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Home My WebLink About19503 63rd Ave NE_035269_2026 C I TY OF ARL I hIGTOhI C O N S T R U C T I O N P E R M I T PE RM I T IR10_ 03-526 9 Owner: CITY OF ARLINGTON 238 N. OLYMPIC ARLINGTON 98223 Value of Work: Tax ID: 153105-4-012-009 Phone: 435-5785 Describe Work: REMOVAL OF EXISTING BLDG Proposed Use: FENCE Legal Description: Job Address: 19503 63RD AVE NE Contractor's Name Type Address License# CORNERSTONE GEN TOTALS Fee Permit Fee $100. 00 State fee $4. 5O SIGNATURE• TOTAL FEE. . . . . . . . . . . . . . . . . $104. 59 I H//EIIEBY CE IF THAT I HAVE READ AN PAYMENTS. . . . . . . . . . . . . . . . . . $0.00 KNQWE HEINE SA ET SBEPTRUEA AND NCOR- D RECT ALL P OVI NS F LAWS AND TOTAL DUE. . . . . . . . . . . . . . . . . $104. 50 OR I ANCE GOV ING THIS TYPE OF W K WIL 1W M LIE WITH WHETHER DATE RECEIPT # RE FIE O OT. 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'iJ'-IfM',iHW J-.mW (33IJqM0� 3a JJIW MROW .TCIM iiC) 1413F13H 03I9IJ392 14 Tqj,;ID3A 3 14"A C JAI',)I'i'qO OHM-11UG Transfer In: 001.322.10.00 $300.00 001.345.83.0 13.50 C--- Signature: I"/mV\ David Anderso W Transfer Out: qp 11 qj D O $313.50 Signature: "44/ / -03 155�� ) I n Latimer Reference Building Permit Number 03-5269, 03-5316, 03-5317 • D � Qo � Q � � D � D City of Arlington Utilities Div. Building Department REQUEST FOR REVIEW FORM PROJECT NAME: F p-/L L,� c y PROJECT ADDRESS: (0 3(—� r�Ls •u L� BP #: -- o'y - Szb9 PROJECT MANAGER: David Anderson, Building Official DATE OF CIRCULATION: ZI z s Jo Z RETURN THIS FORM BY: t i l 3 1 lam, -z_ TYPE OF PROPOSAL: C,/A o c_l M tea! PROJECT SUMMARY: or- 3 RESPONDING DEPARTMENTS: FJ TOM C., FIRE JIM T., GALE & GALE RECEIVED id, TERRY C., KAREN L., UTILITIES IJ PLANNING DEPARTMENT JAN 14 2003 FJ SHARREE L., GENERAL SERVICES CITY OF ARLINGTON GREGG E., ENGINEERING SUBMITTAL INFORMATION IS ATTACHED. Please review the information and return this form and your comments, either on the drawings or in memo form,to the Building Department. If you have no comments, please return the form with the"No Comments"box checked. PLEASE MARK ONE BOX, SIGN, DATE, AND RETURN THIS FORM TO LINDA. r MORE TIME REQUESTED, WILL SUBMIT ON COMMENTS FOR THIS REVIEW ARE ON ATTACHED DRAWING [J COMMENTS FOR THIS REVIEW ARE IN ATTACHED MEMO IJ NO COMMENTS FOR THIS REVIEW, OKAY TO ISSUE PERMIT REVIEWED By , DATE 3 City of Arlington Building Department REQUEST FOR REVIEW FORM PROJECT NAME: -OF �ex�,..jc,,�,•� PROJECT ADDRESS: e 17 S o 3 to 3 �+ e+-✓ef- Al BP #: 2--15 c� g PROJECT MANAGER: David Anderson, Building Official DATE OF CIRCULATION: .5 / L RETURN THIS FORM BY: TYPE OF PROPOSAL: L)e^& t_; -n u PROJECT SUMMARY: RESPONDING DEPARTMENTS: IJ TOM C., FIRE JIM T., GALE & GALE IJ TERRY C., KAREN L., UTILITIES PZ, A-vfL- IJ SHARREE L., GENERAL SERVICES F3 GREGG E., ENGINEERING SUBMITTAL INFORMATION IS ATTACHED. Please review the information and return this form and your comments, either on the drawings or in memo form, to the Building Department. If you have no comments, please return the form with the"No Comments"box checked. PLEASE MARK ONE BOX, SIGN, DATE, AND RETURN THIS FORM TO LINDA. 