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BLD20181002b OV EbAf 1p CITY OF EDMONDS 1215THAVENUENORTH -EDMONDS, WA 98020 'I', 4C. 1 _S 49,'3 PHONE: (425) 771-0220 - FAX: (425) 771-0221 STATUS: ISSUED 08/13/2018 Pennit#: BLD20181002 Expiration Date: 02/13/2019 Pai-cel No: 00434400700401 Project Address: 121 3RD AVE N, EDMONDS APPLICAIiT CONTRACTOR OMBU SALON H2D ARCHITECTS BEAUCHAMP CONSTRUCTION CIO TOM & BETH SANGER C/o BET H 1��J C/O Joel Beauchamp 131 3RD AVE N 23020 EDD ) k_.M A� 22S75 25TH AVE W EDMONDS, WA 98020-3208 EDMOND,' A20 LYNNWOOD, WA 98036 (425) 218-5277 (206) 542-3734 (425) 775-57SO LICENSE #: BEAUCC1984KC EXP:05/23/2019 DEMO OF INTERIOR FIXTURES/FINI SHESINON-BEA RING WA LLS - REMOVA L OF EXTERIOR NON -BEARING ELEMENTS PER PLANS VALUATION: $0 PERMIT TYPE: Commercial PERMIT GROUP: 23 - Demolition GRADING: N CYDS: 0 TYPE OF CONSTRUCTION: VB RETAINING WALL ROCKERY- OCCUPANT GROUP: B OCCUPANT LOAD: FENCE: 0 X 0 FT.) CODE: 2015 IEBC/IBC OTHER: ------- OTHER DESC: IZONE: INUMBER OF STORIES: 0 VEST ED DATE: INUMBER OF DWELLING UNITS: 0 LOT #: F_NISTING ARE�% BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0 11110 PO S ED A R FA BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0 3RD FLOOR: 0 GARAGE: 0 DECK:O OTHER: 0 3RD FLOOR: 0 GARAGE: 0 DECK:O OTHER: 0 BEDROOMS: 0 BATHROOMS: 0 BEDROOMS: 0 BATHROOMS: 0 FRONT SETBACK SIDESETBACK REAR S ETBACK KEQUIKED: PROPOSED: EQUIRED: PROPOSED: REQUIRED: PROPOSED: HEIGHT ALLOWED:O PROPOSED:O PROPOSED: SETBACK NOTES: I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON 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 APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEFIM AND ALL FEES ARE PAID. Signature Rint Narne Date Released By Date ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109/ IBC I 10/ IRCI 10. = FIRE = APPLICANT = ASSESSOR = CITY STATUS: ISSUED *Pre -inspection required. * Street to be cleaned of debris. BLD20181002 • Final approval on a project or final occupancy approval must be granted by the Building Official prior to use or occupancy of the building or structure. Check thejob card for all required City inspections including final project approval and final occupancy inspections. • Any request for alternate design, modification, variance or other administrative deviation (hereinafter "variance") from adopted codes, ordinances or policies must be specifically requested in writing and be called out and identified. Processing fees for such request shall be established by Council and shall be paid upon submittal and are non-refundable. • Approval of any plat or plan containing provisions which do not comply with city code and for which a variance has not been specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision of city code or state law does not approve any items not to code specification. • Sound/Noise originating from temporary construction s ites as a result of construction activity are exempt from the noise limits of ECC Cbapter 5.30 only during the hours of 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to BCC 5.30.120. • Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of whatever nature, arising directly or indirectly from the issuance for this pen-rdt. Issuance of this permit shall not be deemed to modify, waive or reduce any requirements of any City ordinance nor limit in any way the City's ability to enforce any ordinance provision. • Nothing in this permit approval process shall be interpreted as allowing or permitting the maintenance of any currently existing illegal, nonconforming or unpermitted building, structure or site condition which is outside the scope of the permit application, regardless of whether such building, structure or condition is shown on the site plan or drawing. Such building, structure or condition may be the subject of a separate enforcement action. THIS PERMIT AUTHORIZ_ES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRfVB/VAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT TIME LIMIT: SEE ECDC 19.00.005(A)(6) BUILDING ENGINEERING (425) 771-0220 