 50 %=40 -60 %). This report relates only to the Items tested. If sample was not collected by NVL personnel, then the accuracy of the results Is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in fufl, without written approval of NVL Laboratories, Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government. Page 2 of 9 NVL Laboratories, Inc. 4708 Aurora Ave. N., Seattle, WA 98103 Tel: 206.547.0100, Fax: 206.634.1936 www.nvllabs.com Attention: Mr. Paul McGee Project Location: N/A Lab ID: 27040194 Location: N/A . Layer 1 of 1 Layer 1 of 1 • Client: Argus Pacific, Inc. Address: 1900 W. Nickerson St., Suite 315 Seattle, WA 98119 Lab ID: 27040196 Location: N/A Layer 1 of 1 Bulk Asbestos Fibers Analysis By Polarized Light Microscopy Client Sample #: MC- GWB1 - 03 Description: White chalky material with paper and paint Non - Fibrous Materials: Other Fibrous Materials:% Gypsum/binder Cellulose 28% Lab ID: 27040195 Client Sample #: MC GWB2 - 01 Location: N/A Description: White chalky material with paper and paint Non - Fibrous Materials: Other Fibrous Materials:% Gypsum/binder Client Sample #: MC GWB2 - 02 Description: White chalky material with paper and paint Gypsum/binder Lab ID: 27040197 Client Sample #: MC GWB2 - 03 Location: N/A Gypsum/binder Lab ID: 27040198 Client Sample #: MC - LC1 - 01 Location: N/A Cellulose 27% Glass fibers 8% Non - Fibrous Materials: Other Fibrous Materials:% Cellulose 26% Glass fibers 8% Layer 1 of 1 Description: White chalky material with paper and paint Non- Fibrous Materials: Other Fibrous Materials:% Cellulose 25% Glass fibers 9% #102063 Batch #: 2705783.00 Client Project #: 438507 Date Received: 04 /06/2007 Samples Received: 31 Samples Analyzed: 31 Method: EPA/600R- 93/116 Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND i Sampled by: Client Analyzed by: Jason Stuhr 1 Date: 04 /10/2007 DRAFT Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using EPA 600/R - 93/116 Method with the following measurement uncertainties for the reported % Asbestos (1 % =0-3 %, 5 % =1 -9 %, 10 %= 5-15 %, 20 %= 10 -30 %, 50%=40 -60 %). This report relates only to the Items tested. If sample was not collected by NVL personnel, then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except In full, without written approval of NVL Laboratories, Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government Page 3 of 9 J Layer 1 of 1 NVL Laboratories, Inc. 4708 Aurora Ave. N., Seattle, WA 98103 Tel: 206.547.0100, Fax: 206.634.1936 www.nvllabs.com Layer 1 of 4 Layer 2 of 4 Layer 3 of 4 . Layer 4 of 4 Client: Argus Pacific, Inc. Address: 1900 W. Nickerson St., Suite 315 Seattle, WA 98119 ' Attention: Mr. Paul McGee Project Location: N/A By Polarized Light Microscopy Bulk Asbestos Fibers Analysis Description: White compacted powdery material with paint Non - Fibrous Materials: Other Fibrous Materials:% Binder/Filler Description: Gray sandy material Non - Fibrous Materials: Quartz, talc, binder/filler Description: White compacted powdery material Non- Fibrous Materials: Binder /Filler Lab ID: 27040199 Client Sample #: MC OTH1 - 01 Location: N/A Description: White soft material Non - Fibrous Materials: Synthetic foam Cellulose Other Fibrous Materials:% None Detected ND Other Fibrous Materials:% Glass fibers 2% Description: White foam Non - Fibrous Materials: Other Fibrous Materials:% Styrofoam None Detected ND Other Fibrous Materials:% None Detected ND Lab ID: 27040200 Client Sample #: MC - PL1 - 01 Location: N/A - Layer 1 of 2 Description: White compacted powdery material with paint Non - Fibrous Materials: Other Fibrous Materials:% Talc/binder Cellulose Layer 2 of 2 Description: Gray sandy material Non- Fibrous Materials: Other Fibrous Materials:% Quartz, talc, binder /filler Cellulose 2% IMT9 #102063 Batch #: 2705783.00 Client Project #: 438507 Date Received: 04 /06/2007 Samples Received: 31 Samples Analyzed: 31 Method: EPA/600R- 93/116 Asbestos Type: % 2% None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % 2% None Detected ND Asbestos Type: % None Detected ND Sampled by: Client ' Analyzed by: Jason Stuhr Date: 04 /10/2007 DRAFT Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using EPA 600/R - 93/116 Method with the following measurement uncertainties for the reported % Asbestos (1% =0-3 %, 5 % =1 -9 %, 10°4=5-15%, 20 %= 1030 %, 50%=40 -60%). This report relates only to the items tested. If sample was not collected by NVL personnel, then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories, Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government Page 4 of 9 ■ • Layer 1 of 1 tior 1 1 NVL Laboratories, Inc. im 4708 Aurora Ave. N., Seattle, WA 98103 Tel: 206.547.0100, Fax: 206.634.1936 www.nvllabs.com Bulk Asbestos Fibers Analysis #102063 Client: Argus Pacific, Inc. Address: 1900 W. Nickerson St, Suite 315 Seattle, WA 98119 Attention: Mr. Paul McGee Project Location: N/A Lab ID: 27040201 Client Sample #: MC - PL1 - 02 Location: N/A • Lab ID: 27040202 Location: N/A Layer 1 of 1 Lab ID: 27040203 Location: N/A Layer 1 of 1 Lab ID: 27040204 Location: N/A Layer 1 of 1 Description: Gray sandy material with paint Non - Fibrous Materials: Quartz, talc, binder/filler Client Sample #: MC - PL1 - 03 Description: Gray sandy material with paint Non - Fibrous Materials: Quartz, talc, binder/filler Client Sample #: MC - PL1 - 04 Description: Gray sandy material with paint Non - Fibrous Materials: Quartz, talc, binder/filler Client Sample #: MC -PL1 -05 Lab ID: 27040205 Client Sample #: MC-R01-01 ' Location: N/A Layer 1 of 2 By Polarized Light Microscopy Other Fibrous Materials:% Cellulose 2% Other Fibrous Materials:% Cellulose 2% Batch #: 2705783.00 Client Project #: 438507 Date Received: 04 /06/2007 Samples Received: 31 Samples Analyzed: 31 Method: EPA/600R- 93/116 Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Other Fibrous Materials:% Asbestos Type: % Cellulose 2% None Detected ND Description: Gray sandy material with paint Non - Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Quartz, talc, binder/filler Cellulose 2% None Detected ND Description: Black asphaltic material with mineral grains Non - Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder Cellulose 3% None Detected ND Sampled by: Client Analyzed by: Jason Stuhr Date: 04 /10/2007 DRAFT Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using EPA 600/R - 93/116 Method with the following measurement uncertainties for the reported % Asbestos (1 % =0-3 %, 5 % =1 -9 %, 10%= 5-15 %, 20%= 10 -30 %, 50 %=40 -60 %). This report relates only to the items tested. If sample was not collected by NVL personnel, then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except In full, without written approval of MIL Laboratories, Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government. Page 5 of 9 a NVL Laboratories, Inc. ' 4708 Aurora Ave. N., Seattle, WA 98103 #102063 Tel: 206.547.0100, Fax: .com 206.634.1936 Bulk Asbestos Fibers Analysis www .nvliabs By Polarized Light Microscopy Attention: Mr. Paul McGee Project Location: N/A Layer 2 of 2 Client: Argus Pacific, Inc. Address: 1900 W. Nickerson St, Suite 315 Seattle, WA 98119 Description: Black asphaltic fibrous felt Non - Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder Glass fibers 35% None Detected ND Lab ID: 27040206 Client Sample #: MC Location: N/A Layer 1 of 4 Description: Black asphaltic material with mineral grains Non - Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder Cellulose 20% None Detected ND Layer 2 of 4 Description: Black asphaltic material with multi - colored mineral grains Non - Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder Cellulose 25% None Detected ND Layer 3 of 4 Description: Black asphaltic material with multi- colored mineral grains Non - Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder Cellulose 23% None Detected ND Layer 4 of 4 Description: Black asphaltic material with multi- colored mineral grains Non - Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder Cellulose 21% None Detected ND Lab ID: 27040207 Client Sample #: MC-R01-03 Location: N/A Layer 1 of 5 Description: Black asphaltic material with gray - colored mineral grains Non - Fibrous Materials: Other Fibrous Materials:% Layer 2 of 5 Asphalt/binder Cellulose 20% Description: Black asphaltic fibrous material Non - Fibrous Materials: Other Fibrous Mat Asphalt/binder Cellulose 70% Batch #: 2705783.00 Client Project #: 438507 Date Received: 04 /06/2007 Samples Received: 31 Samples Analyzed: 31 Method: EPA/600R- 93/116 Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Sampled by: Client Analyzed by: Jason Stuhr Date: 04 /10/2007 DRAFT Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using EPA 600/R - 93/116 Method with the following measurement uncertainties for the reported % Asbestos (1%—-3 %, 5 % =1 -9 %, 10%= 5 -15 %, 20%= 10 -30 %, 50 %=40 -50 %). This report relates only to the items tested. If sample was not collected by NVL personnel, then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories, Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government. Page 6 of 9 NVL Laboratories, Inc. • 4708 Aurora Ave. N., Seattle, WA 98103 Tel: 206.547.0100, nvllabs. Fax: 206.634.1936 Bulk Asbestos Fibers Analysis www Layer 1 of 2 Attention: Mr. Paul McGee Project Location: N/A Layer 3 of 5 Layer 4 of 5 Layer 5 of 5 Layer 2 of 2 Client: Argus Pacific, Inc. Address: 1900 W. Nickerson St, Suite 315 Seattle, WA 98119 Description: Black asphaltic material with Non - Fibrous Materials: Asphalt/binder Description: Black asphaltic material with Non - Fibrous Materials: Asphalt/binder Description: Black asphaltic material with Non - Fibrous Materials: Asphalt/binder Lab ID: 27040208 Client Sample #: MC VCB1 -01 Location: N/A Description: Gray rubbery material Non - Fibrous Materials: Rubber/binder Description: Tan soft mastic Non - Fibrous Materials: Mastic/binder Lab ID: 27040209 Client Sample #: MC-VCB2-01 Location: N/A Layer 1 of 2 Description: Off -white rubbery material Non - Fibrous Materials: Rubber/binder Layer 2 of 2 Description: Brown brittle mastic Non - Fibrous Materials: Mastic/binder By Polarized Light Microscopy green - colored mineral grains Other Fibrous Materials:% Cellulose 21% multi - colored mineral grains Other Fibrous Materials:% Cellulose 25% multi- colored mineral grains Other Fibrous Materials:% Cellulose 26% Other Fibrous Materials:% None Detected ND Other Fibrous Materials:% Cellulose 2% #102063 Batch #: 2705783.00 Client Project #: 438507 Date Received: 04 /06/2007 Samples Received: 31 Samples Analyzed: 31 Method: EPA/600R- 93/116 Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Other Fibrous Materials:% Asbestos Type: % None Detected ND None Detected ND Other Fibrous Materials:% Asbestos Type: % Cellulose 2% None Detected ND Sampled by: Client Analyzed by: Jason Stuhr Date: 04 /10/2007 DRAFT Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using EPA 600/R - 93/116 Method with the following measurement uncertainties for the reported % Asbestos (1% =0-3 %, 5% =1 -9 %, 10%= 5-15 %, 20%= 10-30 %, 50 %=40 -60 %). This report relates only to the items tested. If sample was not collected by NVL personnel, then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in fug, without written approval of NVL Laboratories, Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government. Page 7 of 9 NVL Laboratories, Inc. Nvi 4708 Aurora Ave. N., Seattle, WA 98103 • Tel: 206.547.0100, Fax: 206.634.1936 www.nvilabs.com D ulk Asbestos Fibers Analysis #102063 Lab ID: 27040210 Client Sample #: MC VFS1 -01 Location: N/A Layer 1 of 5 Description: Tan sheet vinyl Non - Fibrous Materials: Vinyl/binder Layer 2 of 5 Description: Beige fibrous backing Non - Fibrous Materials: Binder /Filler Layer 3 of 5 Description: White fibrous material Non - Fibrous Materials: Binder /Filler Layer 4 of 5 Description: Beige vinyl Non - Fibrous Materials: Vinylbinder • Layer 5 of 5 Description: Black asphaltic fibrous