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Home My WebLink About140 S Olympic Ave_BLD2583_2026 CITY OF ARLINGTON 238 N. OLYMPIC AVE-ARLINGTON,WA.98223 PHONE; (360)403-3551 BUILDING PERMIT Address:140 S.Olympic Ave Permit#:2583 Parcel#:31051100100800 Valuation:25000.00 OWNER APPLICANT CONTRACTOR Name:ARLINGTON STATION CORP Name:Grandview North Name:GRANDVIEW NORTH LLC Address:140 S OLYMPIC ST Address:PO Box 159 Address:PO BOX 159 City,State Zip:ARLINGTON,WA 98223 City,State Zip:Arlington,WA 98223 City,State Zip:ARLINGTON,WA 98223 Phone: Phone-,360-435-7171 Phone:360-435-7171 LIC:GRANDNL013KP EXP:06/15/2020 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 W1TII 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 S'ritucrURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBCI I O/1RCI 10. 5AIX$T,4X NOTICE:Sales tax relating to construction and construction materials in the City of Arlington must be t'cporied on your sales tax return form .u,d eodedCity of Ariingto 3101. / ti 1 a a� t.' f7°cS 44 I Signature Print Name Date Itc:'7rd ay Date CONDITIONS Call for final inspection. THIS PERMIT AUTHORIZS ONLY THE WORKNOTED.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 i Date Description Fee Amount 6/32019 Demolition Fee $100.00 6/3/2019 Inspection Fee $50.00 6/3/2019 Processingffechnology Fee $25.00 Total Due: $175,00 Total Payment: $0.00 Balance Due: $175.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon i I GiTY OF ARLh4GTON 238 N. OLYMPIC AVE -ARLINGTON,WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:140 S.Olympic Ave Permit#:2583 Parcel#:31051100100800 Valuation:25000.00 OWNER APPLICANT CONTRACTOR Name:ARLINGTON STATION CORP Name:Grandview North Name:GRANDVIEW NORTH LLC Address: 140 S OLYMPIC ST Address:PO Box 159 Address:PO BOX 159 City,State Zip:ARLINGTON,WA 98223 City,State Zip:Arlington,WA 98223 City,State Zip:ARLINGTON,WA 98223 Phone: Phone:360-435-7171 Phone:360-435-7171 LIC:GRANDNLO13KP EXP:06/15/2020 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, IBC IO/IRCI10. 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. azu/Ix" 1,;W-e- 44 hq Signature Print Name Date Releac d By ! Date CONDITIONS Call for final 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 6/3/2019 Demolition Fee $100.00 6/3/2019 Inspection Fee $50.00 6/3/2019 Processing/Technology Fee $25.00 Total Due: $175.00 Total Payment: $0.00 Balance Due: $175.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon . _� r 1 Permit Information Date 5/31/2019 Permit Number 2583 Project Name 140 S Olympic Building Demolition Applicant Name Grandview North Applicant Address PO Box 159 City,State,Zip Arlington,WA 98223 Contact Debbie Whitis Phone 360-435-7171 Email debbie@grandviewinc.net Permit Type Demolition Site Address 140 S.Olympic Ave Valuation 25000.00 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Demolition Number of Stories 0 Proposed Use Demolition of existing building(gas station building) MIC/Opportunity Zone Assigned To Raelynn Jones Property Parcel Address Legal Owner Owner Phon453 Zoning 31051100100800 140 S OLYMPIC AVE ARLINGTON STATION CORP Gasoline Service Stations Contractors Contractor Name Primary Contact Phone Email Contractor Type License License# RANDVIEW NORTH LLC OCOTT WAMMACK 60-435-7171 v randviewinc.ne2 PPLICANT 11 abor&Industrii GRANDNLO13KP Review Date Type Description Target Date Completed Date Assigned To Status /31/2019 Demolition 3uilding n Review /31/2019 Demolition W Admin Rev n Review !31/2019 Demolition W-Sew-Rev n Review /31/2019 Demolition W-Wat-Rev n Review Fees Fee Description Notes Amount Demolition Feel322.10.00.001 100.00 Processin ITechnoloc Feel 341.43-00.02 $25.00 Totall $125.00 Uploaded Files Upload File Date File Uploaded B 5/31/201910:09:19AM 2583 Demolition Permit Application 8E1dXVkfjm4pm.pdf Jones, Raelynn }( 5/31/2019 10:09:19 AM 2583 Asbestos Information.pdf Jones, Raelynn �C 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 ASBESTOSIDEMOL177ON NOTIFICATION FROM PUGET SOUND CLEAN AIR AGENCY, TWO(2)COPIES OF AN ASBESTOS SURVEY REPORT AND ABATEMENT REPORT (if applicable)COMPLETED BYAN APPROVED AGENCY. Type of Permit:(check one) ❑ Residential ❑ Commercial ❑ Industrial Project Address: 140 S Olympic Ave Parcel ID#: Lot#: Subdivision: Valuation: 25,000.00 Building Area(Sq Ft) 1325 No. of floors: 1 Number of Buildings:1 Owner: Grandview North LLC Phone Number: (360)435-7171 PO BOX 159 Arlington WA 98223 Address: City: State: Zip Code: Contact Person Debbie Whitis Phone Number: (360)435-7171 Cell Phone: (425)359-5630 E-mail:debbie@grandvieWnc.net Address: PO BOX 159 City:Arlington State:W— Zip Code: 9822 Contractor:Grandview North , LLC Phone Number: (360)435-7171 Address: PO BOX 159 City:Arlington State: WA Zip Code: 98223 Contractor's License Number:GRANDNL013KP Expiration.07/02/2020 Scope of Work: Tear Down Existing Building 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. 05/28/2019 Applicants Signature Date Scott Wammack Print Applicants Name FOR STAFF USE ONLY MAY 2 9 2019 Permit# AccepteRT19y Amount Received Receipt# Date Received ICJ IL May 7, 2019 L A B S INDUSTRIAL H Y G I E N E Ms. Debbie Whitis S E R V I C E S Grandview North, LLC. Laboratory I Management Training PO Box 159 www.NVLLABS.com Arlington, WA 98223 Subject: Good Faith Asbestos Inspection @ 140 S Olympic Ave, Arlington, WA 98223 NVL PROJECT#2019-0449 Dear Ms. Whitis, NVL Labs is pleased to present this proposal for Good Faith Asbestos Inspection, prior to the impending demolition project at the subject site. NVL Labs is a leading Environmental Consulting Firm and EPA/AIHA Certified Laboratory in the Pacific Northwest for the last 23 years. Our team consists of experienced industrial hygienists, AHERA Building Inspectors, AHERA Project designer, WA/ DOC Lead Inspectors and Risk Assessors, who are well versed with our client's project needs and regulatory requirements of the region. We take pride in providing environmental solutions to our client's project demands, from start to successful completion. The cost estimate below is based on the following approach to the work and your project requirements. The survey will include identification of suspect asbestos containing building materials only, which will include destructive sampling of exposed/accessible suspect materials and no soft/limited demolition will be performed onsite. This inspection will serve as a pre-demolition/renovation compliance requirements as below Asbestos • Washington Administrative Code (WAC) 296-62-07721 (b), WAC 296-155-755(9), "Good Faith Inspection". • Puget Sound Clean Air Agency(PSCAA), Regulation III, Article 4 The property owner or owner's agent must have an AHERA-certified building inspector survey the property, using random sampling procedures contained in 40 CFR 763.86, for asbestos and communicate the results to you, and to anyone who may come in contact with the material. A copy of the survey has to be placed at the job site for the duration of the project. Received Phone: 206 5AZO100 I Fax. 206 634.1936 I Toll Free: 1.888.NVL.LABS (685.5227) MAY 2 9 2019 A708 Aurora Avenue North I Seattle, WA 98103-6516 it4w . SCOPE OF WORK L A B /S Inspection and Laboratory Analysis • Conduct Good Faith Asbestos Inspection of the property. • Collect samples of suspect asbestos containing materials, as per 40 CFR 763.86 • NVL Labs will not replace/repair surfaces/building components damaged during the inspection. • Samples analyzed in a NVLAP accredited laboratory as specified by EPA • Identify and quantify Asbestos Containing Material (ACM) for abatement bid specs • Provide final inspection report electronically (as pdf) to include documentation, pictures and discussion of the findings within 3-4 business days after the site inspection. • No hard copy will be mailed to the client. Additional hard copies if requested would be charged at$40.00/copy. COST ESTIMATE: AHERA Building Inspector(inspection/report writing) $775.00 (fixed) *Bulk sample analysis for asbestos PLM analysis 10-15 samples @ 9.50/sample Mileage 90 miles @ $0.54/mile Estimated Survey Cost $966.10 This estimate is based upon your project information and understanding of your project needs. Client will be billed for fixed inspection/report cost and actual number of samples analyzed by the laboratory. We plan to utilize one inspector to complete the site survey in one business day. All samples would be analyzed on a 48 hours turn-around-time. Access to the building will be arranged by the client and/or client will escort Environmental Technician to the building. Any additional accrued Technician time/mileage to complete the inspection on an agreed upon schedule, due to delays not attributed to NVL Laboratories actions will be invoiced to the client, at the rates below. AHERA Building Inspector @ $85.00/hour Mileage 90 miles @ $0.54/mile Cancellations within 48 hours of scheduled site work $150.00 (fixed) `Samples are collected per AHERA/PSCAA guidelines for asbestos surveys. For list of suspect building materials which needs to be sampled in a survey are listed here http://pscleanair.org/reg ulated/asbestos/66-149%2OAsbestos%2OSurvey%2OGuidance.pdf Initial NVL Project#2019-0449 Page 2 of 5 iN\VI M L A B S LIMITATIONS As hazardous materials investigations are intrinsically non-comprehensive, NVL Laboratories, Inc. cannot be held liable for materials which are hidden from sight, materials which cannot be found due to their obscure nature, or which otherwise cannot be discovered with reasonable diligence. These services were requested by Ms. Debbie Whitis of Grandview North, LLC, who understands and agrees to the limitations herein listed. Moreover, the client/property owner agrees to hold harmless, defend, and indemnify NVL Laboratories for any damages, liabilities, or other circumstances as set forth in the attached Terms and Conditions. Signature of this document confirms that persons/corporations acting on the behalf of property owners have informed said owners of the above scope of services and confirmed their permission to proceed. We appreciate the opportunity to offer our assistance. Please do not hesitate to contact us with any questions. Sincerely, NVL Laboratories, Inc. APPROVED SIGNATURE Syed Hasan Manager Field Services (Print Name and Title) (Company) Enc.:Terms&Conditions (Date) Initial NVL Project#2019-0449 Page 3 of 5 INV IL L A B TERMS & CONDITIONS 5 1. SERVICES TO BE PROVIDED AND STANDARD OF CARE NVL Laboratories, Inc., hereinafter referred to as NVL, agrees to provide the Client, for its sole benefit and exclusive use,consulting services set forth in NVL's proposal. Such services shall be performed in accordance with generally accepted environmental services, in the same or similar localities, related to the nature of the work accomplished, at the time the services are performed. The parties agree that the services performed under this Agreement are of a commercial nature and are not of great importance to the general public. 