PSCAA Document.pdfpscleanair.org
Puget Sound Clean Air Agency
Notification case *: 201706065
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, a 4.03
()(6».
Fee Amount Paid
$65.00
Credit Card Transaction # AP0FF16C1DE1
Transaction Date
12/28/17
Owner's Name
City of Edmonds
Project Street Address 310 6th Avenue North Phone (425) 771-0256
City
Edmonds
Contact Person
98020
Carrie Hine 98020
Mailing Address
700 Main Street Phone (425) 771-0256
Edmonds, WA 98020
This project Includes a demolition.
Demolition Start Date 01/08/18 Completion Date 02/28/18
Demolition will be completed by a demolition contractor
Demo Contractor Construction Group Intl LLC
Contact Mark Marcell Contractor Job # D-17411
Mailing Address 19407 144th Ave NE Bldg D Phone (425) 487-2618
Woodinville, WA 98072
(1) I certify that the Information I have provided Is to the best of my knowledge true and accurate.
(2) I understand that I must file an Amendment to this Notification If:
• The type of project has changed. The project types are asbestos and demolition.
• The quantity of friable asbestos to be removed meets a larger project category.
• The project's start or completion date has changed.
(3) I understand one Notification must be filed for each structure. The only exception is for
a single-family residence that includes multiple ancillary structures, such as a detached
garage or other outbuildings having the same street address. If there is no street address, I
have used a building number.
(4) I understand the fees for this Notification are nonrefundable.
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If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058.