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HomeMy WebLinkAbout229 N OLYMPIC AVE_BLD1205_2026 DEMOLITION PERMIT APPLICATION Department of Community& Economic Development City of Arlington•.18204 59th Ave NE•Arlington, WA 98223 • Phone(360)403-3551 THIS APPLICATION MUST BE ACCOMPANIED WITH A COPY OF THE ASBESTOS/DEMOLITION NOTIFICATION FROM PUGET SOUND CLEAN AIR AGENCY, TWO(2)COPIES OF AN ASBESTOS SURVEY REPORT AND ABATEMENT REPORT (if applicable)COMPLETED BY AN APPROVED AGENCY. Type of Permit:(check one) ❑ Residential Commercial ❑ Industrial Project Address: �2 t ©1 y�� t e Parcel ID#: do- Q0I O I�l OQ Lot#: lq� Subdivision: Valuation: Building Area(Sq Ft) No of floors: Number of Buildings: r Owner: 1 P a.vl F)k") n Phone Number���5� 23 I J �(06cl Address: 22_q N nlyvv�Pi C but City: lac! to State W Zip/Code: Contact Person: l n e(-�- 2 OL r�e r Phone Number.2db )` "l I Z- z0 Z Cell Phone: i E-mail: ( r�Le� c� oL� ca yx Gn�el,r Pk see . coo�hel I I I Address: I I��� \�/ Wy 5 toz City State: � Zip Code: Contractor:,S ems,, ' (1Gj fjA-041) �q' A Phone Number: bier: 20Co �Q Z �q Z-02-- 15 Address: I1&7 NOCAAAr'rQp-\C Pa AO city: &+\ne,�I State: �u� Zip Code:: 4MO I� Contractor's License Number: rS, �� ``�� C� M9 Expiration: I Q I 1 Scope of Work: �) ( O�14 i0y-\ 0-C e da,rnC3got I hereby certify that the above information is correct and that the construction on,and the occupancy and the use of the above- described property will be in accordance with the laws, rules and regulations of the Stat of Washington. C Applicants Signature Date Print Applicants Name FOR STAFF USE ONLY Permit# Accepted By Amount Received Receipt# Date Received CITY OF ARLINGTON 238 N. OLYMPIC AVE-ARLINGTON, WA. 98223 4a PHONE; (360)403-3551 BUILDING PERMIT Address:229 N Olympic Ave Permit#: 1205 Parcel#:003 78 800 101800 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:AMBLER DEAN A&DAWN Name:Jenkins Restorations Name:Jenkins Restorations Address:C/O 2 BITS&MORE 229 N OLYMPIC Address:11807 North Creek Parkway S Ste 102B Address: 11807 N Creek Parkway S Ste 102B AVE City,State Zip:ARLINGTON,WA 98223 City,State Zip:Bothell,WA 98011 City,State Zip:Bothell,WA 98011 Phone: Phone:206-492-9202 Phone:206-492-9202 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: IiXP JOB DESCRIPTION PERMIT TYPE: Demolition CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: OCC GROUP: BUILDINGS: I OCC LOAD: PERMIT APPROVAL 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 DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBCI IO/IRC I l0. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form and c ed City Arlin o #3101. Signature Print Name Date Released By of 1 c CONDITIONS Alley way must not be blocked overnight during the demolition process. Proper safety barriers are to always be in place during demolition. The side sewer service must be capped prior to demolition. Contact Jay Lemke @ 360-403-3552 for the side sewer disconnection inspection. THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION PERMIT FEES Date Description Fee Amount 11/17/2016 Demolition Fee $100.00 11/17/2016 State Building Code Surcharge Fee $4.50 Total Due: S104.50 Total Payment: $104 50 Balance Due: SO.