material Non - Fibrous Materials: Asphalt/binder Attention: Mr. Paul McGee Project Location: N/A Client: Argus Pacific, Inc. Address: 1900 W. Nickerson St, Suite 315 Seattle, WA 98119 Lab ID: 27040211 Location: N/A Layer 1 of 4 Layer 2 of 4 Client Sample #: MC-VFS2-01 By Polarized Light Microscopy Other Fibrous Materials:% None Detected ND Other Fibrous Materials:% Cellulose 30% Other Fibrous Materials:% Cellulose 32% Other Fibrous Materials:% Cellulose 20% Other Fibrous Materials:% Cellulose 85% Batch #: 2705783.00 Client Project #: 438507 Date Received: 04 /06/2007 Samples Received: 31 Samples Analyzed: 31 Method: EPA/600R- 93/116 Asbestos Type: % None Detected ND Asbestos Type: % Chrysotile 40% Asbestos Type: % Chrysotile 42% Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Description: Tan sheet vinyl Non - Fibrous Materials: Other Fibrous Materials:% VinyVbinder None Detected ND Description: Gray fibrous backing with mastic Non - Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/binder Cellulose 31% Chrysotile 43% Asbestos Type: % None Detected ND Sampled by: Client Analyzed by: Jason Stuhr ■ Date: 04 /10/2007 DRAFT Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using EPA 600/R - 93/116 Method with the following measurement uncertainties for the reported % Asbestos (1%.1-3 %, 5 °h =1-9 %, 10%=5-15%, 20 %= 10 -30 %, 50 %=40 -60 %). This report relates only to the Items tested. If sample was not collected by NVL personnel, then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories, Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government. Page 8 of 9 • 4708 Aurora Ave. N., Seattle, WA 98103 Tel: 206.547.0100, Fax: 206.634.1936 B www.nvllabs.com ulk Asbestos Fibers Analysis #102063 NVL Laboratories, Inc. Client: Argus Pacific, Inc. Address: 1900 W. Nickerson St, Suite 315 Seattle, WA 98119 Attention: Mr. Paul McGee Project Location: N/A Layer 3 of 4 Layer 4 of 4 Lab ID: 27040212 Location: N/A Layer 1 of 1 Lab ID: 27040213 Client Sample #: MC-WPG2-01 Location: N/A Layer 1 of 1 Lab ID: 27040214 Location: N/A Layer 1 of 1 Description: Tan vinyl Non - Fibrous Materials: Vinyl/binder Description: Black asphaltic fibrous material Non - Fibrous Materials: Asphalt/binder Client Sample #: MC- WPG1 -01 Description: Tan brittle material with paint Non - Fibrous Materials: Caulking compound Description: Gray brittle material with paint Non - Fibrous Materials: Caulking compound Client Sample #: MC Description: Tan brittle material with paint Non - Fibrous Materials: Caulking compound Lab ID: 27040215 Client Sample #: MC WPG4 - 01 Location: N/A Layer 1 of 1 By Polarized Light Microscopy Other Fibrous Materials:% Cellulose 25% Other Fibrous Materials:% Cellulose 70% Other Fibrous Materials:% Cellulose 2% Other Fibrous Materials:% Cellulose 2% Cellulose 2% rkingilaf Batch #: 2705783.00 Client Project #: 438507 Date Received: 04 /06/2007 Samples Received: 31 Samples Analyzed: 31 Method: EPA/600R- 93/116 Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Other Fibrous Materials:% Asbestos Type: % Cellulose 2% None Detected ND Description: White brittle material with paint Non - Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Caulking compound None Detected ND Sampled by: Client Analyzed by: Jason Stuhr Date: 04 /10/2007 DRAFT Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using EPA 600/R - 93/116 Method with the following measurement uncertainties for the reported % Asbestos (1 %=0 -3 %, 5% =1-9 %, 10 %=5 -15 %, 20 %= 10 -30%, 50 %=40 -60 %). This report relates only to the items tested. If sample was not collected by NVL personnel, then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories, Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government. Page 9 of 9 ) ificate of Completion IOW 66 to terttfp t!jat Paul D. McGee bag oatistattoritp complettb bour fi of refreober training ait an Asbestos Building Inspector to tom* bit]) tbe training requirement of TAIQCS iLitte 33 / 40 (Elf33, 763 (fie3a12) Feb