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HomeMy WebLinkAboutPermit D07-144 - CITY OF TUKWILA - HABITAT FOR HUMANITY - DEMOLITIONHABITAT FOR HUMANITY 12230 43 AV S D07 -144 Parcel No.: 0179000270 Address: 12230 43 AV S TUKW Suite No: Tenant: Name: HABITAT FOR HUMANITY Address: 12230 43 AV S , TUKVVILA WA Contact Person: Name: TOM GAYLORD Address: 15439 53 AV S , TUKWILA WA 98188 Phone: 206 292 -5240 X 115 doc: IBC-10/06 Citf 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 Owner: Name: CITY OF TUKWILA Address: 6200 SOUTHCENTER BLVD , TUKWILA WA 98188 Phone: Contractor: Name: HABITAT FOR HUMANITY /SEA/SO KC Address: 15439 53 AV S, STE B , TUKWILA WA 98188 Phone: 206 292 -5240 Contractor License No: HABITFH972LD DEVELOPMENT PERMIT Permit Number: D07 -144 Issue Date: 06/14/2007 Permit Expires On: 12/11/2007 Value of Construction: $7,500.00 Fees Collected: $617.77 Type of Fire Protection: International Building Code Edition: 2003 Type of Construction: VB Occupancy per IBC: 0022 Expiration Date: 05/04/2008 DESCRIPTION OF WORK: DEMOLITION OF 607 SF SFR Public Works activities include Wwater Service Capping @ the WM and Abandonment of Existing Septic. * *continued on next page ** D07 -144 Printed: 06-14 -2007 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Sanitary Side Sewer: Sewer Main Extension: Storm Drainage: Street Use: Water Main Extension: Water Meter: Permit Center Authorized Signatur The granting of constructio Signatur Print Name: doc: IBC-10/06 City cTukwila 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 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: Public: N Private: Profit: N Private: I hereby certify that I have read an governing this work will be compile • whether specified herein or not. Permit Number: D07 -144 Issue Date: 06/14/2007 Permit Expires On: 12/11/2007 Non - Profit: N Public: Date: ed this permit and know the same to be true and correct. All provisions of law and ordinances permit - oes not presume to give authority to violate or cancel the provisions of any other state or local laws regulating ce of work. I = authorized to sign and obtain this development permit. Date: l0 / /4 /Dy 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 - 144 Printed: 06-14 -2007 Parcel No.: 0179000270 Address: Suite No: Tenant: 1: ** *BUILDING DEPARTMENT CONDITIONS * ** 8: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * ** doc: Cond -10/06 12230 43 AV S TUKW 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 HABITAT FOR HUMANITY PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: D07 -144 ISSUED 04/20/2007 06/14/2007 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. 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: Contractor shall notify Public Works Utility Inspector at (206)433 -0179 of commencement and completion of work at least 24 hours in advance. 11: Any material spilled onto any street shall be cleaned up immediately. 12: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation off -site or into existing drainage facilities. 13: 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. 14: 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. D07 -144 Printed: 06-14 -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: 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: 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. Septic abandonment shall be coordinated with King County Public Health at (206) 296 -4932. 