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: CITY OF ARLINGTON 238 N. OLYMPIC AVE-ARLINGTON, WA. 98223 ` PHONE; (360)403-3551 BUILDING PERMIT Address:229 N Olympic Ave Permit#:1205 Parcel#:00378800101800 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:AMBLER DEAN A&DAWN Name:Jenkins Restorations Name:Jenkins Restorations Address:C/O 2 BITS&MORE 229 N OLYMPIC Address:11807 North Creek Parkway S Ste 102B Address: 11807 N Creek Parkway S Ste 102B AVE City,State Zip:ARLINGTON,WA 98223 City,State Zip:Bothell,WA 98011 City,State Zip:Bothell,WA 98011 Phone: Phone:206-492-9202 Phone:206-492-9202 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION - PERMIT TYPE: Demolition CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: OCC GROUP: BUILDINGS: OCC LOAD: PERMIT APPROVAL 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 DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC110/IRC1I0. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form and coded City of Arlington#3101. Signature Print Name Date Released By I e CONDITIONS Alley way must not be blocked overnight during the demolition process. Proper safety barriers are to always be in place during demolition. The side sewer service must be capped prior to demolition. Contact Jay Lemke @ 360-403-3552 for the side sewer disconnection inspection. THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 11/17/2016 Demolition Fee $100.00 11/17/2016 State Building Code Surcharge Fee $4.50 Total Due: $104.50 Total Payment: $104 50 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: CITY OF ARLINGTON 238 N. OLYMPIC AVE-ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:229 N Olympic Ave Permit#: 1205 Parcel#:00378800101800 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:AMBLER DEAN A&DAWN Name:Jenkins Restorations Name:Jenkins Restorations Address:C/O 2 BITS&MORE 229 N OLYMPIC AVE Address:11907 North Creek Parkway S Ste 102B Address: 11807 N Creek Parkway S Ste 102B City,State Zip:ARLINGTON,WA 98223 City,State Zip:Bothell,WA 98011 City,Stale Zip:Bothell,WA 98011 Phone: Phone:206492-9202 Phone:206-492-9202 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,Stale,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Demolition CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: OCC GROUP: BUILDINGS: 1 OCC LOAD: PERMIT APPROVAL 1 AGREF TO COMPLY WITH CITY AND SPATE 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 PO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID, IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBCI l0/IRCI 10. SALES TAX NOTICE 'des tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form and ed City Arlinsiob#3101. Signature Print Name Date Released By 1 c CONDITIONS Alley way must not be blocked overnight during the demolition process. Proper safety barriers are to always be in place during demolition. The side sewer service must be capped prior to demolition. Contact Jay Lemke @ 360-403-3552 for the side sewer disconnection inspection. THIS PERMIT AUTHORIZE ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION PERMIT FEES Date Description Fee Amount 11/17/2016 Demolition Fee $100.00 11/17/2016 State Building Code Surcharge Fee $4.50 Total Due: $104.50 Total Payment: $104 50 Balance Due: S0.