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HomeMy WebLinkAbout17625 79TH DR NE_056422_2026 C I IF' r QF F?L I 114G_F F%4 COhIS-I- F?IJGT I CJt" PE F?M I T P'EF?M I T IVQ _ _ IZI5 -64Ea Oxner: OUILCEDA LAND GROUP LLC 9201 WTZ JEAWITA DR KIRKLAND Value of Work: Tax ID: 310523-004-014--00 Phone: 260. 972. 2786 Describe Work: DEMO EXISTING STRUCTURE Proposed Use: Legal Description: MAGNOLIA MEADOWS DIV 2 LOT 6, 7, 8 Job Address: 17625 79TH AVE NE Contractor's Name Type Address License# UTILITY SYSTEMS INC. GEN P. O. BOX 1772 UTILISIO33P4 TOTALS Fee Permit Fee $100. 00 \\ State fee $4. 50 SIGNATURE: TOTAL FEE. . . . . . . . . . . . . . . . . $104. 50 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND PAYMENT!:;. . . . . . . . . . . . . . . . . . $0. 00 K OW THE SAME TO BE TRUE AND COR- ALL PROVISIONS OF LAWS AND TOTAL DUE:. . . . . . ... . . . . . . . . . $194. 50 D NANCES GOVERNIN THIS TYPE OF kB � R WIL BE C PL D WITH WHETHER F�: ' l : 1 O. DATE r t1 RECEIPT # 64 ` DING OFFICIAL A k II � c 01�i • • tilities DepartMent Memo - To: David Anderson, Building peal From: Reta Shepard, Utilities SpeCia jj,- CC: Earl Anderson,Virgil Renfroe Date: April 29,2005 Re: Building Permit#05-6419-6422 demos at 17625 79'hAve The demo permit for BP# 05-641 9 — 64 existing wells or septic systems We have has been reviewed b have the f been Y the Utilities WELL: Any drinking water webs g comments: division. If there are Department of Ecology (DOE) reg�latiolocated on theProperty be provided within 14 days of completinns and evidenc must be decommissioned 9 vvell deco OE inspection and acceptance SEPTIC SYSTEM: Any septic syste rnmissioning, ptance must Snohomish Health District (SHD) regulatS located on the pro must be provided within 14 days of co °ns and evidence Property must be decom Virgil Renfroe of the Utilities Division of Pletrn9 septic s Of SHD inspection missioned per g Cit ystem decom Y of Arlington missionin and acceptance Send evidence of decommissioning, ins 9 must be completed also Inspection by Arlington Utilities Division, 154 W CoX Arlington and acceptance to Reta WA 98223. Shepard at City of 0 Page 1 C ITV OF AFRL_ I P4GTQr4 COI,ISTHUCT I OIV P FEE F M I -I FEE HM I T IVOi_ a 925L5-6 4-2IZA Owner: QUILCEDA LAND GROUP LLC 9201 WTZ JEAWITA DR KIRKLAND Value of Work: Tax ID: 310523-004-014-00 Phone: 260. 972. 2786 Y Describe Work: DEMO EXISTING STRUCTURE ' Proposed Use: Legal Description: MAGNOLIA MEADOWS DIV 2 LOT 6. 7. 8 Jab Address: 17625 79TH AVE NE Contractor's Name Type Address License* UTILITY SYSTEMS INC. GEN P. O. BOX 1772 UTILISIO33P4 TOTALS Fee _ Permit Fee $100. 00 State fee $4. 50 SIGNATURE: TOTAL FEE. . . . . . . . . . . . . . . . . $104. 50 I HEREBY CERTIFY THAT I HAVE READ AND i;AMINED THIS APPLICATION AND KM HE SAME TO BE TRUE AND COR- RE T LL PROVIS ON S OF LAWS AND TOTAL DUE. . . . . . . . . . . . W K ILL4 GOVE iiIl ' THIS TYPE OF . . . . . S1@4. 