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Home My WebLink About21125 SMOKEY POINT BLVD_BLD2025_2026 CITY OF ARLINGTON 238 N. OLYMPIC AVE - ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address:21125 Smokey Point Blvd Permit#:2025 Parcel#:31050800300100 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:STILLAGUAMISH TRIBE OF INDIANS Name:Stillaguamish Tribe of Indians Name:Faber Construction,Corporation Address: PO BOX 277 Address:21 l25 Smokey Point Blvd Address: 131 E GROVER ST City,State Zip:ARLINGTON,WA 98223 City,State Zip:Arlington,WA 98223 City,State Zip:LYNDEN,WA 98264 Phone: Phone:360-722-4350 Phone:360-354-3500 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: 2 CONST.TYPE: DWELLING UNITS: 0 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/IRCl 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 6&Lfs ngton#3101. d Signature Print Name Date Released By DatJ CONDITIONS Water Meter will need to be removed prior to demolition. Contact COA Utilities to schedule 360-403-3526. Also the RPBA inside the building will need to have a remove report done and submitted to the Water dept, please contact Gus 360-403-3542. Per standard 5-3.20 cut, cap and protect the side sewer prior to demolition, call the sewer inspection line at 360-403-3508 to schedule an inspector to be on-site for any sewer work. 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 7/10/2018 Demolition Fee $100.00 7/10/2018 Processing/Technology Fee $25.00 7/10/2018 State Building Code Surcharge Fee $4.50 Total Due: $129.50 Total Payment: $129.50 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:21125 Smokey Point Blvd Permit#:2025 Parcel#:31050800300100 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:STILLAGUAMISH TRIBE OF INDIANS Name:Stillaguamish Tribe of Indians Name:Faber Construction,Corporation Address: PO BOX 277 Address:21 l25 Smokey Point Blvd Address: 131 E GROVER ST City,State Zip:ARLINGTON,WA 98223 City,State Zip:Arlington,WA 98223 City,State Zip:LYNDEN,WA 98264 Phone: Phone:360-722-4350 Phone:360-354-3500 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: 2 CONST.TYPE: DWELLING UNITS: 0 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/IRCl 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 coded City of Arlington#3101. Cl Signature Print Name Date Released By Datct CONDITIONS Water Meter will need to be removed prior to demolition. Contact COA Utilities to schedule 360-403-3526. Also the RPBA inside the building will need to have a remove report done and submitted to the Water dept, please contact Gus 360-403-3542. Per standard 5-3.20 cut, cap and protect the side sewer prior to demolition, call the sewer inspection line at 360-403-3508 to schedule an inspector to be on-site for any sewer work. 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 7/10/2018 Demolition Fee $100.00 7/10/2018 Processing/Technology Fee $25.00 7/10/2018 State Building Code Surcharge Fee $4.50 Total Due: $129.50 Total Payment: $129.50 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Ci TY OF ARLINGTON I 238 N. OLYMPIC AVE - ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address:21125 Smokey Point Blvd Permit#:2025 Parcel#:31050800300100 Valuation:0.00 OWNER APPLICANT CONTRACTOR _ Name:STILLAGUAMISH TRIBE OF INDIANS Name:Stillaguamish Tribe of Indians Name:Faber Construction,Corporation Address:PO BOX 277 Address:21 125 Smokey Point Blvd Address: 131 E GROVER ST City,State Zip:ARLINGTON,WA 98223 City,State Zip:Arlington,WA 98223 City,State Zip:LYNDEN,WA 98264 Phone: Phone:360-722-4350 Phone:360-354-3500 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: 2 CONST.TYPE: DWELLING UNITS: 0 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. IBC110/IRCl10. 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 Date( CONDITIONS Water Meter will need to be removed prior to demolition. Contact COA Utilities to schedule 360-403-3526. Also the RPBA inside the building will need to have a remove report done and submitted to the Water dept, please contact Gus 360-403-3542. Per standard 5-3.20 cut, cap and protect the side sewer prior to demolition, call the sewer inspection line at 360-403-3508 to schedule an inspector to be on-site for any sewer work. 