3540_0011/8/2020 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.
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If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058.
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