2. PAYMENT: Payment will be due at the time of inspection unless otherwise agreed. Interest will be added to accounts in arrears(thirty(30)days after date of invoice)at the rate of one and one half percent(1 1/2%)of the arrears of each month of delinquency not to exceed the maximum percentage rate allowed by law All expenses incurred by NVL for liens,or collecting any delinquent amount,shall be paid to NVL by the Client. If at any time, present or future, the state or local government assesses a sales or use tax upon NVL for any of the services performed by NVL and/or its subcontractors under this Agreement,then the Client agrees to directly pay such taxes, or should NVL elect to pay such taxes directly,then the Client agrees to reimburse NVL in full. 3. RIGHT OF ENTRY The Client has responsibility for obtaining a right of entry to the property.The right of entry shall allow NVL, its agents, subcontractors, and employees to enter the property from time to time, as necessary to perform all acts,studies,and research pursuant to the agreed services. 4. SITE SAFETY PROVISION NVL has responsibility for its own activities on the property including the safety of its employees;it does not assume control of nor responsibility for the property,the person in charge of the property nor the safety of persons not in NVL's employ. NVL will not supervise or be responsible in any manner for the site safety and health of other parties not in employ of NVL. 5. INSURANCE NVL maintains Worker's Compensation and Employer's Liability Insurance for its employees as required by state laws. NVL maintains comprehensive general liability insurance in the amount of$1,000,000 combined single limits for bodily injury and property damage. NVL also maintains Professional Liability Insurance in the amount of$1,000,000 for each occurrence with an annual aggregate of$1,000,000. NVL will not be responsible to the Client beyond the limits of its insurance. S. REPORTS,RECOMMENDATIONS,AND OWNERSHIP OF DOCUMENTS Reports, recommendations, and other materials, including electronically stored information resulting from NVL's efforts are intended solely for purposes of this Agreement; any reuse by the Client or other's for purposes outside of this Agreement or any failure to follow NVL's recommendations,without NVL's written permission,shall be at the user's sole risk. The Client will furnish such reports,data, studies, plans, specifications,documents, and other information deemed necessary by NVL for proper performance of its services NVL may rely upon the Client-provided documents in performing the services required under this Agreement; however, NVL assumes no responsibility or liability for their accuracy.The Client-provided documents will remain property of the Client. NVL will retain copies of the Client-provided documents solely for the use of NVL.All reports, field notes,calculations, estimates, and other documents which are prepared, as instruments of service,shall remain NVL's property 7. HAZARDOUS SUBSTANCES AND CONDITIONS The Client warrants that, if it knows or suspects that hazardous substances may exist on the property, it has so informed NVL.The Client also agrees that NVL has no responsibility as a handler, generator,operator,transporter, or for treating,storing and/or disposing of hazardous substances found or identified at the project property. 8. LIMITATION OF LIABILITY The Client agrees that to the fullest extent permitted by law, its maximum aggregate recovery for claims against NVL, its'owners,employees, subcontractors, and agents concerning NVL's professional services(which are not covered under the insurance specified in paragraph 5), including negligence, breach of this Agreement, breach of warranty or strict liability shall be the amount of the fee paid NVL for professional services or$50,000,whichever is greater In the event that the Client requests a higher limitation of liability, NVL will increase the limitation of liability for an increased fee that reflects consideration for the increased risk, and this paragraph shall be properly amended in accordance with Paragraph 18. Initial NVL Project#2019-0449 Page 4 of 5 9. INDEMNIFICATION To the fullest extent permitted by law and in excess of the Limitation of Liability in L A B S Paragraph 8, NVL agrees to indemnify,defend and hold the Client harmless from and against any and all claims, actions, liabilities,damages and expenses, including attorneys fees,arising out of the sole negligence of NVL, its employees,agents or subcontractors, in the performance of work and services provided in this Agreement.The Client agrees to defend, indemnify, and hold NVL, its agents,subcontractors,owners and employees harmless from and against any and all claims, actions, liabilities, damages and expenses, including attorneys'fees,arising out of the sole negligence of the Client. In the event of the concurrent negligence of NVL and the Client, NVL and the Client shall bear responsibility proportionate to the percentage of each party's negligence or that of its agents, employees, representatives and subcontractors. 10. UNFORESEEN OCCURRENCES If unforeseen conditions or occurrences are encountered which, in NVL's sole judgment, significantly affect or may affect the recommended scope of work, then NVL will promptly notify the Client.After such notification, NVL will complete the original scope of work, if appropriate, or agree with the Client to modify the Agreement, or terminate the agreement pursuant to Paragraph 11. 11. TERMINATION In the event that the Client requests termination of work prior to completion or NVL terminates work under Paragraph 10, NVL will be paid for all work performed up to notice to termination and for all expenses incurred,or committed to,that cannot be canceled.A termination charge may also be made to cover proposal presentation and administrative costs related to the work. 12. SAMPLING This paragraph applies when NVL is providing field testing and sampling services.All samples will be discarded 30 days after NVL completes its services unless different arrangements are agreed to in writing 13. SEVERABILITY AND SURVIVAL Any element of thus Agreement later held to violate a law shall be deemed void, and all remaining provisions shall continue in force. However,the Client and NVL will in good faith attempt to replace any invalid or unenforceable provision with one that is valid and enforceable, and which comes as close as possible to expressing the intent of the original provision.All terms and conditions of this Agreement allocating liability between the Client and NVL shall survive the completion of the services hereunder and the termination of this Agreement. 14. INTERPRETATIONS AND TIME BAR TO LEGAL ACTION The laws of the State of Washington, shall govern all interpretations, and enforcement of this Agreement.All legal actions by either party against the other related to this Agreement shall be barred after four years have passed from the date by which NVL completes its services. 15. PRECEDENCE These terms and conditions shall take precedence over any inconsistent or contradictory provisions contained in any proposal,contract, purchase order, requisition, notice to proceed or like document regarding NVL's services. 16. VENUE This contract shall be governed by the laws of the State of Washington. Jurisdiction over and venue of any suit between the parties arising out of or related to this contract shall be exclusively in the state and federal courts in King County,Washington. 17. ATTORNEY'S FEES AND COSTS In the event of any dispute or controversy including,without limitation, suit or arbitration arising out of or related to this contract,the prevailing party, shall be entitled to collect the cost and expenses of the suit, including reasonable attorney's fees,from other party, including those incurred on appeal. 18. ENTIRE AGREEMENT This contract constitutes the entire agreement between the parties with respect to this matter and may be modified only in writing signed by the parties. 19. ENFORCEABILITY If for any reason any portion of this contract shall be held to be invalid or unenforceable,the holding of invalidity or unenforceability of that portion shall not effect any other portion of this contract and the remaining portions of this contract shall remain in full force and effect 20. WAIVER The waiver by NVL of a breach of any provision of this contract by the Client shall not operate or be construed as a waiver of any subsequent breach by the Client. No waiver shall be valid unless in writing and signed by NVL. By signing proposal,the Client acknowledges that it has received and read a copy of the terms and conditions and agrees to abide by these terms and conditions. Initial NVL Project#2019-0449 Page 5 of 5 I� �+ �I I II randy" NORTH L.L.C. .yy�. October 17, 2019 City of Arlington 18204 59th Ave NE Arlington WA 98223 360-403-3549 RE: 140 S. Olympic Avenue To whom it may concern: The abatement was completed by Grandview North, L.L.C. prior/during the demolition of the store at Emory Lofts II. E & D Excavation performed the demolition and removal of materials in June 2019. Sincerely, Scott Wammack Managing Member Grandview North, L.L.C. I P.O. Box 159, Arlington, WA 98223 360-435-7171 - Fax 360-435-2265 - 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: 140 5 OlVMDic Ave Parcel ID#: Lot#: Subdivision: Valuation: 25,000.00 Building Area(Sq Ft) 1325 No. of floors: 1 Number of Buildings:1 Owner: Grandview North LLC Phone Number: (360)435-7171 PO BOX 159 Arlington WA 98223 Address: C ty: State: Z p Code: Contact Person:Debbie Whitis Phone Number: (360)435-7171 Cell Phone: (425)359-5630 L ma is debbie@grandviewinc.net Address: PO BOX 159 C ty:Arlington State:�LllA Z p Code: 98223 Contractor: Grandview North , LLC Phone Number: (360)435-7171 Address: PO BOX 159 C ty: Arlington State: WA Zip Code: 98223 Contractor's License Number:GRAN DN L013KP Expiration:07/02/2020 Scope of Work: Tear Down 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. L15 a366„ae,ezoasas�zo,=3as 05/28/2019 Applicants Signature Date Scott Wammack Print Applicants Name FOR STAFF USE ONLY Permit# Accepted By Amount Received Receipt# Date Received I I I N\VI L , May 7, 2019 L A B S INDUSTRIAL H Y G I E N E Ms. Debbie Whitis S E R V I C E S Grandview North, LLC. Laboratory I Management I Training PO BOX 159 www.NVLLABS.com Arlington, WA 98223 Subject: Good Faith Asbestos Inspection @ 140 S Olympic Ave, Arlington, WA 98223 NVL PROJECT# 2019-0449 Dear Ms. Whitis, NVL Labs is pleased to present this proposal for Good Faith Asbestos Inspection, prior to the impending demolition project at the subject site. NVL Labs is a leading Environmental Consulting Firm and EPA/AIHA Certified Laboratory in the Pacific Northwest for the last 23 years. Our team consists of experienced industrial hygienists, AHERA Building Inspectors, AHERA Project designer, WA/ DOC Lead Inspectors and Risk Assessors, who are well versed with our client's project needs and regulatory requirements of the region. We take pride in providing environmental solutions to our client's