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 7/10/2018 Demolition Fee $100.00 7/10/2018 Processing/Technology Fee $25.00 7/10/2018 State Building Code Surcharge Fee $4.50 Total Due: $129.50 Total Payment: $129.50 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number ')e of Inspection being requested,and whether you p morning or afternoon s Permit Information Date 6/29/2018 Permit Number 2025 Project Name Stillaguamish Tribe Clinic Applicant Name Stillaguamish Tribe of Indians Applicant Address 21125 Smokey Point Blvd City,State,Zip Arlington,WA 98223 Contact Josh Wells Phone 360-722-4350 Email (wells@stillaguamish.com Permit Type Demolition Site Address 21125 Smokey Point Blvd Valuation 0.00 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Number of Stories 2 Proposed Use demo existing clinic building Assigned To Launa Peterson Property Parcel Address Subdivision Lot Owner 31050800300100 121125 SMOKEY POINT BLVD STILLAGUAMISH TRIBE OF INDIANS Contractors Contractor Name Primary Contact Phone Email Contractor Type License License# Faber Construction Cor oration 1Ben Faber 360-354-3500 en faberconstruction.com Labor&Industries JFABERCC887138 Review Date T e Descri tion Tar et Date Completed Date Assigned To Status 13/29/2018 Demolition 7/6/2018 Building In Review 6/29/2018 -Demolition 7/6/2018 PW Ad min Rev In Review (3/29/2018 Demolition 7/6/2018 W-Sew-Rev In Review 6/29/2018 'Demolition 7/6/2018 PW-Wat-Rev In Review Fees Fee Description Notes Amount Demolition Fee 322.10.00.0 $100.0 Processincirrechnology Fe 341.43.00.0 $25.0 State Building Code Surchar a Fe 386.00.01.0 $4.50 Total '129.50 —UP loaded Files Upload File Date File Uploaded B 6/29/2018 Peterson, h 9:31:22 Smokey Poinl DEMO PrOject.docx P Patna AM 6/29/2018 9:31:22 Demolition Permit Application IJEMeeQd9LKSCZ.pdf Peterson, AM 6/29/2018 9:31:22 attachments C015031000017652928 BTKWDuILRAOL90nwif2u PAT2180525+STILLAGUAMISH+CUNIC+&+GARAGE+21123+SMOKEY+PT+BLVDp_tll Peterson, AM Launa 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: 21123 Smokev Point BLVD Parcel ID#: 31050800300100 Lot#: Subdivision: Valuation: .000 Building Area (Sq Ft) 12,000 No. of floors: 2 Number of Buildings:) Owner: Stillaguamish Tribe of Indians ____ Phone Number: 3607224350 21123 Smokey Point BLVD Arlington 98223 Address: City State: WA Zip Code: Contact Person)oshua Wells Phone Number: 3607224350 Cell Phone: 3607224350 E-mail:jwells@stillaguamish.com Address: 3322 236th St NE C; Arlington 9ton State: WA Zip Code: 98223 Contractor: Faber Construction Phone Number: 3603056206 Address: 1511, 131 E Grover St City: Lynden State: WA Zip Code: 98264 Contractor's License Number:FABERCC887138 Expiration:02/07/2020 Scope of Work: Demo of Existing building 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. 06/26/2018 Applicants Signature Date Joshua D. Wells Print Applicants Name Received FOR STAFF USE ONLY Permit# Accepted Amount Received Receipt# Date Received 0 .. i . i i q7 1 •�,' f � 1 / � I S Ln Lu 1 _ 1oi Received Tot _ � � a ► :: .. � �. A-T Asbesto-Test, Inc. -) 1429Ave D NI87,Snohomish,WA 98290 425-489-4040 o•u•o••ushr.uoiv i..ungig[rditkrdwsrotaocnm ASBESTOS SURVEY Clinic& Garaze Structures 0a 21123 Smokev Point Blvd-Arlinelon, WA 98223 Page 1 of 10 May 30,2018 PAT2180525 Stillaguamish Tribe POB 277 Arlington,WA 98223 360-722-4350 ; 425-359-5404 Attn.: Josh Wells jwells(&stillaguamish.com On May 21,2018,Asbesto-Test personnel conducted an Asbestos survey(per U.S.E.P.A./A.H.E.R.A.guidelines(as designated and specified by Puget Sound Clean Air Agency and Washington State)of the clinic&naraQe n 21123 Smokev Point Blvd.,Arlington, Snohomish County, Washington 98223. This survey purpose is to identify Asbestos Containing Materials that are present and will require professional removal prior to demolition. Note: Samples of suspect Asbestos Containing Materials were taken and analyzed for the presence of asbestos. THERE WAS NO ASBESTOS DETECTED IN ANY OF THE SAMPLES TAKEN.If there is any additional suspect ACM located prior to or during demolition(such as,but not limited to,those materials listed on the last page of this report),that was not discovered in this survey,the material(s)must be Presumed Asbestos Containing Material unless tested otherwise by laboratory analysis. NARRATIVE OF FINDINGS BASIC CONSTRUCTION: The wood frame clinic structure is two stories on a slab foundation.The siding is hardi-board materials with a stone and mortar accent.The hardi-board materials were sampled. The siding vapor barrier materials were sampled.The mortar