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Home My WebLink About4125 172ND ST NE_BLD1108_2026 CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:4125 172nd Street NE Permit#: 1108 Parcel#:31052100305400 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name: 172ND HOLDINGS LLC Name:Jason McDaniel Name:De-Construction Services,LLC Address: 165 BEACHWOOD AVE Address:165 Beachwood Ave Address:2521 St Clair Street City,State Zip:CAMANO ISLAND,WA 98282 City,State Zip:Camano Island,WA 98282 City,State Zip:Bellingham,WA 98229 Phone: Phone:425-231-0989 Phone:360-201-6977 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Demolition CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: OCC GROUP: BUILDINGS: 1 OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBCIIO/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 5 co ed Ci fA ington#3101. vnl dvl`1�r+iJ/�Z `r`s /4 Signature Print Name Date Released By /Dafd CONDITIONS Approved as submitted. 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 8/4/2016 Demolition Fee $100.00 8/4/2016 State Building Code Surcharge Fee $4 50 I Total Due: 5104.50 Total Payment: $0.00 Balance Due: $104.50 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 OF COMMUNITY DEVELOPMENT DEPARTMENT TA'G-ySvi[[e 80 Columbia Avenue • Marysville, WA 98270 WASHING TON (360) 363-8100 • (360) 651-5099 FAX MEMORANDUM DATE: August 4, 2016 TO: City of Arlington FROM: Deryl Taylor,Development Services Technician RE: Demo permits (AU16-0029 & 16-0030) for 4125 172"d St NE,Arlington CC: Jason McDaniel The existing structures located at 4125 172"d St NE (Parcel #310521-003-054-00) are not connected to City of Marysville utilities. Kristin Foster From: Katrina Newport <knewport@marysvillewa.gov> Sent: Thursday, August 04, 2016 10:15 AM To: Kristin Foster; Bianca Korkeakoski Cc: Brad Zahnow; Deryl Taylor;Jeff Cobb;John Dorcas;Julie Davis; Karen Latimer; Kari Chennault; Kim Bryant; Liz Kehler; Shane Freeman; Tim King Subject: RE: Arlington Permit# 1109 Attachments: AU16-0030 172ND HOLDINGS LLC DEMO REVIEW MEMO.pdf Kristin, The structures in applications 1108 & 1109 are not connected to City of Marysville utilities, therefore, we do not have any comments with regards to either structure being demolished. Please see attached memo from Deryl Taylor. Thanks! Katrina Newport Program Specialist 80 Columbia Avenue Marysville, WA 98270 (360) 363-8201 Office (360) 651-5099 Fax knewport@marysvillewa.gov From:Arlington [mailto:wo@iworq.net] Sent:Wednesday, August 03, 2016 1:13 PM To: Katrina Newport<knewport@marysvillewa.gov>; Bianca Korkeakoski <BKorkeakoski@marysvillewa.gov> Subject:Arlington Permit# 1109 Please have review completed by 8/10/2016. Thanks Click Here to open the permit. Permit Information Date 8/3/2016 Permit Number 1109 Project Name Jason McDaniel Applicant Name Jason McDaniel Applicant Address 165 Beachwood Ave City,State,Zip Camano Island,WA 98282 Contact Jason McDaniel 1 Phone 425-231-0989 Email jasonmcdaniel@live.com Permit Type Demolition Site Address 4127 172nd Street NE Valuation 0.00 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Number of Stories 0 Proposed Use Demo of 26'x 60'"South"Building Assigned To Kristin Foster Contractors Contractor Type Primary Contact Phone De-Construction Services, LLC CONTRACTOR David Bennink 360-201-6977 Property Information Owner Information Parcel#:31052100305400 172ND HOLDINGS LLC 172ND HOLDINGS LLC 165 BEACHWOOD AVE 4125 172ND ST NE CAMANO ISLAND,WA 98282 Fees Fee Description Amount Demolition Fee 322.10.00.00 $100.00 State Building Code Surcharge Fee 386.00.01.00 $4.50 Total $104.50 Uploaded Files [Upload File] Date File 8/3/2016 1:11:48 PM 1109 McDaniel Application.0 8/3/2016 1:11:48 PM 1109 McDaniel Asbestos Survev.pdf 2 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 tW TH A COPY OF THE ASBESTOS/DEMOLMOAI NOTI RCATION FROM PUGET SOUND CLEANAIR AGENCY, TWO(2)COPIES OF AN ASSESTOQS SiVwEY REPORT AND ABATEWNT REPORT (If applic-jble)COMPLETED BYANAPPROVED AGENCY. Type of Permit:(check ore) 13 Residential ] Commercial industrial Project Address: -11 2 L70AjL:? S7- A45 Parcel ID# Lot#: Subdivision: Valuation: Building Area(Sq Pt) 320 No.of floors: Number of Buildings: �Ny Owner: l 72 ND ou-P/NGSO (y-C, Phone Number: 4,Zf; -z:3/-6C/9r7 Address: /, / 67 �ACgWMQ 4V6 City: 15L_AN r-> State: �&)14 9'gZ��Zip Code: Contact Person: J65ioN q �GJ 06AI I CL Phone Number: Cell Phone: 1 Z`J ✓�-t'� I I E-mail: 1R�BA c-PAA11& d /--1VC, d-o10 Address: 6'5 AGj dtJoUP AVt' City: 15 N p State:_WA Zip Code: 96Z`I3 Z- Contractor: 1��-coNs�-�.(J�T(vl-, 2y�c�S, /_Le- Phone Number: 360-7-D1-6977 Address: 292- 1 Sr CL IR, sr City: r�A)w Altq State: 1-A Zip Code: 182-2i' Contractor's License Number: D!5�c f�`J" L 877 3,)1 3 Expiration:,&3/ Z,011 Scope of Work: FC—M0V� /(( �x �D SI�CL� 11Nc9RT74 x 'FU1LIP1/V67 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 the in accordance Wth the laws, rules and regulations of the 5tat of Washington. z— C � 7 9 20 Applicants Signature Date Print Applicants Name FOR STAFF USE ONLY Permit# Accepted By Amount Received Recelpt## Date Received pscIeanair.o g Puget Sound Clean Air Agency Notification Cal a #: 201603693 This page must be printc d. A printout of the notification,all amendments to the notification,and the asbestos survey shall be available for inspection at all times at the asbestos project or demolition site(Reg III,4.03(a)(6)). Fee Amount Paid $105.00 Credit Card Transaction #AROFD8B1DF7D Transaction Date 07/28/16 Owner's Name 172nd Holdings, LLC Phone (425) 231-0989 Project Street Address 4125 172nd St NE City Arlington Zip 98223 Contact Person Jason McDaniel Phone (425) 231-0989 Mailing Address 165 IBeachwood Ave Cam no Island,WA 98282 This project includes a demolition. Demolition Start Date 08/03/16 Completion Date 08/15/16 Demolition will be completed by a demolition contractor