EXT. 1326 1. Go to: www.edmondswa.gov Building Department Inspections 2. Then: SeNces are now scheduled online. If you FIRE (425) 776-7720 3. Then: Perm its/Development have difficulties, please call the 4. Then: Online Permit Info Building Department front desk for PUBLIC WORKS (425) 771-0235 5: If you don't have one already, create a assistance during office hours. login (upper right hand comer) (425) 771-0220 RECYCLING (425) 275-4801 6: Schedule your inspection When calling for an inspection please leave the folloWng information: Permit Number, Job Site Address, Type of Inspection being requested, Contact Name and Phone Number, Date Preferred, and whether you prefer morning or afternoon. • E-Pre-Demo Erosion Control • E-Engineering Final Demo • B-Preconstruction meeting • B-Final Demolition • Site visit �'C. lb7 BUILDING PERMIT APPLICATION Development Services Building Division 121 Sth Ave N / Edmonds, WA 98020 425.771.0220 For handouts, submittal requirements, permit status and inspection scheduling information go to: http://www.edmondswa.gov/ JOB SITE INFORMATION/LOCATION: (Where the work is taking place) JobSiteAddress: /Z1 3#RP A%& W 16Vt_j,0jqL7 Parcel: C1a4_41tqo,0-7eo4c>1 Lot /Unit/Suite #: Subdivision: PROPERTY OWNER: Name: -7—elt-t '0 F_'7VTT4 9AN&UM Mailing Address: City/State/Zip: t1>"ONVS IV4A Phone #: 4Z 5 -.z1f a - � 7- -1 -1 Email: 72�H- e9 �409�;AVAMS.e-a OWNER INSTALLATION: *If yes, read and sign* Will work be performed by the property owner? 0 Yes �O No I own, reside in, or will reside in the completed structure. This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange according to RCW 18.27.090. Owner Signature: APPLICANT / CONTACT INFORMATION: Name of Applicant: PIE5 T-H LA N 15 MailingAddress: ;Z?�PZ47 E-VMANDS "AY' #113 City/State/Zip: Vvt-to;,405 "A q6OZO Phone #: �Z 0 4o - '5q Z - 3-7 3 4 E-mail: POT-H 49 N-Z'C'Alce-" GENERAL CONTRACTOR: (if different from applicant) General Contractor: -I- T,'-' Mailing Address: City/State/Zip: Phone #: E-mail: WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE: CITY OF EDMONDS BUSINESS LICENSE #: Office Use Only TYPE OF PERMIT (Provide 0 Accessory Structure/ Detached Garage Details on Page 2) El Addition XDemolition 0 Mechanical El New Single Family/ Duplex 0 Plumbing 0 Fire Sprinkler 0 Remodel El New Commercial/ Mixed Use E] Re -Roof 0 Signs 0 Tank 0 Tenant Improvement El Other Remodel Permfffees are based on: The value of the work performed. Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the work indicated on this application. Valuation: PROPOSED NEW SQUARE FOOTAGE FOR THIS APPLICATION L�� Basement scl ft: Finished 0 Unfinished 0 Ist Floor, sq ft: 2nd Floor, sq ft: Garage/Carport:, sq ft: Deck/Covered Porch/Patio: Other sq ft: PROJECT DESCRIPTION AKrjAj_ , t2,15&V I cert4 that the information I have provided on this form/application is true, correct and complete, and that I am the property owner or duly authorized agent of the property owner to submit a permit application to the City of Edmonds. Print Name: E5e", L-Akf Signature: _F7��_, Date -7/Zr-/t 15 L/ U GENERAL COMMERCIAL DATA Occupancy Group(s): Occupant Load(s): Type(s) of Construction: Fire Sprinklers: Yes 13 No WA STATE ENERGY CODE: If your project affects the building envelope, mechanical systems, arid/or lighting, you must complete the appropriate WSEC forms. DEFERRED SUBMITTALS: All commercial building permits that will require associated plumbing, mechanical, fire sprinkler, and/or fire alarm permits are applied for separately. TI / CHANGE OF USE / NEW BLDG: Include TRAFFIC IMPACT worksheet MECHANICAL EQUIPMENT COUNTS (New and Relocated) BTUs Gas Elec Other Qty A/C Unit /Compressor Air Handier /VAV Boiler Dryer Duct Exhaust Fans Fireplace Furnace Heat Pump Unit Hydronic Heating Roof Top Unit (Provide eleva- tions if a Commercial Bldg) Other: PLUMBING FIXTURE COUNTS (New, Relocated or re -piped) Qty QtY Clothes Washer Tub/ Showers Dishwasher Backflow Device (RPBA, DCDA, AVB) Drinking Fountain Pressure Reduction/ Regulator Valve Floor Drain/Sink Refrigerator