holding the decorative exterior stone was sampled. The roofing is metal with Tyvek underneath. INTERIOR CONSTRUCTION, FINISHES, AN FLOORINGS: The interior construction is wood and drywall. The drywall and taping materials were sampled.The tile and vinyl flooring materials with the associated mastic and backing materials were sampled. The misc. mastic materials were also sampled. Received INSULATION: The insulation was sampled. JUN 2 7 2018 LTD 2�2� continue to page 2 1 ate. B Page 2 of 10 May 30,2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& Gurtr,e Structures(,21123 Sinoket' Point Blvtl.,Arlington, if A 98223 ELECTRICAL SYSTEM: The electrical wiring insulation is not of the kind to be ACM.Any suspect electrical wiring insulation or any suspect TSI(Thermal System Insulation)found in, around, or behind any located fuse or breaker boxes should be considered to be ACM(Asbestos Containing Material), unless determined otherwise by laboratory analysis. HEATING AND VENTILATION SYSTEM:There is a gas forced air furnace in the structure. There was no relating suspect ACM located. Note:It was not possible to dismantle the furnace and ducting to locate and/or evaluate any additional suspect ACM that may be concealed, inside the unit, or associated in hidden areas. It is our opinion any further handling of the furnace system should be coordinated by the project manager and/or abatement contractor. If any additional relating suspect materials are located prior to and/or during any demolition or renovation, any and all additional related suspect materials should be considered to be ACM (Asbestos Containing Material), unless determined to be otherwise by laboratory analysis. Any TSI that may be present inside or outside the furnace and/or ducting system including but not limited to all gaskets,joint compounds, sealants,and/or insulations,are PACM unless tested otherwise by laboratory analysis. MISC.: None. ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY: The garage is a wood framed structure with composition roofing. The composition roofing materials were sampled.The interior was finished with drywall. The drywall and taping materials were sampled. #of structures included in survey:one methadone clinic,one garage Requested by:Josh Wells 1930 W lli4�aae,Ste 315 5-M.wA9elty n This certifies that •• n Christopher L.Patterson has satisfaclodty completed 4 hours of refresher training as an AHERA Building Inspector to comply with the training requirements of , TSC.A Title II,40 CFR 763(AHERA) ,y EPA Provider#1085 h41GiiY Date May%2018 Eapree in1 year Can Phan:167264 Christopher Patterson VP Operations/Analyst-Asbesto-Test, Inc. Inspector, Certified A.H.E.R.A. Accred #167284 EXP.May 9,2019 continue to page 3 40 BBB A-T 1429Ave.D. r1/87,Snohomish, WA 98290 425-489-4040;f775-665-0420 iriru_r[sbrslnlesl,.cnul;bfy(�irblcslolesl C,_t1N� i Page 3 of 10 May 30,2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& Garage Structures A,21123 Smokey Point Blvd.,Arlington, WA 98223 ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL THERE WAS NO ASBESTOS DETECTED IN ANY OF THE SAMPLES LISTED CLINIC 1.0 mastic NAD adhesive,cellulose holding counter tops throughout-white 2.0 floor tile NAD non-fibrous materials throughout office and clinic areas-color:tan 3.0 mastic NAD adhesive beneath previous sample listed 4.0 mastic NAD adhesive,cellulose holding brown laminate on countertops throughout 5.0 white mastic NAD adhesive,cellulose holding base cove-homogenous throughout 6.0 insulation NAD fiberglass,cellulose color:cream foil around ducting-foil faced 7.0 mastic NAD adhesive,cellulose holding wainscot panels throughout 8.0 sheet vinyl flooring NAD non-fibrous materials clinic areas,restrooms,maintenance areas-gray pebble cellulose,fiberglass 9.0 mastic NAD adhesive beneath previous sample listed 10.0 mastic NAD adhesive holding carpet tile throughout 11.0 acoustic ceiling tile NAD cellulose,paint main floor-gray fiberglass 12.0 drywall/taping compound NAD non-fibrous materials office 1 cellulose,gypsum 13.0 drywall/taping compound NAD non-fibrous materials office 2 cellulose,gypsum 14.0 drywall/taping compound NAD non-fibrous materials office 3 cellulose,gypsum 15.0 drywall/taping compound NAD non-fibrous materials hall 1 cellulose,gypsum continue to page 4 BBB ENRON �r /429Ave.D.9187,Snohomish,WA 98290 425-489-4040;f775-665-0420 i I Page 4 of 10 May 