project demands, from start to successful completion. The cost estimate below is based on the following approach to the work and your project requirements. The survey will include identification of suspect asbestos containing building materials only, which will include destructive sampling of exposed/accessible suspect materials and no soft/limited demolition will be performed onsite. This inspection will serve as a pre-demolition/renovation compliance requirements as below Asbestos • Washington Administrative Code (WAC) 296-62-07721 (b), WAC 296-155-755(9), "Good Faith Inspection". • Puget Sound Clean Air Agency (PSCAA), Regulation I II, Article 4 The property owner or owner's agent must have an AHERA-certified building inspector survey the property, using random sampling procedures contained in 40 CFR 763.86, for asbestos and communicate the results to you, and to anyone who may come in contact with the material. A copy of the survey has to be placed at the job site for the duration of the project. Phone: 206 547.0100 I Fax: 206 634.1936 I Toll Free: 1.888.NVL.LABS (685.5227) A708 Aurora Avenue North I Seattle, WA 98103-6516 IN\V. L A B S SCOPE OF WORK Inspection and Laboratory Analysis • Conduct Good Faith Asbestos Inspection of the property. • Collect samples of suspect asbestos containing materials, as per 40 CFR 763.86 • NVL Labs will not replace/repair surfaces/building components damaged during the inspection. • Samples analyzed in a NVLAP accredited laboratory as specified by EPA • Identify and quantify Asbestos Containing Material (ACM) for abatement bid specs • Provide final inspection report electronically (as pdf) to include documentation, pictures and discussion of the findings within 3-4 business days after the site inspection. • No hard copy will be mailed to the client. Additional hard copies if requested would be charged at $40.00/copy. COST ESTIMATE: AHERA Building Inspector (inspection/report writing) $775.00 (fixed) *Bulk sample analysis for asbestos PLM analysis 10-15 samples @ 9.50/sample Mileage 90 miles @ $0.54/mile Estimated Survey Cost $966.10 This estimate is based upon your project information and understanding of your project needs. Client will be billed for fixed inspection/report cost and actual number of samples analyzed by the laboratory. We plan to utilize one inspector to complete the site survey in one business day. All samples would be analyzed on a 48 hours turn-around-time. Access to the building will be arranged by the client and/or client will escort Environmental Technician to the building. Any additional accrued Technician time/mileage to complete the inspection on an agreed upon schedule, due to delays not attributed to NVL Laboratories actions will be invoiced to the client, at the rates below. AHERA Building Inspector @ $85.00/hour Mileage 90 miles @ $0.54/mile Cancellations within 48 hours of scheduled site work $150.00 (fixed) *Samples are collected per AHERA/PSCAA guidelines for asbestos surveys. For list of suspect building materials which needs to be sampled in a survey are listed here http://pscleanair.org/regulated/asbestos/66-149°/o2OAsbestos%2OSurvey%2OGuidance.pdf Initial NVL Project#2019-0449 Page 2 of 5 IN\V TM L A B S LIMITATIONS As hazardous materials investigations are intrinsically non-comprehensive, NVL Laboratories, Inc. cannot be held liable for materials which are hidden from sight, materials which cannot be found due to their obscure nature, or which otherwise cannot be discovered with reasonable diligence. These services were requested by Ms. Debbie Whitis of Grandview North, LLC, who understands and agrees to the limitations herein listed. Moreover, the client/property owner agrees to hold harmless, defend, and indemnify NVL Laboratories for any damages, liabilities, or other circumstances as set forth in the attached Terms and Conditions. Signature of this document confirms that persons/corporations acting on the behalf of property owners have informed said owners of the above scope of services and confirmed their permission to proceed. We appreciate the opportunity to offer our assistance. Please do not hesitate to contact us with any questions. Sincerely, NVL Laboratories, Inc. APPROVED SIGNATURE Syed Hasan Manager Field Services (Print Name and Title) (Company) Enc.: Terms&Conditions (Date) Initial NVL Project#2019-0449 Page 3 of 5 IN\V TM L A B S TERMS & CONDITIONS 1. SERVICES TO BE PROVIDED AND STANDARD OF CARE NVL Laboratories, Inc., hereinafter referred to as NVL,agrees to provide the Client,for its sole benefit and exclusive use, consulting services set forth in NVL's proposal. Such services shall be performed in accordance with generally accepted environmental services, in the same or similar localities, related to the nature of the work accomplished, at the time the services are performed. The parties agree that the services performed under this Agreement are of a commercial nature and are not of great importance to the general public. 2. PAYMENT: Payment will be due at the time of inspection unless otherwise agreed. Interest will be added to accounts in arrears(thirty(30)days after date of invoice)at the rate of one and one half percent(1 1/2%)of the arrears of each month of delinquency not to exceed the maximum percentage rate allowed by law.All expenses incurred by NVL for liens, or collecting any delinquent amount, shall be paid to NVL by the Client. If at any time, present or future, the state or local government assesses a sales or use tax upon NVL for any of the services performed by NVL and/or its subcontractors under this Agreement,then the Client agrees to directly pay such taxes, or should NVL elect to pay such taxes directly, then the Client agrees to reimburse NVL in full. 3. RIGHT OF ENTRY The Client has responsibility for obtaining a right of entry to the property. The right of entry shall allow NVL, its agents, subcontractors, and employees to enter the property from time to time, as necessary to perform all acts,studies, and research pursuant to the agreed services. 4. SITE SAFETY PROVISION NVL has responsibility for its own activities on the property including the safety of its employees; it does not assume control of nor responsibility for the property,the person in charge of the property nor the safety of persons not in NVL's employ. NVL will not supervise or be responsible in any manner for the site safety and health of other parties not in employ of NVL. 5. INSURANCE NVL maintains Worker's Compensation and Employer's Liability Insurance for its employees as required by state laws. NVL maintains comprehensive general liability insurance in the amount of$1,000,000 combined single limits for bodily injury and property damage. NVL also maintains Professional Liability Insurance in the amount of$1,000,000 for each occurrence with an annual aggregate of$1,000,000. NVL will not be responsible to the Client beyond the limits of its insurance. 6. REPORTS, RECOMMENDATIONS,AND OWNERSHIP OF DOCUMENTS Reports, recommendations, and other materials, including electronically stored information resulting from NVL's efforts are intended solely for purposes of this Agreement; any reuse by the Client or other's for purposes outside of this Agreement or any failure to follow NVL's recommendations, without NVL's written permission, shall be at the user's sole risk. The Client will furnish such reports,data,studies, plans, specifications, documents, and other information deemed necessary by NVL for proper performance of its services. NVL may rely upon the Client-provided documents in performing the services required under this Agreement; however, NVL assumes no responsibility or liability for their accuracy. The Client-provided documents will remain property of the Client. NVL will retain copies of the Client-provided documents solely for the use of NVL.All reports,field notes, calculations, estimates,and other documents which are prepared, as instruments of service, shall remain NVL's property. 7. HAZARDOUS SUBSTANCES AND CONDITIONS The Client warrants that, if it knows or suspects that hazardous substances may exist on the property, it has so informed NVL.The Client also agrees that NVL has no responsibility as a handler, generator,operator, transporter, or for treating, storing and/or disposing of hazardous substances found or identified at the project property. 8. LIMITATION OF LIABILITY The Client agrees that to the fullest extent permitted by law, its maximum aggregate recovery for claims against NVL, its'owners, employees,subcontractors, and agents concerning NVL's professional services(which are not covered under the insurance specified in paragraph 5), including negligence, breach of this Agreement, breach of warranty or strict liability shall be the amount of the fee paid NVL for professional services or$50,000,whichever is greater. In the event that the Client requests a higher limitation of liability, NVL will increase the limitation of liability for an increased fee that reflects consideration for the increased risk, and this paragraph shall be properly amended in accordance with Paragraph 18. Initial NVL Project#2019-0449 Page 4 of 5 IN\V TM L A B S 9. INDEMNIFICATION To the fullest extent permitted by law and in excess of the Limitation of Liability in Paragraph 8, NVL agrees to indemnify, defend and hold the Client harmless from and against any and all claims, actions, liabilities, damages and expenses, including attorneys fees, arising out of the sole negligence of NVL, its employees, agents or subcontractors, in the performance of work and services provided in this Agreement. The Client agrees to defend, indemnify, and hold NVL, its agents, subcontractors,owners and employees harmless from and against any and all claims, actions, liabilities, damages and expenses, including attorneys'fees, arising out of the sole negligence of the Client. In the event of the concurrent negligence of NVL and the Client, NVL and the Client shall bear responsibility proportionate to the percentage of each party's negligence or that of its agents, employees, representatives and subcontractors. 10. UNFORESEEN OCCURRENCES If unforeseen conditions or occurrences are encountered which, in NVL's sole judgment, significantly affect or may affect the recommended scope of work,then NVL will promptly notify the Client.After such notification, NVL will complete the original scope of work, if appropriate, or agree with the Client to modify the Agreement, or terminate the agreement pursuant to Paragraph 11. 11. TERMINATION In the event that the Client requests termination of work prior to completion or NVL terminates work under Paragraph 10, NVL will be paid for all work performed up to notice to termination and for all expenses incurred, or committed to,that cannot be canceled.A termination charge may also be made to cover proposal presentation and administrative costs related to the work. 12. SAMPLING This paragraph applies when NVL is providing field testing and sampling services.All samples will be discarded 30 days after NVL completes its services unless different arrangements are agreed to in writing. 