i3.2007 Date(s) or1rai Rum Scom NA Tixpiration Darie: Feb 13.241(4 03 -05 -2008 JERROD STAFFORD 3006 NORTHUP WY #303 BELLEVUE WA 98004 RE: Permit No. D07 -137 10802 EAST MARGINAL WY S TUKW Dear Permit Holder: 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 and/or the International Mechanical Code, every permit issued by the Building Division under the provisions of this code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days from the date of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days. Based on the above, you are hereby advised to: Call the City of Tukwila Inspection Request Line at 206- 431 -2451 to schedule for the next or final inspection. This inspection is intended to determine if substantial work has been accomplished since issuance of the permit or last inspection; or if the project should be considered abandoned. If such determination is made, the Building Code does allow the Building Official to approve one or more extensions of time for additional periods not exceeding 90 days each. Extension requests must be in writinx and provide satisfactory reasons why circumstances beyond the applicants control have prevented action from being taken. In the event you do not call for the above inspection and receive an extension prior to 04/17/2008 , 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, er Marshall, Permit Technician xc: Permit File No. D07 -137 City of Tukwila Jim Haggerton, Mayor Department of Community Development Jack Pace, Director 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 08 -30 -2007 JERROD STAFFORD 3006 NORTHUP WY #303 BELLEVUE WA 98004 RE: Permit No. D07 -137 10802 EAST MARGINAL WY S TUKW Dear Permit Holder: 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 and/or the International Mechanical Code, every permit issued by the Building Division under the provisions of this code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days from the date of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days. Based on the above, you are hereby advised to: Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or final inspection. This inspection is intended to determine if substantial work has been accomplished since issuance of the permit or last inspection; or if the project should be considered abandoned. If such determination is made, the Building Code does allow the Building Official to approve one or more extensions of time for additional periods not exceeding 90 days each. Extension requests must be in writini and vrovide satisfactory reasons why circumstances beyond the applicants control have prevented action from being taken. In the event you do not call for the above inspection and receive an extension prior to 10/22/2007 , 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, er Marshall, Permit Technician xc: Permit File No. D07 -137 City of Tukwila Steven M. Mullet, Mayor Department of Community Development Steve Lancaster, Director 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 -431 -3670 • Fax: 206 - 431 -3665 Joanna Spencer - RE: Medica Maria Demo @ 10802 EMWS D07 -137 From: "Jerrod Stafford" <Jerrod@McConkeyDev.com> To: "Joanna Spencer" <jspencer @ci.tukwila.wa.us> Date: 04/23/2007 11:15 AM Subject: RE: Medica Maria Demo @ 10802 EMWS D07 -137 CC: "Carolyn Phillip" <Carolyn@McConkeyDev.com> Joanna, I talked to the contractor about this. He thinks it will cost us an additional $900 to pump the septic and abandon the system. Can I give someone a credit card number at the City to pay for additional permit fee this or does it need to be a check? Thanks, Jerrod Stafford McConkey Development Company 3006 Northup Way, #303 Bellevue, WA 98004 425.889.1180 - office 206.999.0358 - cell From: Joanna Spencer [mailto :jspencer @ci.tukwila.wa.us] Sent: Friday, April 20, 2007 4:46 PM To: Jerrod Stafford Subject: RE: Medica Maria Demo @ 10802 EMWS D07 -137 Thanks for the fax. I need a $$ cost for septic pumping and abandonment, since PW permit fee is a % of the above Joanna Spencer Development Engineer City of Tukwila Public Works Department 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 -2544 phone: 206 -431 -2440 fax: 206 -431 -3665 jspencer @ci.tukwila.wa.us. »Joanna COpy Page 1 of 1 file: / /C:\ Documents %20and %20Settings\Joanna\ Local %20Settings \Temp\XPGrpWise \46... 04/23/2007 DEPARTMENTS: A w '� ing Division Public Works 440 40. DETERMINATION OF COMPLETENESS: Comments: APPROVALS OR CORRECTIONS: Approved ❑ Notation: REVIEWER'S INITIALS: Documents/routing slip.doc 2 -28-02 PERMIT COORD COPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D07 -137 DATE: 04 -13 -07 PROJECT NAME: MEDICA SITE ADDRESS: 10802 EAST MARGINAL WY S X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # After Permit Issued 611 Kla- 4 -n -o Fire Prevention Structural (Tues., Thurs.) Complete Incomplete ❑ ❑ Permit Coordinator DUE DATE: 04-17-07 Not Applicable ❑ Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES/THURS ROU ING: Please Route Structural Review Required REVIEWER'S INITIALS: Approved with Conditions ❑ No further Review Required DATE: DATE: -1 --o Planning Divis , on n DUE DATE: 05-15-07 Not Approved (attach comments) ❑ Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: License Information License GREGCEL949CB Licensee Name GREGCO EXCAVATING LLC Licensee Type CONSTRUCTION CONTRACTOR UBI 602576720 Ind. Ins. Account Id #1 Business Type LIMITED LIABILITY COMPANY Address 1 3401 139TH AVE NE Address 2 City LAKE STEVENS County SNOHOMISH State WA Zip 98258 Phone 4253347307 Status ACTIVE Specialty 1 EXCAVATION /GRADING Specialty 2 SANITATION SYSTEM SIDE SEWER Effective Date 2/2/2006 Expiration Date 2/2/2008 Suspend Date Separation Date Parent Company Previous License Next License Associated License Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date #1 COLONIAL AM CAS & SURETY OF M LPM4070792 01/30/2006 Until Cancelled $6,000.00 02/02/2006 Business Owner Information Name Role Effective Date Expiration Date GREGORY, MIKE PARTNER/MEMBER 02/02/2006 Look Up a Contractor, Electrician or Plumber License Detail Page 1 of 2 Washington State Department of Labor and Industries General/Specialty Contractor A business registered as a construction contractor with L &I to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. https: // fortress. wa. gov /lni/bbip /printer.aspx ?License= GREGCEL949CB 04/25/2007 1,oeo S P4. mite ov•Amt(50. Acces5 v lA V 141 Ma.14104. w.P1 50)114 PILE pm* pr Plan review approval Is subject to errors and omissions Approval of con documents deer not aUthOrint the violation of any We cr ordnance. Receipt of approved Field Nied9ed: By Date: cD -7- Calf of Tukwila BUILDING DIVISION SDMH(60") RIM=20.33 IE 48%48" W=11.13 IE 12' CMP NE=16.33 CB TYPE 1 RIM=19.86 IE 12" ADS S=14.96 IE 12" ADS W=14.76 J-BOX CB TYPt 1 RIM=19.82 IE 12" ADS N=15.37 IE 12"(ADS -5=15.45 CB TYP! 1 RIM=19.88 IE 12" TS N=15.98 IE 12" 'OS 5=16.06 SSMH RI =19.97 IE 12" VC 5=6.85 IE 12" C N=6.67 IE 8" P4 E=7.13 SSMH RIM=20.50 1E 8" PVC SE=8.05 I 8" PVC W=7.38 1 N ' 4 4 N8829'28'"W 248.20' SDMH RIM=16.96 BOTTOM=9.81 IE SW=11.51 TOP OF PIPE BELOW WATER LEVEL IE 6"-10" HOLE SE=13.26 IE 6" PVC NE=13.36 IE 6" PVC NE=11.81 C'YP 1 RIM=19.88 =16.93 - c= 'N POWER 6,„. (3)POWER VAULT 4"'TRANSFORMER cm/ of 1 APR 1 31 I MVrCTER • ••• FIRE LANE EASEMENT • 5 ii . 1111, RIM=20.09 3 N=14.64 3 5=15.04 E=14.64 1 RIM=20.14 ADS N=15.24 ADS S=15.29 TEL MH CB TYPE 1 RIM=19.98 (FULL OF IttRT IE 12" ADS N=15.58 IE 12" ADS 5=15.73 FH w/BOLLARDS HER TRANSFORMER CB TYPE 1 RW=1196 (FULL OF DIRT) "... em19 No changes shall be nude to the scope c7 vuork without prior approval of Tukwila Building Divistium NOTE: Revisions will require a new plan submittal (Ind may Include additional plan review fees. ATER LEVEL=9.45 SD VAUL IE 18" fw/SUSPE :1 -"-•+•' --L GO, . • .. •,•• •SDMH /. • • .• ...IE 15 CMP E=11.04 6" PVC SW=11.57 •• IE . „.., ”.• • ., 8 CMP GATE VALVE=11L3....;.•• CMP OVERFLOW=13.47 •••:. ..I 15' CMP W=11.53 1)01--