30,2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clittic& Came Structures(a?21123 Smokev Point Blvd,Arli►reton, WA 98223 ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL CLINIC cont: 16.0 drywall/taping compound NAD non-fibrous materials hall 2 cellulose,gypsum 17.0 drywall/taping compound NAD non-fibrous materials hall 3 cellulose,gypsum 18.0 drywall/taping compound NAD non-fibrous materials stairwell sample cellulose,gypsum 19.0 insulation NAD fiberglass,cellulose above acoustic ceiling tile on main floor COMMON AREAS: 20.0 exterior siding NAD non-fibrous materials, newer vintage"hardy"board cellulose 21.0 siding mortar NAD non-fibrous materials, holding exterior stone sample 1 cellulose 21.1 siding mortar NAD non-fibrous materials, holding exterior stone sample 2 cellulose 21.2 siding mortar NAD non-fibrous materials, holding exterior stone sample 3 cellulose 22.0 vapor barrier NAD cellulose,tar beneath previous sample GARAGE 23.0 drywall/taping compound NAD non-fibrous materials sample 1 composite cellulose,gypsum 24.0 drywall/taping compound NAD non-fibrous materials sample 2 composite cellulose,gypsum 25.0 drywall/taping compound NAD non-fibrous materials sample 3 composite cellulose,gypsum 26.0 insulation NAD fiberglass,cellulose color:cream&beige-attic 27.0 composition roofing NAD cellulose,tar, non-fibrous materials 28.0 vapor barrier NAD cellulose,tar beneath previous sample 29.0 mastic NAD cellulose,adhesive holding composition roofing continue to page 5 40 BBB ® a_r 1429Ave.D.u187,Snohomish,WA 98290 425-489-4040;f775-665-0420 11_ll'1_ M.jf,Y(lL,y'//J/L'.1'Iy4Y7 /injo 7(lf�!(klll7/CSl.ffl�M :; I I I I Page 5 of 10 May 30,2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& GaraQe Structures 64 21123 Smokey Point Blvd,Arlinvon, WA 98223 I, vow s ' r 1 ;Y � S C continue to page 6 BBB CD /429Ave.D.9187,Snohomish, WA 98290 425-489-4040:f 775-665-0420 iru�ii�ol8�s19�afISYt{1�:in i�(�Qarb(uyolmi.rugr i I Page 6 of 10 May 30,2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& Gang,e Structures(a),21123 Smokej, Point Blv(L,.4rlin,,tun, JVA 98 223 y 1 . r l ,c. continue to page 7 8BB " i 1429Ave.D.u187,Snohomish, WA 98290 425-489-4040;f775-665-0420 ivru._mhesimeQcom;n0dWyb—(q,Y_we.4w Page 7 of 10 May 30,2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic do Garare Structures na,21123 Smokev Point Blvd.,Arlington. WA 98223 A i CJ 1 •, I ,i A continue to page S deft Zr P1t38 1429Ave.D. 4/87,Snohomish,WA 98290 425-489-4040;J'775-665-0420 ,ru,v.ns'Aax7f�Hcr-i.cog;f lsbles[�IC�.CfM! i i i I Page 8 of 10 May 30,2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic Gura-e Structures a,21123 Smokev Point Blvd.,Arlinuton, WA 98223 S V � { 1� f�h continue to page 9 BBB 'ierrt" 1429 Ave.D.9187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 Page 9 of 10 May 30,2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& Gara Structiires no 21123 Smoke Point Blvd. Arlin tun WA 98223 .rk i' continue to page 10 BBB CZ) 1429 Ave.A 9187,Snohomish, WA 98290 425-489-4040;f775-665-0420 u{�i�.�;rhq,�_IgfN�'t,cnm;in b (xpf(oie.r!_com Page 10 of 10 May 30,2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& Carare Structures(a)21123 Smokey Point R/rtl..Arlingf(III, Ui A 98223 Samples taken are listed with their corresponding analyses.If asbestos is detected,those samples containing asbestos are listed first and noted with the initials'ACM". Some sample analyses listed may be a representative analysis of individual and separate samplings and analysis of homogenous materials,as prescribed by A.H.E.R.A.guideline. If,during demolition or renovation,any additional suspect asbestos containing materials are located[may include but not limited to: sheet vinyl flooring,the flooring,wall or ceiling texturings or paints,concrete siding or skirting,cement pipes,cement wallboard, electrical cloth,electrical wiring insulation,thermal paper,wallboard,joint compounds,vinyl wall coverings,spackling compounds,or any other suspect TSI(Thermal System Insulation)],those materials are presumed Asbestos Containing Materials unless determined to be non-asbestos by laboratory analysis. Asbesto-Test,Inc.does not guarantee approximations of quantities of ACM,which may be listed with the analyses.It is therefore recommended professional abatement price and/or disposal quotes be obtained by inquiring as to fees per area of specific ACM material(i.e.square