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psc I e a n a r.org
Puget So mid - m /w Agency
angle- Unroll Notification Case #-. 201400593
This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for
inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)).
Fee Amount Paid $65.00
Credit Card Transaction # VLFFA8794459
Transaction Date 02/18/14
Owner's Name Thomas and Robin Goebel Phone (425) 691-0655
Project Street Address 344 Sunset Ave. N.
City Edmonds Zip 98020
Contact Person Robin Goebel Phone (425) 691-0655
Mailing Address PO Box 451
Kirkland, WA 98083
This project includes a demolition.
Demolition Start Date 02/24/14 Completion Date 03/14/14
Demolition will be completed by a demolition contractor
This is an emergency project. The emergency reason:
The project must proceed to avoid imposing an unreasonable burden.
I certify that:
(1) This is a single. -family residence project. The structure is used by one family who owns the property as their domicile.
(2) The information I have provided is to the best of my knowledge accurate and complete.
(3) 1 understand the fee for this Notification is nonrefundable.
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If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058.
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