17: Water service line , since it will be used again in the near future shall be capped at the water meter. doc: Cond -10/06 * *continued on next page ** D07 -144 Printed: 06-14 -2007 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 City of Tukwila 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. Print Name: doc: Cond -10/06 Date: 1/ /¢ /Q D07 -144 Printed: 06-14 -2007 King Co Assessor's Tax No.: 0/7 ,' Site Address: 2 2 30 y3 "' A %/E- h//44 Suite Number: Floor: New Tenant: ❑ .... Yes ❑ ..No Tenant Name: Property Owners Name: Mailing Address: CONTAC PE ] - who do we contact when your permit is ready to be issued Name: Mailing Address: E -Mail Address: GENERAL CONTRACTOR INFORMATION - (Contractor Information for Mechanical (pg 4) for Plumbing "and Gas Piping (pg 5) Company Name: Mailing Address: E -Mail Address: Contact Person: E -Mail Address: Contact Person: E -Mail Address: w I vI ry JIFFS LA Community Developmer 'epartment Public Works DepartmentLer Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us 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 ** O /" /ry Qf 711X 7:54y/orcre /e - Aahi City Day Telephone: 1/2- ' SZ40 ,e-)e 7" //5" City Fax Number: State State 292- -52,41 Zip Zip //4 '37 ?-- - #LJ/1A tu/ry of Atc - .e Contact Person: A/ //in /E.- f� hi/iPg & ��7Y/e - Contractor Registration Number: /Merl - fig/ 97Z A City State Zip Day Telephone: Z.De Z92- - 524-c' 4y_//6 Fax Number: 206, Z92 - 52144 Expiration Date: 6¢ /0S /2008 Company Name: Mailing Address: Q:UpplicationtPonns- Applications On Line\3 -2006 - Permit Application.doc Revised: 9 -2006 bh City Day Telephone: Fax Number: State State Zip Company Name: Mailing Address: City Day Telephone: Fax Number: Zip Page 1 of 6 9¢ Valuation of Project (contractor's bid pr $ 1 Scope of Work (please provide detailed information): Will there be new rack storage? ❑.... Yes Number of Parking Stalls Provided: Standard: Q:Wpplications\For ms- Applications On Line\3 -2006 -Permit Application.doc Revised: 9 -2006 bh ExistingLlding Valuation: $ //JT?fAJb4 / ,>F-Iini,/ Af .4^./ z? .eF/ ,C,e/7/t7 e ,f / /(P /.tJ4 / ,eODf A J 2 SGsEB� Q'. No If yes, a separate permit and plan submittal will be required. 'oxide All Buildin ens_ in . ua 00 ge l e. 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. 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 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 ian ,s araa/Vaaa - 11 . 1 i \J1\ • '' PLUMBING AND GAS PIPING COFACTOR INFORMATION 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:\Applications\Forms- Applications On Line \3 -2006 - Permit Application.doc Revised: 9 -2006 bh Page 5 of 6 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. 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). BUILDING Signa Print Name: 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). 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. Date Application Accepted: R AUTHORIZE P •'ENT: Aye-eaeop Date: -ii— 7/767 Day Telephone: ?,p/ -2x12 //6 Mailing Address: ol I iot Q:\Applications\Forms- Applications On Line\3 -2006 - Permit Application.doc Revised: 9 -2006 bh City State Staff Initials: Zip Page 6 of 6 Parcel No.: 0179000270 Address: 12230 43 AV S TUKW Suite No: Applicant: HABITAT FOR HUMANITY Receipt No.: R07 -01130 Initials: JEM User ID: 1165 ACCOUNT ITEM LIST: Description BUILDING - NONRES PW BASE APPLICATION FEE PW PERMIT /INSPECTION FEE PW PLAN REVIEW 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 Payee: HABITAT FOR HUMANITY OF SEATTLE/SOUTH ICING COUNTY TRANSACTION LIST: Type Method Description Amount Payment Check 23969 494.36 Account Code Current Pmts 000/322.100 000/322.100 000/342.400 000/345.830 000/386.904 RECEIPT Total: $494.36 Permit Number: D07 -144 Status: APPROVED Applied Date: 04/20/2007 Issue Date: Payment Amount: 3494.36 Payment Date: 06/14/2007 11:36 AM Balance: $0.00 189.86 250.00 25.00 25.00 4.50 9335 06/14 9716 