Edmonds Unocal Pier_141749.pdfExpiration Date: 5/19/2009
Parcel No: 27032600200300
CITY OF EDMONDS
121 STH AVENUE NORTH - EDMONDS,WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
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CITY OF EDMONDS-
MANSON CONSTRUCTION CO.
MANSON CONSTRUCTION CO.
121 FIFTH AVE N
PO BOX 24067
PO BOX 24067.
EDMONDS, WA 98020
SEATTLE, WA 981240067
SEATTLE, WA 981240067
NUMBER.OF STORIES: 0
206-762-0850
206-762-0850
EXISTING AREA
BASEMENZ:.O 1ST FLOOR: 0 2ND FLOIOR:.O .._ . -
LICENSE #: MANSOCCO32MI EXP:2/1/2009
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
JOB DESCRIPTION
REMOVAL OF THREE TANKS.
VALUATION: $0
PERMIT TYPE: Commercial
PERMIT GROUP: 70 - Tanks/Fuel '
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N ( 0 X 0 FT.)
CODE` 06
OTHER: N ------- OTHER DESC:
ZONE:
NUMBER.OF STORIES: 0
VESTED DATE:
NUMBER OF DWELLING UNIT S:`0
EXISTING AREA
BASEMENZ:.O 1ST FLOOR: 0 2ND FLOIOR:.O .._ . -
PROPOSED AREA
BASEMENT_: 0 I ST FLOOR: 0 _ 2ND FLOOR' 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
FRONT 1 `
REQUIRED: PROPOSED: IREQUIRED: PROPOSED: REQUIRED`. PROPOSED:
HEIGHT ALLOWED:O PROPOSED:O REQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED
XPiBY, ERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
THIS APP T IS NOT A PERMIT UNTI SIGNED BY THE BUILDING OFFICIAL OR HI ER DEPUTA AND ALL FEES ARE PAID.
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ignature Print Name Date Ras5d By Date
ATTENTION
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE,OF
OCCUPANCY HAS BEEN GRANTED. UBC109/ IBC110/ IRC110.
ARCHIVE APPLICANT ASSESSOR OTHER
`NON=HAZARDOUS
1. Generator ID Number
2. Page 1 of
3. Emergency. Response Phone
4. Waste Tracking Number
WASTE MANIFEST.;,,,,
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5. Generator's Name and Mailing Address Generator's Site Address (if different than mailing address) ..
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6. Transporter 1 Company Name U.S. EPA ID Number
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8 Designated Facility Name and Site Address U.S. EPA ID Number
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9. Waste Shipping Name and Description'
10. Containers
11. Total
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14. GENERATOR'S CERTIFICATION: I certify the materials described above on this manifest are not subject to federal regulations for reporting proper disposal of Hazardous Waste.
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Orators/Offerors Printed/Typed Name Signature 3.
Month Day Year
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Import t0 U.S ❑ Expdrt from U.S.- Port
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16. Transporter Acknowledgment of Receipt of Materials
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Month Day Year
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Transporter 2 Printed/Typed Name Signature 77
Month Day Year.
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17. Discrepancy
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Month Day Yearj
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18. Designated Facility Owner or Operator: of receipt of materials covered by the manifest except as ^nWedau,Item 17a
"Printed/Typed �Name Signa dire ?` //
Month Day Year
169-BLC-0 5 11977 (Rev. 8/06). r
TRANSPORTER #1
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NON=HAZARDOUS
1. Generator ID Number
2. Page 1 of
3. Emergency Response Phone
4. Waste TrackingNumber ro q
WASTE MANIFEST
5. Generator's Name and Mailing
Address
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6. Transporter 1 Company Name
U.S. EPA ID Number
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7. Transporter 2 Company Name
U.S. EPA ID Number
8. Designated Facility Name and Site Address
U.S. EPA ID Number
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Facility's Phoney
9. Waste Shipping Name and Description
10. Containers
11. Total
12. Unit
No.
Type
Quantity
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14. GENERATOR'S CERTIFICATION: I certify the materials described above on this manifest are not subject to federal regulations for reporting proper disposal of Hazardous Waste,
a
Generators/OffesPrmtedTyed Name
Signature ;'
"Day
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Month Year
1
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15. International Shipments
1:11. port to. U.S.
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❑ Export
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from U,S. Port of entry/exit:
Trans orter Si—t— for ex orts onl :
Date leavin U.S.:
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16. Transporter Acknowledgment of Receipt of Materials
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Transporter 1 Printed/Typed Name
Signature
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Month Day Year
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Transporter 2 Printed/Typed Name _
Signature
Month Day Year
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17. Discrepancy
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17a. Discrepancy Indication Space
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❑ Residue ❑Partial Rejection
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Full Rejection
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Manifest Reference Number:
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Month Day Year
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18. Designated Facility Ow Aerator: Certification cei t of materia covered by them except as noted in Item 17
Printed ame Signature Month Day Year
/
169-BLC-0 5 11977 (Rev. 8/06) TRANSPORTER #2
SOUND TESTING, INC.
206-932.0206
24 HOUR SERVICE
MARINE CHEMIST CERTIFICATE`'°'
SERIAL NO.. N 7 0 ®2 2
Page X of �—
Suryy Reques d by
Vessel O_wnner or Agent Date,
42
Vessel _
Type of Vessel Specific Location of Vessel
Last Three (3) Loadings
Tests Performed Time Survey Completed
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I „•clrr;:i-7n me compartment or space so designated, entry is not permitted.
ENTER WITH RESTRICTIONS: In the compartment or space so designated, entry for work is permitted only if conditions of proper protective equipment, or clothing, or time,
or all of the aforementioned, as appropriate, are as specified.
SAFE FOR HOT WORK: In the compartment or space so designated (a) the oxygen content of the atmosphere is not greater than 22 percent by volume; (b) the concentration
of flammable materials in the atmosphere is less than 10 percent of the lower explosive limit; (c) the residues, scale, or preservative coatings are cleaned sufficiently to
prevent the spread of fire and are not capable of producing a higher concentration than permitted by (a) or (b); (d) all adjacent spaces, containing or having contained
flammable or combustible materials shall be sufficiently cleaned of residues, scale, or preservative coatings to prevent the spread of fire, or they are inerted. Ship's fuel
tanks, lube tanks, or engine room or fire room bilges, or other machinery spaces, are treated in accordance with the Marine Chemist's requirements.
SAFE FOR LIMITED HOT WORK: In the compartment or space so designated (a) portions of the space meet the requirements for Safe for Hot Work and Partial Cleaning,
as applicable, or (b) the space is inerted, adjacent spaces meet the requirements for Safe for Hot Work, and hot work is restricted to specific locations; (c) p rt' ns of the
space shall meet the requirements for Safe for Hot Work, as applicable, and the nature or type of hot work is limited or restricted. �— ZA
NOT SAFE F O , : In the compartment or space so designated, hot work is not permitted.���.
CHEMIST ENDOR ENT. This is to certify that I have personally determined that all spaces in the foregoing in ap rdance with NFPA 3p6Z tro o Gas
Hazer on Vessels have and the condition of each to be in accordance with its assigned designation.CCQ1
"The undersi ed acknowled es ��l
ipt �d.rtr"'e`ca
te under NFP 6 and understands conditions This C ificate s based o ditions e�is�rfg at the inpecti forth was com-
and limitatiorus under hich ' wasued,quirements aintaining its validity." plet nd is 'sued subject to compliance with all qualifi instructions.
Signed'
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