or linear ft etc.),or by on site assessment. Any and all materials identified as ACM and/or PACM in this report must be abated prior to disturbance in renovation or demolition. PLM(polarized light microscopy)has been known to miss asbestos in small percentages of some samples,which contain asbestos, thus negative PLM results cannot be guaranteed. Floor tiles and wipes should be tested with SEM(scanning electron microscope)or TEM(transmitting electron microscope),to insure analytical accuracy when asbestos is reported in small percentages Analytical test method.,USEPA 600/R93/116"(PLM);WAC 296-62-07753 App.J **One percent is the USEPA regulatory limit for asbestos in bulk samples. Key: "FRIABLE"signifies"Easily Airborne" ACM signifies Asbestos Containing Material" PACM signifies"Presumed Asbestos Containing Material" CAB signifies"Concrete Asbestos Board" c signifies"less than" TSI signifies'Thermal System insulation" HVAC signifies"Heating Ventilating Air-Conditioning" NAD signifies"No Asbestos Detected" END OF REPORT ArLynn Hammond, Pres., BSc. Analytical Chemist,AIHA proficient Inspector, certified A.H.E.R.A. accred.#1628675(Expires July 26,2018) �� BBB AvaR 1429 Ave.D.r 187,Snohomish,WA 98290 425-489-4040;f775-665-od20 11-11'6VAKh&Wote.1'1,e091;IIII!) QAhlel'II)IONLO H) :, I I A-T C sbesto-Test, Inc. 1429 Ave.D.#187,Snohomish, WA 98290 425-489-4040 www.asbestotest.com into Ldasbestotest.com ASBESTOS SURVEY Clinic& Garage Structures(a)21123 Smokev Point Blvd.,Arlington, WA 98223 Page I of 10 May 30,2018 PAT2180525 Stillaguamish Tribe POB 277 Arlington, WA 98223 360-722-4350 ; 425-359-5404 Attn.: Josh Wells jwells(&stillaguamish.com On May 21, 2018,Asbesto-Test personnel conducted an Asbestos survey(per U.S.E.P.A./A.H.E.R.A. guidelines (as designated and specified by Puget Sound Clean Air Agency and Washington State) of the clinic&garage (a,21123 Smokev Point Blvd.,Arlington, Snohomish County, Washington 98223. This survey purpose is to identify Asbestos Containing Materials that are present and will require professional removal prior to demolition. Note: Samples of suspect Asbestos Containing Materials were taken and analyzed for the presence of asbestos. THERE WAS NO ASBESTOS DETECTED IN ANY OF THE SAMPLES TAKEN.If there is any additional suspect ACM located prior to or during demolition(such as,but not limited to,those materials listed on the last page of this report),that was not discovered in this survey,the material(s)must be Presumed Asbestos Containing Material unless tested otherwise by laboratory analysis. NARRATIVE OF FINDINGS BASIC CONSTRUCTION: The wood frame clinic structure is two stories on a slab foundation. The siding is hardi-board materials with a stone and mortar accent. The hardi-board materials were sampled. The siding vapor barrier materials were sampled. The mortar holding the decorative exterior stone was sampled. The roofing is metal with Tyvek underneath. INTERIOR CONSTRUCTION, FINISHES, AN FLOORINGS: The interior construction is wood and drywall. The drywall and taping materials were sampled. The tile and vinyl flooring materials with the associated mastic and backing materials were sampled. The misc. mastic materials were also sampled. INSULATION: The insulation was sampled. continue to page 2 1 BBB c Page 2 of 10 May 30, 2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& Garage Structures A 21123 Smokey Point Blvd.,Arlin,-ton, WA 98223 ELECTRICAL SYSTEM: The electrical wiring insulation is not of the kind to be ACM. Any suspect electrical wiring insulation or any suspect TSI(Thermal System Insulation)found in, around, or behind any located fuse or breaker boxes should be considered to be ACM(Asbestos Containing Material), unless determined otherwise by laboratory analysis. HEATING AND VENTILATION SYSTEM: There is a gas forced air furnace in the structure. There was no relating suspect ACM located. Note:It was not possible to dismantle the furnace and ducting to locate and/or evaluate any additional suspect ACM that may be concealed, inside the unit, or associated in hidden areas. It is our opinion any further handling of the furnace system should be coordinated by the project manager and/or abatement contractor. If any additional relating suspect materials are located prior to and/or during any demolition or renovation, any and all additional related suspect materials should be considered to be ACM (Asbestos Containing Material), unless determined to be otherwise by laboratory analysis. Any TSI that may be present inside or outside the furnace and/or ducting system including but not limited to all gaskets,joint compounds, sealants,and/or insulations, are PACM unless tested otherwise by laboratory analysis. MISC.: None. ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY: The garage is a wood framed structure with composition roofing. The composition roofing materials were sampled. The interior was finished with drywall. The drywall and taping materials were sampled. #of structures included in survey: one methadone clinic, one garage Requested by:Josh Wells 1900 W.Nickerson,Ste 315 Seeme,WA 98119 (Dl (206)285-3373 T This certifies that �• -Nn Christopher L.Patterson has satisfactorily completed 4 hours of refresher training as an AHERA Building Inspector to comply with the training requirements of TSCA Title II,40 CFR 763(AHERA) EPA Provider#1085 Offie'May 9,2018 EV,res r 1 year. Cerl Num:167284 Christopher Patterson VP Operations/Analyst-Asbesto-Test,Inc. Inspector, Certified A.H.E.R.A. Accred. #167284 EXP. May 9, 2019 continue to page 3 1AWOL BBB CD 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info(dasbtestotest.com Page 3 of 10 May 30, 2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& Garaze Structures A 21123 Smokey Point Blvd.,Arlington, WA 98223 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL THERE WAS NO ASBESTOS DETECTED IN ANY OF THE SAMPLES LISTED CLINIC 1.0 mastic NAD adhesive,cellulose holding counter tops throughout-white 2.0 floor tile NAD non-fibrous materials throughout office and clinic areas-color:tan 3.0 mastic NAD adhesive beneath previous sample listed 4.0 mastic NAD adhesive,cellulose holding brown laminate on countertops throughout 5.0 white mastic NAD adhesive,cellulose holding base cove-homogenous throughout 6.0 insulation NAD fiberglass,cellulose color: cream foil around ducting-foil faced 7.0 mastic NAD adhesive,cellulose holding wainscot panels throughout 8.0 sheet vinyl flooring NAD non-fibrous materials clinic areas,restrooms,maintenance areas-gray pebble cellulose,fiberglass 9.0 mastic NAD adhesive beneath previous sample listed 10.0 mastic NAD adhesive holding carpet tile throughout 11.0 acoustic ceiling tile NAD cellulose,paint main floor-gray fiberglass 12.0 drywall/taping compound NAD non-fibrous materials office 1 cellulose,gypsum 13.0 drywall/taping compound NAD non-fibrous materials office 2 cellulose,gypsum 14.0 drywall/taping compound NAD non-fibrous materials office 3 cellulose,gypsum 15.0 drywall/taping compound NAD non-fibrous materials hall 1 cellulose,gypsum continue to page 4 1 a9aa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info(dasbtestotest.com Page 4 of 10 May 30, 2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& Garage Structures A 21123 Smokey Point Blvd.,Arlington, WA 98223 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL CLINIC cont: 16.0 drywall/taping compound NAD non-fibrous materials hall 2 cellulose,gypsum 17.0 drywall/taping compound NAD non-fibrous materials hall 3 cellulose,gypsum 18.0 drywall/taping compound NAD non-fibrous materials stairwell sample cellulose,gypsum 19.0 insulation NAD fiberglass,cellulose above acoustic ceiling tile on main floor COMMON AREAS: 20.0 exterior siding NAD non-fibrous materials, newer vintage"hardy"board cellulose 21.0 siding mortar NAD non-fibrous materials, holding exterior stone sample 1 cellulose 21.1 siding mortar NAD non-fibrous materials, holding exterior stone sample 2 cellulose 21.2 siding mortar NAD non-fibrous materials, holding exterior stone sample 3 cellulose 22.0 vapor barrier NAD cellulose,tar beneath previous sample GARAGE 23.0 drywall/taping compound NAD non-fibrous materials sample 1 composite cellulose,gypsum 24.0 drywall/taping compound NAD non-fibrous materials sample 2 composite cellulose,gypsum 25.0 drywall/taping compound NAD non-fibrous materials sample 3 composite cellulose,gypsum 26.0 insulation NAD fiberglass,cellulose color: cream&beige-attic 27.0 composition roofing NAD cellulose,tar, non-fibrous materials 28.0 vapor barrier NAD cellulose,tar beneath previous sample 29.0 mastic NAD ccllulose, adhesive holding composition roofing continue to page 5 1 a9aa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;infoAasbtestotest.com Page 5 of 10 May 30, 