PCS Notification Firdale Ave4/20/2021 Approved Transaction
pscIeanair.org
Puy et Sound Clean Air Agency
Single -Family Notification Case #: 202101956
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 # AROA6E36BCF7
Transaction Date
04/20/21
Owner's Name
Victor Arroyo Phone (425) 321-8769
Project Street Address
9627 Firdale Ave
City
Edmonds Zip 98020
Contact Person
Victor Arroyo Phone (425) 321-8769
Mailing Address
This project includes asbestos removal.
Project Size linear feet / 500 square feet
Project Start Date 04/30/21 Completion Date 04/30/21
Asbestos will be removed by the home owner
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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