TOTAL 494.36 dm! Ran int -(1R Printadt O6- 14 -90Q7 Receipt No.: R07 -00635 ACCOUNT ITEM LIST: Description PLAN CHECK - NONRES TRANSACTION LIST: Type Method Description 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 RECEIPT Parcel No.: 0179000270 Permit Number: D07 -144 Address: 12230 43 AV S TUB:W Status: PENDING Suite No: Applied Date: 04/20/2007 Applicant: HABITAT FOR HUMANITY Issue Date: Initials: JEM Payment Date: 04/20/2007 02:27 PM User ID: 1165 Balance: $ 194.36 Payee: HABITAT FOR HUMANITY OF SEATTLE/SOUTH KING COUNTY Amount Payment Check 23759 123.41 Account Code Current Pmts 000/345.830 123.41 Total: $123.41 Payment Amount: $123.41 7334 04/20 9716 TOTAL 123.41 doc: Receiot -06 Printed: 04 -20 -2007 Project: Type of Inspection: 1 -11---4./ Address: t f)J Date Called: P i/ I I/ C- 7 Special Instructions: Date Wanted: . c C a.m. p.m. Requester: - Phone No: 007 -Iy� 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 �C1pproved per applicable codes. ❑ Corrections required prior to approval. COMMENTS: (, t(o -7////o5 I ( , ✓r--. 1 1, i(' 1 7/h[(5? --[ L-.'. 8i? Inspector: Date: cc / ❑ $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. 'Receipt No.: 'Date: Projec • Type onspe n: / Addre : [� A �( v Date Special Instructions: Date Wanted: a.m Requester: Phone No: t INSPECTION RECORD Retain a copy with permit INSPE ON NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 COMMENTS: aL 7:0 X17/ A pproved per applicable codes. El Corrections required prior to approval. ❑ $58.00 R SPECTION REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter lvd., Suite 100. Call the schedule reinspection. (Receipt No.: 'Date: COMMENTS: Type of I spection: , ,' /ti i-14 Address: )2), C y� Ave .S Date Called: D1 /o? /u 7 7/ /4 si ft-<. - rd P of2Z s p .m. Ca m. (6A A¢Lt C Awl -2-P Phone o P06 ')3 - 7o7(4 , • 7/ ? /f7 /U 0 Cori c9A_lvc i /207 Mme-, C -g-d h L Project: HAbit for t1). �,i,��. Type of I spection: , ,' /ti i-14 Address: )2), C y� Ave .S Date Called: D1 /o? /u 7 �.- Special Instructions: Date Wanted: 0 p .m. Ca m. Request t_' e, I - 1, i)f' Phone o P06 ')3 - 7o7(4 , w tm i Do 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 Approved per applicable codes. El Corrections required prior to approval. (Inspector: Date: - 2 rqg 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: PBS Prepared for: City of Tukwila Public Works 6300 Southcenter Boulevard Tukwila, Washington 98188 RECEIVED AUG 18 2006 TUKANtbk PUBLIC WORKS Fusco" P Ho. L7 C" i c"11 itpt Pk'n r^' t t: - . Asbestos-Ccintaining Materials and Lead Paint Summary of Findings 12230 43rd Avenue South (Peterson - Ha lI) 4 — Project Site Tukwila, Washington 98168 August 2006 PBS Project #: 40407.008 ENGINEERING AND ENVIRONMENTAL www.pbsonv.com RECEIVED APR 2 0 7007 PERMITCENTER 130 Nickerson Street Suite 107 Seattle, WA 98109 — '205.233:9639 - 206.762.4780 FAX PBS August 15, 2006 Mr. Michael Cusick City of Tukwila Public Works Department 6300 Southcenter Boulevard Tukwila, WA 98188 RE: 12230 43rd Avenue South (Peterson Hall) Asbestos - Containing Materials and Lead Paint Survey PBS Project No. 40407.008 Dear Mr. Cusick: PORTLAND SEATTLE VANCOUVER EUGENE BEND TRI- CITIES PBS Engineering and Environmental (PBS) performed an inspection of the former Peterson Hall located at 12230 43rd Avenue South in Tukwila, Washington for the presence of asbestos - containing materials (ACMs) and lead- containing paint (LCP). According to your information, this project is in conjunction with a proposed demolition of the site structure. The former community center is a one -story concrete block building built on a concrete slab. The structure contains a total of approximately 670 square feet. The residence was constructed around 1939. The residence has been vacant for several years. Interior finishes consist of exposed concrete block walls, gypsum wallboard ceilings, and carpeting over a concrete slab floor. The roof is covered with two layers of asphalt composition shingles. There is no roofing paper under the shingles. Asbestos - Containing Materials (ACM) The intent of this letter is to ensure that the City of Tukwila Public Works Department is in compliance with the Puget Sound Clean Air Agency and Washington State Department of Labor and Industries' requirement that a "good faith" inspection for ACM be performed prior to renovation or demolition activities. While PBS has endeavored to identify all ACM, unidentified ACM may exist in concealed or inaccessible locations. Inaccessible areas are defined as those requiring selective demolition, fall protection or confined -space entry protocols to gain access. PBS recommends that concealed components and materials be sampled for asbestos prior to impact. Suspect materials were sampled on July 25, 2006 by AHERA- accredited Inspector, Harry Goren (Certification #1018422, exp. 11/2/06). Samples were assigned unique identification according to EPA Method 600R- 93/116 using Polarized Light Microscopy (PLM), which has a r- II II . • I S I ENGINEERING AND ENVIRONMENTAL www.pbsenv.cam 130 Nickerson Street Suite 107 — Seattle-WA -98109 206.233.9639 MMN 206.762.4780 FAX 12230 43rd Avenue South (Peterson Hall), Tukwila, WA Asbestos - Containing Materials and Lead Paint Survey August 15, 2006 Page 2 of 3 The attached bulk sample chain -of- custody forms identify all suspect materials that were sampled by PBS and analyzed for asbestos. The following materials were found to contain asbestos during PBS's survey: • ') Joint compound on gypsum wallboard system on ceiling. Less than 1% asbestos content by composite (Estimated 670 square feet). • Window glazing on the north window (Assume all window glazing contains asbestos due to variation of glazing — 5 windows 4' x 2' -7" w/4 panes each) • Roof sealant around chimney The ACM identified above should be removed by properly trained personnel using appropriate protection, work practices and engineering controls prior to impact by demolition or renovation. A qualified asbestos abatement contractor licensed in the State of Washington should be employed to remove all such ACM according to applicable local, state and federal regulations. ') A composite of the gypsum wallboard and the joint compound tested less than 1% asbestos and may be treated as a non - asbestos - containing material. Although the material is not considered an asbestos- containing material, contractors performing renovation work should be notified of the presence of asbestos in the joint compound. The following materials were not found to contain asbestos via sampling by PBS: • Surfacing board over gypsum wallboard ceiling • Carpet mastic • Top and bottom layers of asphalt composition roof shingles Lead - Containing Paint (LCP) Representative painted coatings were sampled and analyzed to determine lead content. Paint samples were analyzed by Flame Atomic Absorption for total lead content to determine the extent of LCP in the substrate. Five (5) paint chip samples were collected from representative substrates and analyzed. Lead was detected in concentrations above the analytical limit of detection in all of the paint chips samples analyzed. The following building components contain lead paint coatings. • Green paint on the fascia board exterior trim (0.89 %) • Gray over the exterior concrete block wall (0.0082%) No lead was detected above laboratory detection limits in the interior white painted walls and ceiling. One gray sample on the exterior concrete block wall was below the laboratory detection limit, but it may be assumed that the entire exterior is coated with lead paint. 12230 43rd Avenue South (Peterson Hall), Tukwila, WA Asbestos - Containing Materials and Lead Paint Survey August 15, 2006 Page 3 of 3 The painted surfaces are in relatively good condition, but are flaking off the concrete block on the south side of the building exterior. Based on the sample results of representative coatings, it may be assumed that all coatings on building materials within the project site contain lead. See attached laboratory analysis report. The presence of lead in painted coatings requires construction work to be performed in compliance with State and Federal regulations. Employers of personnel impacting lead - containing paint and coatings are required to perform a negative exposure assessment and provide proper training, respiratory protection and medical surveillance as outlined in WAC 296 -155. Respectfully, Harry Goren Project Manager Attachments: Representative Photographs of Site Conditions PLM Laboratory Reports and Chain -of- Custody Lead paint Laboratory Reports and Chain -of- Custody Project: `9.1- a-e-2.• Project #: 4 6 '4 0 1. 6 0 Analysis requested: G?A- Date: /rz576 G Relinq'd by /Signature: Received by /Signature: -•� Fax results to: ▪ Bdaa Stanford D Ernest Edwards O . Gregg Middaugh ❑ Mark Kiley TURN AROUND TIME: D t Hour D 2 Hares ❑ 4 Hours S- '1Mfastera1OtIIce Tach Pbrrm & TamaJa Lab Chain- of{Yutody4oc PBS BATCH ID _ 2609729 Date/Time: 1 Dater ime: ❑ Prudy Stuudt -McRae X Harry Goren O Michael Smith ❑ Thu Ogden O Janet Murphy 0 Mike Smolt O Willem Mager ❑ Other ❑ 24 Hours ❑ 48 Hours PBS RNG(NErauNC AND StlyritO.`UntrrAL, t!0 N1CalPSON ST. x101. SEMTLB WASH)NGTON9P109. (306)433 PAX: (206) - 762.4710 3 -5 Daya ed• .+ ❑ Other NVL Laboratories Inc. 4708 Aurora Ave. N., Seattle, WA 98103 Tel: 206.547.0100, Fax: 206.634.1936 B www.nellabs.com Client: PBS Environmental (Seattle) Address: 130 Nickerson St Suite 107 Seattle, WA 98109 Attention: Mr. Harry Goren Project Location: Peterson Hall Lab ID: 26060820 Client Sample #: 40407.008 - 01 Location: Peterson Hall Comments: Composite result for whole sample is less than 1% asbestos Layer 1 of 3 Description: White compacted powdery material with paint Non - Fibrous Materials: Other Fibrous Materials:% Layer 2 of 3 Layer 3 of 3 Lab ID: 26060821 Client Sample #: 40407.008 -02 Location: Peterson Hall Comments: Layer 1 of 3 Layer 2 of 3 Calcareous binder, Paint Description: Tan compacted powdery material Non - Fibrous Materials: Calcareous binder Description: White chalky material with paper Non - Fibrous Materials: Gypsum/binder Layer 3 of 3 Sampled -by-:- Client Analyzed by: Nick Ly Revi ulk Asbestos Fibers Analysis By Polarized Light Microscopy Composite result for whole sample is less than 1% asbestos Description: White compacted powdery material with paint Non - Fibrous Materials: Other Fibrous Materials:% Calcareous binder, Paint Cellulose 1% Description: Tan compacted powdery material with paper Other Fibrous Materials:% Cellulose 50% Non-Fibrous Materials: Calcareous binder Description: White chalky material with paper Non- Fibrous Materials: Gypsum/binder Lab ID: 26060822 Client Sample #: 40407.008-03 Location: Peterson Hall Comments: Composite result for layers 2 & 3 is less than 1% asbestos Date: 07/28/2006 Cellulose 1% Other Fibrous Materials:% Cellulose 2% Other Fibrous Materials:% Cellulose 30% Other Fibrous Materia!s:% Cellulose 60% a #102063 J Batch #: 2609729.00 Client Project #: 40407.008 Date Received: 07252006 Samoles Received: 10 Samples Analyzed: 10 Method: EPA/600R- 93/116 Asbestos Type: % None Detected ND Asbestos Type: % Chrysotile 3% Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % Chrysotile 3% Asbestos Type: °lo None Detected ND 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°4=1-9%, 10%=5 -15 %, 20 %= 10.30 %, 50%=40 -60%). This report relates on to the — ifems tate4. If sampl was not collected by NVL personne - aCCUracTof the - results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in MI, 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 3 NVL Laboratories Inc. 4106 Aurora Ave. N., Seattle, WA 98103 Tel: 206.547.0100, Fax: 206.634.1936 www,nvllabs.com Client PBS Environmental (Seattle) Address: 130 Nickerson St Suite 107 Seattle, WA 98109 Attention: Mr. Harry Goren Project Location: Peterson Hall Layer 1 of 3 Layer 2 of 3 Layer 3 of 3 Bulk Asbestos Fibers Analysis By Polarized Light Microscopy Description: White compacted powdery material with paint Non- Fibrous Materials: Other Fibrous Materials:% Calcareous binder, Paint Cellulose 1% Description: Tan compacted powdery material with paper Non - Fibrous Materials: Other Fibrous Materials:% Calcareous binder Cellulose 50% Description: White chalky material with paper Non- Fibrous Materials: Other Fibrous Materials:% Gypsum/binder Cellulose 60% Lab ID: 26060823 Client Sample #: 40407.008 - 04 Location: Peterson Hall Layer 1 of 1 ' Description: Gray & yellow loose -fill foam and mastic debris Non- Fibrous Materials: Other Fibrous Materials:% Mastic/binder, Synthetic foam Synthetic fibers 2% Lab ID: 26060824 Client Sample #: 40407.008 - 05 Location: Peterson Hall Layer 1 of 1 Description: Gray brittle material with paint Non Fibrous Materials: Binder/Filler, Paint Lab ID: 26060825 Client Sample #: 40407.008 - 06 Location: Peterson Hall Layer 1 of 1 Description: White brittle material with paint Non- Fibrous Materials: Binder/Filler, Paint Lab ID: 26060826 Client Sample #: 40407.008-07 Location: Peterson Hall Other Fibrous Materials:% None Detected ND None Detected ND V #102063 Batch #: 2609729.00 Client Project #: 40407.008 Date Received: 07/25/2006 Samples Received: 10 Samples Analyzed: 10 Method: EPA/600R- 931116 Asbestos Type: % None Detected ND Asbestos Type: Chrysotile 3% Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Other Fibrous Materials :% Asbestos Type: % None Detected ND one Note: If samples are not homogeneous, remeMU certainties for the reported % Asbestos (1%=0 -3%. 6%=1-9%, 10%= 5.15 %, 20%=10-30%, 50 % = -60%)6 -Method- wtrelate only +rl a - ,- personnel, then- the - accuracy of_the_results '►s limited by the .60 %). This report relates only to the items tested. If same a was not Conededfiyr 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 produ ct endorsement by NVLAP or any other agency of the US Government. --- —' Page 2 of 3 MENEM NVL Laboratories, Inc. 4708 Aurora Ave. N., Seattle, WA 98103 Tel: 206.547.0100, Far. 206.834.1936 www.nvilabs.com Client PBS Environmental (Seattle) Address: 130 Nickerson St Suite 107 Seattle, WA 98109 Attention: Mr. Harry Goren Project Location: Peterson Hall Bulk Asbestos Fibers Anal sis Client Sample #: 40407.008.08 By Polarized Light Microscopy Layer 1 of 1 Description: Gray soft material with paint Type: s esto Ty Ty Non- Fibrous Materials: Other Fibrous Materials:% Asbestos 2% Binder/Filler, Paint Polyethylene fibers 3% Lab ID: 26060827 Location: Peterson Hall Layer 1 of 2 Description: Black asphaltic material with granules Non - Fibrous Materials: Other Fibrous Materials:% Asphalt/binder, Granules, Mica Cellulose 5% Layer 2 of 2 Description: Black asphaltic material with granules Non -Fibrous Materials: Other Fibrous Materials :% Asphalt/binder, Granules Cellulose 7% Client Sample #: 40407.008 -09 Lab ID: 26060828 Location: Peterson Hall Layer 1 of 2 Description: Black asphaltic material with granules Non-Fibrous Materials: Other Fibrous Materials:% Asphalt/binder, Granules, Mica Cellulose 5% Layer 2 of 2 Description: Black asphaltic material with granules Non - Fibrous Materials: Other Fibrous Materials :% Asphalt/binder, Granules Cellulose 7% Lab ID: 26060829 Client Sample #: 40407.00840 Location: Peterson Hall Layer 1 of 1 Description: Black asphaltic material Non - Fibrous Materials: Asphalt/binder Batch #: 2609729.00 Client Project #: 40407.008 Date Received: 07/25/2006 Samples Received: 10 Samples Analyzed: 10 Method: EPA/600R 931116 Other Fibrous Materials :% Asbestos Type: % Cellulose 2% Chrysotite 3% Ctfw0a,* #102083 Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Asbestos Type: % None Detected ND Sample • • y: ten _ __ Date: 07/28/2006 ��'� �� Analyzed by: Nick Ly « n cal Dir .. - • r ; r 006 Nick Rev ewe • • y: — Note; if samples are not homogeneous, then subsamples of the components were analyzed separately. All buck samples 10%=5-15%, analyzed %=10 limited 50%P4 0 431116- Method - With- the-tollrowing measurement uncertainties for the reported % Asbestos (1%4 (1 rie _ 1 1 res =10 (united by the -60%). This report relates only to the Items tested if sample wall not coltected - by methodology and acuity of the sample collector. 'This report shall not be reproduced G mahout written approval of NVL Laboratories, Inc. It shall not be used to claim product endorsement by NVLAP or any other agency cy Page 3 of 3 Project: t" - Analysis requested: Relinq'd by /Signature: Fax results to: ❑ Brian Stanford ❑ Ernest Edwards ❑ Gregg Middaugh • Mark Fiiey TURN AROUND TIME: ❑ 1 Rour ❑ 2 Hours ❑ 4 Hour PBS Received by /Signature:, ❑ Prudy Stoudt•McRae © Michael Smith ❑ Janet Murphy O Willem Mager ❑ 24 Hours ❑ 0 Hours BATCH !D 2609728.00 Project #: *' 4 Gog' Date: 1l i 5ia to Datemme:11 - Harry Goren [] Tim Ogdcn • Mike Smith O Other 3 -5 Days o- ciarifsW ❑ Other MasrarsOfAce \Tech Forma & Terrulatcs bb OuJn-of•C63tody,doc PDS 2NQ NRLR1NO AND V1RONM (TAL,130 MCKSRSON ST. 4107, SEATTLE, WASHDVOTON 9310. (W6 }2334639. FaX (2060624180 NVL Laboratories, Inc. 4708 Aurora Ave. N., Seattle, WA 98103 Tel; 206.547.0100, Fax: 206.634.1936 www.nvllabs.com Client PBS Environmental (Seattle) Address: 130 Nickerson St Suite 107 Seattle, WA 98109 Attention: Mt. Harry Goren Project Location: Peterson Hall Lab ID 26060815 26060816 26060817 26060818 26060819 - Client Sample it 40407.008 -LD-1 40407.008 -1D-2 40407.008 -LD-3 40407.008 -LD-4 40407.008 -1D-5 Analysis Report Total Lead (Pb) Sample Weight Sampled by: Client Analyzed by: Ahmed Izzat Date Analyzed: 07/28/2006 RLin mg /Kq 0.2026 43.0 0.1846 47.0 0.1759 49.0 0.1614 54.0 0.1825 47.0 mg/- 1<g- =Milligrams_peridlogr-arn Percent = Milligrams per kilogram / 10000 Note : Method QC results are acceptable unless stated otherwise. Unless otherwise indicated, the condition of all samples was acceptable Bench Run No: 26 -07284 AIHA - IH # 101861 WA - DOE # C1785 at time of receipt ACCREDITED LABORATORY Batch #: 2609728.00 Matrix. Paint Chips Method: EPA 7000E Client Project #: 40407.008 Date Received: 07/25/2006 Samples Received: 5 Samples Analyzed: 5 Results Results in in mg /Kg percent < 43.0 < 0.0043 < 47.0 < 0.0047 8900.0 0.8900 82.0 0.0082 < 47.0 < 0.0047 RI = Reporting Limit < = Below the reporting Limit i Page 1 of 1 ACTIVITY NUMBER: D07 -144 DATE: 04 -20 -07 PROJECT NAME: HABITAT FOR HUMANITY - DEMO SITE ADDRESS: 12230 43 AV S X Original Plan Submittal Response to Correction Letter # Response to Incomplete Letter # Revision # after Permit Issued DEPARTMENTS: Bu ng'Di Iv sio ubFc orks UV 1�2 DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete E Comments: Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg El Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES/THURS RO ING: Please Route D121 Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: a -••r 2-28 -02 PLAN REVIEW /ROUTING SLIP 1 PERMIT COORD COPY 611 flift t f -2 1t1 Fire Prevention Structural ❑ Incomplete Planning Division Permit Coordinator ❑ DUE DATE: 04 -24 -07 Not Applicable ❑ DUE DATE: 05 -22 -07 Approved ❑ Approved with Conditions Not Approved (attach comments) n Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: License Information License HABITFH972LD Licensee Name HABITAT FOR HUMANITY /SEA/SO KC Licensee Type CONSTRUCTION CONTRACTOR UBI 601059723 Ind. Ins. Account Id 82709900 Business Type CORPORATION Address 1 15439 53RD AVE SO SUITE B Address 2 City TUKWILA County KING State WA Zip 98188 Phone 2062925240 Status ACTIVE Specialty 1 GENERAL Specialty 2 UNUSED Effective Date 6/4/2003 Expiration Date 4/5/2008 Suspend Date PRESIDENT Separation Date 03/09/2006 Parent Company Previous License SEATTHF055MJ Next License Associated License Business Owner Information Name Role Effective Date Expiration Date HADALLER, DONNA TREASURER 06/04/2003 GALLEGOS, DIANE VICE PRESIDENT 06/04/2003 CROSON, KATHLEEN VICE PRESIDENT 03/09/2006 GAYLORD, TOM VICE PRESIDENT 03/09/2006 EPP, BRYON M VICE PRESIDENT 03/09/2006 HINES, BENTON VICE PRESIDENT 10/30/2006 LARSON, ALLEN VICE PRESIDENT 10/30/2006 WILSON, ALICE VICE PRESIDENT 03/09/2006 10/30/2006 HOWLAND, TIMOTHY PRESIDENT 06 /04/2003 03/09/2006 Look Up a Contractor, Electrician or Plumber License Detail Page 1 of 2 " tome ' 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= HABITFH972LD 06/14/2007 KOPPE I WAGONER A r c h i t e c t s 811 FIRST AVENUE SUITE 615 SEATTLE, WASHINGTON 98104 P. (206) 344 -5788 F. (206) 344 -5789 EGISTERED CHITECT ti e /(l S TEOFw worn Habitat for Humanity Contact Tom Gaylord 1 3925 Interurban Ave 5 # 200 Tukwila, WA 98168 (206) 292 -5240 PRAIEC1: CITY OF TUKWILA HABITAT HOUSING PROJECT PROJECT NO: DRAWN BY: SMH DATE. 0 PLOTTED: 20 Apr 2007, 10:27 YARIC DATE D ESCIt1PBON 9EE raE DEMOLITION PLAN � 9W N0: DI a A B D E I 1 i I I i Q s H N y Vl co) co) V V V V V V V CO i V 9 - - - - - - - • - - - - - - DECOMISSION DOSING SEPTIC SYSTEM 3 4- - - ■/MOZMP - • ==I■- - - rrM- • - - - W-MIONMIN - - - • r - - - - EXISTING BURRING TO BE DEMOLISHED - - to+ f L - - OM IMP WM GNP OM OM • IMP =II 1 NO - 3/16' = I' -0' - - DEMOLITION PLAN - • 1111=11■Mr - - nu COPT ■ Permit No. Plan rr .::... . _ ye.I Is subject to anus and emission& :::::'� i documents does not authorial tha t::. -: code or , i, .. -e. of : % - d co F �/ acknoviledgesk - - litariarg r3 changes shall be made to the scope c , , : _:'_s without prior approval cf via require a ne+f plan submittal cad may Include additional plan review 1 City of lbkwtia BUILDING DIVISION • , ED 1 i Thecc piano have been reviewed � 'F the Public Forks Department for conforms -e with current City standards. Acceptance is sub ct to errors and omihcions which do not authorize olarkms of adopted standards or ordinance. The rev'n "l'iIity for the adequacy of the design rest' totally with the :'igr..er. Additions, deletions or revi. one to thee •: ravings aft this dat l I- ' me/ra 1•11.11111-1•11•■PED IMO OM 7r i for t approval. � :_ 5 I•ina,I acceptance is ptsfeet to field irpxrion by . I is (Y. S cti;:r: r CS 6."'Z1Ci(''i. g 200? � f S WATER, C/f /MS AM/ 5Erne i¢a,9Npe,NME/UT N c oy of ilikV• - "I" Ar( t pg�T� FA4-1L-1 •