2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& Garage Structures A 21123 Smokey Point Blvd.,Arlin ton, WA 98223 xae continue to page 6 1 aaaa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info(dasbtestotest.com Page 6 of 10 May 30, 2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& Garaze Structures A 21123 Smokey Point Blvd.,Arlin ton, WA 98223 _ r • continue to page 7 1 a9aa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info(dasbtestotest.com Page 7 of 10 May 30, 2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& Garage Structures A 21123 Smokey Point Blvd.,Arlin ton, WA 98223 C-1 i 1 ti i I Q 1 ram" continue to page 8 1 aaaa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info(dasbtestotest.com Page 8 of 10 May 30, 2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& Garaze Structures A 21123 Smokey Point Blvd.,Arlin ton, WA 98223 iff `Y I r i III /l Y � I 1 1 continue to page 9 1 a9aa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info(dasbtestotest.com Page 9 of 10 May 30, 2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& Gara a Structures 21123 Smoke Point Blvd. Arlin ton WA 98223 21123 O continue to page 10 1 aaaa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info(dasbtestotest.com Page 10 of 10 May 30, 2018 PAT2180525 Asbesto-Test,Inc. 425-489-4040 Clinic& Garage Structures A 21123 Smokey Point Blvd.,Arlin,-ton, WA 98223 Samples taken are listed with their corresponding analyses.If asbestos is detected,those samples containing asbestos are listed first and noted with the initials'ACM". Some sample analyses listed may be a representative analysis of individual and separate samplings and analysis of homogenous materials,as prescribed by A.H.E.R.A.guideline. If,during demolition or renovation,any additional suspect asbestos containing materials are located[may include but not limited to: sheet vinyl flooring,the flooring,wall or ceiling texturings or paints,concrete siding or skirting,cement pipes,cement wallboard, electrical cloth,electrical wiring insulation,thermal paper,wallboard,joint compounds,vinyl wall coverings,spackling compounds,or any other suspect TSI(Thermal System Insulation)],those materials are presumed Asbestos Containing Materials unless determined to be non-asbestos by laboratory analysis. Asbesto-Test,Inc.does not guarantee approximations of quantities of ACM,which may be listed with the analyses.It is therefore recommended professional abatement price and/or disposal quotes be obtained by inquiring as to fees per area of specific ACM material(i.e.square or linear ft,etc.),or by on site assessment. Any and all materials identified as ACM and/or PACM in this report must be abated prior to disturbance in renovation or demolition. PLM(polarized light microscopy)has been known to miss asbestos in small percentages of some samples,which contain asbestos, thus negative PLM results cannot be guaranteed. Floor tiles and wipes should be tested with SEM(scanning electron microscope)or TEM(transmitting electron microscope),to insure analytical accuracy when asbestos is reported in small percentages Analytical test method:USEPA 600/R93/116**(PLM);WAC 296-62-07753 App.l **One percent is the USEPA regulatory limit for asbestos in bulk samples. Kev: "FRIABLE"signifies"Easily Airborne' ACM signifies"Asbestos Containing Material" PACM signifies"Presumed Asbestos Containing Material" CAB signifies"Concrete Asbestos Board" < signifies"less than" TSI signifies'Thermal System Insulation" HVAC signifies"Heating Ventilating Air-Conditioning" NAD signifies"No Asbestos Detected" END OF REPORT ArLynn Hammond, Pres., BSc. Analytical Chemist, AIHA proficient Inspector, certified A.H.E.R.A. accred.#1628675(Expires July 26, 2018) 1 a9aa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info(dasbtestotest.com - 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 BYANAPPROVED AGENCY. Type of Permit:(check one) ❑ Residential ❑✓ Commercial ❑ Industrial Project Address: 21123 Smokey Point BLVD Parcel ID#: 31050800300100 Lot#: Subdivision: Valuation: '000 Building Area(Sq Ft) 12,000 No. of floors: 2 Number of Buildings:1 Owner: Stillaguamish Tribe of Indians Phone Number: 3607224350 21123 Smokey Point BLVD Arlington WA 98223 Address: C ty: State: Z p Code: Contact Person)oshua Wells Phone Number: 3607224350 Cell Phone: 3607224350 E-mail:jwells@stillaguamish.com Address: 3322 236th St NE City:Arlington� State:�LllA