13 MORE TIME REQUESTED, WILL SUBMIT ON 13 COMMENTS FOR THIS REVIEW ARE ON ATTACHED DRAWING IJ COMMENTS FOR THIS REVIEW ARE IN ATTACHED MEMO NO COMMENTS FOR THIS REVIEW, OKAY TO ISSUE PERMIT `l REVIEWED By DiLe ��vt��-Ct-sti — DATE / /;z �; 5 I City of Arlington Building Department REQUEST FOR REVIEW FORM PROJECT NAME: PROJECT ADDRESS: / 9 5o 3 toy C iv L BP #: 0•2- -Sr2GC) PROJECT MANAGER: David Anderson, Building Official DATE OF CIRCULATION: z 23 z RETURN THIS FORM BY: i 2 3 i / z� TYPE OF PROPOSAL: -i ,E M 0 L- t 7-%-J -J PROJECT SUMMARY: C. f 3 &A I L-0 1^3f, .S RESPONDING DEPARTMENTS: TOM C., FIRE MJ JIM T., GALE & GALE IJ TERRY C., KAREN L., UTILITIES IJ PLANNING DEPARTMENT IJ SHARREE L., GENERAL SERVICES GREGG E., ENGINEERING SUBMITTAL INFORMATION IS ATTACHED. Please review the information and return this form and your comments, either on the drawings or in memo form, to the Building Department. If you have no comments, please return the form with the"No Comments"box checked. PLEASE MARK ONE BOX, SIGN, DATE, AND RETURN THIS FORM TO LINDA. FJ MORE TIME REQUESTED, WILL SUBMIT ON IJ COMMENTS FOR THIS REVIEW ARE ON ATTACHED DRAWING IJ COMMENTS FOR THIS REVIEW ARE IN ATTACHED MEMO NO COMMENTS FOR THIS REVIEW, OKAY TO ISSUE PERMIT REVIEWED BY J— !G-z�� DATE >Z C Z 10io9/2001 09:33 FAX 253 512 6573 CORRECTIONAL INDUSTRIES (ao35/asa O • rion Environmental Services 34M 9+avenge so.m 0 willing A 5aiee 5 4 Federal way,Wasi ingtou 98093-6740 '%ME W21FS912535 Telephone Seattle(29)S74-41118•Tacoma (2537 M-6717• Facsimile(253)927-4714 •email 0RION6,M(gael Polarized Light Microscopy Test Report EPA Method 6001R-981116 Client Correctional Industries Environmental Services Date September 27,2001 9704 47'h Avenue SW Bldg. Suite C Page Page 1 o>:3 Tumms, WA 98499 Invoice 011545 Attic Gary Brock Date Received September 25,2001 Project Number NA Project Name Arlington Airport—Lot 111 Clent Orion Sample Asbestos Otber Numbe Number Stsreo Scone Exam Treatment Percent Tie Ibers 11I-01-01a 10925-25a Joint Compound - ND - Cellulose Assoc.w1l11-01-01b 111-01-01b 10925-25b Wallboard ND - Cellulose Homogeneous 111-01-02a 10925-26a Joint Compound - ND - Cellulose Assoc. w/111-01.02b ll1.01-02b 10925-26b Wa5cad - ND Cellulose Homogeneous 111-01-03a 10925-27a Joint Compound - ND - Cellulose Assoc. wil 11-01-03b 111-01-03b 10925-27b Wallboard - ND Cellulose Homogeneous 111-02-01 10925-28 Insulation - ND Cellulose Homogeneous 111.03-01 10925419 Sheetroek ND - Cellulose Homogeneous 111-04-01 10925-39 Building Paper Ash ND - Cellulose Homogeneous l 1 I-05-01 a 1092540a Vinyl Tile Ash ND - Homogeneous 111-05-01b 1092540b Tan Mastic Chloroform ND - Cellulose Assoc. w1l 11-05-01 a 111-05-02a 109254Ia Vinyl Tile Ash AND Homogeneous 111-05-02b 10925-41b Tan Mastic Chloroform