13. SEVERABILITY AND SURVIVAL Any element of thus Agreement later held to violate a law shall be deemed void, and all remaining provisions shall continue in force. However,the Client and NVL will in good faith attempt to replace any invalid or unenforceable provision with one that is valid and enforceable,and which comes as close as possible to expressing the intent of the original provision. All terms and conditions of this Agreement allocating liability between the Client and NVL shall survive the completion of the services hereunder and the termination of this Agreement. 14. INTERPRETATIONS AND TIME BAR TO LEGAL ACTION The laws of the State of Washington, shall govern all interpretations, and enforcement of this Agreement.All legal actions by either party against the other related to this Agreement shall be barred after four years have passed from the date by which NVL completes its services. 15. PRECEDENCE These terms and conditions shall take precedence over any inconsistent or contradictory provisions contained in any proposal, contract, purchase order, requisition, notice to proceed or like document regarding NVL's services. 16. VENUE This contract shall be governed by the laws of the State of Washington. Jurisdiction over and venue of any suit between the parties arising out of or related to this contract shall be exclusively in the state and federal courts in King County,Washington. 17. ATTORNEY'S FEES AND COSTS In the event of any dispute or controversy including,without limitation, suit or arbitration arising out of or related to this contract,the prevailing party, shall be entitled to collect the cost and expenses of the suit, including reasonable attorney's fees,from other party, including those incurred on appeal. 18. ENTIRE AGREEMENT This contract constitutes the entire agreement between the parties with respect to this matter and may be modified only in writing signed by the parties. 19. ENFORCEABILITY If for any reason any portion of this contract shall be held to be invalid or unenforceable, the holding of invalidity or unenforceability of that portion shall not effect any other portion of this contract and the remaining portions of this contract shall remain in full force and effect. 20. WAIVER The waiver by NVL of a breach of any provision of this contract by the Client shall not operate or be construed as a waiver of any subsequent breach by the Client. No waiver shall be valid unless in writing and signed by NVL. By signing proposal,the Client acknowledges that it has received and read a copy of the terms and conditions and agrees to abide by these terms and conditions. Initial NVL Project#2019-0449 Page 5 of 5 NVL INDUSTRIAL HYGIEN' SERVICES LABORATORY + MANAGEMENT + TRAINING Good Faith Asbestos Inspection "Service Station" 140 S. Olympic Avenue Arlington, WA 98223 =fi i1 N-6 �A Prepared For Ms. Debbie Whitis Grandview North, LLC. P.O. Box 159 Arlington, WA 98223 Project Number: 2019-0449 Inspection Date: May 16, 2019 Report Date: May 21, 2019 Inspected By: Jason Lindahl AHERA Certification: # 173191 Certification Expiration Date: May 15, 2020 TABLE OF CONTENTS 1.0 SCOPE OF WORK 3 2.0 INSPECTION METHOD 4-5 3.0 LABORATORY INFORMATION 6 4.0 BUILDING DESCRIPTION 7 5.0 FINDINGS 8-9 6.0 CONCLUSIONS AND RECOMMENDATIONS 10-11 7.0 LIMITATIONS OF SURVEY 11 APPENDICIES A Sample Locations (Floor Plan) B Laboratory Analysis Results C AHERA Certification & Laboratory Qualifications "Service Station" 140 S,Olympic Avenue Arlington,WA 98223 Project Number:2019-0449 1.0 SCOPE OF WORK A Good Faith Asbestos Inspection was conducted at the former service station (store & pump station) located at 140 S Olympic Avenue, Arlington, WA 98223 on May 16, 2019. Jason Lindahl, an AHERA Certified Building Inspector, conducted this inspection at the request of Ms. Debbie Whitis of Grandview North, LLC. The purpose of this inspection was to identify all suspect asbestos-containing building materials which would be impacted by the planned demolition of the structures. Destructive sampling methods were utilized to collect samples of suspect building materials. No soft/limited demolition was performed during this inspection. Please note that hidden materials may exist within the structures, and all suspect materials must be treated as asbestos containing until testing proves otherwise. This inspection constitutes a survey of accessible suspect ACM in the project area and was conducted in accordance with: The National Emission Standards for Hazardous Air Pollutants (NESHAP) 40 Code of Federal Regulations (CFR) Part 61, Subpart M requires a survey by an accredited asbestos inspector prior to demolition of a structure. This asbestos survey also satisfies the requirements for"Good Faith" inspection outlined in Washington Administrative Code (WAC) 296-62-07721 (2) Communication of hazards, which requires the owner of a structure to provide contractors with a written report identifying the asbestos-containing materials expected to be disturbed during renovation or demolition. The asbestos survey section is written to comply with the AHERA asbestos sampling procedure as stated in 40 CFR 763,86. This protocol is required under the Puget Sound Clean Air Agency (PSCAA Regulation III, Article IV, rev. March 26, 2009)for all asbestos surveys prior to a building demolition. A floor plan indicating locations of samples collected by NVL personnel has been included in Appendix A. NVL Laboratories,Inc 4708 Aurora Ave N Seattle,WA 98199 Phone(206)547-0100•Fax(206)634-1936 3 "Service Station" 140 S.Olympic Avenue Arlington,WA 98223 Project Number:2019-0449 2.0 INSPECTION METHOD Asbestos Inspection Method The NVL Labs field inspector is an Asbestos Building Inspector, certified under the requirements of the United States Environmental Protection Agency (EPA) Asbestos Hazard Emergency Response Act (AHERA) regulation 40 CFR 763, Subpart.E. A copy of his certificate is provided in Appendix C. The AHERA Guidelines dictate the following: The inspector must determine homogenous areas, which are defined as an area of Thermal System Insulation, Surfacing Material, or Miscellaneous Material that is uniform in texture and color. Once homogenous areas have been determined, the inspector must determine whether or not material is friable or non-friable. Friable is defined as a material, that when dry, can be crushed, pulverized, or reduced to dust using hand pressure, and non-friable material is defined as a material, that when dry, cannot be crushed pulverized or reduced to dust using hand pressure. Materials normally defined as non-friable can become friable by definition if sufficiently damaged. Once friability has been determined, the materials suspected of containing asbestos are divided into one of three categories: Thermal System Insulation (TSI), Surfacing Material (SM), or Miscellaneous Material (MM). Generally speaking, TSI and SM are considered to be friable, with the exception of TSI where the structural integrity of the insulation is intact and the protective out wrap is undamaged. Once materials are divided into one of the categories, samples are collected in the following manner: Friable Thermal System Insulation: 1. Inspector shall collect three (3) randomly distributed samples; 2. Inspector shall collect a minimum of one sample of each TSI materials that appears to have been used as a patch, as long as the patch is less than six linear feet or six square feet; 3. Inspector shall collect in a manner sufficient, samples from areas of TSI applied to fittings, tees, and joints. Friable Surfacing Material: 1. Inspector shall collect samples in statistically random manner of surfacing materials as follows: a. Collect three bulk samples from an area believed to be homogeneous (defined as a material that appears to be the same or similar and was installed at the same time) that is 1,000 square feet or less in size; b. Collect five bulk samples from an area believed to be homogeneous that is greater than 1,000 square feet in size, but less than 5,000 square feet in size; c. Collect seven bulk samples from an area believed to be homogeneous that is greater than 5,000 square feet. NVL Laboratories, Inc. 4708 Aurora Ave N Seattle,WA 98199 Phone(206)547-0100•Fax(206)634-1936 4 "Service Station" 140 S.Olympic Avenue Arlington,WA 98223 Project Number:2019-0449 2.0 INSPECTION METHOD (continued) Miscellaneous Materials: 1. Inspector shall collect samples in a manner and number sufficient to determine if the material is asbestos-containing or not. All Materials Determined to Be Non-Friable: 1. Inspector shall collect samples in a manner and number sufficient to determine if the material is asbestos containing or not. In addition to these sampling requirements, the AHERA Building Inspector is required to assess the following of each material that is found to be positive for asbestos: 1. The condition of each material; 2. Accessibility; 3. Possibility for air erosion. Once the samples have been collected, they must be analyzed by an accredited laboratory, and they must be analyzed using polarized light microscopy methods, commonly referred to as EPA Method 600/R-93/116. NVL Labs collected samples and obtained analytical data for suspect asbestos-containing materials identified in the building. Once collected, each bulk sample was sealed in an unadulterated plastic bag to eliminate the possibility of cross-contamination. "Chain-of-Custody" tracking was followed to maintain sample integrity during handling and data reporting at NVL Labs. A walk-through inspection of all accessible areas of this structure was performed to identify potential asbestos-containing materials. The walk-through inspection included a review of the internal and external aspects of this structure. The locations and types of potential asbestos-containing materials were noted. Homogeneous Materials Homogeneous materials are defined as an area of asbestos-containing material or presumed asbestos- containing material which appears similar throughout in terms of color, texture, and date of material application. The report listing for homogenous materials will appear as follows: Sample I Number T Material Description by Layer j Location `i Asbestos sot Quantity I Friable Layer 1 is not asbestos-containing 1. � Location description "X"LFJftZ Yes/No Layer 2 is asbestos-containing 2. % NVL Laboratories, Inc. 4708 Aurora Ave N Seattle,WA 98199 Phone(206)547-0100•Fax(206)634-1936 5 "Service Station" 140 S.Olympic Avenue Arlington,WA 98223 Project Number.2019-0449 3.0 LABORATORY INFORMATION Laboratory Analysis: Asbestos In accordance with 40 CFR Chapter 1 (7-01-07 Edition) Part 763, Subpart E, Appendix E, asbestos samples are analyzed at NVL Labs using polarized light microscopy (PLM) with dispersion staining. If samples are not homogeneous, then sub-samples of the components are analyzed separately. All bulk samples are analyzed using EPA Method 600/R-93/116 with the following measurement uncertainties for reported % asbestos: 1%=0-3%, 5%21-9%, 10%=5-15%, 20%=10-30%, 50%=40-60%. Only materials containing more than 1% total asbestos were classified as "asbestos-containing" based on EPA, state, and local regulations. Findings for samples containing more than one separable layer of materials are reported for each layer. The asbestos concentration in the sample is determined by visual estimation. NVL Labs is accredited by the National Institute of Standards and Technology(NIST) under the National Volunteer Laboratory Accreditation Program (NVLAP) program for bulk asbestos fiber analysis; NVLAP Lab Code 102063-0 Laboratory Accreditation Professional accreditations for NVL Laboratories, Inc. include the following: NVL Laboratories, Inc. is currently accredited by the National Institute of Standards and Technology (NIST) under the National Volunteer Laboratory Accreditation Program (NVLAP) program for bulk asbestos fiber analysis. NVLAP Lab Code 102063-0 NVL Laboratories, Inc. is approved by the American Industrial Hygiene Association (AIHA) Asbestos Analysts Registry (AAR) program for airborne asbestos fiber analysis. AAR Counter 1D 7412 NVL Laboratories, Inc. is currently accredited by the American Industrial Hygiene Association (AIHA) under the Industrial Hygiene Laboratory Accreditation Program (IHLAP). The IHLAP program is designed specifically for laboratories involved in analyzing samples to evaluate workplace exposure. 1NLAP Certification Number 563 NVL Laboratories,Inc. 4708 Aurora Ave N Seattle,WA 98199 Phone(206)547-0100•Fax(206)534-1936 6 "Service Station" 140 S.Olympic Avenue Arlington,WA 98223 Project Number:2019-0449 4.0 BUILDING DESCRIPTION Parcel Number 0140673 Year of Construction Not Available Buildings Square Footage 2000 ft2 County Snohomish General Building Type The property consists of a commercial store of traditional wood framed construction, and a pump station of metal construction. Primary External Components The exterior of the store is brick, and wood siding. The pump station has no siding. Foundation Type The structures have on-grade concrete foundations. Roofing Material(s) The store has tri-tab asphaltic shingle, and built-up roofing. The pump station has metal roofing. Window Type(s) The store has aluminum framed windows with no associated caulking/glazing. The pump station has no windows. Flooring The store has vinyl tile, and ceramic tile flooring. The pump station has no flooring. Thermai Systems with The store is heated via forced air with no visible suspect Insulation insulation. The pump station is not heated. Finishing The store is finished with drywall, metal panels, compressed board, ceiling panels and wood panels. The pump station has no finishes. NVL Laboratories,Inc. 4708 Aurora Ave N Seattle,WA 98199 Phone(206)547-0100-Fax(206)634-1936 7 "Service Station" 140 S,Olympic Avenue Arlington,WA 98223 Project Number:2019-0449 5.0 FINDINGS Sample Dumber Material Description by Layer Location { Asbestos Quantity" Friable" 1:Joint compound with paint 1:ND 2019-0449-3-1 Store—room 5—wall joint 2:Drywall 2:ND 1 2019-0449-3-2 Drywall with paint Store—room 5—mid-wall ND 1:Green ceramic tile 1:ND 2019-0449-3-3 Store—room 1 —floor 2:Gray leveler 2: ND 1:Blue vinyl coating 1: ND I 2019-0449-3-4 2:White sheet vinyl Store—room 2—on shelf 2: ND 3:Beige backing with mastic 3: ND 1:Wood panel 1:ND 2019-0449-3-5 Store—room 3—on the wall 2:Tan mastic 2:ND 1 1:Compressed board 1:ND 2019-0449-3-6 Store—room 3—on the wall 2:Brown mastic 2:ND 1:Green laminate 1:ND 2:Yellow mastic 2: ND 2019-0449-3-7 Store—room 3—counter 3:Brown laminate 3:ND 4:Clear adhesive 4:ND 1:White vinyl the 1:ND 2019-0449-3-8 Store—room 4—floor 2:Yellow/black mastic 2:ND — F2G,ay ite sheet vinyl 1:ND 2019-0449-3-9 Store—room 4—on the cabinetbacking with mastic 2:ND 1:White vinyl tile 1:ND 2019-0449-3-10 2:Yellow mastic Store—room 5—floor 2:ND 3:White leveler 3:ND 1:Textured paint 1:ND 2019-0449-3-11 Store—room 5—false ceiling 2:Ceiling panel 2:ND 1:Beige vinyl cove base 1:ND 2019-0449-3-12 Store—room 5—wall base 2:White mastic 2:ND 1:White vinyl tile 1:ND 2019-0449-3-13 Store—room 5—floor 2:Yellow mastic 2:ND ND None Detected NVL Laboratories,Inc. 4708 Aurora Ave N Seattle,WA 98199 Phone(206)547-0100•Fax(206)634-1936 $ "Service Station" 140 S.Olympic Avenue Arlington,WA 96223 Project Number:2019-0449 5.0 FINDINGS (continued) Sample Number I Material Description by Layer Location ` Asbestos Quantity" Friable' 1:Black mastic on paper with foil 1: ND 2019-0449-3-14 Store—room 5—wall cavity 2:Pink fiberglass insulation 2: ND 1:Gray vinyl cove base 1:ND 2019-0449-3-15 Store—room 5—counter base 2:Yellow mastic 2: NO 1:White mesh with paper&foil 1:ND 2019-0449-3-16 Store—room 5—false ceiling 2:Yellow fiberglass insulation 2: ND 2019-0449-3-17 Brown mastic dots Store—room 5 ceiling ND 1:Mortar 1:NO 2019-0449-3-18 Store—exterior—siding 2:Brick 2: NO 1:Black asphaltic tri-tab shingle 1:NO 2019-0449-3-19 2:Black mastic Store—exterior—pitched roof 2:NO 3:Black felt 3:ND 1:Silver paint 1:4% 2019-0449-3-20 I 2:Built-up roofing Store—exterior—flat roof 2:ND 300 ftz Yes perimeter 3:Built-up roofing 3:ND 2019-0449-3-21 Gray sealant PStore—exterior—roof—on HID ND —� lights 1:Silver paint 1:NO 2019-0449-3-22 2:Built-up roofing Store—exterior—flat roof 2:ND 3:Built-up roofing 3:NO 1:Silver paint 1:4% i 2: Built-up roofing 2:ND i 2079-0449-3-23 Store—exterior—flat roof 700ft' Yes q 3:Built-up roofing 3:ND 4:Built-up roofing I 4:ND ND None Detected The friability of this material was determined at the time of this inspection, Subsequent activities such as demolition, renovation,or abatement may affect the friability of this material. ,y These quantities are only an estimate of the asbestos containing material discovered on site. Accuracy of these estimates must be verified by the asbestos abatement contractor on site. Any suspect material(s) not identified above should not be disturbed and should be tested immediately. All suspect materials must be treated as'asbestos-containing until testing proves otherwise. NVL Laboratories,Inc. 4708 Aurora Ave N Seattle,WA 98199 Phone(206)547-0100•Fax(206)634-1936 9 "Service Station" 140 S.Olympic Avenue Arlington,WA 98223 Project Number:2019-0449 6.0 CONCLUSIONS AND RECOMMENDATIONS The following is an inventory of asbestos-containing building materials identified during Good Faith Asbestos Inspection of the subject property: 1. Silver paint(Friable) There is approximately 1000 square feet of Sample numbers: 2019-0449-3-20&3-23 asbestos containing silver paint associated with built-up roofing located on the flat roof of the v store. The substrate is wood. C. N � 2. White sealant White sealant located on the corner joints of the Sample number.' Presumed pump station roof was not safely accessible, and should be treated as asbestos containing. - Contractors should be aware that concealed suspect asbestos-containing building materials may be uncovered during the course of demolition or renovation work. Contractors should have contingency plans that include stopping work, evacuation of the immediate area and sampling by a certified AHERA Building Inspector whenever these materials are found. Concealed suspect materials may include, but are not limited to: non-fiberglass pipe or roof drain insulation; spray-applied coatings; cement board; asphalt or paper vapor barriers; floorings and adhesives. If discovered, all asbestos-containing materials that will be disturbed as a natural part of renovation and/or demolition are required to be removed and disposed of in accordance with Washington State regulations. Washington State Department of Labor and Industries and PSCAA require that the abatement be performed using Certified Asbestos Workers under the direct on-site supervision by a Certified Asbestos Supervisor. NVL recommends that an AHERA inspector/project manager be on site at the time of renovation/demolition to ensure that any potentially asbestos-containing materials uncovered during the process of renovation/demolition be dealt with properly. NVL Laboratories,Inc. 4708 Aurora Ave N Seattle,WA 98199 Phone(206)547-0100•Fax(206)634-1936 10 "Service Station" 140 S.Olympic Avenue Arlington,WA 98223 Project Number:2019-0449 6.0 CONCLUSIONS AND RECOMMENDATIONS (continued) NVL Labs, Inc. is making the following recommendations regarding asbestos: 1. A copy of this inspection report should be maintained at the project site during the duration of renovation/demolition. 2. A copy of this inspection report should be provided to the General Contractor and any Sub Contractors working on the renovation/demolition project. 3. The inspection report is not intended to serve as a design /bidding document, or scope of work prior to renovation /demolition. 4. Abatement specifications should be prepared by a Hazardous Materials Consulting firm covering the regulated building materials that will be impacted by the renovations /demolition, and these specifications should be part of any contract documents prepared for this project. 5. A licensed asbestos abatement contractor must be utilized to remove any asbestos-containing materials that will be impacted by the planned renovation /demolition. 6. A Hazardous Materials Consulting Firm should provide project oversight and air monitoring during the removal of the asbestos-containing materials. 7.0 LIMITATIONS The sole purpose of this Good Faith Asbestos Inspection report is to document asbestos-containing building materials discovered at the commercial building located at 5505 Rainier Avenue S, Seattle, WA 98118. The purpose of this inspection was to identify all suspect asbestos-containing building materials which would be impacted by the planned demolition of the, structure. Destructive sampling methods were utilized to collect samples of suspect building materials. No soft/limited demolition was performed during this inspection. Please note that hidden materials may exist within the structure, and all suspect materials must be treated as asbestos containing until testing proves otherwise. This site visit consisted of a thorough visual walk-through of the building for the purpose of viewing and sampling potential asbestos-containing material. As hazardous material surveys are non- comprehensive by nature, NVL Laboratories, Inc. cannot be held liable for materials which require destructive means to access, materials which are hidden from sight (e.g. materials hidden behind walls), materials which cannot be found due to their obscure nature, or which otherwise cannot be discovered with reasonable diligence. This document is the sole property of NVL Laboratories and the property owner, or his agent, authorizing this survey. Inspected By Reviewed By 'r �y� r ✓ Jason Lindahl Syed Hasan AHERA Building Inspector Manager Field Services AHERA Certification: # 173191 AHERA Certification: # 168599 Expiration Date: May 15, 2020 Expiration Date: July 18, 2019 NVL Laboratories,Inc. 4708 Aurora Ave N Seattle,WA 98199 Phone(206)547-0100•Fax(206)634-1936 11 IN IL L A `B S Appendix A Sample Locations (Floor Plan) IN ! , NVL Project# 2019-0449 L A B S Client Grandview North, LLC.