Zip Code: 98223 Contractor: Faber Construction Phone Number: 3603056206 Address: 1511, 131 E Grover St City: Lynden State: WA Zip Code: 98264 Contractor's License Number:FABERCC887138 Expiration:02/07/2020 Scope of Work: Demo of Existing building 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. a366,ede,eza sas,ezo,=,3as 06/26/2018 Applicants Signature Date Joshua D. Wells Print Applicants Name FOR STAFF USE ONLY Permit# Accepted By Amount Received Receipt# Date Received Date: 03/23/2026 Permit#: 2025 Permit Date: 06/29/2018 Review Date: 06/29/2018 Permit Type: DEMOLITION Review Type: DEMOLITION Target Date: 07/06/2018 Scheduled 00:00 Time: Completed 06/29/2018 Date: Description: Water Meter will need to be removed prior to demolition. Contact COA Utilities to schedule.GS Also the RPBA inside the building will need to have a remove report done and submitted to the Water dept,please contact Gus 360-403-3542 Thamk you Review Status: Assigned To: PW-WAT-REV Time In: 00:00 Time Out: 00:00 Hours: 0.0 Property Information Parcel#: 31050800300100 STILLAGUAMISH TRIBE OF INDIANS STILLAGUAMISH TRIBE OF INDIANS PO BOX 277 21125 SMOKEY POINT BLVD ARLINGTON, WA 98223 Zoning: 699 Other Miscellaneous Services NECLot: Block: Permit#: 2025 Permit Date: 06/29/18 Permit Type: DEMOLITION Project Name: Stillaguamish Tribe Clinic Applicant Name: Stillaguamish Tribe of Indians Applicant Address: 21125 Smokey Point Blvd Applicant,City,State,Zip:Arlington,WA 98223 Contact: Josh Wells Phone: 360-722-4350 Email:jwells@stillaguamish.com Scope of Work: demo existing clinic building Valuation: 0.00 Square Feet: 0 Number of Stories: 2 Construction Type: Occupancy Group: ID Code: Permit Issued: 07/10/2018 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Launa Black Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 31050800300100 21125 SMOKEY POINT BLVD Not Trust Land STILLAGUAMISH 699 Other Miscellaneous TRIBE OF INDIANS Services NEC Contractors Contractor Primary Contact Phone Address Contractor Type License License# Faber Construction, Ben Faber 360-354-3500 6951 Hannegan Rd CONSTRUCTION UBI 601 268 821 Corporation CONTRACTOR Faber Construction, CONSTRUCTION Corporation Ben Faber 360-354-3500 6951 Hannegan Rd CONTRACTOR Labor&Industries FABERCC887138 Plan Reviews Date Review Type Description Assigned To Review Status 06/29/2018 DEMOLITION BUILDING 06/29/2018 DEMOLITION No comments,LT PW-ADMIN-GIS Per standard 5-3.20 cut,cap and protect the side sewer prior to 06/29/2018 DEMOLITION demolition,call the sewer inspection PW-SEW-REV line at 360-403-3508 to schedule an inspector to be on-site for any sewer work.JL 06/29/2018 DEMOLITION Water Meter will need to be removed prior to demolition. PW-WAT-REV Contact COA Utilities to schedule.GS Also the RPBA inside the building will need to have a remove report done and submitted to the Water dept,please contact Gus 360-403- 3542 Thamk you Fees Fee Description Notes Amount Demolition $100.00 Processing/Technology $25.00 State Surcharge-1 st DU Residential-1 st Unit $4.50 Total $129.50 Attached Letters Date Letter Description 07/10/2018 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 07/10/2018 Stillaguamish Tribe check#116148 Launa Black $129.50 Outstanding Balance $0.00 Notes Date Note Created By: 08/20/2019 Never Finaled Launa Black 07/10/2018 Emailed permit for signature. Kristin Foster Uploaded Files Date File Name 07/16/2018 3718176-2025 Issued Permit.pddf 06/29/2018 3666822- attachments CO15031000017652928 BTKWDgILRAOL9Onwlf2u PAT2180525+STILLAGUAMISH+CLINIC+&+GARAGE+21123+SMOKEY+PT+BLUD.pdf 06/29/2018 3666823-Demolition Permit Application 1JEMeeOd9LKSCZ.12 06/29/2018 3666824-Smokey Point DEMO Pro'ect.docx Date: 03/23/2026 Permit#: 2025 Permit Date: 06/29/2018 Review Date: 06/29/2018 Permit Type: DEMOLITION Review Type: DEMOLITION Target Date: 07/06/2018 Scheduled 00:00 Time: Completed 07/05/2018 Date: Description: Per standard 5-3.20 cut, cap and protect the side sewer prior to demolition, call the sewer inspection line at 360-403-3508 to schedule an inspector to be on-site for any sewer work. JL Review Status: Assigned To: PW-SEW-REV Time In: 00:00 Time Out: 00:00 Hours: 0.0 Property Information Parcel#: 31050800300100 STILLAGUAMISH TRIBE OF INDIANS STILLAGUAMISH TRIBE OF INDIANS PO BOX 277 21125 SMOKEY POINT BLVD ARLINGTON, WA 98223 Zoning: 699 Other Miscellaneous Services NECLot: Block: