RESUB1 BLD2023-0503+PSCAA+5.15.2023_4.29.35_PM+35459354/21/23, 12:25 PM RES U 6 Approved Transaction
aVN'A\\\ May 16 2023
CILOPM E T SERVI BLD2O23-0503 RwOeT snUHo DEVELOPMENT SERVICES
Cloon Air Agency DEPARTMENT
Single -Family Notification Case #: 202301772
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 # AEOASAFE34E0
Transaction Date 04/21/23
Owner's Name Duane & Deanne Landsverk
Project Street Address 19515 94th PI W
City Edmonds
Contact Person Duane Landsverk
Mailing Address 24113 56th Ave W
Mountlake Terrace, WA 98043
This project includes asbestos removal.
Project Size linear feet / 12 square feet
Project Start Date 04/21/23 Completion Date 04/21/23
Asbestos will be removed by a licensed asbestos abatement contractor
This project includes a demolition.
Demolition Start Date 05/10/23 Completion Date 09/01/23
Demolition will be completed by a demolition contractor
Phone (425) 754-2069
Zip 98020
Phone (425) 754-2069
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.gov or 206.689.4058.
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