Demo Contractor Re-Use Consulting Contractor Job# Contact Dave Bennink Phone (360) 201-6977 Mailing Address 2521 St Clair St Bell Ingham,WA 98229 This is an emergency project. The emergency reason: The project must pro eed to avoid imposing an unreasonable burden. (1) I certify that the irift rmation I have provided is to the best of my knowledge true and accurate. (2) I understand that I must file an Amendment to this Notification if: • The type of project has changed.The project types are asbestos and demolition. • The quantity off cable asbestos to be removed meets a larger project category - • The project's sta t or completion date has changed. (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Create Another Notification View History Log Out If you have questions,c ntact us at asbestos@pscleanair.org or 206.689.4058. PHILLIPS ENVIRONMENTAL SERVICES 29354 BAcus RD. SEDRO WOOLLEY,WA 98284 360-854-7900 FAX 360.854.7731 July 18, 2016 Survey No. 16125 172nd Holdings, LLC 165 Beachwood Ave. Camano Island, WA 98282 425-231-0989 jasonmcdaniel@live.com RE: Asbestos Survey: 4125 172nd St.NE,Arlington,WA 98223 On July 15, 2016, 1 inspected a three buildings identified as North, Middle, and South located at the above referenced address for the purpose of determining the presence or absence of building materials that might contain asbestos. Title 40 Code of Federal Regulations (40 CFR), subpart M, section 61.141, established the allowable limit of asbestos in building materials at 1%by weight. Materials containing more than 1%asbestos are regulated and must be handled in accordance with Federal, State, and Local regulations. Surveys are based on 'visible and accessible materials' and although reasonable effort was made to locate and test all suspect materials, some suspect materials may remain hidden in walls or below floor underlayment or other areas until demolition or renovation work makes them accessible. If other suspect materials are discovered during the course of demolition or remodel activities they will require testing prior to continuing work. Thirty bulk samples were collected and twenty-eight samples were subsequently analyzed for asbestos content by Polarized Light Microscopy with Stain Dispersion. Samples#4,5,6, and 9a (all from the middle building)were found to contain more than 1% asbestos. These materials will require handling/removal by trained asbestos workers prior to any remodeling, renovation, or demolition that will lead to the disturbance or removal of asbestos. Prior to removal of these materials,ten-day notices must be filed with the local Clean Air Agency and the State Department of Labor& Industries. This letter along with the attached material list and lab report will comprise the `Asbestos Survey'. Please call us if you have any questions. Sincerely, (Z.-_ I?, izk- Dave B. Phillips AHERA Bldg. Insp. Cert.# 154454 (expires 12-8-16) enclosure PHILLIPS ENVIRONMENTAL SERVICES 29354 BAcus RD. SEDRO WOOLLEY,WA 98284 360.854-7900 FAX 360.854-7731 Client: 172nd Holdings,LLC Asbestos Survey- 4125 172nd St.NE Survey#: 16125 165 Beachwood Ave. Arlington,WA 98223 Camano Island,WA 98282 425-231-0989 Survey date: 7-15-16 North Building-Homoeeneous Material List Material#&Description Location(homog.area) I Typel Friaq Cond I Qty. Sample#&Location Asbestos 1 Drywall&joint Walls,ceiling Misc N F la East wall N/D compound lb West wall N/D 2 Asphalt roof w/sand Roof Misc N F 2 Roof N/D N/D=None Detected Note: Friability assessments were made on these materials in their present undisturbed condition, N/T=Not Tested-previous sample tested positive damage or disturbance of any kind may cause some non-friable materials to become friable Quantities shown are approximate-field verification recommended PHILLIPS ENVIRONMENTAL SERVICES 29354 BACUS RD. SEDRO WOOLLEY,WA 98284 360.854.7900 FAX 360-854-7731 Client: 172nd Holdings,LLC Asbestos Survey- 4125 172nd St.NE Survey#: 16125 165 Beachwood Ave. Arlington,WA 98223 Camano Island,WA 98282 425-231-0989 Survey date: 7-15-16 Middle Buildine-Homogeneous Material List Material#&Description Location(homog.area) I Typel Fria Cond I Qty. I Sample#&Location Asbestos 3 Asphalt roof w/sand Roof Misc N F 3a Roof,N.side N/D 3b Roof,S.side N/D 4 4 layers vinyl sheet Kitchen floor Misc N F 108sf 4 Kitchen floor Chry.40% * Asbestos found in top vinyl sheet at 40%,none found in lower vinyl sheets or mastics 5 2 layers vinyl sheet Bed/bath floor Misc N I F I 70sf 1 5 1 Bed/bath floor Chry.40%* on vinyl tile&mastic * Asbestos found in top vinyl sheet at 40%and bottom vinyl tile at 4%,none found in mastics 6 Vinyl sheet Bathlbed floor,N side IMisel N I F I 14sf 1 6 1 Bath/bed floor,N side I Chry.40% 7 Vinyl sheet&mastic Bathroom S.wall Misc I N I F 1 1 7 1 Bathroom S.wall N/D 8 Mastic Kitchen backsplash IMiscl N I F 1 1 8 1 Kitchen backsplash N/D 9 Popcorn texture Kitchen ceiling Surf N F 110sf 9a Kitchen ceiling Chry.4% 9b Kitchen ceiling N/T 9c Kitchen ceiling N/T 101 Drywall&jt.comp. Apartment walls,ceiling Misc I N I F 10 Kitchen S.wall N/D 11 Texture on drywall Living room walls,ceiling Surf N F l la Living room ceiling N/D 1 lb Living room W.wall N/D l l c Living room N.wall N/D N/D=None Detected Note: Friability assessments were made on these materials in their present undisturbed condition, N/T=Not Tested-previous sample tested positive damage or disturbance of any kind may cause some non-friable materials to become friable. Quanunes shown are approximate-field verification recommended PHILLIPS ENVIRONMENTAL SERVICES 29354 BACUS RD. SEDRO WOOLLEY,WA 98284 360.854^7900 FAX 360-854�7731 Client: 172nd Holdings,LLC Asbestos Survey- 4125 172nd St.NE Survey#: 16125 165 Beachwood Ave. Arlington,WA 98223 Camano Island,WA 98282 425-231-0989 Survey date: 7-15-16 South Buildine-Homoeeneous Material List Material#&Description Location(homog.area) I Typel Fria Cond I Qty. I