-Debbie Whitis Page of INDUSTRIAL H Y G I E N E Location 140 S Olympic Ave. Date 5/16/2019 SERVICES �+ Laboratory I Management I Training City Arlington Made by Jason Llndahl —, fy� I STO9C_ I ,r it {� •IZ 6 2- :1) l 1, 3 -i3 2- 3-6 J- Phony: 206 547.0100 f Fox: 206 634.1936 Toll Fro®: 1.888.NVL.LABS (685.5227) 4708 Aurora Avanue North f Seattle, WA 98103-6516 IN IL L A a B 5 Appendix B Laboratory Analysis Results May 20, 2019 INDUSTRIAL HYGIENE SERVICES LABORATORY.MANAGEMENT TRAINING Jason Lindahl NVL Field Services Division 4708 Aurora Ave. N. Seattle,WA 98103 RE: Bulk Asbestos Fiber Analysis; NVL Batch#1910105.00 Client Project:2019-0449 Location: 140 S Olympic Ave Arlington, WA 98223 Dear Mr. Lindahl, Enclosed please find test results for the 23 sample(s) submitted to our laboratory for analysis on 5/16/2019. Examination of these samples was conducted for the presence of identifiable asbestos fibers using polarized light microscopy (PLM) with dispersion staining in accordance with both EPA 600/M4-82-020, Interim Method for the Determination of Asbestos in Bulk Insulation Samples and EPA 600/R-93/116 Method for the Determination of Asbestos in Bulk Building Materials. For samples containing more than one separable layer of materials, the report will include findings for each layer (labeled Layer 1 and Layer 2, etc. for each individual layer). The asbestos concentration in the sample is determined by calibrated visual estimation. For those samples with asbestos concentrations between 1 and 10 percent based on visual estimation, the EPA recommends a procedure known as point counting (NESHAPS, 40 CFR Part 61). Point counting is a statistically more accurate means of quantification for samples with low concentrations of asbestos. The detection limit for the calibrated visual estimation is <1%, 400 point counts is 0.25% and 1000 point counts is 0.1% Samples are archived for two weeks following analysis. Samples that are not retrieved by the client are discarded after two weeks. Thank you for using our laboratory services. Please do not hesitate to call if there is anything further we can assist you with. Sincerely, Matt Macfarlane,Asbestos Lab Supervisor Enc.: Sample Results Lab Code:102063-0 Phone- 206 547.0100 1 Fox: 206 634,1936 Toll Free: 1.888.NVL.LABS (685.5227) 4708 Aurora Avenue North Seattle,WA 98103-6516 page 1 of 14 Bulk Asbestos Fibers Analysis NVL By Polarized Light Microscopy Client: NVL Field Services Division Batch#: 1910105.00 Address: 4708 Aurora Ave. N. Client Project#: 2019-0449 Seattle, WA 98103 Date Received: 5/16/2019 Samples Received:23 Attention: Mr.Jason Lindahl Samples Analyzed: 23 Project Location: 140 S Olympic Ave Arlington, WA 98223 Method: EPA1600IR-93/116 &EPA/600/M4-82-020 Lab ID: 19052373 Client Sample#: 2019-0449-3-1 Location: 140 S Olympic Ave Arlington, WA 98223 Layer 1 of 2 Description: White compacted powdery material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Calcareous binder, Calcareous particles. Paint Cellulose <1% None Detected ND Layer 2 of 2 Description: White chalky material with paper Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Gypsum/Binder, Fine grains, Fine particles Cellulose 23% None Detected ND Mica Glass fibers 6% Lab ID: 19052374 Client Sample#: 2019-0449-3-2 Location: 140 S Olympic Ave Arlington, WA 98223 Layer 1 of 1 Description: White chalky material with paper and paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Gypsum/Binder, Fine grains, Fine particles Cellulose 32% None Detected ND Paint Glass fibers 4% Lab ID: 19052375 Client Sample#: 2019-0449-3-3 Location: 140 S Olympic Ave Arlington, WA 98223 Layer 1 of 2 Description: Green patterned ceramic tile Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Ceramic/Binder, Fine particles None Detected ND None Detected ND Layer 2 of 2 Description: Gray brittle sandy material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Sand, Mineral grains Cellulose <1% None Detected ND Sampled by: Client Analyzed by: Hilary Crumley Date:05/20/2019 , Reviewed by: Matt Macfarlane Date:05/20/2019 Matt Macfarlane,Asbestos Lab Supervisor Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA 600/R-93/116 and 600/M4-82-020 Methods with the following measurement uncertainties for the reported %Asbestos(1%=0-3%,5%=1-9%, 10%=5-15%, 20%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government ASB-02 page 2 of 14 Bulk Asbestos Fibers Analysis NVL By Polarized Light Microscopy Client: NVL Field Services Division Batch #: 1910105.00 Address. 4708 Aurora Ave. N. Client Project#: 2019-0449 Seattle,WA 98103 Date Received: 5/16/2019 Samples Received:23 Attention: Mr.Jason Lindahl Samples Analyzed:23 Project Location: 140 S Olympic Ave Arlington, WA 98223 Method: EPA/600/R-93/116 & EPA/600IM4-82-020 Lab ID: 19062376 Client Sample#: 2019-0449-3-4 Location: 140 S Olympic Ave Arlington, WA 98223 Layer 1 of 3 Description: Blue and white flexible material with clear adhesive and debris Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler. Miscellaneous particles, Debris Cellulose <1% None Detected ND Layer 2 of 3 Description: Off-white sheet vinyl Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/Binder, Synthetic foam, Fine particles None Detected ND None Detected ND Layer 3 of 3 Description: Beige fibrous material with yellow brittle mastic and paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Fine particles, Mastic/Binder Cellulose 51% None Detected ND Paint Glass fibers 12% Lab ID: 19052377 Client Sample#: 2019-0449-3-5 Location: 140 S Olympic Ave Arlington, WA 98223 Layer 1 of 2 Description: Tan compressed fibrous material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Fine grains, Paint Cellulose 89% None Detected ND Layer 2 of 2 Description: Tan soft mastic with paper Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/Binder, Fine particles Cellulose 37% None Detected ND Lab ID: 19052378 Client Sample#: 2019-0449-3-6 Location: 140 S Olympic Ave Arlington, WA 98223 Layer 1 of 2 Description: Brown compressed fibrous material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Fine grains, Paint Cellulose 93% None Detected ND Sampled by: Client Analyzed by: Hilary Crumley Date:05/20/2019 ......... Reviewed by: Matt Macfarlane Date:05I20/2019 Matt Macfarlane,Asbestos Lab Supervisor Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA 600/R-93/116 and 600/M4-82-020 Methods with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%, 10%=5-15%, 20%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories, Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government ASB-02 page 3 of 14 Bulk NVL Asbestos Fibers Analysis By Polarized Light Microscopy Client: NVL Field Services Division Batch#: 1910105.00 Address: 4708 Aurora Ave. N. Client Project#:2019-0449 Seattle,WA 98103 Date Received: 5/16/2019 Samples Received: 23 Attention: Mr. Jason Lindahl Samples Analyzed:23 Project Location: 140 S Olympic Ave Arlington, WA 98223 Method: EPA/600/R-93/116 &EPA/600/M4-82-020 Layer 2 of 2 Description: Brown soft mastic with trace paper and paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/Binder, Fine particles, Paint Cellulose 19% None Detected ND Lab ID: 19062379 Client Sample#: 2019-0449-3-7 Location: 140 S Olympic Ave Arlington, WA 98223 Comments: Unsure of correct layer sequence. Layer 1 of 4 Description: Brown flat hard compressed fibrous material with blue surface Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Fine grains, Fine particles Cellulose 51% None Detected ND Layer 2 of 4 Description: Yellow soft mastic with debris Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/Binder, Fine grains, Fine particles Cellulose 2% None Detected ND Debris Layer 3 of 4 Description: Brown flat hard compressed fibrous material with tan surface and debris Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Fine grains, Fine particles Cellulose 51% None Detected ND Debris,Asphaltic particles Layer 4 of 4 Description: Trace clear adhesive with debris and trace paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Adhesive/Binder, Fine grains, Debris Cellulose <1% None Detected ND Paint Synthetic fibers <1% Lab ID: 19062380 Client Sample#: 2019-0449-3-8 Location: 140 S Olympic Ave Arlington, WA 98223 Comments: Unable to separate mastics for analysis Sampled by: Client Analyzed by: Hilary Crumley Date:05/20/2019 `{ Reviewed by: Matt Macfarlane Date:05/20/2019 Matt Macfarlane, .. .............rlane,Asbestos Lab Supervisor Note: If samples are not homogeneous,then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA 600/R-93/116 and 600/M4-62-020 Methods with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%, 10%=5-15%, 20%=10-30%,50%=40-60%).This report relates only to the items tested, If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector This report shall not be reproduced except in full, without written approval of NVL Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government ASB-02 page 4 of 14 Bulk Asbestos Fibers Analysis NVL By Polarized Light Microscopy Client. NVL Field Services Division Batch#: 1910105.00 Address: 4708 Aurora Ave. N. Client Project#: 2019-0449 Seattle, WA 98103 Date Received: 5/1 612 0 1 9 Samples Received: 23 Attention: Mr.Jason Lindahl Samples Analyzed: 23 Project Location: 140 S Olympic Ave Arlington, WA 98223 Method: EPA/600/R-93/116 &EPA/600/M4-82-020 Layer 1 of 2 Description: White vinyl tile with debris Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/Binder, Fine grains, Debris Cellulose <1% None Detected ND Layer 2 of 2 Description: Yellow and black asphaltic soft mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/Binder, Fine grains, Fine particles Cellulose 2% None Detected ND Lab ID: 19052381 Client Sample#: 2019-0449-3-9 Location: 140 S Olympic Ave Arlington, WA 98223 . Layer 1 of 2 Description: White and pale pink sheet vinyl Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/Binder, Synthetic foam, Fine particles None Detected ND None Detected ND Layer 2 of 2 Description: Off-white fibrous material with yellow brittle mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Fine grains, Fine particles Cellulose 47% None Detected ND Mastic/Binder Glass fibers 11% Lab ID: 19052382 Client Sample#: 2019-0449-3-10 Location: 140 S Olympic Ave Arlington,WA 98223 Layer 1 of 3 Description: White vinyl the Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/Binder, Fine grains, Fine particles Cellulose 2% None Detected ND Layer 2 of 3 Description: Yellow brittle mastic with thin white brittle material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Mastic/Binder, Mineral grains Cellulose 3% None Detected ND Fine grains, Fine particles Sampled by: Client Analyzed by: Hilary Crumley Date:05120/20.19 Reviewed by: Matt Macfarlane Date:05/20/2019 Matt Macfarlane,Asbestos Lab Supervisor Note: If samples are not homogeneous, then subsamples of the components were analyzed separately.All bulk samples are analyzed using both