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BE DONE ON AID VAIS PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURB S. SIDEWALKS, DRIVEWAYS , MAROUEIES. ETC.1 WILL REQUIRE
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SEPARATE PERMISSION,
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IT APPLICATION: 18D DAYS
T PERMIT LIMIT� 1 YEAR . PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG. REVIEW FEES
'A PLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
IN INTE E T. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY
EDMONDS WA HINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
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ALLCLAIM FOR DAMAGES OF WHATEVER NATURE, ARISING D RECTLYOR INDIRECTLY
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LANDSCAPING
INSPECTION FEE
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE 08 REDUCE ANY REQUMEMENTOFANY CITY ORDINANCE
PLAN CHECK DEPOS1111
0 NOR LIMIT IN ANY WAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
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TOTAL AMOUNT DUE
I HEIREIBY ACKNOWLEDGE THAT T I
H S APPLICATION. THAT THE INFORMATION
GIVEN IS CORRECT. AND TNAT;HAVEREAD
AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE CWNER� I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND INDOING THE WORK AUTHOR,2ED THEREBY. NO PERSON WILL BE EMPLOIED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON HILATIN. TO
CALL
FOR INSPECTIO
WORIMEN'S COMPENSATION INSURANCE AND RCW 18.27,
SIGNJUR�(CWNERO EN Te
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771-0220
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IT IS UNLAWFULTO USE 08 OCCUPY A BUILDING OR STRUICTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED. LED SECTION 109
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ORIGINAL-11ILC YELLOW- INSPECTOR
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GARY HAAKENSON
CITY OF EDMONDS MAYOR
121 M AVENUE NOFGH -EDMONDS, %A9M - (425) 771-OM -FAX (425) 771-Mi
WebSlte: mwxl.edmonds.�Us
DEVELOPMENT SERVICES DEPARTMENT
18913 Planning - Building - Englneedng
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December 19,2002
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Mr. Charles Nathan
Nalund Construction
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9792 Edmonds Way, Suite 266
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Edm�onds, Washington 98020
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RE: Demolition Permit #2002-0694 @ 21501 81P Avenue West, Edmonds
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Dear W. Nathan:
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The purpose of this letter is to inform you that our Fire Department has been in contact
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with my office regarding the subject demolition permit. As you know, the demolition
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permit fees were waived because the house was being considered for potential fire
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training. However, since the home was not used for fire training purposes demolition
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permit fees are required. The outstanding fees owed are $285.00 and are immediately
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due and payable to the City.
Please remit full fees within 10 business days date of this letter. If you have any
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questions please feel free to contact me at 425-771-0220.
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Sincerely,
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Jeannine L. Graf
Building Official
Incorporated August 11, 1890
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Sister City - Hekinan, Japan
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ASBESTO-TEST, INC.
ASBESTOS SURVEY
21501800 Ave. W-. E monds WA 98026
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Page I of 4
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)7V#220948
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October 1, 2002
Nalund& Associates Inc.
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9792 dratinds Way
PMB 266
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Edmonds, WA 9MO
SERVICES 01R'
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Attn: Sandra DEVEL V of EDMONDS
Ph: 425-771-7270 Fax: 425-771-7105
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Note to PSCAA: This Is a newer vintage small rumbler home. Most ofthefloors throughout are wood
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The vinyl and illeflooring materials are ofnewer vintage and were sampledper each located
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homogenousarea. ThelotenforlsdrywallandwooA The drywall andiapingmaterials were also
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-mPkd Tke-n-sNonmoflngm0oddsweresa7npled. Thegasforcedairfurnace Is under the
houS4 There was no visible locaredassodated
relating suspedACH with thefurmice or dacting, if
that Is tiny addideffellocaledsaspectACMprior to or during demolition (such as, but not 11migedia,
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those materials thted on Pirge 4), that was not discovered in this survey, the awterial(s) must be PA CM
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junt— tested otherwise by laboratory analysis
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INTRODUCTION
On September 27", 2002, Asbesto-Test personnel conducted an Asbestos survey (per
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U.S.E.P.AJAII.E.R.A. guidelines as designated and specified by Jouget Sound Clean Air
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Agency and W-kington State) offk sinde AbAlly Awsiftne 04 WO-1 8#* Ave. W., Zbnomk
Snohomish CgiruM Washington This survey purpose is to identify any Asbestos
containing Mterials that may be present and will require professional removalprior to
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removadon andlor demolition ofthe structure.
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NA RRA MIF OF FMj7VGS
BASIC CONSTRUCTION (including siding and roofing "es) The one story house is an a
concrete and wood foundation. The exterior siding is wood. The wood siding vapor barrier was
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sampled. The composition roofing was also sampled.
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ATTIC/WALL INSULATION: There was no relating suspect ACM located.
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]PLUMBING STSTEX- There was no relating suspect ACM located.
INTERIOR CONSTRUCTION, FINISHES, AND FLOORINGS: The interior is drywall
and wood. The drywall/taping materials were uniformly sampled. Vinyl and tile flooring
materials with relating backings and mastics were sampled per each located homogenous area.
CONTINUE TO PAGE 2
1429 Am D. PMR #1#7,S"k*MW WA 9112" pik: 20&914-5Sft in: M6-563-Uff Me: n"".4at -T
Page 2 qf4 October 1, 202
IM220948 Asbesta-Ant, Ina (425) 489-4040
21501800 A w— W., Edmonds. Snohomish County, Washington 98026
ELECTRICAL SYSTEM: The electrical wiring insulation is not ofthe kind to be ACM and
was not sampled. Any additional suspect electrical wiring insulation or any suspect TSI
(nermai System Insulation) found in, around, or behind any locatedfine or breaker boxes
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should be considered to, be ACM (Asbestos Containing Material), unless determined otherwise
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by laboratory analysis.
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HEATING AND VENTIIATION SYSTEM: There is a newer vintage gas forced air furnace
under the house. There was no visible suspect ACM located associated with the furnace or
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ductin& Note: It was not possible to dismantle thefurnace and ducting to locate andlor
evaluate any additional suspect A CM which may be concealed, Inside the unit, or
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associated In hidden areas. It is our opinion anyfurther handling ofthefurnace system
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should be coordinated by the project manager andlor abatement contractor. Ifany
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additional relating suspect materials are locatedprior to andlor during any demolition
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or renovation, any and all additional related suspect materials should be considered to
be ACM (Asbestos Containing Material), tailess determined to be otherwise by
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laboratory analysis. Any addifloned located suspect ACMTSI Inside or outside the Airmce
andlor ducting system including but not limited to all gasket% joint compounds, sealants,
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andfor Insulations, an PACM unless tested otherwise by laboratory analysis. There was no
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suspect ACM located associated with the fireplace system.
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Misc.: None.
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ADDITIONAL STRUCTMES ON SITE INCLUDED IN SURVEY- None.
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To
# ofstrudures Included in survey.- one house
Reqneardby. Sandra@ Nahmd& Assor-
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RFCFIVF-D
NOV 2 2002
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DEVELC �VMENT SERVICES C'n'
CITY OF EDMONDS
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L Schneider, B.Sc.
I ctor, ccrtified A.H.E.R.A.
acered.#CLS327 (Ekpires 9111/03)
CONTINUE TO PAGE 3
Page 3 of4
Odobfr 1, 2002
)M220948
Asbalo-Test Inc— (425) 489L4040
2150110! Ave. W., Ednwn&. Shohondsh Coagnth
Wmhingfon
THERE WASNOASBESTOSDETECTED RVAIVY OF THE S"PLES TAKEN
ANALYSISID ASBFSTOSI/TYPFJ/OUANTYrY MELAATEWAL
1.0) drywidl
NAD
non -fibrous materials
Cellulose, fiberglass,
paiK (gypsum)
1.1) dMmU taping compounds
NAD
non -fibrous materials,
SAMPLED PER AHERA PROTOCOL
cellulose, fiberglass
2.0) shed vinyl flooring:
NAD
non -fibrous materials
bathroom -color. brown octagon
cellulose, fiberglass
2.1) mastic
NAD
adhesive
3.0) tile flooring
NAD
non -fibrous materials
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Ititchen-color: white
3.1) mastic:
NAD
adhesive
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4.0) sheet vinyl flooring
NAD
non -fibrous materials
laundry roont-color. white square
cellulose� fiberglass
4.1) nuLqtk
NAD
adhesive
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5.0) wood siding vapor barrier
NAD
cellulose, tar
beneath wood siding on house
6.0) composition rooft
NAD
cellulom tar, fiberglass,
non -fibrous materials
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DEVELOP,",* F EDMONDS
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21501 L#* A w- W., Ed
I—Mx-d,S Snohondsk County, WashinizAhn,
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anablial Van mothad: USEPA600/R93/116-(PLM); WAC 29642-077$3 AM J
Agy: ACM
PACM 0
CAB iPifie%"CocmftA*�sIm8osW 0
sipffift-Imthair
T91 signifi-InwmalSysteml—Istiod"
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HVAC signifin�HftftVenhlatinsAk-Condftionine
NAD Sliptiffes -No Asbest. Detected"
"One powd Is the USEPA mpfigmey limit the asbesaw in bulk samples.
PLM basi been known to min ubwas in mull pmotaftiles ofsome somptes, which coaftin asbefts, thus nopthte PLM malts cavown be
guarvalved. Float bles and wim should be twited with SEM m TEM, to imaramblical accuraq when re,Mn In�ltpmm"ft
Asbesto-Test, Inc claim msponsibillryfirwarple content only.
END OFREPORT
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DEVELoiwl I,,. 6MONDS
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-FINAL PROJECT APPROVAL FORM
TO:
DATE: M
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
�(--��FIRE DEPARTMENT DATE
FROMW —1
ENGINEERING DIVISION DATE—.
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PLANNING DIVISION DATE —
PROJECT 14m
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SITE ADDRESS -jig
PERmrr#-&( DATE INSPECTED
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DESCRIPTION OF WORK TO BE INSPECTEI)4kt_K����.
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A field inspection was conducted to determine final compliance with approved plans. Final approval
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denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of
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FINAL PROJECT APPROVAL
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_____�GRANT
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Si
ocaprvl.doc.l:temp-.bldg:fon-nsIO/OI
FINAL PROJECT APPROVAL FORM
TO:
DATE:
mEmo To: PERmrr cooRDINATop, BUILDING DIVISION
FROM: FIRE DEPARTNIENT DATE-_
ENGlNEERlNGD1VIS10N DATE
PLANNING DIVISION DATE
PROJEC
SITE ADDRESS
PERAM # :�000L AD # DATE INSPECTED
DES I CRIPTION OF WORK TO BE INSPECTED_a'6&����,
A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORAIANCE BONDS and the granting of:
RANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
o Copy of CONDITIONS given to owner/contractor by inspector
1
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractorby inspector
1.
2.
3.
RE -INSPECTED OUTSTANDING ISSUES -GRANT FINAL PROJECT APPROVAL
Date Si
ocaprvl.doc.l:temp:bldg:fonnsIO/OI
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SETBACKS .....................
FOUNDATION:
Footlng.......... ...........
wall ................
Pier/Porch .................
Retaining Wall
Slab Insulation ..........
PLUMBING:
Underground... ..........
Rough -in ...................
commercial Final
HEATING:
Gas Test ...........
Ges Piping
Equipment .................
Commercial Final
EXTER OR SHEATHING
NAILING ..........................
FRAMING .................
*FIRST FLOOR FRAMING_
INSULATION . ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
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