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the fallowing information: CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address:229 N Olympic Ave Permit#:1205 Parcel#:00378800101800 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:AMBLER DEAN A&DAWN Name:Jenkins Restorations Name:Jenkins Restorations Address:C/O 2 BITS&MORE 229 N OLYMPIC Address:11807 North Creek Parkway S Ste 102B Address: 11807 N Creek Parkway S Ste 102B AVE City,State Zip:ARLINGTON,WA 98223 City,State Zip:Bothell,WA 98011 City,State Zip:Bothell,WA 98011 Phone: Phone:206-492-9202 Phone:206-492-9202 MECHANICAL CONTRACTOR ' PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION - . PERMIT TYPE: Demolition CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: OCC GROUP: BUILDINGS: 1 OCC LOAD: PERMIT APPROVAL 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 DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC110/IRCI 10. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form and coded City of Arlington#3101. 0-1 1 ll Signature Print Name Date Released By I e CONDITIONS Alley way must not be blocked overnight during the demolition process. Proper safety barriers are to always be in place during demolition. The side sewer service must be capped prior to demolition. Contact Jay Lemke @ 360-403-3552 for the side sewer disconnection inspection. THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 11/17/2016 Demolition Fee $100.00 11/17/2016 State Building Code Surcharge Fee $4.50 Total Due: $104.50 Total Payment: $104.50 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Snohomish County Fire Marshal's Office 3000 Rockefeller Avenue MIS 604 Everett,WA 98201-4046 Office: 425-388-3557 - Fax: 425-388-3130 This information is being provided to your fire agency as a resource for entering this incident into your National Fire Incident Reporting System(NFIRS)database. Fire Department Case#: 2016-004430 NFIRS#31D01 October 24, 2016 SCFMO Case#: FM16-00195 NFIRS#31 FM Incident Date: Fire Investigator's Name: G. Bontrager, FM28A Phone#: 1425.388.3557 Fire Module Address:229 N Olympic Ave,Arlington,WA 98223 (2 Bits or More) Estimated Dollar Losses and Values Losses: Pre-Incident Value: Property: $ 425,000.00 Property: $ 425,000.00 Content: $ 30,000.00 Content: $ 40,000.00 #of Civilian Fire Casualties:#of Deaths:0 #of Injuries:0 #of Fire Service Casualties Was the State Fire Marshal Office Notified? Any Incident #of Deaths:0 #of Injuries: 0 Yes ❑ No❑ If no,please call (360)753-0523 to report Ignition Information Cause of Ignition Human Factors Area of Origin: Mezzanine, NE corner of the ® Intentional Contributing to Ignition ❑Asleep structure. ❑ Unintentional El Possibly impaired by alcohol/drugs Heat Source: Hand held flame. ❑ Failure of Equipment/Heat Source ❑ Unattended person Item First Ignited:Available combustibles. ❑Act of Nature ❑ Possibly mentally disabled Factors Contributing to Ignition: Fire El Physically disabled extended up and throughout the structure, ❑ Cause under investigation I El Multiple persons involved resulting in the structure being a total loss.. El Cause Undetermined after investigation ❑Age was a factor Estimated Age: Male❑ Female ❑ Equipment Involved in Ignition ® None Mobile Property Involved ® None Type: ❑ Not involved, but burned Brand: ❑ Involved in ignition, but did not burn Model: ❑ Involved in ignition and burned Serial#: Type of Mobile Property: Year: Make: Power Source: Model: Portability: ❑ Portable ❑ Stationary Year: License Plate Number: State: VIN: ModuleStructure Fire Main Floor Size Story of Fire Origin: 2nd floor ❑ Below Grade Total Square Footage: 3,920 square feet Fire Spread OR Length by Width: x El Confined to room of origin ® Confined to building of origin ❑ Confined to floor of origin ❑ Beyond building of origin Presence of Detectors Automatic Extinguishing System ® Not Present ❑ Present El Undetermined ® Not present El Present El Partial System Present ❑ Undetermined Detector Type Type of System ❑ Smoke❑ Heat❑ Smoke/Heat❑Water flow ❑Wet❑ Dry❑ Other❑ Dry Chemical ❑ Multiple types ❑ Other❑ Undetermined ❑ Foam❑ Halogen❑ Carbon Dioxide(CO2) Power Source: None ❑ Other Special Hazard Operation ❑ Undetermined ❑ Fire too small❑ Operated ❑ Failed to Operate #of Heads operated: ❑ Undetermined Explain Failure or Effectiveness: Explain effectiveness or failure reason: .zc 1% A C un O a W a 44 N � N 7 o, o+ r O O S Oe rp rp 41 N CL — > > N 01 V1 r1 C 3 3 v' vu', 0 0 00 m u, �o rn � � o x xOp !1 A W N N O O W W A 1 3 3 V to to m 4 u+ I r Permit Information Date 11/3/2016 Permit Number 1205 Project Name 2 Bits&More Applicant Name Jenkins Restorations Applicant Address 11807 North Creek Parkway S Ste 102E City,State,Zip Bothell,WA 98011 Contact Robert Barker Phone 206-492-9202 Email rbarker@jenkinsrestorations.com Permit Type Demolition Site Address 229 N Olympic Ave Valuation 0.00 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Number of Stories 1 Proposed Use Demo of fire damaged building Assigned To Kristin Foster Property Information Owner Information Parcel#:00378800101800 AMBLER DEAN A&DAWN AMBLER DEAN A&DAWN C/O 2 BITS&MORE 229 N OLYMPIC AVE 229 N OLYMPIC AVE ARLINGTON,WA 98223 Contractors Contractor Name Primary Phone Email Contractor License License# Contact Type Jenkins Robert Barker 206-492- irbarker@jenkinsrestorations.com CONTRACTOR (Labor& 1ENKIR"851 M9 (Restorations 9202 @1 Industries Review Date Type Description Target Date Completed Date Assigned To Status 11/15/2016 (Demolition '11/22/2016 (Kevin Olander In Review 11/15/2016 (Demolition No comments. LT '11/22/2016 11/15/2016 IPWAdmin Rev _Complete 11/15/2016 (Demolition '11/22/2016 PW Storm Rev In Review 11/15/2016 (Demolition '11/22/2016 PW-Sew-Rev In Review 11/15/2016 (Demolition '11/22/2016 PW-Sew-Rev In Review DEMOLITION PERMIT APPLICATION Department of Community& Economic Development City of Arlington•.18204 59th Ave NE•Arlington, WA 98223 • Phone(360)403-3551 THIS APPLICATION MUST BE ACCOMPANIED WITH A COPY OF THE ASBESTOS/DEMOLITION NOTIFICATION FROM PUGET SOUND CLEAN AIR AGENCY, TWO(2)COPIES OF AN ASBESTOS SURVEY REPORT AND ABATEMENT REPORT (if applicable)COMPLETED BY AN APPROVED AGENCY. Type of Permit:(checkk one) Q Residential Commercial ❑ Industrial Project Address, 2`2 ` n1 Yin R t Parcel ID#: 0071 (0 00I O A X) Lot#: �� Subdivision: Valuation: Building Area(Sq Ft) No of floors_ Number of Buildings: \ Owner: QPa.y1 �3 quJ r, Arnh1e.v— Phone Numbed Address: 2-Zq AJ 01 y yv�p i C 4 V( City: 1k6 State:�\Zip Co de: q 1 ZZ?J Contact Person: 1 n e c-� o rke r Phone Number. Z- .9 -z-0z Cell Phone: L i E-mail: r�po,,r�C.P.