ND - Cellulose Assoc. w/III-05-02a VC ut, DEC 19 200? C1 �- satq i ioiO3i2001 09: 33 FAX 253 512 6573 CORRECTIONAL INDUSTRIES �058!a58 Orion Environmental Services 340H 9'An%%t*8m*♦Hn3dkCA soiteS a Federalway Wwkingwa 9MM-040 WBE W2FS912535 Telephone Seattle(253)8744119+Tacoea (:53)962-6717+Fnsimile(253)9274714+email MUGN6717@so1 Polarized Light Microscopy Test Report EPA Method 600/R-98/116 Cbent Correctional Industries Environmental Services Date September Z7, 2001 9704 47°Avenue SW Bldg. Suite C Page Page 2 of 3 Tacoma,WA 98499 Invoice 011545 Attn: Gary Brack Date Received September 25, 2001 Project Number NA Project Name Arlington Asport—Lot 111 C13ent Orion Sample Asbestos Other Nub Number Stereo Scope Exam Ireatment Percent Tne Fiber9 111-06-01a 10925-33a Skim Coat ND - Cellulose Assoc.w!I 11-06-31c 111-06-01b 10925-33b loins Compound ND - Cellulose Assoc.w/111-06-01c 111.06-01 c 10925-33c Wallboard ND - Cellulose Homogeneous 111-06-02a 10925-34a Skim Coat ND - Cellulose Assoc.w/111-06-02b II1-06-02b 10925-34b Wallboard - ND Cellulose Homogeneous 111-06-03a 10925-35a Joint Compound - ND Cellulose Assoc, w/11146-03b 111-06-03b 10925-35b Wallboard - ND - Cellulose Homogeneous I11-07-01a 10925-36a Ceiling Tome - ND - Cellulose Assoc. wit I1-07-0Ib 111-07-01b 10925-36b Wallboard - ND Cellulose Homogeneous 111-07-02a 10925-37a Ceding Texture - ND - Canulose Assoc. w/111-07-02b 111-07-02b 10925-37b Wallboard - ND - CelIulose Homogeneous 111-07-03a 10925-38a CeiingTexture - ND Cellulose Assoc. w/111-07-03b M ioioai:ooi 09:33 pax 253 Sit $373 CORRECTIONAL INDUSTRIES Q037/D53 Orion Environmental Services 34004 9+Avenue See*♦Bending A Ute 5+Federal Way,Washiaatee 95003-67a0 WBE W2FS912535 Telephone Seattle(20)37"119•Tacams (20)952-6717♦Far h"t(253)927-4714•email ORION67I7(pol Polarized Light Microscopy Test Report EPA Method 600/R-98/116 Client Correctional Industries Environmental Services Date September 27,2001 9704 47ie.Avenue SW Bldg. Suite C Page Page 3 of 3 Tacoma,WA 98499 Invoice 011545 Attn: Gary Brock Date Received September 25,2001 Project Number NA, Project Name Arlington Airport—Lot 111 Client Orion Sample Asbestos Other Number Number Stereo Scove Edam Treatment Percent Type Fibers 111-07-03b 10925-33b Wallboard - NI) - Cellulose Homogeneous Dup.-Laboratory QAIQC Duplicate;M;Mastic((a),(b),(c),etc]:Semple Inyers numbered from franc to back Commeatt: For layered samples,each component has been ansl)zed sgxmteiv.ND meow non-detect for asbestos 11bers by EPA Method 6001R-91VIld. Disclaimers: PLM has been known to miss asbestos in a small percentage of samples tint contain asbestos. Thus negative PLM results cannot be guaranteed. This repent may only be reproduced in full with written approval of ORION Environmental Services. Orion samples are analyzed accorchng to EPA IMetflod 6MR-931116 by A114A Bulk Asbestos Analytical Testing Pro 11)proficient analysts. Reviewed By Member AOAC,ACS, AMA Donna McNeal Z"4*mrf 2z rMrs1,Ir11-(4IMF YL-i01fWtmg11W ek2PCmr z Laboratory Director 10/03? 001 09:34 F,11 255 512 6575 CORRECTIONAL INDUSTRIES _. V4038/058 CORRECTIONAL INDUST-R-I-ES" " �� -� � EnvironmenLif SemiceslBuridinq Assessment Awastos/UST q Tacoma.W A 98499 Fe 7v 102- / Phone: (253)5e9-7370 Fwv-CM3)399-rW ! Chain of Custody TO:(Lab) ADDRESS: SAMPLE: TYPE NUMBI R TURN AROUND TIME AM Q 24 Hour SULK 51 48 Naar 901E ❑ ❑Law NOTIFICATION OF ANALYSIS:' Q'6e0ncne J$I ray ❑written ATTENTION: PROJECT NAME: AA iA ra LOCATION: La7 �! JOB NUMBER: SAMPLE DATE: 4 P °( PLE SAMPLE DESCRIPTIQN SAMPLE BY Cerl.9 / Ma + —C{ —of r,-1 •To�l� P l 5/L cc�c� Z5- yl� r — LI IL tt uO — <7-01 5:fA443 antes 3coa-) �� 3S. -07-0 It. 3-7 RELINQUISHED SY: RECEIVED SY* PRINTED NAME: PRINTED 4AME: t7f1 SIGNATURE: SIGNATURE: /1 TIME: /o DATE: Z z- ��0 TIME: !O yl :)ATE: LABORATORY•pLEASE F(MFt V ONE COPY OFTHS CHAIN OF CUSTODY WITH WRlrmq ANLYnCAL RESULTS. NOTE:stop tasting as seen as you pet i posture sample In any one sample=teyury please. 10/03/2001 09:35 FAX 253 512 6573 CORRECTIONAL INDUSTRIES Z048/05& CORRECTIONAL INDUSTRIES Environmental ServicesiBuilding Assessment O CY Asbestos 1 UST ` a Tacoma.WA 98499 phone: (253)589-7370 Fax:(253)589-7388 Chain of Custod TO_( Lab ) O 4) -- ADDRESS,. SAMPLE: TYPE NUMBER TURN AROUND TIME ❑A1A ❑14►dour ❑BULK ❑48 Hour ❑50:L �&Mer �2AD 2— NCTIFICATIONOFANALYSIS: ❑Tdeamne f�F= ❑Written ATTENTION: uln yI PROJECT NAME: LOCATION: o JOB NUMBER: SAMPLE DATE: C SAMPLE# SAMPLE DESCRIPTION SAMPLE BY Cert.# �8 L -C j REUN ( —O 9Y: RECEIVED 9Y: �{. PRINTED NAME: _ 7� G� PRINTED NAME: SIGNATURE. SIGNATUR . TIME: fa `� DATE: 9 )� f TIME: LABORATORY•PLEASE RETURN ONE COPY OF THE CHAIN OF CUSTODY Wr7H WFJTTEN ANLYTICAL RESULTS. NOTE: stop Issung es soon as you yet t positive asmpb in arty one sampb eatsgery plaase. 10/03/2001 09:35 FAX 253 512 8573 CORRECTIONAL INDUSTRIES Q 047J058 OrionEnvironmental Services 34094 9`,krmme South• tt4d&img A Safte 5•Fedsral Way,Wlashwoon 48003-6740 WHE WM912535 Telephone Sestdo(M S744133•Tacoma (253)952-671T•Faaifm7E(253)927-4714#mud 03U0N6717@a91 Total Lead Test Report EPA Method 7420 Client Correctional Industries EnviromncnW Services Date September 27. 2001 9704 47dL Avenue SW,Bldg.23 Suite C Page Page 1 of 1 Tacoma, OVA 98499 Invoice 011549 Attu:Gary Brock Date Received September 25,2001 Project Number NA Project Name ArIkgton Airport—Lot 111 Total Lead Cheat OlUori Material LOD(m&W PPM %by weight Number Nome Dmcriptioo (1094W 1 I1-L-01 I0925-53 Paint Chips—BIue Color, F-=-rior 33.3 3,318.7 0.332 I 1 I-L-02 10925-54 Paul Chips—Silver Color,Exterior 2.17 <2.17 <0.002 Qaaity Assiarance Iaformatfun Method Blank.<5.0 mg/1 Linear Regression Lower Limit:0.990 Actual Bain Linear Regression: 0.997 Check Standard Per Set:-0.6 mg/1 Reviewed By Member AOAC,ACS,AAA Donna McNeal Lm �c irvmcnrrQlCvatpl�a�uCm�rr�lr ylatoAfr,:rCentrq Laboratory Director � ,� I 0 N G' Y f� C i f I I C'* ! 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