Water Supply Hose Bibs Water Heater - Tankless? Y or N Hydronic Heat Water Service Line Sinks Other: Toilets Other: GAS/FUEL CONNECTION COUNTS (New, Relocated or re -piped) BTUs Qty BTUs Qty A/C Unit Outdoor BBQ/ Fire pit Boiler Stove/Range/Oven Dryer Water Heater Fireplace/ Insert I Other: I I Furnace J-1 Other: MEDICAL GAS, AIR VACUUM COUNTS (New, Relocated or re -piped) QtY Qty Carbon Dioxide Nitrous Oxide Helium Oxygen Medical Air Other: Medical - Surg DEMOLITION ,4&e� Type of structure to be demolished: Vxj!9r f4.o-,sF, *CAr Cle �40 Square footage of structure to be demolished: I -:�P ' SP 6ACk 26Q�'— AboVC- AHERA Survey done? Y/N PSCAA Case #: Critical Areas Determination: Study Required 0 Conditional Waiver El Waiver 0 Fill in Place El Fill Material: Removal E] —_ 7S,11 Of Tank (Gallons) Critical Areas Determination: Study Required El Conditional Waiver El Waiver 0 GRAD E/F1 LL/ EXCAVATE Grading: Cut cubic yards Fill cubic yards Cut / Fill in Critical Area: Yes El No 11 GENERAL PROVISIONS APPLICATIONS: Applications are valid for a maximum of I year. ESLHA Applications, 2 years. LICENSING: All contractors and subcontractors are required to be licensed with Washington State Department of Labor & Industries and have a current City of Edmonds Business License. NVLAP ACCREDITATION LAB CODES: 200768-0, SEATTLE ASBESTOS TEST, LLC 200876-0 Lynnwood Lab: 19701 Scriber Lake Road, # 103, Lynnwood, WA 98036, Tel:425.673.9850, Fax: 425.673.9810; Bellevue Lab: 12727 Northup Way, Suite 1, Bellevue, WA 98005, Tel: AHERA Inspector Number: 425.861. 1111, Fax:425.861.1118-, Seattle Lab: 4500 9th Ave. NE, Suite 300, Seattle, WA 161374 98105, Tel: 206.633.1111, Fax: 206.633.4747 Website: www.seattleasbestostest.com, Email: admin@seattleasbestostest.com, Facebooki Batch#: 201812190 www.facebook.com/seaftleasbestostest Property Location: 121 3rd Ave N, Edmonds, WA ASBESTOS SURVEY REPORT SCANNED AUG 10 2018 Property Location: Prepared For: Prepared By: 121 3rd Ave N, Edmonds, WA Mr. Tom Sanger Mr. Tom Sanger 121 3rd Ave N, Edmonds, WA Steve (Fanyao) Zhang AHERA Cert. 166059; expiration: 03/07/2019 Seattle Asbestos Test, LLC 19701 Scriber Lake Road, Suite 103, Lynnwood, WA 98036 Inspection Date: 8/6/2018 Report Date: 8/7/2018 No E�7,- C � r, AUG 10 2018 BUILDING c7py C(apy�, Note: Summary information for asbestos at named property can be found in "Conclusions" section of the report, in the floor plans, or in table 3, Nature and Distribution of Asbestos. A "Point Count Supplement", if attached, may change the original asbestos percentage, SEATTLE ASBESTOS TEST NVLAP ACCREDITATION LAB CODES: 200768-0, 200876-0 Lynnwood Lab: 19701 Scriber Lake Road, # 103, Lynnwood, WA 98036, Tel:425.673.9850, Fax- 425.673.9810,- Bellevue Lab- 12727 Northup Way, Suite 1, Bellevue, WA 98005, Tel: AHERA Cert. 166059; expiration: 425-861.1111, Fax:425.861.1118-1 Seattle Lab: 4500 9th Ave. NE, Suite 300, Seattle, WA 03/07/2019 98105, Tel: 206.633.1111, Fax: 206.633.4747 Website: www.seaftleasbestostest.com, Email: admin@seaftleasbestostest.com, Facebook: Batch#: 201812190 www.facebook-com/seaftleasbestostest Property Location: 121 3rd Ave N, Edmonds, WA Purpose/Scope of Survey This survey is intended to investigate, sample and test ACM in accordance with 40 CFR 763.86, the EPA regulations for Asbestos Hazard Emergency Response Act (AHERA). The client named will use this report to meet their regulatory requirements in their project. Methodology/Findings Inspection, sampling and assessment procedures were performed in general accordance with the AHERA guidelines published by the U.S. EPA in 40 CFR Part 763 subpart E, October 30, 1987. The survey include three integrated tasks: visual inspection, sampling and quantification. Special attention should be paid to the following: material classification, recognizing of homogeneous areas, differentiation between friable and nonfriable asbestos, and interpretation of testing results. Material classification There are three main kinds of material according to EPA sampling guidelines. They are Surfacing