EPA 600/R-93/116 and 600/M4-82-020 Methods with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%, 10%=5-15%, 20%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government ASB-02 page 5 of 14 Bulk Asbestos Fibers Analysis NVL By Polarized Light Microscopy Client: NVL Field Services Division Batch#: 1910105.00 Address: 4708 Aurora Ave. N. Client Project#:2019-0449 Seattle, WA 98103 Date Received: 5/16/2019 Samples Received:23 Attention: Mr.Jason Lindahl Samples Analyzed: 23 Project Location: 140 S Olympic Ave Arlington, WA 98223 Method: EPA/600/R-93/116 &EPA/600/M4-82-020 Layer 3 of 3 Description: White crumbly material with debris Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Binder/Filler, Fine particles Cellulose 7% None Detected ND Organic debris Lab ID: 19052383 Client Sample#: 2019-0449-3-11 Location: 140 S Olympic Ave Arlington, WA 98223 Comments: Insufficient compacted powdery material for further analysis(Layer 1). Layer 1 of 2 Description: Trace white compacted powdery material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Calcareous binder, Calcareous particles, Paint Cellulose 3% None Detected ND Layer 2 of 2 Description: Beige compressed fibrous material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Glass debris, Glass beads Cellulose 46% None Detected ND Glass fibers 22% Lab ID: 19062384 Client Sample#: 2019-0449-3-12 Location: 140 S Olympic Ave Arlington, WA 98223 Layer 1 of 2 Description: White rubbery material with debris Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/Binder, Fine grains, Fine particles Cellulose <1% None Detected ND Debris Layer 2 of 2 Description: White soft mastic with debris and thin flexable material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/Binder, Miscellaneous particles, Binder/Filler Cellulose 3% None Detected ND Fine grains, Debris Synthetic fibers <1% Sampled by: Client Analyzed by: Hilary Crumley Date:05/20/2019 Reviewed by: Matt Macfarlane Date:05120/2019 Matt Macfarlane,Asbestos Lab Supervisor Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA 600/R-93/116 and 600/M4-82-020 Methods with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%, 10%=5-15%, 20%=10-30%,50%=40-60%),This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government ASB-02 page 6 of 14 Bulk Asbestos Fibers Analysis NVL By Polarized Light Microscopy Client: NVL Field Services Division Batch M 1910105.00 Address: 4708 Aurora Ave. N. Client Project#:2019-0449 Seattle, WA 98103 Date Received: 5/16/2019 Samples Received:23 Attention: Mr.Jason Lindahl Samples Analyzed: 23 Project Location: 140 S Olympic Ave Arlington,WA 98223 Method: EPA/600/R-93/116 &EPA/600/M4-82-020 Lab ID: 19052386 Client Sample#: 2019-0449-3-13 Location: 140 S Olympic Ave Arlington,WA 98223 Comments: Insufficient mastic for further analysis Layer 1 of 2 Description: White vinyl tile Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/Binder, Fine grains, Fine particles None Detected ND None Detected NO Layer 2 of 2 Description: Trace yellow soft mastic with debris Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/Binder, Miscellaneous particles, Debris Cellulose 2% None Detected NO Lab ID: 19052386 Client Sample#: 2019-0449-3-14 Location: 140 S Olympic Ave Arlington, WA 98223 Layer 1 of 2 Description: Black asphaltic mastic with paper and foil Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/Binder, Fine particles, Metal foil Cellulose 39% None Detected NO Layer 2 of 2 Description: Pink fluffy fibrous material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type:% Binder/Filler, Miscellaneous particles, Fine grains Glass fibers 93% None Detected NO Calcareous particles, Glass debris,Asphaltic particles Cellulose 2% Lab ID: 19052387, Client Sample#: 2019-0449-3-15 Location: 140 S Olympic Ave Arlington, WA 98223 Layer 1 of 2 Description: Gray rubbery material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/Binder, Fine grains None Detected ND None Detected NO Sampled by: Client Analyzed by: Hilary Crumley Date:05/20/2019 Reviewed by: Matt Macfarlane Date:05/20/2019 Matt Macfarlane,Asbestos Lab Supervisor Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA 600/R-93/116 and 600/M4-82-020 Methods with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%, 10%=5-15%, 20%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is. limited by the methodology and acuity of the sample collector, This report shall not be reproduced except in full, without written approval of NVL Laboratories,Inc„ It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government ASB-02 page 7 of 14 Bulk Asbestos Fibers Analysis By Polarized Light Microscopy Client: NVL Field Services Division Batch M 1910105.00 Address: 4708 Aurora Ave. N. Client Project#: 2019-0449 Seattle,WA 98103 Date Received: 5/16/2019 Samples Received: 23 Attention: Mr.Jason Lindahl Samples Analyzed: 23 Project Location: 140 S Olympic Ave Arlington,WA 98223 Method: EPA/600/R-93/116 & EPA/600/M4-82-020 Layer 2 of 2 Description: Soft yellow mastic with debris Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/Binder, Fine grains, Fine particles Cellulose 2% None Detected ND Debris Lab ID: 19052388 Client Sample#: 2019-0449-3-16 Location: 140 S Olympic Ave Arlington,WA 98223 Layer 1 of 2 Description: White woven fibrous material with foil and paper with clear adhesive Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler,Adhesive/Binder, Fine grains Cellulose 38% None Detected ND Fine particles, Metal foil Glass fibers 16% Layer 2 of 2 Description: Yellow fibrous material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Adhesive/Binder, Fine grains, Fine particles Glass fibers 96% None Detected ND Asphaltic particles , Miscellaneous particles Lab ID: 19052389 Client Sample#: 2019-0449-3-17 Location: 140 S Olympic Ave Arlington,WA 98223 Layer 1 of 1 Description: Brown soft mastic with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/Binder, Fine grains, Fine particles Cellulose 2% None Detected ND Paint Glass fibers <1% Lab ID: 19052390 Client Sample#: 2019-0449-3-18 Location: 140 S Olympic Ave Arlington, WA 98223 Sampled by: Client Analyzed by: Hilary Crumley Date:05/20/2019 Reviewed by: Matt Macfarlane Date:05/20/2019 Matt Macfarlane,Asbestos Lab Supervisor Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA 600/R-93/116 and 600/M4-82-020 Methods with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%, 10%=5-15%, 20%=10-30%,50%=40-60%) This report relates only to the items tested, If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector, This report shall not be reproduced except in full, without written approval of NVL Laboratories,Inc; It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government ASB-02 page 8 of 14 Bulk Asbestos fibers F' Analysis NVL By Polarized Light Microscopy Client: NVL Field Services Division Batch #: 1910105.00 Address: 4708 Aurora Ave. N. Client Project#: 2019-0449 Seattle, WA 98103 Date Received: 5/16/2019 Samples Received:23 Attention: Mr. Jason Lindahl Samples Analyzed:23 Project Location: 140 S Olympic Ave Arlington, WA 98223 Method: EPA/600/R-93/116 &EPA/600/M4-82-020 Layer 1 of 2 Description: Thin gray sandy material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Sand, Mineral grains None Detected ND None Detected ND Fine grains Layer 2 of 2 Description: Red brittle material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Fine grains, Mineral grains Cellulose <1% None Detected ND Fine particles, Paint Lab ID: 19052391 Client Sample#: 2019-0449-3-19 Location: 140 S Olympic Ave Arlington, WA 98223 Layer 1 of 3 Description: Black asphaltic material with gray granules Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/Binder, Fine grains, Fine particles Glass fibers 19% None Detected ND Granules Cellulose 2% Layer 2 of 3 Description: Black asphaltic mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/Binder, Fine grains, Fine particles Cellulose 2% None Detected ND Layer 3 of 3 Description: Black asphaltic fibrous material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/Binder, Fine grains, Fine particles Cellulose 54% None Detected ND Lab ID: 19052392 Client Sample#: 2019-0449-3-20 Location: 140 S Olympic Ave Arlington, WA 98223 Sampled by: Client - Analyzed by: Hilary Crumley Date:05/20/2019 Reviewed by: Matt Macfarlane Date:05/20/2019 Matt Macfarlane, Asbestos Lab Supervisor Note: If samples are not homogeneous, then subsamples of the components were analyzed separately,All bulk samples are analyzed using both EPA 600/R-93/116 and 600/M4-82-020 Methods with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%, 10%=5-15%, 20%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories,Inc, It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government ASB-02 page 9 of 14 Bulk Asbestos Fibers Analysis By Polarized Light Microscopy Client: NVL Field Services Division Batch #: 1910105.00 Address: 4708 Aurora Ave. N. Client Project M 2019-0449 Seattle,WA 98103 Date Received:5/16/2019 Samples Received:23 Attention: Mr.Jason Undahl Samples Analyzed: 23 Project Location: 140 S Olympic Ave Arlington, WA 98223 Method: EPA/600/R-93/116 & EPA/600/M4-82-020 Layer 1 of 3 Description: Silver paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Metallic paint, Fine particles Wollastonite 5% Chtysotile 4% Layer 2 of 3 Description: Black soft asphaltic material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/Binder, Fine grains, Fine particles Synthetic fibers 11% None Detected ND Layer 3 of 3 Description: Black asphaltic material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/Binder, Fine grains, Fine particles Glass fibers 21% None Detected ND Lab ID: 19052393 Client Sample#: 2019-0449-3-21 Location: 140 S Olympic Ave Arlington, WA 98223 Layer 1 of 1 Description. Silver rubbery material with debris Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Rubber/Binder, Fine particles, Debris Cellulose <1% None Detected ND Lab ID: 19052394 Client Sample#: 2019-0449-3-22 Location: 140 S Olympic Ave Arlington, WA 98223 Layer 1 of 3 Description: Silver paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Metallic paint, Fine particles Cellulose 6% None Detected ND Layer 2 of 3 Description: Black soft asphaltic material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/Binder, Fine grains, Fine particles Synthetic fibers 9% None Detected ND Cellulose 3% Sampled by: Client ( (� ��j Analyzed by: Hilary Crumley Date:05/20/2019 Lxll Reviewed by: Matt Macfarlane Date:06/20/2019 Matt Macfarlane,Asbestos Lab Supervisor Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA 600/R-93/116 and 600/M4-82-020 Methods with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%, 10%=5-15%, 20%=10-30%,50%=40-60%)_This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government ASB-02 page 10 of 14 Bulk NVL Bu Asbestos Fibers Analysis By Polarized Light Microscopy Client: NVL Field Services Division Batch#: 1910105.00 Address: 4708 Aurora Ave. N. Client Project* 2019-0449 Seattle, WA 98103 Date Received: 5/16/2019 Samples Received:23 Attention: Mr.Jason Undahl Samples Analyzed:23 Project Location: 140 S Olympic Ave Arlington, WA 98223 Method: EPA/600/R-93/116 &EPA/600/M4-82-020 Layer 3 of 3 Description. Black asphaltic material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/Binder, Fine grains, Fine particles Glass fibers 22% None Detected ND Lab ID: 19052395 Client Sample#: 2019-0449-3-23 Location: 140 S Olympic Ave Arlington, WA 98223 Layer 1 of 4 Description: Silver paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Metallic paint, Fine particles Wollastonite 4% Chrysotile 4% Cellulose 2% Layer 2 of 4 Description: Black soft asphaltic material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/Binder, Fine grains, Fine particles Synthetic fibers 14% None Detected ND Cellulose 2% Layer 3 of 4 Description: Black soft asphaltic material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/Binder, Fine grains, Fine particles Synthetic fibers 16% None Detected ND Cellulose 3% Glass fibers <1% Layer 4 of 4 Description: Black asphaltic material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/Binder, Fine grains, Fine particles Glass fibers 23% None Detected ND Sampled by: Client ",--_ Analyzed by: Hilary Crumley Date:05/20/2019 ' Reviewed by: Matt Macfarlane Date:05120/2019 Matt Macfarlane,Asbestos Lab Supervisor Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA 600/R-93/116 and 600/M4-82-020 Methods with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%, 10%=5-15%, 20%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government ASB-02 page 11 of 14 ASBESTOS LABORATORY SERVICES VL Company NVL-Field Services-Division NVI-BatchNumber 1910-10-5.,0-0- Address 4708 Aurora AveAN. AH_ -No aeattle,-WA-981 oa. Rush TAT Project Manager Mr,Jason Lindah1_____ Due Date 5L20001 9- _Tl(rLe___ A'.40PPA ___ Phone (206-) 547-01 00 Ernall ja,son,.1@rw1labs.c.crn_____ Cell (763)-2.86-3494- Fax (206)634-1936 Project Name/Number:2019-0449 Project Location: 14-0--S-Olympic-Ave Arlington,.WA 98223 Subcategory PLM Bulk. Item Code ASB:w02 -EPA 600/R-9-3::-11-6-Asb-e.sto.s-b-y-P-LM-!5bulk>-- Total Number of Samples 23 Rush Samples Lab ID Sample ID Description A/R 1 2019-0449-3-1 Composite A !I 2 119052374 2019-0449-3-2 A I 3 19052375 `2019-0449-3-3 A 4 1.119052376 2019-0449-3-4 A 5 119052377 12019-0449-3-5 A 6 19052378 12019-0449-3-6 A t 7 19052379 �2019-0449-3-7 A 8 19052380 12019-0449-3-8 I A 9 19052381 '2019-0449-3-9 A 10 i19052382 2019-0449-3-10 A 11 19052383 2019-0449-3-11 A 12 19052384 .2019-0449-3-12 A 13 119052385 12019-0449-3-13 A 14 19052386 12019-0449-3-14 A r 15 1_19052387 2019-0449-3-15 A 16 19052388 2019-0449-3-16 A 17 19052389 2019-0449-3-17 A-1 18 19052390 2019-0449-3-18 A Print Name -.Signature Company —.—Date -Time Sampled by EClient Relinquished by ;Client Office Use Only Print Name Signature Cornpariy Date Time .......... ....................................... ......... . ....... Received by Kelly AuVu 1NVL 15116/19 11640 ................ Analyzed by Hilary Crumley INVL 15/20/19 Results Called by ❑Faxed n Emailed Special instructions: Di(_-:5116/2019 Ti-re:4:55 PM Entered By:Kelly AuVu page 12 of 14 ASBESTOS LABORATORY SERVICES %10 w aw ri v L Company WL-Field-S-ervices.Division NVL Batch Number 19101W0Q------ Address 4708Aurora-Ave.-N.--- TAT \,YA 98 Rush TAT Project Manager I ;r Due Date 5/20/2019 Time 4:40 PM Phone (206) 547-0100 Email jason.I@nv1Iab-s-c-orn-------- -- Cell (763)2-8673494 Fax (206)634-1936 Project Name/Number:2019-0449 Project Location: 140 S-Olympic.Ave Arlington,--WA-98223 Subcategory PLM Bulk Item Code ASB-02 EPA 6.0-OIR-9.3-nA-1-6..Asbestos-by.PLM. bulk,,?-. Total Number of Samples -23 Rush Samples Lab ID Sample ID Description A/R .. .. ............... ....... 19 .19052391 2019-0449-3-19 i A 20 �19052392 2019-0449-3-20 A 21 119052393 2019-0449-3-21 A 22 19052394 12019-0449-3-22 A 23 !19052395 2019-0449-3-23 A Print Name Signature Company Date Time Sampled by !Client Relinquished by 'Client .............. .......... Office Use Only Print Name Signature Company Date Time Received by- ;' Kelly AuVu i NVL 5/16/19 1640 Analyzed by Hilary Crumley NVL 5/20/19 Results Called by F7 Faxed n Emailed Special nstructlons: Date:511612019 Time:4.55 PN. ErInred By:Ke7';y AuVu page 13 of 14 NVL Laboratories, Inc. CHAIN of CUSTODY 19 ,140105 4708 Aurora Ave N,Seattle,WA 98103 SAMPLE LOG p 206-547,0100 i f 206,634 1936 i www.nvllabs corn Client NVL Laboratories Inc NVL Batch Number Street 4708 Aurora Ave N Client Job Number 2019-0449 Seattle, WA 98103 Total Samples 25 Project Manager Sved Hasan Turn Around Time'-1 t Hr 16 His 3 Days I 10 Days 12 Hrs 'j t Day 4 Days Project Location 14Q S Olympic Ave.. ❑4 Hrs X 2 Days ❑5 Days Arlington, WA 98223 Please call for TAT less than 24 Hrs Email address debbieOgrandview_inc.net Phone: (425) 359-5630 Fax: I Asbestos Air l?CM(NiOSi-1 7400) i TEM(NIOSH'74D2) TEM(AHERA) L_ TEM(EPA Lever 1€) I `Other 'X Asbestos Butk V PLM(EPA/6{01R-93L116). ILI PLM(EPA Point Count) I I PLM(EPA Gravimeirv) r 1 TEM BULK i_.-I Mold/Fungus 11 I Mold Air Moist Bulk 'Rvtameter erallbratior: METALS Det..Limit Matrix RCRA Metals All 8 Other Metals L'Total Metals 1 J,FAA(ppm) rJ Air Filter I Solt Arsenic(As) I Chromium(Cr ;�All 3 1 ;TCLP _ ;ICp(ppm) I_-�Drinking water I paint Chips in°Jo tl riunl(Eif1) I Le7r!(Pb) I .!Copper(Cu) I Cr 8 l CaFAA(ppbt 1._I Dus"ipe(Area) Paint.Chips in crr C dinium(Cd) I. Mercury(Hg) I Nickel(Ni) 1 Zinc(rn) )Other Types '�Fiberglass U Nuisance Dust U Other(Specify) of Analysis 1.qilira 1 Rr?cnirahla nw-t Condition of Package: ❑Good D Damaged(no spillage) ❑Severe damage(spillage) Seq.# Lab 1D Client Sample Number,/Comments A/R 2 i 3r 4 5 6 '3 Z( 7 1-7 9 10b ; 11 �^ I 12 -I 1 a4 16 .Print Betowp Sian Bet w Company, Dat . Time . Sampled by ,- T>.... ry (_.1 . '� �( a f 1111 Ift1. / -M Relinquished by Received by Analyzed by Results Called by Results Faxed by Special Instructions: Unless requested in writing, all samples will be disposed of two(2)weeks after analysis. Results report to page 14 of 14 IN IL L A ,B 5 Appendix C AHERA Certifications ter, Laboratory Qualificatiol; o ro 0. o a c� N Lam' tii OD �r■�, . i I E w N t O m L Cuj p s 1 a OCD Q C CCL s C3 �c fi o 4C LL wo o Aq LW U V► � C � i O r .N � � rn ® 4— w E +r � uj ■...» 2 Q � m y i Q CD "Aolr of goy National Voluntary _ ;. � Laboratory Accreditation Program &-Nres SCOPE OF ACCREDITATION TO ISO/IEC 17025:2005 NVL Laboratories,Inc. 4708 Aurora Avenue N. Seattle,WA 98103 Mr.Nghiep Vi Ly Phone:206-547-0100 Fax: 206-634-1936 Email:nick.l@nvllabs.com http://www,nvllabs.com ASBESTOS FIBER ANALYSIS NVLAP LAB CODE 102063-0 Bulk Asbestos Analysis "ode &Lvcr// /rx4 I8/AO I EPA--40 CFR Appendix E to Subpart E of Part 763,Interim Method of the Determination of Asbestos in Bulk Insulation Samples I S/A03 EPA 600/R-93/116:Method for the Determination of Asbestos in Bulk Building Materials For the National Voluntary L7horalor)r Accreditation Program Effective 2018-10-01 through 2019-09-30 Page 1 of 1 � � 3 ' t w l7 ' � M C) ® Nw O N 1 ! e � i co 0 M 'i m CL o. 1 ++ N O CL � o w � _ �� z o IN V ��, O CD Z E z 3 'C 4.0 N = O ! i� 'c O ~ � (1) s ) cLO (I o i 00 � SO z r`r U I C LL. N ,aai, pr a r w CITY OF ARLINGTON 238 N. OLYMPIC AVE - ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address:140 S.Olympic Ave Permit#:2583 Parcel#:31051100100800 Valuation:25000.00 OWNER APPLICANT CONTRACTOR Name:ARLINGTON STATION CORP Name:Grandview North Name:GRANDVIEW NORTH LLC Address: 140 S OLYMPIC ST Address:PO Box 159 Address:PO BOX 159 City,State Zip:ARLINGTON,WA 98223 City,State Zip:Arlington,WA 98223 City,State Zip:ARLINGTON,WA 98223 Phone: Phone:360-435-7171 Phone:360-435-7171 LIC:GRANDNLO13KP EXP:06/15/2020 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/IRC110. 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 Releas d By J Date CONDITIONS Call for final 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 6/3/2019 Demolition Fee $100.00 6/3/2019 Inspection Fee $50.00 6/3/2019 Processing/Technology Fee $25.00 Total Due: $175.00 Total Payment: $0.00 Balance Due: $175.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon ~. CITY OF AR ! 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:140 S.Olympic Ave Permit#:2583 Parcel#:3 105 11 00100800 Valuation:25000.00 OWNER APPLICANT CONTRACTOR Name:ARLINGTON'STATION CORP Name:Grandview North Name:GRANDVIEW NORTH LLC Address:140 S OLYMPIC ST Address:PO Box 159 Address:PO BOX 159 City,State Zip:ARLINGTON,WA 98223 City,State Zip:Arlington,WA 98223 City,State Zip:ARLINGTON,WA 98223 Phone: Phone:360-435-7171 Phone:360-435-7171 LIC:GRANDNLO13KP EXP:06/15/2020 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. IBCI 10/IRCI 10. I R Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form NO d coded City of Arlingt 3101. io a% Signature Print Name Date Releaird By Date CONDITIONS Call for final 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_+ +ES i Date Description Fee Amount 6/3/2019 Demolition Fee $100.00 6/3/2019 Inspection Fee $50.00 6/312019 Process!ng/Technology Fee $25.00 Total Due: $175.00 Total Payment: $0.00 Balance Due: $175.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an Inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon Permit#: 2583 Permit Date: 05/31/19 Permit Type: DEMOLITION Project Name: Emory Lofts Applicant Name: Grandview North Applicant Address: PO Box 159 Applicant, City, State, Zip: Arlington,WA 98223 Contact: Debbie Whitis Phone: 360-435-7171 Email: debbie@grandviewinc.net Scope of Work: Demolition of existing building(gas station building) Valuation: 25000.00 Square Feet: 0 Number of Stories: 0 Construction Type: Occupancy Group: ID Code: Permit Issued: Permit Expires: Form Permit Type: Status: COMPLETE Assigned To: Raelynn Jones Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 31051100100800 140 S OLYMPIC AVE ARLINGTON 553 Gasoline Service STATION CORP Stations Contractors Contractor Primary Contact Phone Address Contractor Type License License# GRANDVIEW NORTH SCOTT 360-435-7171 PO BOX 159 CONSTRUCTION COA 601 858 917 LLC WAMMACK CONTRACTOR GRANDVIEW NORTH SCOTT 360-435-7171 PO BOX 159 CONSTRUCTION Labor& GRANDNLO13KP LLC WAMMACK CONTRACTOR Industries Plan Reviews Date Review Type Description Assigned To Review Status 05/31/2019 DEMOLITION BUILDING 05/31/2019 DEMOLITION No comments,LT PW-ADMIN-GIS 05/31/2019 DEMOLITION PW-SEW-REV 05/31/2019 DEMOLITION PW-WAT-REV Fees Fee Description Notes Amount Demolition $100.00 Processing/Technology $25.00 Inspection $50.00 Credit Card Service $5.25 Total $180.25 Attached Letters Date Letter Description 06/03/2019 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 06/11/2019 Grandview North 75717938 iTransact CC $175.00 06/11/2019 Grandview North,LLC CC Surcharge Transaction $5.25 #75717938 Outstanding Balance $0.00 Notes Date Note Created By: 10/18/2019 Emailed permit for signature. Kristin Foster Uploaded Files Date File Name 10/21/2019 5774622-583 Issued Permit.pdf 05/31/2019 5135264-2583 Asbestos Information.pdf 05/31/2019 5135265-2583 Demolition Permit Application 8E1dXVkfjm4pm.pdf