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PSCAA#1/8/2020 Approved Transaction pscleanair.org Puget Sound dean Air Agency Single -Family Notification Case #: 202000123 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 $25.00 Credit Card Transaction # AROA675AA68C Transaction Date 01/08/20 Owner's Name Mark Coons Phone (425) 422-0900 Project Street Address 8427 202nd St SW City Edmonds Zip 98026 Contact Person Mark Coons Phone (425) 422-0900 Mailing Address This project includes asbestos removal. Project Size linear feet / 600 square feet Project Start Date 01/09/20 Completion Date 01/10/20 Asbestos will be removed by a licensed asbestos abatement contractor 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) I understand the fee for this Notification is nonrefundable. Create Another Notification If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. https://secure.pscleanair.org/Asbestos/Approved.aspx 1!1