Material, Thermal system Insulation, and Miscellaneous material. The classification bears implications for number of samples to be taken. For Surfacing material, there's the 3-5-7 rule, meaning 3 samples from less than 1,000 square feet area, 5 samples from 1,000 to 5,000 square feet area, and 7 samples from greater than 5,000 square feet area. For Thermal system material, with some exceptions, 3 samples should be taken for each homogeneous area. For Miscellaneous material, at least one sample should be taken from each homogeneous material. Table 1 shows the types of material recognized during the survey, and the following is a tabulated summary of the material types: Total Miscellaneous Material ---------------------------------- — ----------- > 10 Total Thermal System Insulations (TSI) ---------------------------------- > 0 Total Surfacing Material ------------------------------------------------------- > 0 Homogeneous Areas NVLAP ACCREDITATION LAB CODES: 200768-0, SEATTLE ASBESTOS TEST 200876-0 Lynnwood Lab: 19701 Scriber Lake Road, # 103, Lynnwood, WA 98036, Tel:425.673.9850, Fax: 425.673.9810; Bellevue Lab: 12727 Northup Way, Suite 1, Bellevue, WA 98005, Tel: AHERA Cart. 166059; expiration: 425.861.1111, Fax-.425.861.1118; Seattle Lab: 4500 9th Ave. NE, Suite 300, Seattle, WA 03107/2019 98105, Tel: 206.633.1111, Fax: 206.633.4747 Website: www.seattleasbestostest.com, Email: admin@seattleasbestostest.com, Faoebook: Batch#: 201812190 www.facebook.com/seattleasbestostest Property Location: 121 3rd Ave N, Edmonds, WA Homogeneous material means an area of surfacing material, thermal system insulation material or miscellaneous material that is uniform in color and texture. It should be pointed out that materials appear to be homogeneous and adjacent to each other may in fact have different contents in terms of asbestos, and only laboratory testing will decide whether they are really the same homogeneous area. Table 2 shows the identified homogeneous areas for this survey. Total homogeneous areas ---------------------------------------------------- > 7 For each homogeneous area, its representative location and sample number are given in the table. Friable vs. Non friable A material that contains asbestos is friable if the material, when dry, may be crumbled, pulverized, or reduced to powder by hand pressure, and includes previously non -friable material after such previous nonfriable material becomes damaged to the extent that it meets the criteria as a friable material. The term friable during an AHERA asbestos survey applies only to ACM, and table 3 shows friable ACIVIs and nonfriable ACMs during this survey. Total ACM found on the property ------------------------------------------ > 0 Laboratory Testing Results Analytical testing is done in house in Seattle Asbestos Test, which is a NVILAP Accredited lab and participates in PAT rounds administered by NVILAP. Seattle Asbestos Test has over 20 years of analytical testing experience among its key analysts, and it conducts extensive inter- and intra- laboratory QA/QC testing. The method of testing employed are polarized light microscopy, or PILIVI. For QC purposes, one in every ten samples are analyzed as duplicate and check samples are randomly cross - analyzed by different analysts SEATTLE ASBESTOS TEST NVLAP ACCREDITATION LAB CODES: 200768-0, 200876-0 Lynnwood Lab: 19701 Scriber Lake Road, # 103, Lynnwood, WA 98036, Tel:425.673.9850, Fax: 425.673.9810; Bellevue Lab: 12727 Northup Way, Suite 1, Bellevue, WA 98005, Tel: AHERA Cert. 166059; expiration: 425.861.1111, Fax:425.861.1118; Seattle Lab: 4500 9th Ave. NE, Suite 300, Seattle, WA 03/07/2019 98105, Tel: 206.633.1111, Fax: 206.633.4747 Website: www.seattleasbestostest.com, Email: admin@seaftleasbestostest.com, Facebook: Batch#: 201812190 www.facebook.com/seaftleasbestostest Property Location: 121 3rd Ave N, Edmonds, WA Table 4 is the test results for the samples taken during the survey. For each sample, it is sub -divided into layers if the sample is separable, and each layer is then prepared into slides