��/�to,�K-��S(�C,S�toYp�-�-�OVIS1� CoVVk Address: l I�G7 1✓t�eebt Pkwy S t SO�h2L I \/ City. State: l IJa Zip Code: Contractor:S �, IK—�n �}O�171r'�p(1 Phone Number: 2016 a Z ZOZ Address: U,07 N01-44A ��^e �a�O�b6y1�city Q_9O[+`QeAk State: �A Zip Code:�o 1� + Contractor's License N mber:Cl .3 FN�I lam" O 7 I t�� Expiration: Scope of Work: be,'MO�j4 i0Y\ I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above- described property will be in accordance with the laws, rules and regulations of the Stat of Washington. Applicants Signature Date Print Applicants Name R STAFF USE ONLY Received Perniit at NOV 0 S 2016 ay Amount Received Receipt# Date Received N Gov V NOVO Laboratory&Consulting, Inc. Bulk Asbestos 0 138 SW 154th Street Analysis Report Laboratory&Consulting Services, Inc. Burien,WA 98166 Page 1 Office: (206)244-1060 Fax: (206)244-1063 Created by CrystalW, 1:02PM 11-07-16 CUENTV CU€NT 1006.01 Sery ro Of Central Seattle David Weedston JOB ID yy JOB a® I N BATCH ID CLIENT PO SAMPLING DATE I SAMPLES TAKEN BY 116-1622 JENKINS RESTORATION 11-07-16 lClient DATE REC'D SAMPLES SUBOITTE1 SAMPLES ANALYZED SAMPLES NOT ANAL YZEC I SAMPLES NOT REVIEWED DATE REV'D IREVtEVWDBY 11-07-16 4 4 _ 11-07-16 1 Crystal Wright BATCH ANALYSIS SUMMARY None of the analyzed samples contained identifiable asbestos. #54MPLE IIC-1 1. _ _ CLIENT ID CLIENT DESCRIPTION 0 CA T prd 1 I I Store LAB DESCRIPTION ANALYZED BY ANALYSIS DATE ISTATUS Paper lCrystal Wright 11-07-16 jAnalyzed SAMPLE ANALYSIS SUMMARY No identifiable asbestos was detected in this sample. »LAYER 1 Black asphaltic fibrous papery material COMPOSITION CATEGORY - FIBER TYPE ,,,,,,,,._PERCENTAGE Non-Asbestos Fibrous Glass Fiber 45% Non-Fibrous lAsphalt Filler and Binder 55% SAMPLE_ 116-162.2/2 CLIENT IO CLIENT DESCRIPTION LOCATION 2 1 1 Store LAB DESCRIPTION ANALYZED BY ANALYSIS DATE STATUS Wb lCrystal Wri ht 11-07-16 lAnalyzed SAMPLE ANALYSIS SUMMARY No identifiable asbestos was detected in this sample. LAYERS Tan papery material with white powder COMPOSITION CATEGORY FIBER TYPE PERCENTAGE Non-Asbestos Fibrous Cellulose 46% Non-Fibrous Filler and Binder 55% w-KAMPLE 116-162 3 CLIENT ID CLIENT DESCRIPTION LOCATION 3 1 Store LAB DESCRIPTION ANALYZED BY ANALYSIS DA TE STATUS Plaster lCrystal Wright 11-07-16 jAnalyzed SAMPLE ANALYSIS SUMMARY No identifiable asbestos was detected in this sample. »LAYER 1 Paint on gray hard chunk [COMPOSITION CATEGORY TT FIBER TYPE PERCENTAGE Non-Fibrous (Filler and Binder�100%�Fibrous (Filler and Binder�100%% CONFIDENTIALITY NOTICE:This report is for the sole use of the intended recipent and may contain confidential or proprietary information Any unauthorized review,use,disclosure,or distribution is prohibited O NOVO Laboratory&Consulting, Inc. Bulk Asbestos NVO 138 SW 154th Street Analysis Report Laboratory&Consulting Services, Inc. Burien,WA 98166 Page 2 Office: (206)244-1060 Fax: (206)244-1063 Created by CrystalW, 1:02PM 11-07-16 »CLIENT CLIENT ID CLIENT CONTACT 1006.01 Sery ro Of Central Seattle David Weedston JOB ID JOB BATCH ID jCUENTPO SAMPLING DATE I SAMPLES TAKEN Bl 116-1622 1JENKINS RESTORATION 11-07-16 IClient DATE REC'D I SAMPLES SUBMITTE1 SAMPLES ANALYZED SAMPLES NOT ANALYZEL I SAMPLES NOT REVIEWED DATE REVD REVIEWED BY 11-07-16 4 4 11-07-16 Crystal Wright BATCH ANALYSIS SUMMARY None of the analyzed samples contained identifiable asbestos. o,SAMPLE 116-1622 4 CLIENT ID CLIENT DESCRIPTION LOCATION 4 1 Store LAB DESCRIPTION ANALYZED BY ANALYSIS DATE STATUS Insulation lCrystal Wright 11-07-16 Analyzed SAMPLE ANALYSIS SUMMARY No identifiable asbestos was detected in this sample. v LAYER 1 Yellow fibrous material COMPOSMON CATEGORY INISE>:z TYPE= �: �, PERCENTAGE ` Non-Asbestos FibrouslGlass Fiber I r 100% I [End of Batch] �� Crystal Wright,Laboratory Supervisor CONFIDENTIALITY NOTICE:This report is for the sale use of the intended recipent and may contain confidential or proprietary information- Any unauthorized review,use,disclosure,or distribution is prohibited. 11/3/2016 JENKINS RESTORATIONS Home Espanol Contact Search L&I A-Z Indcx Help Nly L-I Safety&Health Claims&Insurance Workplace Rights Trades&Licensing Washington State Deparhnent of Labor & Industries JENKINS RESTORATIONS Owner or tradesperson 22980 SHAW RD Principals STERLING,VA 20166 206-858-9101 BASTIS, DONALD BRIAN, PARTNER/MEMBER YOH,JEFFREY M, PARTNER/MEMBER JENKINS,WARREN P, PARTNER/MEMBER JENKINS, RUSSELL W III, PARTNER/MEMBER JENKINS,JEREMY III, PARTNER/MEMBER (End:07/25/2016) Doing business as JENKINS RESTORATIONS WA UBI No. Business type 603 466 776 Limited Liability Company Parent company Governing persons JENKINS SERVICES LLC D BRIAN BASTIS JEFF YOH; JEREMY JENKINS III; RUSSELL W JENKINS III; WARREN P JENKINS; License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. JENKIR*851M9 Effective—expiration 08/19/2015—08/19/2017 Bond Hartford Fire Ins Co $12,000.00 Bond account no. 42BSBHF7492 Received by L&I Effective date 06/01/2015 06/01/2015 Expiration date Until Canceled Insurance Arch Specialty Ins Co $1,000,000 00 Policy no. 12EMP0560100 Help us improve https://secure.I ni.wa.gov/verify/Detail.aspx?UBI=603466776&LIC=JENKIR*85l M 9&SAW= 1/2 11/3/2016 JENKINS RESTORATIONS Received by L&I Effective date 07/25/2016 07118/2016 Expiration date 07/18/2017 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. L&I Account ID Account is current 626,819-00 Doing business as JENKINS RESTORATIONS Estimated workers reported Quarter 3 of Year 2016"11 to 20 Workers" L&I account representative T4/ALISON WOODWARD(360)902-4629-Email:WOAL235@lni.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. hftps://secure.I ni.wa.gov/verify/Detai i.aspx?U BI=603466776&LIC=J EN KIR*85l M 9&SAW= 2/2 Date: 03/12/2026 Permit#: 1205 Permit Date: 11/03/2016 Review Date: 11/15/2016 Permit Type: DEMOLITION Review Type: DEMOLITION Target Date: 11/22/2016 Scheduled 00:00 Time: Completed 11/16/2016 Date: Description: Alley way must not be blocked overnight, proper safety safety barriers to be in place during demo, may require sidewalk closure and parking spaces barricaded during demo. Review Status: Assigned To: BUILDING Time In: 00:00 Time Out: 00:00 Hours: 0.0 Property Information Parcel#: 00378800101800 AMBLER DEAN A& DAWN AMBLER DEAN A&DAWN C/O 2 BITS &MORE 229 N OLYMPIC AVE 229 N OLYMPIC AVE ARLINGTON, WA 98223 Zoning: 539 Other Retail Trade NECLot: Block: Permit#: 1205 Permit Date: 11/03/16 Permit Type: DEMOLITION Project Name: 2 Bits & More Applicant Name: Jenkins Restorations Applicant Address: 11807 North Creek Parkway S Ste 102B Applicant, City, State, Zip: Bothell,WA 98011 Contact: Robert Barker Phone: 206-492-9202 Email: rbarker@jenkinsrestorations.com Scope of Work: Demo of fire damaged building Valuation: 0.00 Square Feet: 0 Number of Stories: 1 Construction Type: Occupancy Group: ID Code: Permit Issued: 11/18/2016 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Kristin Foster Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 00378800101800 229 N OLYMPIC AVE AMBLER DEAN A 539 Other Retail &DAWN Trade NEC Contractors Contractor Primary Contact Phone Address Contractor Type License License# 11807 N Creek CONSTRUCTION Jenkins Restorations Robert Barker 206-492-9202 Parkway S Ste CONTRACTOR Labor&Industries JENKIR*851M9 102B Plan Reviews Date Review Type Description Assigned To Review Status 11/15/2016 DEMOLITION Alley way must not be blocked overnight,proper safety BUILDING safety barriers to be in place during demo,may require sidewalk closure and parking spaces barricaded during demo. 11/15/2016 DEMOLITION No comments,LT PW-ADMIN-GIS 11/15/2016 DEMOLITION Catch basins should be protected to prevent debris from pW Storm Rev entering storm system. Side sewer service must be capped to protect the City's 11/15/2016 DEMOLITION sewer system from demo debris.Contact Jay Lemke 360- PW-SEW-REV 403-3552.FR 11/15/2016 DEMOLITION No comments for this review. pW-WAT-REV Gus Fees Fee Description Notes Amount Demolition $100.00 State Surcharge- 1st DU Residential- 1st Unit $4.50 Total $104.50 Attached Letters Date Letter Description 11/17/2016 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 11/04/2016 Sarah Waltz 62156204 cc $104.50 Outstanding Balance $0.00 Notes Date Note Created By: 12/15/2016 Re-emailed permit for signature.KF Kristin Foster 11/18/2016 Emailed for signature.KF Kristin Foster 11/14/2016 Received asbestos survey. Kristin Foster 11/03/2016 Waiting for asbestos survey. Kristin Foster Uploaded Files Date File Name 12/15/2016 2012494-1205 Issued Permit.pdf 12/15/2016 2012107-NFIRS.pdf 12/15/2016 2012106-Insurance.pdf 11/15/2016 1951336-AsbestosReport.pdf 11/04/2016 1932755-Jenkins Restorations Cert.of Insurance.pdf 11/03/2016 1931861-1205 Apnlication.pdf Date: 03/12/2026 Permit#: 1205 Permit Date: 11/03/2016 Review Date: 11/15/2016 Permit Type: DEMOLITION Review Type: DEMOLITION Target Date: 11/22/2016 Scheduled Time: 00:00 Completed Date: 11/21/2016 Description: Catch basins should be protected to prevent debris from entering storm system. Review Status: Assigned To: PW Storm Rev Time In: 00:00 Time Out: 00:00 Hours: 0.0 Property Information Parcel#: 00378800101800 AMBLER DEAN A& DAWN AMBLER DEAN A& DAWN C/O 2 BITS &MORE 229 N OLYMPIC AVE 229 N OLYMPIC AVE ARLINGTON, WA 98223 Zoning: 539 Other Retail Trade NECLot: Block: Date: 03/12/2026 Permit#: 1205 Permit Date: 11/03/2016 Review Date: 11/15/2016 Permit Type: DEMOLITION Review Type: DEMOLITION Target Date: 11/22/2016 Scheduled 00:00 Time: Completed 11/16/2016 Date: Description: Side sewer service must be capped to protect the City's sewer system from demo debris. Contact Jay Lemke 360-403-3552. FR Review Status: Assigned To: PW-SEW-REV Time In: 00:00 Time Out: 00:00 Hours: 0.0 Notes 01/03/2017 12/30/2016 Talked with Bob Barker(Jenkins Restorations) and let him know the side sewer will need to be cut and capped in the alley. Property Information Parcel#: 00378800101800 AMBLER DEAN A& DAWN AMBLER DEAN A& DAWN C/O 2 BITS &MORE 229 N OLYMPIC AVE 229 N OLYMPIC AVE ARLINGTON, WA 98223 Zoning: 539 Other Retail Trade NECLot: Block: