HomeMy WebLinkAboutBLD2021-00608 FLD2021-00023 Retaining Wall Foundation - BLD Application - 4/27/2021 MASON COUNTY COMMUNITY SERVICES PermitNo:_13i
PERMIT ASSISTANCE CENTER:
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584 APR 2 7 2021
Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone
Belfair.(360)275-4467•Phone Elma:(360)482-5269
615 W. Alder Street
BUILDING PERMIT APPLICATION
PRO E OWNER INFORMATION: CONTRACTOR INFORMATION: V�.
Tim Perry NAME:Matvey Foundation Repair
G ADDRESS:611 E Rauschert Rd MAILING ADDRESS:421 SW 152nd St ��W
® Y:Grapeview STATE:WA ZIP:98546 CITY:Buden STATE:WA ZIP:98166
HONE#1:(206)524-8258 PHONE:(206)660-7971 CELL: Za r lJL>
PHONE#2: EMAIL:permits@gomatvey.com
EMAIL: trobperryQgmail.com LBLI REG#MATVEFR837K5 EXP. 06/15/21
PRIMARY CONTACT: OWNER❑ CONTRACTOR® OTHER❑
NAME Ayden Wagner EMAIL Permits@gomatvey.com
MAILING ADDRESS 421 SW 152nd St CITY Burien STATE WA ZIP 98166
PHONE (206)660-7971 CELL(206)660-7971
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 12118-50-00008 ZONING RR-5
LEGAL DESCRIPTION(Abbreviated) WUNT NSHORE MS&IIBOINTTR4i336=,S37n80,6363 FIRE DISTRICT 3
SITE ADDRESS 611 E Rauschert Rd CITY Grapeview
DIRECTIONS TO SITE ADDRESS Take a right out of the building onto Alder St.Continue on to the traffic cirice,take first e/dt onto N 1st st.Then
turn left on E Pine St,continue on Wa-3 N,then turn right onto E Grapeview loop rd,continue straight until turning right onto E Rauschert Rd.House on the left.
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO[N SNOW LOAD:_Psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Checkall that apply):
SALTWATER❑X LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR❑X OTHER ❑
USE OF STRUCTURE(Retidenc4 Garage,Commercial Bldg,Etc...Residential Retaining Wall
IS USE: PRIMARY[N SEASONAL❑ NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(Whole Bldg)❑ YES(,art[s]ofBidg)❑ NO❑
DESCRIBE WORK Installing helical anchors in the ebsbng retaining wall to stabilize the foundation.No additions or change in footprint
SOUARE FOOTAGE:(Proposed) B0 10,()00,
I ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC R SEWER❑ / NEW❑ EXISTING
PLUMBING IN STRUCTURE? YES❑ NO❑ Ifyes,attach completed Water Adequacy Form
PERIMETERNOUNDATION DRAINS PROPOSED? YES❑ NON EXISTING SQ.FT. 1188
EXISTING BEDROOMS 2 PROPOSED BEDROOMS 0 TOTAL BE 2
OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by
signature below.I declare that I am the owner and(.further declare that I am entitled to receive this permit and to do the work as proposed.I have
obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal
representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s)for review and inspection. This pernittappiication becomes null&void if work or authorized construction is not commenced within 180
days or if construction work is suspended for a period of 180 days.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
x
0(1_1 04142021
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIE W APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
MASON COUNTY Mason County Permit Center Use:
COMMUNITY SERVICES FLD 2b21 - dc�a�
Building,Planning,Environmental Health,Community Health
C I615 W.Alder Street—Bldg.8,Shelton,WA 98584 Date Rcvd 7"30•-262— i
l EEY427-9670 Ext.352 ♦Fax:(360)427-7798
V ��,,JJ .�t�. 61 zo2 _ � Fee: $300.00
JUL 3 0 2021 o fee if w/other permits
FDPO Development Permit Application
A Ilcan .' 1 Street Contractor:
1 n
Mailing Address: Mailing Addres
de- U
LO
City, State, Zip City, State, Zip
lA 'IW (P LI, lbb
Phone: ) Phone: 00 1p fO 7111
Email: Email:
Parcel Number: Property Address:
I •g - d0U0 i E �'
I understand I am making application for a permit to develop in a designated flood hazard area. The
undersigned agrees that all such work shall be done in accordance with the requirements of the County Flood
Damage Prevention Ordinance, building codes and all other applicable Local, State and Federal regulations.
This application does not create liability on the part of the County or any officer or employee thereof for any
flood damage that results from reliance on this application, or any administrative decision made lawfully
thereunder.
Applicants Signature: Date:
Official Use:
A. Description of Work (complete for all work):
1. Proposed Development Description:
❑ New building/Addition ❑ Manufactured home ❑ Fill/grade Other:
❑ Commercial (see section D) �
❑ Remodel/repair to existing building (see section C)
2. The parcel has been identified in the following Flood Hazard Area:
❑ A ❑ AE ❑ AO XVIE
3. Are any other Federal, State or local permits required? Must attach copies of permits.
Yes ❑ No If yes, list type: v t--r
4. Is the proposed development in an identified floodway?
❑Yes INo
5. If yes to#4, a No Rise Certification must be attached.
❑ Yes ❑ No
B. Complete for Historic Structure.
1. Provide documentation of historic registry from Federal or State.
2. Provide a detailed letter requesting a variance.
Letter must include parcel number, address of site, scope of work and mitigation items regarding
wetproofing or floodproofing that are available.
No work can affect or result in increase flood heights or additional threats to public safety.
All mechanical and plumbing must be flood or wetproofed.
No variances will be granted in a Floodway.
C. Complete for New Structures and Building Sites:
1. A FEMA Elevation Certificate is required, must be completed by a Washington State licensed Surveyor.
Elevation Certificate must be attached.
2. Base Flood Elevation at the building site: feet NAVD 88
3. Required lowest floor elevation (including basement floor): feet NAVD88
4. In flood hazard areas without a base flood elevation (BFE), what is the highest adjacent.
Grade? (HAG)
Structure must be a minimum of two (2) feet above the HAG.
The required finish floor height is
D. Complete for Alterations, Additions, or Improvements to Existing Structures:
******(See attached Substantial Improvement & Substantial Repair) *******
1. What is the estimated market value of the existing structure? $
Attached:
Assessor's Parcel Detail Report OR
Appraisal from a Washington State Licensed Appraiser
2. What is the cost/valuation of the proposed construction? $ Percentage
Attached:
Contractors Bid (FEMA Criteria) OR
County Valuation per Mason County Ordinance
3. If the cost or valuation of the proposed construction equals or exceeds 50 percent of the market value
of the structure, then the substantial improvement/repair provisions shall apply.
Is the proposed work a substantial repair/improvement ❑ Yes ❑ No
LL Complete for Non-Residential Floodproofed Construction:
1. Type of floodproofing method:
2. The required floodproofing elevation is: feet NAVD88
3. Floodproofing certification by a registered engineer is attached:
❑ Yes ❑ No
1 E. Complete for Subdivisions and Planned Unit Developments:
1. Will the subdivision or other development contain 50 lots or 5 acres?
❑ Yes ❑ No
2. If yes, does the plat or proposal clearly identify base flood elevations?
❑ Yes ❑ No
3. Are the 100 Year Floodplain and Floodway delineated on the site plan?
❑ Yes ❑ No
Administrative
1. Approved: Denied:
Planning Staff Signature: Date:
Building Staff Signature: Date o I
3. As-built lowest floor elevation: feet NAVD88
Comments/Conditions:
on
Mason County Flood Damage Prevention Ordinance #41-17 & International Building Codes
MASON COUNTY Mason County Permit Ce er Use:
COMMUNITY SERVICES FLDZ_o71 -
Building,Planning,Environmental Health,Community Health A
615 W.Alder Street—Bldg.8,Shelton,WA 98584 Date Rcvd R 2
Phone:(360)427-9670 Ext.352♦ Fax:(360)427-7798
Fee: $300.00
No fee if w/other permits
FDPO Development Permit Application
Applicant: Contractor:
Owner: Tim Perry Matvey Foundation Repair
Mailing Address: Mailing Address:
611 E Rauschert Rd 18915 16th Ave S
City, State,Zip City, State, Zip
Grapeview, WA 98546 Seatac, WA 98188
Phone: (206) 524-8258 Phone: (206) 660-7971
Email: trobperry@gmail.com Email: permits@gomatvey.com
Parcel Number: Property Address:
12118-50-00008 611 E Rauschert Rd
I understand I am making application for a permit to develop in a designated flood hazard area. The
undersigned agrees that all such work shall be done in accordance with the requirements of the County Flood
Damage Prevention Ordinance, building codes and all other applicable Local, State and Federal regulations.
This application does not create liability on the part of the County or any officer or employee thereof for any
flood damage that results from reliance on this application, or any administrative decision made lawfully
thereunder.
Applicants Signature: Date: 9/20/2021
Official Use:
A. Description of Work (complete for all work):
1. Proposed Development Description:
❑ New Residence (section C) ❑ New Manufactured home (section C)
❑ Commercial (see section E) ❑ Fill/grade
XAddition/Remodel/Repairto an existing structure (see section D)(Push Piers udder Foundation)
2. The parcel has been identified in the following Flood Hazard Area:
❑ A ❑ AE ❑ AO XVE
3. Are any other Federal, State, or local permits required? Must attach copies of permits.
❑ Yes ❑ No If yes, list type:
4. Is the proposed development in an identified floodway?
Wes ❑ No
5. If yes to#4, a No Rise Certification must be attached.
❑ Yes 0 No
B. Complete for Historic Structure. .
1. Provide documentation of historic registry from Federal or State.
2. Provide a detailed letter requesting a variance.
Letter must include parcel number, address of site, scope of work and mitigation items regarding
wetproofing or floodproofing that are available.
No work can affect or result in increase flood heights or additional threats to public safety.
All mechanical and plumbing must be flood or wetproofed.
No variances will be granted in a Floodway.
C. Complete for New Structures and Building Sites:
1. A FEMA Elevation Certificate is required, must be completed by a Washington State licensed Surveyor.
Elevation Certificate must be attached.
2. Base Flood Elevation at the building site: feet NAVD 88
3. Required lowest floor elevation (including basement floor): feet NAVD88
4. In flood hazard areas without a base flood elevation (BFE), what is the highest adjacent.
Grade? (HAG)
Structure must be a minimum of two (2) feet above the HAG.
The required finish floor height is
D. Complete for Alterations, Additions, or Improvements to Existing Structures:
1. What is the estimated market value of the existing structure? $ 187,729
Atta hed:
Assessor's Parcel Detail Report OR
Appraisal from a Washington State Licensed Appraiser
2. What is the cost/valuation of the proposed construction? $ 40,450 Percentage 22%
Attached:
V Contractors Bid (FEMA Criteria) OR
County Valuation per Mason County Ordinance
3. If the cost or valuation of the proposed construction equals or exceeds 50 percent of the market value
of the structure, then the substantial improvement/repair provisions shall apply.
Is the proposed work a substantial repair/improvement ❑ Yes No
If yes, complete section C above. �S �{- SkXb j-k44 +0 5
E. Complete for Non-Residential Floodproofed Construction: CkkA-t' A-0 11r 1t& OL
1. Type of floodproofing method:
2. The required floodproofing elevation is: feet NAVD88
3. Floodproofing certification by a registered engineer is attached:
11 Yes 0 No
F. Complete for Subdivisions and Planned Unit Developments:
1. Will the subdivision or other development contain 50 lots or 5 acres?
❑ Yes ❑ No
2. If yes, does the plat or proposal clearly identify base flood elevations?
❑ Yes ❑ No
3. Are the 100 Year Floodplain and Floodway delineated on the site plan?
❑ Yes ❑ No
Administrative
1. Approved: Denied:
Planning Staff Signature: Date:
Building Staff Signature: Date:Q .ZI
3. As-built lowest floor elevation: feet NAVD88
Comments/Conditions:
L_ -----Jl
Mason County Flood Damage Prevention Ordinance #41-17 & International Building Codes
Patti McLean Parcel Details
. .. Mason County Assessor 12118-50-00008/2021
411 N 5TH ST Active
600 BOX J
-4227 6y70 x49184 1111 IE�IE�1E1 1EI itl 111 I 11R El 11 II
* 3 0 0 0 0 + 4 0 1 2 7 5 2
Identification
Parcel Number: Roll Year: Type: Retired: Exempt:
12118-50-00008 2021 Active No No
Assessment Type: Description
Real Property
Primary Owner Primary Situs:
PERRY, SHAUN WATCHIE&TIMOTHY R 611 E RAUSCHERT RD GRAPEVIEW
Legal:
MOUNTAIN SHORES TR 8& 1/80 INT TR 41 S 36/20, S 37/160,
S 38/3
DOR: Secondary Land Code Map Number
18-Residential-All other 32
Total Acres Property Class Appraiser Initials
0,25000 TX
Field Sheet
FS 06315:
District: Neighborhood
0080-Tax District 0080 N2(Pickering&Gra eview Lp areas !AREA 6
SubDivision:
MOUNTAIN SHORES
Quick Value Summary
Exemption Type/Level:
Frozen Value: Category 121 New Const 121 Market 121 Assessed
Estimated Exemption Amount: 0 Land: 0 192,825 192,825
Non-Senior Amount: 0 Impr: 0 203,050 203,050
Exemption Amount: 0 Perm Crop: 0 0 0
Remaining Taxable Value: 395,875 Total: 0 395,875 395,875
• •
•• Description Value Roll Adjustment Value
Land Land ® ® 192,823
172,163
Economic Adjustment A6 N2(WF)FOR 2021 UPDATE O 0- z % 20,660
Single Family Residence Building 1 ® ® 187,729
Single-family Residence 17 119,725 + 1 119,725
Economic Adjustment A6 N2(WF)FOR 2021 UPDATE El O 52 % 1 62,018
Market Adjustment Area 6 Imp Strat 17 ❑O 5 % 5,986
Miscellaneous Improvements ® ® 4,320
t_ump Sum 288 sq It Storage CX1 ❑x 4,3201 + 1 4,3201
300002 ParcelDetaiis www.terrascan.com
Parcel Details Printed on 8/2/2021 1:16:54 PM Page 1 of 3
MATVEY FOUNDATION Prepared by: Prepared for:
REPAIR Matthew Sommerville Tim Perry
matthews@gomatvey.com trobperry@gmail.com
Matvey Foundation Repair Inc. P (206)524-8258
www.GoMatvey.com Job location:
TF(253)327-1650 611 E Rauschert Rd
License#MATVEFR837K5 Grapeview,WA 98546-9439
Prepared on:
2-24-21
Project Summary
CustomSolution .................................................................................................................................... $40,450.00
TotalInvestment .................................................................................................................................... $40,450.00
WA Sales Tax(estimated) $4,045.00
...........................................................................................................................
Total Contract Price ................................................................................................................. $44,495.00
DepositRequired-50% ........................................................................................................................... $22,247.50
DepositPaid .................................................................................................................................................. $0.00
Amount Due Upon Installation .............................................................................................. $44,495.00
Customer Consent
If the foundation(including foundation walls,footings and/or concrete slab)is found to be in too poor of condition to safely complete the
contracted work,additional work and associated costs will be required.Any alteration in scope and/or cost will only be made after a
consultation and approval between Matvey Foundation Repair and Customer.While Matvey Foundation Repair Foundation Systems will
do its best to evaluate the condition of the foundation concrete prior to work commencing,Matvey Foundation Repair is not responsible
for any damage that occurs as the result of failing foundation concrete.Completing the work in this Proposal at the time scheduled is
contingent upon accidents or delays beyond our control.This Proposal is based primarily on the Customer's description of the problem.
This Proposal may be withdrawn if not accepted by the Customer within 45 days.
Authorized Signature Date
Acceptance of Contract—I am/we are aware of and agree to the contents of this Proposal,the attached Job Detail sheet(s),and the
attached Limited Warranty,(together,the"Contract").You are authorized to do the work as specified in the Contract.I/we will make the
payment set forth in this Contract at the time it is due.I/we will pay your service charge of 1 and 1/3%per month(16%per annum)if my/
our account is 30 days or more past due,plus your attorney's fees and costs to collect and enforce this Contract.
Customer Signature Date
««Tax rate will be adjusted if necessary on final invoice*« Initial
`*A 1%Credit Card Fee will be applied to all credit card charges- Initial
Matvey Foundation Repair Inc. Job Location Page 1/8
421 SW 152nd St Seattle WA 98166 611 E Rauschert Rd Grapeview WA 98546-9439 2-24-21
Job Details
NTS
Stabilize upper retaining wall. House
Products
(8)Helical Anchors(HA)
(8)Push Piers
(8)3'Angle Iron
(8)Cocrete R/R
(40)Whaler Lf
Matthew
253-777-7612
�. Retaining wall height is 8'
Retaining wall thickness11
10'
HA HA — HA HA HA
HA HA HA
PP
PP PP
PP PP PP PP PP
Matvey Foundation Repair Inc. Job Location Page 2/8
421 SW 152nd St Seattle WA 98166 611 E Rauschert Rd Grapeview WA 98546-9439 2-24-21
Job Details (Continued)
Specifications
Contractor Will
1.)Stabilize and attempt to lift the foundation,if requested,but is not responsible for cosmetic damage that may result.(Achieving lift is
not guaranteed)
2.)Attempt to straighten the foundation waII(s).Although straightening is likely,it is not guaranteed.
3.)Install piers to any depth necessary at no additional cost to the customer.
Customer Will
1.)Remove and replace any landscaping that is in the work area.
2.)Move items at least 10 feet away from the work area.
3.)Mark any and all buried private lines,sprinklers and utilities.Should an unmarked private line/utility be damaged,owner assumes all
liability.
4.)Customer Acknowledges Above Tasks:\i2\
Matvey Foundation Repair Inc. Job Location Page 3/8
421 SW 152nd St Seattle WA 98166 611 E Rauschert Rd Grapeview WA 98546-9439 2-24-21
Job Details (Continued)
Additional Notes
Terms&Conditions
1-COST:contract price shall remain valid for 45 days from the date hereof.After that,the contract price is subject to change based upon
changes in the cost of labor and materials.
2-Any alteration to and/or deviation from the terms on this contract must be signed by client(s)and contractor to be valid.
3-Payment terms:50%deposit due at signing,balance due upon completion. The payment on all work orders is due upon their
completion.To be eligible for a full refund,customer must cancel the contract within 5 business days after contract signing. If a
cancellation is made after 5 business days,Matvey Foundation Repair may retain up to 15%of total contract amount.
4-Matvey Foundation Repair agrees to furnish the labor,materials and accessories to complete the work specified in the contract/
proposal.If there are unforeseen conditions which make it unsafe or impossible to complete all work as planned,the remaining work will
be excluded from this contract and Matvey Foundation Repair will reimburse the customer/homeowner for any work not completed.
5-Matvey Foundation Repair will not be responsible for installation failure caused by natural or man-made disasters.
6-DELAY:Matvey Foundation Repair will/shall not be held liable for any delay in the performance of this contract/proposal.
7-In the event of dispute,both parties agree to mediation to resolve their differences.If mediation is not successful and legal action is
necessary to enforce the terms of this agreement,the prevailing party shall be entitled to collect any judgment or settlement sums due
plus reasonable attorney's fees,court costs and other expenses incurred
8-WARRANTY: Matvey Foundation Repair provides a free 75 year,fully transferable,limited warranty on structural steel products,as
well as a 25 year,fully transferable,warranty on PolyLevel,conditional on payment in full per terms of contract and the client signature
on the final invoice.
9-Due to multiple factors(i.e.,existing building defects,previous attempts at leveling,etc.),Matvey Foundation Repair does not warrant
that the building wil I be entirely level upon completion of the job.Moreover,Matvey Foundation Repair is sometimes unable to achieve
full lift due to concrete defects and structural steel issues.By initialing below,the client understands and agrees to this.
10-Matvey Foundation Repair will make every reasonable effort to preserve the integrity of underground utilities,surrounding
landscaping,sprinkler systems,etc. However,Matvey Foundation Repair will not be liable for any damage to above structures caused by
installation of scope of work unless utility insurance is purchased.
11-If Matvey runs the risk of hitting trees or damaging our vehicles to get access to the job site,we will notify customer and discuss best
options.Vehicle access require 11'of height clearance.
12-When lifting a structure or slab that has settled over time,there is the possibility of damage occurring.Any installations that were
done in the past(doors,windows,etc.)may be affected by the lifting of a structure or slab.Cracking of concrete or drywal I may occur.
Moreover,lifting settled areas may cause weight transfer to other portions of the structure or slab which can potentially sink.Matvey
Foundation Repair will use extreme care to prevent and/or minimize any damage/alteration,but will not be responsible for such damage
or repairs.If you are concerned about the likelihood and extent of such potential damages,please discuss with your design technician.
13-Client(s)responsible for all city fees,permits,engineering,surveying and home owner insurance requirements.Matvey Foundation
Repair reserves the right to alter/modify the design,installation methods,layouts and FSI products in order to better accommodate
client's scope of work.
14-Final reports and warranty will be issued by Matvey Foundation Repair upon project completion within 15 business days of receiving
payment in full and final invoice signed by client.
15-Unanticipated Conditions:Additional fees apply if concrete demo work required apart from standard slab(4"-6"depth)and footing
dimensions(16"-20"width x 8"-14"depth).If concrete disposal not included in bid,additional fee may apply. Additional fees apply if
excavation more than Xis needed to install foundation repair products.
16-Proposal is based upon a site inspection without extensive information or knowledge of original construction or previous repairs.At
times we encounter various obstacles or attempted repairs that impede our progress.These repairs may or may not be known to the
owner.We will do what is necessary to avoid such obstacles,however,if extra work involving additional manpower or trades are
required,we will contact the owner immediately to discuss how the work shall progress.
17- Matvey Foundation Repair will not be held responsible for:
•Purchase,placement,and compaction of fill soils if needed
•Slumping of soils over time after back-filling excavation pits which is normal
•Matching new concrete color and texture with existing surfaces-regular grey concrete is used
•Any preparatory work such as moving personal possessions,furniture,etc.
18-Project duration's average:1-5 days for structural repairs and 1-2 days for PolyLevel repairs,but can vary.
Customer Initials and Approves this page:\i2\
Matvey Foundation Repair Inc. Job Location Page 4/8
421 SW 152nd St Seattle WA 98166 611 E Rauschert Rd Grapeview WA 98546-9439 2-24-21
Job Details (Continued)
Additional Notes
Additional Notes
1.)Customer understands that Matvey Foundation Repair will not charge the Customer's deposit for Engineering and Permits and the
Customer will need to pay them directly as a third party.
2.)If engineer of record or governingjurisdiction require a full Geo-Technical Report to acquire a permit,an additional charge will be
added based on access and scope of report.
5.)Customer understands if the Smart-lack Post Replacement are utilized on the existing concrete pier pads,there is NO warranty against
settlement,and that any future adjustments will be an additional charge.
Customer Initials and Approves this page:\i2\
Department of Labor and Industries Construction Compliance
DISCLOSURE STATEMENT
NOTICE TO CUSTOMER
This contractor is registered with the state of Washington,registration no.CC MATVEC1991CB,and has posted with the state a bond or
deposit of$12,000.00 for the purpose of satisfying claims against the contractor for breach of contract including negligent or improper
work in the conduct of the contractor's business.The expiration date of this contractor's registration is 9-18-2021.
THIS BOND OR DEPOSIT MIGHT NOT BE SUFFICIENTTO COVER A CLAIM THAT MIGHT ARISE FROM THE WORK DONE UNDER
YOUR CONTRACT.
This bond or deposit is not for your exclusive use because it covers all work performed by this contractor.The bond or deposit is intended
to pay valid claims up to$12,000.00 that you and other customers,suppliers,subcontractors,or taxing authorities may have.
FOR GREATER PROTECTION YOU MAY WITHHOLD A PERCENTAGE OF YOUR CONTRACT.
You may withhold a contractually defined percentage of your construction contract as retainage for a stated period of time to provide
protection to you and help ensure that your project wil I be completed as required by your contract.
YOUR PROPERTY MAY BE LIENED.
If a supplier of materials used in your construction project or an employee or subcontractor of your contractor or subcontractors is not
paid,your property may be lien to force payment and you could pay twice for the same work.
FOR ADDITIONAL PROTECTION YOU MAY REQUEST THE CONTRACTOR TO PROVIDE YOU WITH ORIGINAL"LIEN RELEASE"
DOCUMENTS FROM EACH SUPPLIER OR SUBCONTRACTOR AT YOUR PROJECT.
The contractor is required to provide you with further information about lien release document if you request it.General information is
also available from the state Department of Labor and Industries.
I have received a copy of this disclosure statement.
Signature of Customer:\s2\
The contractor must retain a signed copy of the disclosure statement in his or her files for a minimum of three years,and produce a signed
or electronic signature copy of the disclosure statement to the department upon request.
F625-030-000 model disclosure statement notice to customer 09-2007
Product List
Matvey Foundation Repair Inc. Job Location Page 5/8
421 SW 152nd St Seattle WA 98166 611 E Rauschert Rd Grapeview WA 98546-9439 2-24-21
Product List (Continued)
Custom Solution
HelicalWall Anchors .......................................................................................................................................... 8
PushPiers ..................................................................................................................................... .................. 8
3'Angle Iron ..................................................................................................................................................... 8
Whaler .......................................................................................................................................................... 40
ConcreteR/R .................................................................................................................................................... 1
Mobility/Steel .................................................................................................................................................. 1
Matvey Foundation Repair Inc. Job Location Page 6/8
421 SW 152nd St Seattle WA 98166 611 E Rauschert Rd Grapeview WA 98546-9439 2-24-21
Recommendations to Your Project
Custom Solution-Protect 1 Estimated Engineering 1-10 Piers $5,130.70
8 Estimated Special Inspections
1 Estimated Geotechnical Engineer Report,Custom 48
5 Estimated Permit Cost 4-10%of pier project,Custom 61
NTS
Stabilize upper retaining wall.
House
Products
(8)Helical Anchors(HA)
(8) Push Piers
(8)3'Angle Iron
(8)Cocrete R/R
(40)Whaler U
Matthew
253-777-7612
Retaining wall height is 8'
_ � Retaining wall thickness 11"
AL A AL
E
l
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Matvey Foundation Repair Inc. Job Location Page 7/8
421 SW 152nd St Seattle WA 98166 611 E Rauschert Rd Grapeview WA 98546-9439 2-24-21
Limited Warranty
Standard Exclusions Permitted By State Law-This Foundation Limited Warranty("Warranty")is made in lieu of and excludes all other
warranties,express or implied,and all other obligations on the part of Matvey Foundation Repair("Contractor")to the customer
("Customer").There are no other verbal or written warranties and no warranties that extend beyond the description on the face hereof,
including NO WARRANTIES OF EXPRESS OR IMPLIED MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.
General Terms-For the applicable time periods indicated below,this Warranty is transferable at no charge to future owners of the
structure on which the work specified in this Contract is completed.This Warranty is in effect if the job specified in this Contract is
completed and paid in full and,alternatively,is null and void if full payment is not received.Contractor does not warrant products not
mentioned below,but some of such products may be covered by a manufacturer's warranty.All material used is warranted to be as
specified in this Contract.All work will be completed in a workmanlike manner according to the standard practices of the industry.
Exclusions-THIS WARRANTY DOES NOT COVER,CONTRACTOR SPECIFICALLY DISCLAIMS LIABILITY FOR,AND CUSTOMER
HOLDS CONTRACTOR HARMLESS FROM:1)exterior waterproofing;2)plumbing damage;3)Customer-caused damage;4)dust from
installation;5)damage to real or personal property such as walls,countertop,or floor coverings,framing,sheetrock,exterior materials,
cabinets,appliances,and so on,including anydamage alleged to have been done by the Contractor's use of heavy equipment necessary to
complete the job;6)any injury or damage caused by mold to property or person;7)failure or delay in performance or damage caused by
acts of God(flood,fire,storm,methane gas,etc.),acts of civil or military authority,or any cause outside Contractor's control;8)damage
from a lifting operation;9)basement water seepage;and 10)damage from heave,lateral movements/forces of hillside creep,land sliding,
or slumping of fill soils.While Contractor assumes responsibility for utilitydamage that occurs as a result of Contractor's installation,
such protection is limited to replacing/repair the area Contractor damaged and does not include any upgrades to utilities for code
compliance or other reasons.
Items For Which Customer Is Responsible-Customer shall:1)make full payment to the crew leader upon completion of work;2)prepare
the work area for installation;3)be responsible for any finish carpentry,painting,paneling,landscaping,etc.that may be necessary after
Contractor's work is finished;4)mark private lines(satellite,propane,sprinkler,etc.)5)maintain positive drainage away from the
repaired wall(s);6)keep gutters clean and in good working order;7)direct downspouts a sufficient distance away from the repaired
wall(s);8)maintain proper expansion joints in concrete slabs that are adjacent to the repaired wall(s);and 9)any items mentioned in this
Contract under"Customer Will"or"Additional Notes."
Handyman services:offers a 3 year warranty on workmanship unless otherwise noted.This Warranty is in effect if the job specified in this
Contract is completed and paid in full and,alternatively,is null and void if full payment is not received.
Matvey Foundation Repair Inc. Job Location Page 8/8
421 SW 152nd St Seattle WA 98166 611 E Rauschert Rd Grapeview WA 98546-9439 2-24-21
FEMA Region X(OFEMA
INTRODUCTION
The National Flood Insurance Program(NFIP)is a voluntary federal program through which property owners in participating communities can
purchase federal flood insurance as a protection against flood losses.In exchange,communities must enact local floodplain management
regulations to reduce flood risk and flood-related damages within the mapped Special Flood Hazard Area(SFHA),The National Marine Fisheries
Service's Biological Opinion(BiOp)(September 22,2008)on the implementation of the National Flood Insurance Program in Puget Sound
requires local communities that do not have BiOp-compliant floodplain management ordinances to require and review a Habitat Assessment
(HA)before approving a floodplain permit,with some exceptions as noted below.
This worksheet is a tool for land use planners and biologists to 1)determine if an HA is needed and 2)identify items that must,at a minimum,
be addressed in HAs.If a project does not fit into the categories in Section U or 1.2,then an HA would be required.
The permit application reviewer can use this worksheet to work through whether the application meets the requirements.By checking the box,
the reviewer can track that the activity has been completed satisfactorily. If an HA is not required,check the box by the criteria that apply and
retain this worksheet with the permit file. If an HA is required,complete the worksheet and retain a copy with the permit file,
The Regional Guidance for Floodplain HabitatAssessment and Mitigation(August 2013)provides more detail on how to prepare an HA and
assess impacts of land management actions on Endangered Species Act(ESA)-listed salmonid species,orcas,and their designated critical
habitats within floodplains.
For each permit decision,a community is required to retain the documentation relied upon in making the determination of effects on ESA-
listed salmonids and orcas in perpetuity, Such documentation may include this completed checklist,the HA,or any other documents,reports,
or studies that support the determination of effect on ESA-listed species.
1. EXCEPTIONS
1J Neither a Floodplain Permit nor Habitat Assessment is needed
Communities may allow the following activities in the floodplain without requiring a floodplain development permit,provided all applicable
federal,state,and local requirements are met.A Floodplain Permit is not required because these activities do not meet the NFIP definition of
"development':Note;local community regulations may be more restrictive than the minimum standards(44 CFR 59),
❑ Routine maintenance of existing landscaping that does not involve grading,excavation,or filling,
❑ Removal of noxious weeds,hazard trees,and replacement of non-native vegetation
with native vegetation. "Development" is"any man-made change
❑ Normal maintenance of above ground utilities and facilities,such as replacing power to improved or unimproved real estate,
lines and utility poles. including but not limited to buildings or
other structures,mining,dredging,filling,
❑ Normal road maintenance,such as filling potholes,repaving,installing signs and grading,paving,excavation or drilling
traffic signals,but not including any expansion. operations or storage of equipment or
❑ Normal maintenance of a levee or other flood control facility as prescribed in the materials" Source;FEMA
operations and maintenance plan for the facility.Normal maintenance does not
include repair from flood damage,any expansion of the prism,face or toe expansion,or the addition of material for protection or armor.
❑ Plowing and other normal farm practices(other than new structures or filling)on legally existing agricultural areas.Clearing additional
land for agriculture will likely require a floodplain development permit and a Habitat Assessment.
FEMA Region X-Puget Sound BiOp Floodplain Habitat Assessment Worksheet(v1.6-November 2017) Page 1 of 6
r
1.2 A Floodplain Permit is required but a Habitat Assessment is not Required
Communities may allow the following activities in the floodplain without an HA,provided a floodplain development permit is obtained,and all
applicable federal,state,and local requirements are met.Please include documentation that supports the determination that an application
is exempt from the HA requirement in the permit file when any of the following are applied to a project. Documentation must be kept in
perpetuity.
❑ Normal maintenance,repairs,or remodeling of structures,such as re-roofing and replacing siding,provided such work is not a substantial
improvement or a repair of substantial damage.To comply,such work must be less than 50%of the value of the structure(s),
❑ Expansion or reconstruction of an existing structure that is no greater than 10% A"Regulatory Floodway"is the channel
beyond its existing footprint.If the structure is in the floodway,there shall be no of a river or other watercourse and the
change in the structure's dimensions perpendicular to flow.All other federal and adjacent land areas that must be reserved
state requirements and restrictions relating to floodway development still apply. in order to discharge the base flood without
❑ Activities with the sole purpose of creating,restoring or enhancing natural functions cumulatively increasing the water surface
associated with floodplains,streams,lakes,estuaries,marine areas,habitat,and elevation more than a designated height.
riparian areas that meet federal and state standards,provided the activities do not Source:FEMA
include structures,grading,fill,or impervious surfaces,
❑ Development of open space and recreational facilities,such as parks,trails,and hunting grounds,that do not include structures,fill,
impervious surfaces or removal of more than 5%of the native vegetation on that portion of the property in the floodplain.
❑ Repair to onsite septic systems,provided ground disturbance is the minimal necessary and best management practices(BMP's)to
prevent stormwater runoff and soil erosion are used.
❑ Projects that have already received concurrence under another permit or other consultation with the Services,either through Section 7,
Section 4d,or Section 10 of the Endangered Species Act(ESA)that addresses the entirety of the project in the floodplain(such as an Army
Corps 404 permit or non-conversion Forest Practice activities including any interrelated and interdependent activities.).
1 Repair of an existing,functional bulkhead in the same location and footprint with the same materials when the Ordinary High Water Mark
(OHWM)is still outside of the face of the bulkhead(i.e.if the work qualifies for a Corps exemption from Section 404 coverage).
Table 1,Bulkhead Considerations
Armoring Scope Habitat Assessment Needed? Floodplain Development Permit
Required
Bulkhead repair in same location and footprint No HA required Yes
with same materials.Bulkhead must be
functioning and OHWM cannot be behind the
structure to qualify as a repair,
Bulkhead replacement; different material, Yes-An abbreviated HA may be appropriate Yes
different place,or different angle and address the Marine Shorelines Design
Guidelines(MSDG)/Integrated Streambank
Protection Guidelines(ISPG)methodology
New bulkhead Yes,address MSDG or ISPG methodology Yes
FEMA Region X-Puget Sound BiOp Floodplain Habitat Assessment Worksheet(v1.6-November 2017) Page 2 of 6
1
PUGET SOUND BIOLOGICAL OPINION FLOODPLAIN HABITAT ASSESSMENT MINIMUM
STANDARDS WORKSHEET (V 1.5)
Brief Description of Proposal: Permit#-,02�I-`'6a-/�3
aLLjVic, �L- i 1
lot ., �
This checklist is intended to assist permit reviewers in determining whether an HA meets the minimum standards for the habitat assessment
analysis,
General BiOp Minimum Standards:
Each of the following must be documented in the permit file or an explanation provided as to why it does not apply to the project,
❑ New structures located in the least impactful location,as practicable.The permit file should include documentation of the measures taken
to avoid placing structures in the floodplain and to minimize the impacts of the proposed project on floodplain functions(see Floodplain
Habitat Assessment and Mitigation,Section 5,2),
❑ Any removed large woody debris is replaced per WDFW Aquatic Habitat Widelines,
The Protected Area is defined as greater of
❑ Bank armoring/stabilization follows and documents methodology consistent with the Floodway,Riparian Buffer Zone(RBZ),or
WDFW Marine Shorelines Design Guidelines or the Integrated Streambank Protection Channel Migration Zone(CMZ),If no CMZ is
Guidelines,A needs and alternatives analysis is essential for these projects, identified in a riverine system,the Protected
❑ The project is either inherently designed to avoid adverse impacts on floodplain Area extends to the outer limits of the
functions(if in the Protected Area)or compensatory mitigation is provided so there are floodplain.Please note the Protected Area
no adverse impacts on floodplain functions that support ESA listed species.See below does not extend outside of the SFHA.
for more information.
As part of the flood permit,applicant has been notified that their property contains land within the Riparian Buffer Zone(RBZ)and/or
floodplain.
❑ Prior to permit issuance,the applicant has recorded a notice on the title of the property stating that the property is within the RBZ and/or
the 100-year floodplain.
Minimum Habitat Assessment Standards:
In addition to customary elements of a project application such as a project description, The action area to be analyzed should
site plans,and methods of work,the HA must show that the proposal will result in no typically be well beyond the subject parcel(s)
adverse effects on floodplain functions and/or includes appropriate compensatory and must consider all areas that could be
mitigation, The HA document and analysis must include the elements listed below, This impacted by the proposal,especially including
checklist is provided to assist the HA reviewer in determining whether an HA is sufficient. indirect effects and effects of interrelated
and interdependent actions,in the vicinity of
❑ Project and action area description,maps,and site plans have been provided and downstream from the proposal(and only
❑ Methods of work are described within the SFHA).
❑ Projects in the Protected Area are designed to inherently avoid detrimental impacts
without mitigation. An interrelated activity is part of the
❑ The HA specifically considers both direct and indirect impacts,Indirect impacts the proposed action and depends on the
are a result of an action and can occur later in time or in a different place and are proposed action for its justification.
reasonably foreseeable, An interdependent activity has no independent
utility apart from the proposed action(USFWS,
❑ The HA evaluates the impacts of interrelated and interdependent activities. NMFS 1998)
FEMA Region X-Puget Sound BiOp Floodplain Habitat Assessment Worksheet(vl,6-November 2017) Page 3 of 6
1.
I
❑ The HA specifically considers cumulative impacts of reasonably foreseeable projects
beyond the subject proposal/lot for all of the elements of the analysis listed below, Cumulative impacts are the incremental
and especially loss of storage. effect of an action,together with impacts of
present and reasonably foreseeable future
❑ The HA contains sufficient analysis for each specific item below to demonstrate a actions by state,tribal,local,or private
claim of no adverse effect on the existing(legal)condition of the floodplain functions entities.Cumulative effects can result
(baseline condition).If an element does not apply to a particular project,the HA from individually minor but collectively
should briefly explain why. significant actions taking place overtime.
❑ 1. Water quantity and quality will not be affected by demonstrating that
pre-development water pattern will be substantially the same as the post- The hyporheic zone is a region beneath
development water pattern.The following items should be included in the and alongside a stream bed,where there is
analysis:
mixing of shallow groundwater and surface
• The HA demonstrates how low impact development techniques have been water.
used
• New impervious surfaces are noted and included in the analysis
• Water temperature impacts from development have been evaluated
• Potential changes in groundwater and hyporheic functions,pollutants,and sediment runoff have been evaluated
• Stormwater leaves the site with the same frequency,timing,and duration as before the development
❑ 2, Flood velocities and volumes are not increased,even when considering cumulative
impacts. Compensatory storage is generally
❑ 3. Flood storage capacity is not affected or compensatory storage has been proposed necessary for displaced flood storage
that: volume and loss of accessible floodplain
refugia for listed fish when a project
• Provides sufficient capacity to hold displaced flood storage volume includes fill or structural displacement.
• Restores ground elevations that are comparable to the existing conditions
• Maintains floodplain connectivity and fish access(fish will not be stranded or
trapped as the floodplain fills and drains) A refugium(plural:refugia)is a location
• Provides floodplain refugia and habitat for listed fish comparable to the existing which supports an isolated or relict
condition population of a once more widespread
• Is hydrologically connected to the flooding source species.
• Is located within the same hydraulic reach as the proposed development to
minimize effects on fish populations.
❑ 4. Riparian vegetation evaluation has been included Substrate:a substance or layer that
❑ 5. Measures to preserve habitat forming processes(such as large woody debris underlies something,or on which some
process occurs,in particular.
recruitment)are included the surface or material on or from
❑ 6. Refuge from higher velocity floodwaters is provided which an organism lives,grows,or
El obtains its nourishment.7 Spawning substrate is provided or protected the substance on which an enzyme
❑ 8. Ensure there are no adverse effects resulting from: acts.
• Habitat isolation
• Bankarmoring
• Channel straightening Habitat Isolation means the separation
of habitat components(such as main
• Construction effects(transport of sediment from the work area,noise,etc.) channel and off channel habitats)
• Direct effects such that a species can no longer
access all of the habitat elements even
though they may still be present on the
landscape.
FEMA Region X-Puget Sound BiOp Floodplain Habitat Assessment Worksheet(0.6-November 2017) Page 4 of 6
Effect Determinations:
Following the evaluation of potential effects,the HA should make a determination of the effect of the proposed development on listed salmonid
species and orcas.The effects determination should be one of the following options. Please check which effects determination has been made
in the HA under review.
❑ No Effect(NE): The project will have no effect whatsoever on listed species and designated floodplain functions.An insignificant or
discountable affect is not the same as no effect.If work affects any items evaluated in the HA section above,even insignificantly,an NE
determination is typically not appropriate.
❑ May Affect,Not Likely to Adversely Affect(NLAA): The appropriate conclusion when effects on the species or floodplain functions
that support those species are expected to be beneficial,discountable,or insignificant-even when considering direct,indirect,and
cumulative impacts.Beneficial effects are positive impacts without any adverse effects on fish or habitat. Insignificant effects refer to the
size of the impact and discountable effects are those extremely unlikely to occur due to timing.Based on best judgement,a person cannot
meaningfully measure,detect,or evaluate insignificant effects or expect discountable effects to occur.The term"negligible"means the
same as"insignificant"(immeasurable).
❑ Likely to Adversely Affect(LAA): The effect of the project is likely to result in a short or long-term adverse effect on listed species or
floodplain functions.
Proposal is Within the Protected Area
If the proposal is within the Protected Area,the following four conditions must be met through the HA analysis. The Protected Area is defined
below.
❑ All"General BiOp Minimum Standards"have been met.
❑ All minimum"Habitat Assessment Standards"have been addressed.
❑ No mitigation is proposed.The project design inherently avoids adverse effects.Project design elements that consider and improve
floodplain functions that support ESA-listed species may be incorporated.
❑ The proposal will result in an NE or NLAA effects determination for ESA-listed species..
Table 2,Minimum Area of Habitat Assessment in Protected Areas
Water/Stream Type RIBZ The riparian buffer zone(RBZ)is the land adjacent to
streams and other bodies of water where vegetation
CMZ CMZ+50 feet is strongly influenced by the presence of water.They
are often thin lines-of-green containing native grasses,
S(Shorelines of the State) 250 feet flowers,shrubs and trees that line the banks of streams
and other bodies of water.
F>5'and Marine Shorelines 200 feet
The channel migration zone(CMZ)is the area along
F<5'and Lakes' 150 feet a river within which the channel(s)can be reasonably
predicted to migrate over time as a result of natural and
normally occurring hydrological and related processes.
N w/unstable slopes 225 feet
N 150 feet
Lakes are defined as over 20 acres.
FEMA Region X-Puget Sound BiOp Floodplain Habitat Assessment Worksheet(v1,6-November 2017) Page 5 of 6
Proposal is Outside the Protected Area and Within the SFHA
If the proposal is outside of the Protected Area,but still within the SFHA the following conditions must be met through the HA analysis.
❑ All"General BiOp Minimum Standards"have been met,
❑ All minimum"Habitat Assessment Standards"have been addressed. Flood zones describe the probability of a flood occurring:
• 100 year=once every 100 years or 1%chance
❑ New structures are located at least 15 feet from edge of the Protected 50 year=once every 50 years or 2%chance
Area,in previously disturbed/cleared areas,or outside of the SFHA,as 10-year=once every 10 years or 10%chance
practicable, Any property having a 1%or greater chance of flooding is
❑ Removal of native vegetation leaves at least 65%of the area of the lot in the floodplam.
within the SFHA in an undeveloped state.
❑ 10,50,and 100-year flood zones are conveyed to the applicant and marked onsite.
❑ Creation of new impervious surfaces does not exceed 10%of the portion of the lot in the SFHA unless sufficient mitigation is provided.
❑ New structures are located such that new flood protection or armoring will not be needed.
❑ The proposal will result in an NE or NLAA effects determination for ESA-listed species.
Additional Considerations for Lake and Coastal Floodplains
❑ Armoring/stabilization:See"General BiOp Standards"section above.
❑ Lakes:The Protected Area is the RBZ(150 feet from the OHWM)because floodways and CMZ's are not applicable.
❑ Coastal:The Protected Areas is the SFHA located within 200 feet of the OHWM(i.e.the coastal RBZ)because floodways and CMZs are not
applicable.
NOTES:
FEMA Region X-Puget Sound BiOp Floodplain Habitat Assessment Worksheet(0.6-November 2017) Page 6 of 6