and analyzed separately. Each layer is also described to show its color, and nature, so that it provides a check to the homogeneous area classification done on site. Different from the lab report format, which is listed in the appendices, Table 4 also shows the location of each sample, and the material as seen by the inspector on -site. This kind cross-reference enhances degree of certainty to the final report. The following is a tabulated summary Total number of samples Total number of layers Conclusions F-2 10 No ACMs were found on the client's property during the inspection. Note: Only main floor and the attached garage are affected in the project. Limitations Major limitations of this survey are: (1) it's impossible to sample every inch of building material by the method called, (2) sample appears the same, i.e., homogeneous may in fact be different in terms of asbestos containing, (3) concealed or difficult -to -access materials, such as underground constructions, areas under vast carpeted spaces where it is difficult to reveal everything under the carpet, materials inside walls, or under plywood if destructive sampling is not possible, building foundations, floor substrates, live electric wires, crawl spaces, areas where the inspector has no access, and debris pile from burning can not be adequately sampled, (4) random sampling scheme called by the method may skip areas that contains asbestos, and (5) measurements of area, length and size are all estimated, and should not be relied on for bidding purposes. As such, materials that are not addressed in this survey should be assumed ACM and should be treated as such unless additional samples were taken and tested otherwise. Any effort for additional survey that may take place after the release of this report should be in the form of an addenda. NVLAP ACCREDITATION LAB CODES: 200768-0, SEATTLE ASBESTOS TEST 200876-0 Lynnwood Lab. 19701 Scriber Lake Road, # 103, Lynnwood, WA 98036, Tel-425.673.9850, Fax: 425.673.9810-, Bellevue Lab: 12727 Northup Way, Suite 1, Bellevue, WA 98005, Tel: AHERA Cert. 166059; expiration: 425,861.1111, Fax-.425.861.1118; Seattle Lab: 4500 9th Ave. NE, Suite 300, Seattle, WA 03/07/2019 98105, Tel: 206.633.1111, Fax: 206.633.4747 Website: www.seaftleasbestostest.com, Email: admin@seaftleasbestostest.com, Facebook: Batch* 201812190 www.facebook.com/seaftleasbestostest Property Location: 121 3rd Ave N, Edmonds, WA This report is for the exclusive use of Client named and their representatives. The inspection and the report follow the general guidance recommended by AHERA, and no any other warranty, express or implied, is made. Any unauthorized use or use of this report beyond its scope are strictly prohibited, and Seattle Asbestos Test, LLC and its inspectors resume no liability. Respectfully Submitted, Steve (Fanyao) Zhang Appendices Table 1: Types of Material Table 2: Homogeneous Areas Table 3: Nature and Distribution of Asbestos Table 4: Analytical Testing Results Floor Plans Laboratory Analytical Report & Chain of Custody * Table 3 not attached because no ACM was found NVLAP ACCREDITATION LAB CODES: 200768-0, SEATTLE ASBESTOS TEST, LLC 200876-0 Lynnwood Lab: 19701 Scriber Lake Road, # 103, Lynnwood, WA 98036, Tel-425.673.9850, Fax: 425.673.9810; Bellevue Lab: 12727 Northup Way, Suite 1, Bellevue, WA 98005, Tel: AHERA Cert. 166059; expiration: 425.861.1111, Fax:425.861.1118; Seattle Lab: 4500 9th Ave. NE, Suite 300, Seattle, WA 03/07/2019 98105, Tel: 206.633.1111, Fax: 206.633.4747 Website: www.seaftleasbestostest.com, Email: admin@seaftleasbestostest.com, Facebook: Batch#: 201812190 www.facebook.com/seattleasbestostest Table 1: Types of Material Property Location: 121 3rd Ave N, Edmonds, WA 10 Total Material Type SAMPLE NUMBER LAYER MATERIAL TYPE MATERIAL DESCRIPTION LOCATION 1 1 M-001 Beigettan ceramic Kitchen 2 M-002 Gray briftle/sandy material Kitchen 2 1 M-003 Gray/brown ceramic Bathroom Two 3 1 M-004 Brown[black mastic Kitchen 4 1 M-005 White powdery material with paint Bathroom 5 1 M-006 White powdery material with