Sample#&Location Asbestos 12 Vinyl tile&mastic Hallway,bath,utility, Misc I N I F 12 1 Sharon's room floor N/D Sharon's room floors 1131 Ceramic tile grout Living room hearth&entry IMiscl N I F 1 1 13 1 Living room hearth N/D 1141 Ceramic tile mastic Living room hearth&entry I Misc I N I F 1 1 14 1 Living room hearth N/T 1151 Vinyl tile&mastic Upstairs bathroom floor Misc N F 15 Upstairs bathroom floor N/D 16 Texture on drywall Apartment walls,ceilings Surf N F 16a Upstairs bedroom ceiling N/D 16b Living room S.wall N/D 16c Living room N.wall N/D 16b Main bath E.wall N/T 16e Sharon's room wall N/T 1171 Drywall&jt.comp. Apartment walls,ceilings Misc N F 1 1 17 Utility room wall N/D 1181 Asphalt roof w/sand Sunroom roof Misc N F 1 1 18 Sunroom roof N/D 1191 Asphalt roof w/sand Roof,E.portion Misc N F 19 Roof,E.portion N/D 20 Asphalt felt Roof,W.portion under Misc N F 20 Roof,W.portion under N/D cedar cedar N/D=None Detected Note: Friability assessments were made on these materials in their present undisturbed condition, N/T=Not Tested-previous sample tested positive damage or disturbance of any kind may cause some non-friable materials to become friable Quantities shown are approximate-field verification recommended PHILLIPS ENVIRONMENTAL SERVICES 29354 BACus RD. SEDRO WOOLLEY,WA 98284 360-854-7900 American Industrial Hygiene Association Lab I.D #102950 FAX 360-854-7731 ASBESTOS BULK SAMPLE ANALYSIS Client Name: 172nd Holdings,LLC 165 Beachwood Ave. Survey#: 16125 Camano Island,WA 98282 425-231-0989 jasonmcdaniel@live.com Source of Samples: 4125 172nd St.NE,Arlington,WA 98223 Date Rec'd:7-15-16 Analytical Method: Polarized Light Microscopy with Dispersion Staining(PLM-DS Method) Sample#: la Lab No.: 83370 Location: North building,E.wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: lb Lab No.: 83371 Location: North building,W.wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer l of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 2 Lab No.: 83372 Location: North building,roof Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 Asphalt roof w/sand Asphalt/sand Glass 20% None detected Layer 2 of 2 Asphalt felt Asphalt Cellulose 60% None detected Sample#: 3a Lab No.: 83373 Location: Middle buildin ,roof,N.side Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 Asphalt roof w/sand Asphalt/sand Cellulose 20% None detected Layer 2 of 2 Asphalt felt Asphalt Cellulose 60% None detected Sample#: 3b Lab No.: 83374 Location: Middle building,roof,S.side Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 Asphalt roof w/sand Asphalt/sand Cellulose 20% None detected Layer 2 of 2 Asphalt felt Asphalt Cellulose 60% None detected � - . V Analyst: Date: 7-18-16 Dave B.Phillips Samples retained for 2 weeks unless otherwise requested in writing. Lab results are completely confidential. Written permission is required to release results to another party. PHILLIPS ENVIRONMENTAL SERVICES 29354 BACUS RD. SEDRO WOOLLEY,WA 98284 360.854-7900 American Industrial Hygiene Association Lab I.D.#102950 FAX 360-854-7731 ASBESTOS BULK SAMPLE ANALYSIS sample#: 4 Lab No.: 83375 Location: Middle buildin ,kitchen floor Layers Description: Non-Fibrous Material: Other Fibrous Mat'l;% Asbestos Type: % Layer 1 of 9 Off white/tan vinyl sheet Vinyl/Binder None detected None detected Layer 2 of 9 Grey fibrous paper-like material Binder/Fine particles Cellulose 10% Chrysotile 407/ Layer 3 of 9 Off white&yellow vinyl sheet Vinyl/Binder None detected None detected Layer 4 of 9 Black fibrous paper-like material Binder/Fine particles Cellulose 60% None detected Layer 5 of 9 Blue vinyl sheet Vinyl/Binder None detected None detected Layer 6 of 9 Black fibrous paper-like material Binder/Fine particles Cellulose 60% None detected Layer 7 of 9 Tan vinyl sheet Vinyl/Binder None detected None detected Layer 8 of 9 Black fibrous paper-like material Binder/Fine particles Cellulose 60% None detected Layer 9 of 9 Black mastic Mastic/binder Cellulose trace None detected Sample#: 5 Lab No.: 83376 Location: Middle buildin ,bedroom/bath floor Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 7 Off white/tan vinyl sheet Vinyl/Binder None detected None detected Layer 2 of 7 Grey fibrous paper-like material Binder/Fine particles Cellulose 10% Chrysotile 40% Layer 3 of 7 Yellow mastic Mastic/binder Cellulose trace None detected Layer 4 of 7 Brown vinyl sheet Vinyl/Binder None detected None detected Layer 5 of 7 Black fibrous paper-like material Binder/Fine particles Cellulose 60% None detected Layer 6 of 7 Tan vinyl tile Vinyl/Binder Cellulose trace Chrysotile 4% Layer 7 of 7 Black mastic Mastic/binder Cellulose trace None detected Sample#: 6 Lab No.: 83377 Location: Middle buildin ,bedroom/bath,N.side Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 3 Brown vinyl sheet Vinyl/Binder None detected None detected Layer 2 of 3 Grey fibrous paper-like material Binder/Fine particles Cellulose 10% Chrysotile 40% Layer 3 of 3 Yellow mastic Mastic/binder Cellulose trace None detected Sam ple#: 7 Lab No.: 83378 Location: Middle buildin bathroom S.wall,panel &mastic Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 Pink vinyl sheet Vinyl/Binder None detected None detected Layer 2 of 2 Yellow mastic Mastic/binder I Cellulose trace None detected Sample#: 8 Lab No.: 83379 Location: Middle building,kitchen backs lash mastic Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of I Yellow mastic Mastic/binder Cellulose trace None detected Sample#: 9a Lab No.: 83380 Location: Middle building,kitchen ceiling Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 1 `Popcorn'ceiling texture Binder/synthetic foam lumps Cellulose trace Chrysotile 4% Analyst: (fkD,, 1?, ok- Date: 7-18-16 Dave B.Phillips Samples retained for 2 weeks unless otherwise requested in writing. Lab results are completely confidential. Written permission is required to release results to another party. PHILLIPS ENVIRONMENTAL SERVICES 29354 BACUS RD. SEDRO WOOLLEY,WA 98284 360-854-7900 American Industrial Hygiene Association Lab I.D.#102950 FAX 360.854-7731 ASBESTOS BULK SAMPLE ANALYSIS Sam le#: 10 Lab No.: 83383 Location: Middle buildin ,kitchen wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'1: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: l la Lab No.: 83384 Location: Middle buildin ,living room ceiling Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer I of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 1lb Lab No.: 83385 Location: Middle building,living room W.wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 1 lc Lab No.: 83386 Location: Middle buildin ,living room N.wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer I of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 12 Lab No.: 83387 Location: South building,hallway,bath,Sharon's room floors Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 Off white vinyl tile Vinyl/Binder None detected None detected Layer 2 of 2 Clear mastic mastic Cellulose trace None detected Sample#: 13 Lab No.: 83388 Location: South building,living room hearth Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 1 Red ceramic tile grout Binder/fine particles Cellulose trace None detected Sample#: 14 Lab No.: 83389 Location: South building,living room hearth Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer I of I Grey ceramic tile mastic Binder/fine particles Cellulose trace None detected Sample#: 15 Lab No.: 83390 Location: South building,upstairs bathroom floor Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 Off white vinyl tile Vinyl/Binder None detected None detected Layer 2 of 2 Clear mastic mastic Cellulose trace None detected � .- . Analyst: i"'� Date: 7-18-16 Dave B.Phillips Samples retained for 2 weeks unless otherwise requested in writing. Lab results are completely confidential. Written permission is required to release results to another party. PHILLIPS ENVIRONMENTAL SERVICES 29354 BACus RD. SEDRO WOOLLEY,WA 98284 360-854,7900 American Industrial Hygiene Association Lab I.D.#102950 FAX 360.854.7731 ASBESTOS BULK SAMPLE ANALYSIS Sam le#: 16a Lab No.: 83391 Location: South building upstairs bedroom ceiling Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 16b Lab No.: 83392 Location: South building Living room S.wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 16c Lab No.: 83393 Location: South building,Living room N.wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% j None detected Sample#: 16d Lab No.: 83394 Location: South building,Main bathroom,E.wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 16e Lab No.: 83395 Location: South building,Sharon's room wall Layers Descri tion: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 17 Lab No.: 83396 Location: South building,utility room wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 18 Lab No.: 83397 Location: South building,sun room roof Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer I of 1 Asphalt roof w/sand Asphalt/sand Glass 20% None detected Sample#: 19 Lab No.: 83398 Location: South building,E.roof section Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of I Asphalt roof w/sand Asphalt/sand Glass 20% None detected Sample#: 20 Lab No.: 83399 Location: South building,W.roof section,under cedar Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 1 Asphalt felt Asphalt Cellulose 40% None detected Analyst: - Date: 7-18-16 Dave B.Phillips Samples retained for 2 weeks unless otherwise requested in writing. Lab results are completely confidential. Written permission is required to release results to another party. ITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:4125 172nd Street NE Permit#:1108 Parcel#:31052100305400 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name: 172ND HOLDINGS LLC Name:Jason McDaniel Name:De-Construction Services,LLC Address: 165 BEACHWOOD AVE Address:165 Beachwood Ave Address:2521 St Clair Street City,State Zip:CAMANO ISLAND,WA 98282 City,State Zip:Camano Island,WA 98282 City,State Zip:Bellingham,WA 98229 Phone: Phone:425-231-0989 Phone:360-201-6977 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Demolition CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: OCC GROUP: BUILDINGS: 1 OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC110/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 c ed Ci fA 'ngton#3101. Signature Print Name Date Released By Da CONDITIONS Approved as submitted. 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 8/4/2016 Demolition Fee $100.00 8/4/2016 State Building Code Surcharge Fee $4.50 Total Due: $104.50 Total Payment: $0.00 Balance Due: $104.50 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 Information Date 8/3/2016 Permit Number 1108 Project Name Jason McDaniel Applicant Name Jason McDaniel Applicant Address 165 Beachwood Ave City, State,Zip Camano Island,WA 98282 Contact Jason McDaniel Phone 425-231-0989 Email jasonmcdaniel@live.com Permit Type Demolition Site Address 4125 172nd Street NE Valuation 0.00 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Number of Stories 0 Proposed Use Demo of a 16'x 20'Shed-North Building Assigned To Kristin Foster Property Information Owner Information Parcel#:31052100305400 172ND HOLDINGS LLC 172ND HOLDINGS LLC 165 BEACHWOOD AVE 4125 172ND ST NE CAMANO ISLAND,WA 98282 Contractors Contractor Name Primary Contact Phone Email Contractor Type License License# De-Construction Services,LLC jDavid Bennink 60-201-6977 1 1CONTRACTOR 1-abor and Industries DECONSL873J3 Review Date Type Descri lion Target Date Completed Date Assigned To Status /3/2016 10emolition 8/10/2016 lKevin Olander Illn Review Fees Fee I Description Notes Amount Demolition Feel 322.10.00.01 $100.00 State Building Code Surcharge Fe 386.00.01.0 $4.5 Total $104.5a Uploaded Files r Upload File Date File 8/3/2016 12:45:24 PM 11 108 McDaniel Application. df 8/3/2016 12:45:24 PM 11108 McDaniel Asbestos Surve df DEMOLITION PERMIT APPLICATION Department of Community&Economic Development City of Arlington-.182204 59th Ave NE- Arlington,WA 98223- Phone(360)403-3551 7FIIS APPLICATION MUST BE ACCOMPANIED tWTH A COPY OF THE ASBESTOSiDEMOLITION N077RCATION FROM PUGET SOUND CLEAN AIR AGENCY, TWO(2)COPIES OF ANASSESTOS SURVEY REPORT AND ABATEMENT REPORT (if applicable)COMPLETED 8YANAPPROVED AGENCY. Type of Permit:(check one) 13 Residerfial ® Commercial ® Industrial Project Address: -1125 I-7Z„)j�;) ST 6115 Parcel ID# 31 D52I'DD3-O54-O Lot#: Subdivision: Valuation: Building Area(Sq Ft) 320 No.of floors: dAJl= Number of Buildings: nJ� Owner: 72/N)7 /fC>f,l�/NG S� LG-� Phone Number: -4?_5'2-3/026-1 G�MftNO q, Address: I�S e"-Acgwco.D yG city: )_6�N 1� State:�1� zip Code: '262RZ Contact Person: -JA5oN M C-Q7 nAILCL Phone Number: -4z-23/- c)?86) Cell Phone: 1 Z✓5"Z 31-0 9 8C( E-mail: ��SoA/ML I7/4/✓/L— d��--1 Vr LD/Yl car -�tiv Address: �� Gl F kJL�G�p /1 UL City: i E IV-2 State: A1� Lip Code: p 1/1Z(i L Contractor: D_�-�Ns%1 UcT(c�l-3 :f;'�IZVJC_65, GLe Phone Number: 360-ZOI-6977 Address: 7-521 sr CL-Air?, sr City: OCELWOC,KAM State: Y 4 zip Code: `?'Z_2J Contractor's License Number: 7)ECcsN5L 87 2 3 Expiration: Scope of Work: I hereby oertify 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. :S.--ZC d 741/401& Applicants Signature Date �.,)A50i✓ M e-pm)11�6_ Print Applicants Name Ar FOR STAFF USE ONLY Received bt--- Permit AkepA ev Amount Received Receipt N D 1 u r ti I 1 r � _ L 11 i 8/3/2016 De-Construction Services LLC 1 Search L&I " Washington State Department of Labor & Industries De-Construction Services LLC Owner or tradesperson 2421 St Clair Street BENNINK, DAVID ALLEN BELLINGHAM,WA 98229 360-733-1363 Principals WHATCOM County BENNINK, DAVID ALLEN, PARTNER/MEMBER BENNINK, DAVID ALLEN,AGENT Doing business as De-Construction Services LLC WA UBI No. Business type 603 293 090 Limited Liability Company Governing persons DAVID ALLEN BENNINK License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. DECONSL873J3 Effective—expiration 04/23/2013—04/23/2017 Bond Contractors Bonding&Insurance Co $12,000.00 Bond account no. SJ8973 Received by L&I Effective date 04/23/2013 04/22/2013 Expiration date Until Canceled Insurance Colony Ins Co $1,000,000.00 Policy no. GL4119254 Received by L&I Effective date 04/12/2016 04/22/2016 Expiration date 04/22/2017 Insurance history Savings https://secure.ini.wa.gov/verify/Detail.aspx?UBI=603293090&LIC=DECONSL873J3&SAW= 1/2 8/3/2016 De-Construction Services LLC No savings accounts during the previous 6 y"--)'eriod. 1 Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp No active workers'comp accounts during the previous 6 year period. Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Q Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the slate of Washington. https://secure.Ini.wa.gov/verify/Detail.aspx?UBI=603293090&LIC=DECONSL873J3&SAW= 212 J l� I I COMMUNITY DEVELOPMENT DEPARTMENT fMa-' ry!5 l le 80 Columbia Avenue • Marysville, WA 98270 (360) 363-8100 • (360) 651-5099 FAX MEMORANDUM DATE: August 4,2016 TO: City of Arlington FROM: Deryl Taylor,Development Services Technician RE: Demo permits (AU16-0029 & 16-0030) for 4125 172"d St NE,Arlington CC: Jason McDaniel The existing structures located at 4125 172"d St NE (Parcel#310521-003-054-00) are not connected to City of Marysville utilities. Kristin Foster From: Katrina Newport <knewport@marysvillewa.gov> Sent: Thursday,August 04, 2016 10:15 AM To: Kristin Foster, Bianca Korkeakoski Cc: Brad Zahnow; Deryl Taylor,Jeff Cobb;John Dorcas;Julie Davis; Karen Latimer, Kari Chennault; Kim Bryant; Liz Kehler;Shane Freeman;Tim King Subject: RE:Arlington Permit# 1109 Attachments: AU16-0030 172ND HOLDINGS LLC DEMO REVIEW MEMO.pdf Kristin, The structures in applications 1108 & 1109 are not connected to City of Marysville utilities,therefore, we do not have any comments with regards to either structure being demolished. Please see attached memo from Deryl Taylor. Thanks! Katrina Newport Program Specialist 80 Columbia Avenue Marysville, WA 98270 (360) 363-8201 Office (360) 651-5099 Fax knewport@marysvillewa.gov From:Arlington [mailto:wo@iworq.net] Sent: Wednesday,August 03, 2016 1:13 PM To: Katrina Newport<knewport@marysvillewa.gov>; Bianca Korkeakoski<BKorkeakoski@marysvillewa.gov> Subject:Arlington Permit#1109 Please have review completed by 8/10/2016. Thanks Click Here to open the permit. Permit Information Date 8/3/2016 Permit Number 1109 Project Name Jason McDaniel Applicant Name Jason McDaniel Applicant Address 165 Beachwood Ave City, State,Zip Camano Island.WA 98282 Contact Jason McDaniel 1 Phor '5-231-0989 Email lasonmcdaniel@live.com Permit Type Demolition Site Address 4127 172nd Street NE Valuation 000 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupsney,Load Number of Stories 0 Proposed Use Demo 02V x,60!"South"Building Assigned To Kristin Foster Contractors Contractor Type Primary Contact Phone De-Construction Services, LLC CONTRACTOR David Bennink 360-201-6977 Property Information Owner Information Parcel#:31052100305400 172ND MOLDINGS LLC 172ND HOLDINGS LLC 165 BEACHWOOD AVE 4125 172ND ST NE CAMANO ISLAND,WA 98282 Fees Fee Description Amount Demolition Fee 322-10.00 00 $100 00 State Building Code Surcharge Fee 386.00.01 00 $4 50 Total $104.50 Uploaded Files ]Upload File] Date File 8/3/2016 1.11 A8 PM 1109 McDaniel Application.pdf 8/3/2016 1:11:48 PM 1109 McDaniel Asbestos_Survey pdf 2 1 �o� 71`f pscleanar.�� Puget Sound Uean Air Age Cy Notification Case #: 201603693 This page must be print d. A printout of the notification,all amendments to the notification, and the asbestos survey shall be available for inspection at all times at the asbestos project or demolition site(Reg III,4.03(a)(6)). Fee Amount Paid $105.00 Credit Card Transaction #AROFD8BiDF7D Transaction Date 07/28/16 Owner's Name 172nd Holdings, LLC Phone (425) 231-0989 Project Street Address 4125 172nd St NE City Arlington Zip 98223 Contact Person Jason McDaniel Phone (425) 231-0989 Mailing Address 165 Beachwood Ave Camano Island,WA 98282 This project includes a demolition. Demolition Start Date 08/03/16 Completion Date 08/15/16 Demolition will be completed by a demolition contractor Demo Contractor Re-Use Consulting Contractor Job# Contact Dave Bennink Phone (360) 201-6977 Mailing Address 2521 St Clair St Bell Ingham,WA 98229 This is an emergency project. The emergency reason. The project must proceed to avoid imposing an unreasonable burden. (1)I certify that the inf,rmation I have provided is to the best of my knowledge true and accurate. (2)I understand that I rhust file an Amendment to this Notification if: • The type of prof ct has changed.The project types are asbestos and demolition. • The quantity of f-iable asbestos to be removed meets a larger project category. • The project's sta-t or completion date has changed. (3) I understanc one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Orate Another Ntifil'ration View History Log Out If you have questions, cl ntect us at asbestos@pscleanair.org or 206.689.4058. J 1 PHILLIPS ENVIRONMENTAL SERVICES 29354 BACus RD. SEDRO WOOLLEY,WA 98284 360-854-7900 FAX 360-854^7731 July 18, 2016 Survey No. 16125 172nd Holdings, LLC 165 Beachwood Ave. Camano Island, WA 98282 425-231-0989 jasonmedaniel@live.com RE: Asbestos Survey: 4125 172nd St.NE,Arlington,WA 98223 On July 15, 2016, I inspected a three buildings identified as North, Middle, and South located at the above referenced address for the purpose of determining the presence or absence of building materials that might contain asbestos. Title 40 Code of Federal Regulations (40 CFR), subpart M, section 61.141, established the allowable limit of asbestos in building materials at 1%by weight. Materials containing more than 1%asbestos are regulated and must be handled in accordance with Federal, State, and Local regulations. Surveys are based on 'visible and accessible materials'and although reasonable effort was made to locate and test all suspect materials, some suspect materials may remain hidden in walls or below floor underlayment or other areas until demolition or renovation work makes them accessible. If other suspect materials are discovered during the course of demolition or remodel activities they will require testing prior to continuing work. Thirty bulk samples were collected and twenty-eight samples were subsequently analyzed for asbestos content by Polarized Light Microscopy with Stain Dispersion. Samples#4,5,6, and 9a(all from the middle building)were found to contain more than 1% asbestos. These materials will require handling/removal by trained asbestos workers prior to any remodeling, renovation, or demolition that will lead to the disturbance or removal of asbestos. Prior to removal of these materials,ten-day notices must be filed with the local Clean Air Agency and the State Department of Labor& Industries. This letter along with the attached material list and lab report will comprise the `Asbestos Survey'. Please call us if you have any questions. Sincerely, Q 0, Qom- Dave B. Phillips AHERA Bldg. Insp. Cert.# 154454 (expires 12-8-16) enclosure I PHILLIPS ENVIRONMENTAL SERVICES 29354 SACus RD. SEDRO WOOLLEY,WA 98284 360-854-7900 FAX 360-8547731 Client: 172nd Holdings,LLC Asbestos Survey- 4125 172nd St. NE Survey#: 16125 165 Beachwood Ave. Arlington,WA 98223 Camano Island,WA 98282 425-231-0989 Survey date: 7-15-16 North Buildine-Homoeeneous Material List Material#&Description Location(homog.area) I Type Fria Cond I Qty. I Sample#&Location Asbestos 1 Drywall&joint Walls,ceiling Misc N F la East wall N/D compound lb West wall N/D 2 Asphalt roof w/sand Roof I Misc N F 2 Roof N/D N/D=None Detected Note: Friability assessments were made on these materials in their present undisturbed condition, N/T=Not Tested-previous sample tested positive damage or disturbance of any kind may cause some non-friable materials to become friable. Quantities shown are approximate-field verification recommended i i PHILLIPS ENVIRONMENTAL SERVICES 29354 BACus RD. SEDRO WOOLLEY,WA 98284 360.854,7900 FAX 360.854-7731 Client: 172nd Holdings,LLC Asbestos Survey- 4125 172nd St.NE Survey#: 16125 165 Beachwood Ave. Arlington,WA 98223 Camano Island,WA 98282 425-231-0989 Survey date: 7-15-16 Middle Buildim!-Homoeeneous Material List Material#&Description Location(homog.area) Type Fria Cond Qty. Sample#&Location Asbestos 3 Asphalt roof w/sand Roof Misc I N I F 3a Roof,N.side N/D 3b Roof,S.side N/D 4 4 layers vinyl sheet Kitchen floor Misc N I F 108sf 4 Kitchen floor Chry.40%* * Asbestos found in top vinyl sheet at 40%,none found in lower vinyl sheets or mastics 5 2 layers vinyl sheet Bed/bath floor Misc N I F I 70sf 1 5 1 Bed/bath floor Chry��!i on vinyl tile&mastic * Asbestos found in top vinyl sheet at 40%and bottom vinyl file at 4%,none found in mastics 6 Vinyl sheet Bath/bed floor,N side IMisel N I F I 14sf 1 6 1 Bath/bed floor,N side I Chry.40% 7 Vinyl sheet&mastic Bathroom S.wall I Misc I N I F 1 7 Bathroom S.wall I N/D 8 Mastic Kitchen backsplash I Misc I N I F 8 Kitchen backsplash I N/D 9 Popcorn texture Kitchen ceiling Surf N F 110sf 9a Kitchen ceiling Chry.4% 9b Kitchen ceiling N/T 9c Kitchen ceiling N/T 10 Drywall&jt.comp. Apartment walls,ceiling I Misc I N I F 1 10 1 Kitchen S.wall N/D 11 Texture on drywall Living room walls,ceiling Surf N F 1la Living room ceiling N/D 1 lb Living room W.wall N/D 11 c Living room N.wall N/D N/D—None Detected Note: Friability assessments were made on these materials in their present undisturbed condition, N/T=Not Tested-previous sample tested positive damage or disturbance of any kind may cause some non-friable materials to become friable. Quantities shown are approximate-field verification recommended a. PHILLIPS ENVIRONMENTAL SERVICES 29354 BACus RD. SEDRO WOOLLEY,WA 98284 360-854^7900 FAX 360.854,7731 Client: 172nd Holdings,LLC Asbestos Survey- 4125 172nd St.NE Survey#: 16125 165 Beachwood Ave. Arlington,WA 98223 Camano Island,WA 98282 425-231-0989 Survey date: 7-15-16 South Building- Homoeeneous Material List Material#&Description Location(homog.area) I Typel Fria Cond I Qty. Sample#&Location Asbestos 12 Vinyl tile&mastic Hallway,bath,utility, Misc N F 12 Sharon's room floor N/D Sharon's room floors 1131 Ceramic tile grout Living room hearth&entry Misc N F 13 Living room hearth N/D 1141 Ceramic tile mastic Living room hearth&entry Misc N F 14 Living room hearth N/T 1151 Vinyl tile&mastic Upstairs bathroom floor Misc N F 15 Upstairs bathroom floor N/D 16 Texture on drywall Apartment walls,ceilings Surf N F 16a Upstairs bedroom ceiling N/D 16b Living room S.wall N/D 16c Living room N.wall N/D 16b Main bath E.wall N/T 16e Sharon's room wall N/T 1171 Drywall&it.comp. Apartment walls,ceilings Misc N F 17 Utility room wall N/D 18 Asphalt roof w/sand Sunroom roof Misc N F 18 Sunroom roof N/D 1191 Asphalt roof w/sand Roof,E.portion Misc N F 19 Roof,E.portion N/D 20 Asphalt felt Roof,W.portion under Misc N F 20 Roof,W.portion under N/D cedar cedar N/D=None Detected Note: Friability assessments were made on these materials in their present undisturbed condition, N/T=Not Tested-previous sample tested positive damage or disturbance of any kind may cause some non-friable materials to become friable. Quantities shown are approximate-field verification recommended i PHILLIPS ENVIRONMENTAL SERVICES 29354 BACUS RD. SEDRO WOOLLEY,WA 98284 360-854,7900 American Industrial Hygiene Association Lab LD.#102950 FAX 360-854+7731 ASBESTOS BULK SAMPLE ANALYSIS Client Name: 172nd Holdings,LLC 165 Beachwood Ave. Survey#: 16125 Camano Island,WA 98282 425-231-0989 jasonmcdaniel@live.com Source of Samples: 4125 172nd St.NE,Arlington,WA 98223 Date Rec'd: 7-15-16 Analytical Method: Polarized Light Microscopy with Dispersion Staining(PLM-DS Method) Sample#: la Lab No.: 83370 Location: North building,E.wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: lb Lab No.: 83371 Location: North building,W.wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 2 Lab No.: 83372 Location: North building,roof Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 Asphalt roof w/sand Asphalt/sand Glass 20% None detected Layer 2 of 2 Asphalt felt Asphalt Cellulose 60% None detected Sample#: 3a Lab No.: 83373 Location: Middle buildin ,roof,N.side Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 Asphalt roof w/sand Asphalt/sand Cellulose 20% None detected Layer 2 of 2 Asphalt felt Asphalt Cellulose 60% None detected Sample#: 3b Lab No.: 83374 Location: Middle building,roof, S.side Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 Asphalt roof w/sand Asphalt/sand Cellulose 20% None detected Layer 2 of 2 Asphalt felt Asphalt Cellulose 60% None detected � -- . Qk- Analyst: Date: 7-18-16 Dave B.Phillips Samples retained for 2 weeks unless otherwise requested in writing. Lab results are completely confidential. Written permission is required to release results to another party. PHILLIPS ENVIRONMENTAL SERVICES 29354 BACus RD. SEDRO WOOLLEY,WA 98284 360-854-7900 American Industrial Hygiene Association Lab I.D,#102950 FAX 360.854-7731 ASBESTOS BULK SAMPLE ANALYSIS Sample#: 4 Lab No.: 83375 Location: Middle buildin ,kitchen floor Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 9 Off white/tan vinyl sheet Vinyl/Binder None detected None detected Layer 2 of 9 Grey fibrous paper-like material Binder/Fine particles Cellulose 10% Chrysotile 40% Layer 3 of 9 Off white&yellow vinyl sheet Vinyl/Binder None detected None detected Layer 4 of 9 1 Black fibrous paper-like material Binder/Fine particles Cellulose 60% None detected Layer 5 of 9 Blue vinyl sheet Vinyl/Binder None detected None detected Layer 6 of 9 Black fibrous paper-like material Binder/Fine particles Cellulose 60% None detected Layer 7 of 9 Tan vinyl sheet Vinyl/Binder None detected None detected Layer 8 of 9 Black fibrous paper-like material Binder/Fine particles Cellulose 60% None detected Layer 9 of 9 Black mastic Mastic/binder Cellulose trace None detected Sample#: 5 Lab No.: 83376 Location: Middle buildin ,bedroom/bath floor Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 7 Off white/tan vinyl sheet Vinyl/Binder None detected None detected Layer 2 of 7 Grey fibrous paper-like material Binder/Fine particles Cellulose 10% Chrysotile 40% Layer 3 of 7 Yellow mastic Mastic/binder Cellulose trace None detected Layer 4 of 7 Brown vinyl sheet Vinyl/Binder None detected None detected Layer 5 of 7 Black fibrous paper-like material Binder/Fine particles Cellulose 60% None detected Layer 6 of Tan vinyl tile Vinyl/Binder Cellulose trace Chrysotile 4% Layer 7 of 7 Black mastic Mastic/binder Cellulose trace None detected Sample#: 6 Lab No.: 83377 Location: Middle buildin ,bedroom/bath,N.side Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer I of 3 Brown vinyl sheet Vinyl/Binder None detected None detected Layer 2 of 3 Grey fibrous paper-like material Binder/Fine particles Cellulose 10% Chrysotile 40% Layer 3 of 3 Yellow mastic Mastic/binder Cellulose trace None detected Sample#: 7 Lab No.: 83378 Location: Middle buildin ,bathroom S.wall,panel&mastic Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 Pink vinyl sheet Vinyl/Binder None detected None detected Layer 2 of 2 Yellow mastic Mastic/binder Cellulose trace None detected Sample#: 8 Lab No.: 83379 Location: Middle buildin ,kitchen backs lash mastic Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 1 Yellow mastic Masticibinder Cellulose trace None detected J Sample#: 9a Lab No.: 83380 Location: Middle building,kitchen ceiling Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 1 `Popcorn'ceiling texture Binder/synthetic foam lumps Cellulose trace Chrysotile 4% Y Analyst: �' Date: 7-18-16 Dave B.Phillips Samples retained for 2 weeks unless otherwise requested in writing. Lab results are completely confidential. Written permission is required to release results to another parry. y PHILLIPS ENVIRONMENTAL SERVICES 29354 BACus RD. SEDRO WOOLLEY,WA 98284 360-854,7900 American Industrial Hygiene Association Lab I.D.#102950 FAX 360.854,7731 ASBESTOS BULK SAMPLE ANALYSIS Sample#: 10 Lab No.: 83383 Location: Middle building,kitchen wall Layers Description: Non-Fibrous Material: Other Fibrous MatT % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 1 la Lab No.: 83384 Location: Middle building,living room ceiling Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 1lb Lab No.: 83385 Location: Middle building,living room W.wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 1 lc Lab No.: 83386 Location: Middle buildin ,living room N.wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 12 Lab No.: 83387 Location: South building,hallway,bath, Sharon's room floors Layers Description: Non-Fibrous Material: Other Fibrous Mat'[: % Asbestos Type: % Layer 1 of 2 Off white vinyl tile Vinyl/Binder None detected None detected Layer 2 of 2 Clear mastic mastic Cellulose trace None detected Sample#: 13 Lab No.: 83388 Location: South building,living room hearth Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 1 Red ceramic tile grout Binder/fine particles Cellulose trace None detected Sample#: 14 Lab No.: 83389 Location: South building,living room hearth Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 1 Grey ceramic tile mastic Binder/fine particles Cellulose trace None detected Sample#: 15 Lab No.: 83390 Location: South building,upstairs bathroom floor Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 Off white vinyl tile Vinyl/Binder None detected None detected Layer 2 of 2 Clear mastic mastic Cellulose trace None detected i�. Analyst: Qk- Date: 7-18-16 Dave B.Phillips Samples retained for 2 weeks unless otherwise requested in writing. Lab results are completely confidential. Written permission is required to release results to another party. M . 1. PHILLIPS ENVIRONMENTAL SERVICES 29354 BAcus RD. SEDRO WOOLLEY,WA 98284 360-854-7900 American Industrial Hygiene Association Lab I.D.#102950 FAX 360-854-7731 ASBESTOS BULK SAMPLE ANALYSIS Sample#: 16a Lab No.: 83391 Location: South building,upstairs bedroom ceiling Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 16b Lab No.: 83392 Location: South building,Living room S.wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer I of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 16c Lab No.: 83393 Location: South building,Living room N.wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 16d Lab No.: 83394 Location: South building,Main bathroom,E.wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer I of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 16e Lab No.: 83395 Location: South building,Sharon's room wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sam le#: 17 Lab No.: 83396 Location: South building,utility room wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 18 Lab No.: 83397 Location: South buildina,sun room roof Layers Description: Non-Fibrous Material: Other Fibrous Mat'1:% Asbestos Type: % Layer 1 of 1 Asphalt roof w/sand Asphalt/sand Glass 20% None detected Sample#: 19 Lab No.: 83398 Location: South building,E.roof section Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of I Asphalt roof w/sand Asphalt/sand Glass 20% None detected Sample#: 20 Lab No.: 83399 Location: South building,W.roof section,under cedar Layers Description: Non-Fibrous Material: Other Fibrous Mat'l:% Asbestos Type: % Layer 1 of 1 Asphalt felt Asphalt Cellulose 40% None detected Analyst: �' Qk- Date: 7-18-16 Dave B.Phillips Samples retained for 2 weeks unless otherwise requested in writing. Lab results are completely confidential. Written permission is required to release results to another party. Permit#: 1108 Permit Date: 08/03/16 Permit Type: DEMOLITION Project Nam e Jason McDaniel Applicant Name Jason McDaniel Applicant Address: 165 Beachwood Ave Applicant, City, State, Zip: Cam aio Island, WA98282 Contact: Jason McDaniel Phone: 425-231-0989 Em al:jasonm olaniel@live.com Scope of Work: Dem oof a 16' x 20' Shed -North Building Valuation: 0.00 Square Feet: 0 Num ber of Stories: 0 Construction Type: O xupancy G ioup: ID Code: Permit Issued: 08/05/2016 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Kristin Foster Property Parcel# Address L egal Description O wrier Nam e Cvner Phone Zoning 31052100305400 4 125 172ND ST NE 172ND HOLDINGS 189 Other LLC Residential Contractors Contractor P rim ay Contact P hone A ddress C ontractor Type L icense License# De-Construction 2521 St Clair CONSTRUCTION Labor and DECONSL873J3 Services,LLC David Bennink 3 60-201-6977 Street CONTRACTOR Industries Plan Reviews Date R eview Type D escription A ssigned To R eview Status 08/03/2016 D EMOLITION B UILDING Fees Fee D escription N otes A m cunt Dem dition $100.00 State Surcharge- 1 st DU R esidential- 1 st Unit $ 4.50 Total $ 104.50 Attached Letters Date Letter D escription 08/04/2016 Building Penn Paym dits Date Paid By D escription P aym ant Type A ccepted By A m cunt 08/04/2016 Mariner Holdings,LLC C heck#2530 K ristin Foster $104.50 O ttstanding Balance $0.00 Notes Date Note C reated By: 08/03/2016 Em dled De-Construction Services LLC out of city business license application.KF K ristin Foster 08/03/2016 Need out of city for De-Construction.KF K ristin Foster Uploaded Files Date File Nam e 08/04/2016 1771435-1108 Issued Perm i.pdf 08/04/2016 1770236-1108 Marysville Em dl.pdf 08/04/2016 1770235-1108 MarysvilleCommuts.pdf 08/03/2016 1767921-1108 McDaniel AsbestosSurvey..pdf 08/03/2016 1767922-1108 McDaniel Application.pdf