paint Hall 6 1 M-007 White powdery material with paint Dining 2 M-008 White chalky material with paper Dining 7 1 M-009 White powdery material with paint Room One F 81 1 F-M-01 0 Black asphaltic material with sand Roof SEATTLE ASBESTOS TEST, LLC NVLAP ACCREDITATION LAB CODES: 200768-0.200876-0 Lynnwood Lab: 19701 Svilber Lake Road, # 103, Lynnwood, WA 98036; Bellevue Lab: 12727 Northup Way, Suite 1, Bellevue, WA 98005; Seattle Lab: 4500 9rth Ave. NE, Suite 300, Seattle, WA 98105, AHERA Cert. 166059; expiration: 03/07/2019 Website�seatfieasbestostestoom, Email: admin@seattleasbestostest.00m, Facebook,.facebook-com/seatteasbestostest Batcb#: 201812190 Property Location: 121 3rd Ave N, Edmonds, WA Table 2: Homogeneous Areas 7 Total Homogeneous Areas SAMPLE NUMBE LAYER SAMPLE DESCRIPTION SAMPLE LOCATIONS 1 1 Beigettan ceramic Kitchen 8 12 1 Black asphattic material with sand Roof 3 1 Brown/black mastic Kitchen 1 Gray briftle/sandy material Kitchen 2 11 Graythrown ceramic Bathroom Two 6 12 White chalky material with paper Dining 4,5,6,7 11 White powdery material with paint Various NVLAP ACCREDITATION LAB CODES: 200768-0, SEATTLE ASBESTOS TEST, LLC 200876-0 Lynnwood Lab: 19701 Scriber Lake Road, # 103, Lynnwood, WA 98036, Tel:425-673.9850, Fax: 425.673.9810; Bellevue Lab: 12727 Northup Way, Suite 1, Bellevue, WA 98005, Tel: AHERA Cert. 166059; expiration: 425.861.1111, Fax:425.861.1118-, Seattle Lab: 4500 9th Ave. NE, Suite 300, Seattle, WA 03/07/2019 98105, Tel: 206.633.1111, Fax: 206.633.4747 Website: www.seattleasbestostest.com, Email: admin@seaftleasbestostest.com, Facebook: Batch#: 201812190 www.facebook.com/seaftleasbestostest Table 4: Analytical Testing Results Property Location: 121 3rd Ave N, Edmonds, WA 10 Total Layers SAMPLE NUMBER LAYER DESCRIPTION MATERIAL TYPE SAMPLE LOCATION ASBESTOS TYPE % 1 1 Beige/tan ceramic M-001 Kitchen None detected 2 Gray brittlelsandy material M-002 Kitchen None detected 2 1 Gray/brown ceramic M-003 Bathroom Two None detected 3 1 Brown/black mastic M-004 Kitchen None detected 4 1 White powdery material with point M-005 Bathroom None detected 5 1 White powdery material with paint M-006 Hall None detected 6 1 White powdery material with paint M-007 Dining None detected 2 White chalky material with paper M-008 Dining None detected 7 1 White powdery material with paint M-009 Room One None detected F81 1 1 Black asphaltic material with sand I M-010 lRoof None detected NVLAP ACCREDITATION LAB CODES: 200768-0, SEATTLE ASBESTOS TEST, LLC 200876-0 Lynnwood Lab: 19701 Scriber Lake Road, # 103, Lynnwood, WA 98036, Tel:425.673.9850, Fax: 425.673.9810; Bellevue Lab: 12727 Northup Way, Suite 1, Bellevue, WA 98005, Tel: AHERA Cert. 166059; expiration: 425.861.1111, Fax:425.861.1118-, Seattle Lab: 4500 9th Ave. NE, Suite 300, Seattle, WA 03/07/2019 98105, Tel: 206.6331111, Fax: 206.633.4747 Website: www.seaftleasbestostest.com, Email: admin@seaftleasbestostest.com, Facebook: Batch#-. 201812190 www.facebook.com/seaftleasbestostest Property Location: 121 3rd Ave N, Edmonds, WA FLOOR PLAN AND SAMPLING SCHEME - 1 Kitchen Room Two 1 3 Hall Bathroom Two 5 2 Dining 6 Bathroom 4 Room One 7 Note: (1) Positive samples in bold face and underlined, (2) Map not exact, not in scale Roof 8 Note: (1) Positive samples in bold face and underlined, (2) Map not exact, not in scale SEATTLE ASBESTOS TEST Lynnwood Laboratory: 19701 Scriber Lake Road, Suite 103, Lynnwood, WA 98036, Tel: 425-673-9850, Fax: 425.673.9810, NVLAP Lab Code: 200768-0 Disclaimer: This report must not be used by the client to claim product certification, approval, or endorsement by Seattle Asbestos Test, LLC, NVLAP, NIST, or any agency of the Federal government. ANALYTICAL LABORATORY REPORT PLM by Method EPA/600[R-93/116 Attn-: Mr. Tom Sanger Client: Mr- Tom Sanger Address: 121 3rd Ave N, Edmonds, WA Job4: N/A Batch#: 201812190 DateReceived: 8/6/2018 Samples Rec'd: 8 DateAnalyzed: 8/6/2018 Samples Analyzed: 8 Project Loc-: 121 3rd Ave N, Edmonds, WA Analyzed by Xianjie (Enc) Zeng Reviewed by: Steve (Fanyao) Zhang, President Lab ID Client Sample ID Layer Description % Asbestos Fibers Non -fibrous Components % Non -asbestos Fibers I Beige/tan ceramic None Ceramic/binder None detected 1 1 detected 2 Gray brittle/sandy None Binder, Sand 2 Cellulose material detected 2 2 1 Gray/brown None Ceramic/binder None detected ceramic detected 3 3 1 Brown/black mastic None Mastic/binder 4 Cellulose detected 1 4 4 1 White powdery None Binder/fille r, Paint 3 Cellulose material with paint detected 5 5 1 White powdery None Binder/filler, Paint 3 Cellulose material with paint detected 1 White powdery None Binder/filler, Paint 3 Cellulose 6 6 material with paint ldetected 2 White chal'ky None Binder/filler, 28 Cellulose I 1 t material with a er detected Gypsum/binder 7 7 1 White powdery Ewith None Binder/filler, Paint 4 Cellulose paint 1 it i t material detected 8 1 Black asphaltic None Asphalt/binder, 25 I Glass fibers I -1 material with sand I detected Sand SEATTLE ASBESTOS TEST, LLC NVLAP ACCREDITATION LAB CODES: 200768-0, 200876-0 Lynnwood Lab: 19701 Scriber Lake Road, # 103, Lynnwood, WA 98036, Tel:425.673-9850, Fax: 425.673.9810; Bellevue Lab: 12727 Northup Way, Suite 1, Bellevue, WA 98005, Tel: 425.861.1111, Fax:425.861.1118- Seattle Lab: 4500 9th Ave. NE, Suite 300, Seattle, WA 98105, Tel: 206.633.1111, Fax: 266.633.4747 Website: www-seattleasbestostest-com, Email: admin@seaftleasbestostest.com, Facebook: www.facebook.com/seaftleasbestostest Property Location: 121 3rd Ave N, Edmonds, WA Job#: N/A CHAIN OF CUSTODY Sample Condition: Good Damaged Severe Damage(Spillage)_ AHERA Cert. 166059-1 expiration: 03/07/2019 Batch#: 201812190 Total Number of Samples: 8 SAMPLE DESCRIPTION Print Name Signature Company Name Date Time Sampled: Steve Zhang Seattle Asbestos Test 8/6/2018 Relinquished: Steve Zhang Seattle Asbestos Test 8/6/2018 Delivered: Steve Zhang Seattle Asbestos Test 8/6/2018 Received: Xianjie (Eric) Zeng Seattle Asbestos Test 8/6/2018 Analyzed� I Xianjie (Eric) Zeng Seattle Asbestos Test 8/6/2018 Reported: I Steve Zhang Seattle Asbestos Test 8/7/2018 EKIST]Ni�--, GARAGE LOT 9 4�' 1� A EX15TING DRTYF INSTALL STRAW WATTLES PER CITY OF EDMONDS FEQUIPEMENT5 SITE PLAN SCALE: 1" = 10 NOTES EXI >TING, S GAF�(kGE 45650- FFL = 98.00- LOT 5 -5TOCKPILET05F COVERED WITHIN 24 HOURS EX15TING 6" SIDE SEWER K QN LOT 4 /* )) /* / 121 3RD AVE W. ) EDMONDS, WA 9&020 B FFL 100.00 98.00, D 96.50 kt Or GAS ER (01 MET 6 610, 1 1-0�' tv EMS 4, SHEDT013 ED ` CO, STING, 0 ATER 4e LOT 3 METER OWNER/CONTRACTOR RESPONSIKE C -SITIE UTILITIES. 98.0(Y POR LOCATING ALL ON C.� RELOCATIOWREVISION TO ANY UTILITIES 0 �AAy REQUIRE SEPARATE PERMIt 01 Cl Zone Flag 0 Corner Jetbacks ��—eowmd Front Sides Rear Other c2 HeiQk 0VqNEPJG0N'(Kf',CTQR IS RESPONSIBLE FOR � I 'I DRININAGE ,,p,OSI()N CONTfln p.NL N A 96.50' 1. CONSTRUCTION ER05ION CONTROL MEASURES MUST BE IN PLACE AND APPROVED 15Y PFP PRIOR TO ANY EARTH P15TUR13ANCF 2. NO SEDIMENT SHALL BE TRACKED ONTO PAYEE) STREET OR ROADWAY5.5EDIMENT SHALL BE REMOVED FROM TRUCKS AND EQUIPMENT PRIOR TO LEAVING THE CONSTRUCTION SITE IN THE EVENT OF FAILURE OF THE TESC SYSTEM RESULTING IN SEDMINr TRACKING ONTO PAYEMENr. THE CONTRACTOR SHALL IMPLEMENT MEASURES IMMEDIATELY TO CORRECT THE SITUATION. THE CONTRACTOR SHAUL EMPLOY EMERGENCY MEASURES TO IZEMOYE SEDIMENT FROM PAVED SURFACES. AS NECESSARY. STREET 5WFEFTIr, SHALL BE CONSIDERED AN EMERGENCY MEASURE. a AFTER CONSTRUCTION 15 COMPLETE. ALL EXPOSED EARTH SURFACES WILL BE LANDSCAPED WITH SUITABLE VEGETATION TO PREVENT EP05ION FOR THE PERMANENT CONDITION. 4. ALL DISTURBED SOILS WILL BE COMP05T AMENDED PER CITY OF EOMOND5 5MP T5.13. 5. CONTRACTOR TO VERIFY LOCATION OF ALL EXISTING UTILITIES. V—Ap—plicantshall repair/replace all damage to I utlfts or frontage improvements in City right-of-way parC-tystandards that 1, caused )r occuia during the permitted project. Nothing in this permit approval process shall be interpreted as allowing or permitting the maintenance of my currently existing illegal, nonconfortning, or unpermitted building, structure, or ite condition which is outside the cope of the permit application, regardless of whether such building,: :tructure' or condition is shown on the its plan or drawing. Such building, Structure, or condition may be the subject of a separate enforcement action. Sound/noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits only during the hours of 7:00arn to 6:00pm on weekdays and 10:00am and 6:00pm an Saturdays, excluding Sundays and Federal Holidays. At all other times the noise originating from construction sitesilactivities; must cor�ply with the noise limits, unless a vanance has bass granted. ECDC Chapter 5.30 All changes in plans and field modifications shall be approved by the local jurisdiction. The design professional shall pr?pm drawings as 'I" LAN required for approval. P P r VE' 1) P- EBC 107.4 F� D P L A H K 2 W" 3 T i E " E. OWNER APPROVED DATE- 61-10-tie; EILDG. OFFICIAL: 791:7�,- T-1 — PERMI U M B E—: R —'g-'----'�—A�4,9�', f Date: '15holilk, 61V wlv*"e RECEIVED CITY COPY iUL 25 2013 BUILDING n C/) C�' 04 0 z z 00 < LL) 0') z < 0 0 U) J 0� r) < z C/) N 0 D W 0 � 2716 fRECIf9TERED ARCHITECT arArR0FWMHtNGT0N 1— :2 W7.1 10" H 2 D A R C H I T E C T U R E D E S I G N 23020 EDMONDSWAY, #113 EDMONDS, WA 98020 P. 206 . 542 - " 7 34 www.h2darchit..ts.com DATE: 7/24/2018 DEMO PERMIT SITE PLAN A- 1- -o�f- 3 AS BUILT - LOWER FLOOR AND DETACHED GARAGE SCALE: 1/4" = T-0' AS BUILT - MAIN FLOOR SCALE: 1/4�' = 1�0" ill RECEOVED N JUL 2 5 2018 T-1\ BUIUDING In U) C) N z z 0 Co < LLJ M z 0 U) (Y) < z cl) 0 :5 Z) n 00 LLI 15; 0 VREGI'STERED A" IT " ARCHITECT An -.1 .—E� HELGMO STATEOF 2 H 2 D A R C H I T E C T U R E D E S I G N 23020 EDMONDSWAY, #113 EDMONDS, WA 9802D P. 2D6 . 542 . 3 7 34 www.h2darchitects.com DATE: 7/24/2018 DEMO PERMIT AS BUILT FLOOR PLANS A-2- &� 3 DEMO EXIST AflAP,64- L4'J00"A&"L-50 U"61�3 TO 40OF T-0 S& �_%.I_1.160 U-606L p!4mrr i;Lp W16-101-1 *,ja Ar&AV-j�1A"VA-- 9-6. I�AMUb A - V�'-O 1/4" NEW EXIST DOOR & LOWER FLOOR DEMO PLAN SCALE: 1/4" = T-O" = EXISTING WALLS rl — I DEMO WALLS NOTES: 1. PEMOEXi5TING WINDOWS FOR INFlLL OR REPLAGEMENr (PER PLAN). 2. 13UILPER TO PROTECT EXISTING FINISHES TO REMAIN DURING CONSTPUCTION. T-8 5/8"— : I :"A L 'I'MO __ PAYEP5 AS RlEalp DotTION 0 NEW "OOMO F-I EXIST FIREPIT TO REMAIN ___7 PST T?ALL EW EXCAVATE AS RE9D 0 NEW CRAWLSPACE LOCATIO 3EEAST PAVERS FOR LINE OF EXIST DECK (ADOVE) To OE DEMOD J KNPOW TO 13E SALVAGED & RFLOCATED. PEFFR TO WINDOW SCHEDULE (WINDOW 02) — . . I m.0 EXIST _u MO EX15T WINDOW �FTXTUFE_,,'5 & AqNPOW TO 13E SALVAGED & I - RELOCATED. REFER TO WINDOW FINISHES 0 OATH SCHEDULE (WINDOW 01) r T� MO EXIST X FixruPE5 �, .i'tMO EXIST WALL5 FIN15HEW b:� = - = �� A ll� & DOORS (a CL05ET OATH _j & VATHS, TYP -DEMO FX15T P" EXIST \vCL`0m5uEtT:A5 & DOORS CLOSETS. WALL5 & >PO F DOORS D e_X L - - - - - L L - - _Lr ib!W 7: 3.r - - - - - - . . . . . . r 11 ir- REMO FX15T -I r . . . . NALLS MO T L - - - - - - - - - - - - DN EXIST J L ALL5 x u MO �5" O*N -4 REMAIN r -r -r -r j I fA5T STAIRS TO AID exTST Arnc Of- HigAL4 WA---< 7E EXIST". ACCESS TO REMAIN III w` Y, Mo FIXX TIF & L. -L J_ _L FINISHES'@ r REF F -!-.P* '\PEMO EXIST DECK, 'rL FioT- / -m ip- __c CEILING ASOVE & STEPS - - - - - - �LINDOW TO BE SALVAGED & E Go PORCH DEMO EX15T RELOCATED, REFER TO WINDOW WINDOW SCHEDULE (WINDOW 03) EXCAVATE/PRFP AS PEQ'P 0 NEW FAMP LOCATION DEMO EXIST WINDOW ,VtMO EXISTING FRONT FENCE & GATE 1 POM EX15T DOOR DEMO EXIST PORCH 5 'P �T TEP5; TO OE -U---LL-U RE13UILT 0 0 5T PO u C0066s TIB A-(-- A4;% Ae_6 _L5tmo EX15T 5& 9-A'o ww- ?YAW WINDOW j3 LO -1.0 1 RECEIVED JUL 25 2010 BUILDING N -MAIN FLOOR DEMO PLAN SCALE:1/#' = T-O" NOTES: EXISTING WALLS 1. DEMO EXISTING WINDOWS FOR INFlLL OR REPLACEMENT (PER PLAN). r: DEMO WALL5 2. DLALPER TO PROTECT EXISTING FINISHES TO REMAIN DURING CONSTPUCTION. U) C) c\I C) z z 00 < LLJ z < 0 U) _j r) < z C/) C'4 0 LLJ 0 W 97to REGI.STERED �. I ARCHITECT El.1 �.IC.E.E HILGE— S-0—H—TON [ :2 101 H 2 D A R C H I T E C T U R E D E S I G N 23020 EDMONDS WAY, #113 EDMONDS, WA 98020 P. 206 . 642 . 3 7 34 —w.h2clarchitects.com DATE: 7/24/2018 DEMO PERMIT DEMOLITION PLANS A-3 —Dc 3