50 OR IN NCE.� PL . 'D WITH WHETHER S I IED l F Dl NOT. DATI-7 f RECEIPT # � ([, NG - - inicunni, w�ninwr;�r 425 438 1927 P.0i/01 y 0 Al DEMOLITION PERMIT APPLICATION Deparbnvnf of Community Development j City of ArUnplan•238 N Olympla Ave.-Arlington,WA 9M3•Phone (360)403 U31 -FAX(360)403 3441 - WS APMXAT/ON MUST BE ACCOMPAN=0 TtMO(2)SETS OF FULLY DINaVSIONED PLOT PLA S AND SnX CLEAN-UP PLAN,TWO(2)COPIES OF AN ASSEMS ABATEMENT REPORT COMPLETrD 9Y AN APPAOveb AGENCK Type of Permit(check one) ( Residential ( )Commerdel 3105 3-OOLA- oty' w Project Address: � ar A Parcel lQ E; •� r�41-�1y-Ot LotS; �Os�e $ Subditiialon; - ��acse. Suilding Area(Sq Ft) No.of Moors: �� Number of 8uildinpt:-i owner Gk�\C.C\S.C,�—\.O� QC k�. tip ,OM Phone Number, Addrasa: $1\5 )!�r-00A\ ►{, Su�Ze a0q Clty: EVtf#-A ' State: Zip Bode: ContactPemon: ASsa. LI..0 jo barb. yRRS4 phone Number. (tAab� a ale Cell Phone: Fax: E-mail: �'h,�a c7b• Address: krizL �&. Sot. y \ city. EUUe11 Stater Zip Code: 1 QQJ --- Scope of wont �tmo\anon ona ctMou�1 04 400C P�Ui�g ���d�r�i �a m atu way fo r 'P\ak ds.►aeAoPef�tJlk. i 1 i Contractor Phone Number: n Addnu: /a ��S^�i T�(-of7/ °�'�,�,, �o�evi"'(w. ate: �'_ zo Code: 7 � (p C Cont selore I:wnca Number, I hereby certify ftt the above inform0lon is correct and lftatthe constWIom on,and the oocup"ohd 1he use of the rbova- d cAbod prdperty will be In eccordsanc�sy)th the laws.rules and regulations of the Stet of WASNnglon. Ap-pllca s Si nature �•��rr,,—�— Date Print Applicants Name 7 I t APR 2 2 2005 i TOTAL P.01 City of • • DepartmentUtilities Memo To: David Anderson, Building Official From: Reta Shepard, Utilities Specialist CC: Earl Anderson,Virgil Renfroe Date: April 29, 2005 Re: Building Permit#05-6419-6422 demos at 17625 79'h Ave The demo permit for BP#05-6419—6422 has been reviewed by the Utilities division. If there are existing wells or septic systems we have the following comments: WELL: Any drinking water wells located on the property must be decommissioned per Department of Ecology (DOE) regulations and evidence of DOE inspection and acceptance must be provided within 14 days of completing well decommissioning. SEPTIC SYSTEM: Any septic systems located on the property must be decommissioned per Snohomish Health District (SHD) regulations and evidence of SHD inspection and acceptance must be provided within 14 days of completing septic system decommissioning. Inspection by Virgil Renfroe of the Utilities Division of City of Arlington must be completed also. Send evidence of decommissioning, insepction and acceptance to Reta Shepard at City of Arlington Utilities Division, 154 W Cox Arlington WA 98223. 0 Page 1 uricannL ivvrclnwr5r 425 438 1927 P.01/01 ioo DEMOLITION PERMIT APPLICATION DeparbnOng of Community Datrelopment i Clty of ArUngton•238 N Olymplc Ave.-Arlington,WA 9M3-Phone (360)403 U31 -FAX(360)403 3441 7INS APPUCATTON Yusr eE ACCOMPA (2)SM OF FULLY DIMENISJONE'D PLOrPLANS AND WITCW*UP PLAN,TWO 0) COPIES OF AN AsanroS AaATEmemrREPORy COMPLETED BY AN APPROVL AGENCK Type of Permit(check One) (A Reaudenfral ( )Commeftial 3105 3-ooa- OA- too Project Address:-%-rl( s-��A oetwe WE. Parcel ID 0: �105a, -CQy-O\4-01 LoIIS: lo•ri $ S1rbdl01310n; - 'C1ka5c Building Area(Sq Ft) No,of doors: Wh— Number of Buildinp:. - OVR1eW E10 30y\ Phone Number, Aedrou• `><e coy_citf. EVLfLA ' State: W21 ZIP gods: ao Contact Pamon: LLC 4p barla TLUS4 Phone Number. �41a5� 0�5�-a ale Ced Phone: Fax: (4a5> a5 a-9 s% E-mail: d�tcs�@`h i�� a b• Ceo rn Address: yi a\ Nkw, tr �t„ 54t. q D\ City: su"a-A' State: ZIP Co". qmL -- scope ofworh: 1b'CM\kb'A Mr.& t-ut\oual 04 400C emik+\ mu:. way for 'P\a.� bwa�opent,l��. J C . Phone Number:3 0 — �'6 -9.2 V 9 Contraetar: n /-? IDS-/,� r61C eS�/ °C�C �o�e.," 1/3tate:�1' ' ZrOCods: Address: ` Ze / /s/ 0 33 Pq E 6 o G Contradora L"IGtrntia Number. �iratfon; I hereby certify that the elbow informstlon is correct and 1hotthe construction on,and the oacupenoy ohd the usa atft sbeva- de cHhed property will be In Oft ocmdanoe h the laws,ruler:and reguMom of the Mat of Washington. LA r'C C�F>'q A `� `Y q 01�t App��e sigmawre r� Dote Pdnt Applicants Nern• APR 2 2 2005 TOTAL P.01 C I TY UF' ARL__ I r4C3TU114 UOIVSTRUCT I UIV PERM I T PERM I T NU_ o 92!15-6 42 1 Owner: QUILCEDA LAND GROUP LLC 9201 WTZ JEAWITA DR KIRKLAND Value of Work: Tax ID: 310523-004-014-00 Phone: 260. 972. 2786 Describe Work: DEMO EXISTING STRUCTURE+ Proposed Use: Legal Description: MAGNOLIA MEADOWS DIV 2 LOT 6, 7, 8 Job Address: 17625 79TH AVE NE Contractor's Name Type Address License# UTILITY SYSTEMS INC. GEN P. O. BOX 1772 UTILISIO33P4 TOTALS Fee C . Permit Fee $100. 00 '<�� State fee $4. 50 SIGNATURE: TOTAL FEE. . . . . . . . . . . . . . . . . $104. 50 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND PAYMENTS. . . . . . . . . . . . . . . . . . $0. 00 KNu„ THE SAME TO BE TRUE AND COR- TOTAL DUE. . . . . . $104. 50 OR ANCESRNOW TYPE DOF W 1: WIL'. H WHETHER S ) ,, W FIC DATE RECEIPT # �), DING ~ City ofArlington DepartmentUtilities Memo To: David Anderson, Building Official From: Reta Shepard, Utilities Specialist CC: Earl Anderson,Virgil Renfroe Date: April 29, 2005 Re: Building Permit#05-6419-6422 demos at 17625 79th Ave The demo permit for BP#05-6419—6422 has been reviewed by the Utilities division. If there are existing wells or septic systems we have the following comments: WELL: Any drinking water wells located on the property must be decommissioned per Department of Ecology(DOE) regulations and evidence of DOE inspection and acceptance must be provided within 14 days of completing well decommissioning. SEPTIC SYSTEM: Any septic systems located on the property must be decommissioned per Snohomish Health District (SHD) regulations and evidence of SHD inspection and acceptance must be provided within 14 days of completing septic system decommissioning. Inspection by Virgil Renfroe of the Utilities Division of City of Arlington must be completed also. Send evidence of decommissioning, insepction and acceptance to Reta Shepard at City of Arlington Utilities Division, 154 W Cox Arlington WA 98223. 0 Page 1 i. .�unn� iv�nittwr51 425 438 1927 P.01/01 j5'"` DEMOLITION PERMIT APPLICATION ( 1 Z �1 �Z1G�0 N Deparbnenf of Community Development j City of Arlingtnn•238 N Olymplo Ave.-Arlington,WA 88223•Phone (360)403 U31 •FAX(380)403 3441 -TWS APRXAT/0N MUST DE ACCONPAN=r"(2)SETS OF FOLLY DINENISIONLD FLOTPLA S AND WFUCLEMUP PLAN,TWO(2)COPIES OF AN ASSES70S A9UtTF.1<ICNrRr-PORr comPLErED BY AN APPROvEOAGENCIC Type of Permit(check on•) ( Residenf81 ( )Commercial 3105 '3-ooa- Ott- 00 Project Address:-0(°a5-rlg+% Aoetwe W Parcel In 0: � �'004- -- Lot E. �o' , $ Subdiftlon; �Vaau ' LA 13uilding Area(Sq ft) No,of floors: Number of 8ui1&pa:. pwnr 'I0 ,I,M L-a`�`�s� Phone Number, Ad4nu �\\5 coals,�%yA e ao �� EVue'A ' Stets:Sil�R ap qod.:_01ao� --i--- Contact Person: }LP- '40 Qorla Ter-4 Phone Number. Ced Phone: Fax: (�a51 r�5 a-q 55�_E-mail: d r4c&G r l 12 0,b• O M Address: Xr1a\ C tC. yo\ city: F—wa- Stater Zlp Code: q&W scope of Work: dttnol�lnov� ov,l ee Mom o� fax P,?usig b���dvn9s �a maw wad for 'P\n.� bwe�nPs1�e11�. i CoMraeter. ��TZ/ G/`7 Y `' X 7 C- mLP, C Phone Number: �O O -5-6 s -9 a 7 9. Addnaa: �`2 1..2,S^1i r�L eS�/ a��C'1 rods e �S�lStale: '!:�l/� 7. Zp Code: 0 9 �.. Zeil��s� 033�� . 6o ContMelor's L'icerlia Number. — E�heBan: ,_ ; I hereby centfy that the above infonm0lon is correct and Wthe conslWlon on,and the oocup"9hd the use a/lhe ebove- de cAbed PrdPerty will be In w=cwdoncey� h the laws,rule&and regulatlom of the.Stal of W"Nngton. Agplka s B+gmture Data Print Applicants Name APR 2 2 2005 F I TOTAL P.01 G I T1F UF= ARL- I hlGTON C"ME;-r FtUCT' I ON PE F2M I T PE FZM I T NO.. _ 121S—Ex 4 1 9 Owner: ®UILCEDA LAND GROUP LLC 9201 WTZ JEAWITA DR KIRKLAND Value of Work: Tax ID: 310523-004-014-00 Phone: 260. 972. 2786 Describe work: ADEMO EXISTING STRUCTURE Proposed Use: Legal Description: MAGNOLIA DIV 2 LOT 6, 7, 8 Job Address: 17625 79TH AVE NE Contractor's Name Type Address License# UTILITY SYSTEMS INC. GEN P. O. BOX 1772 UTILISI033P4 TOTALS Fee Permit Fee a100. 00 --� State fee $4. 50 SIGNATURE: TOTAL FEE. . . . . . . . . . . . . . . . . 6104. 50 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND PAYMENTS. . . . . . . . . . . . . . . . . . $0. 00 THE SAME TO BE TRUE AND COR- ALL PROVISIONS OF LAWS AND TOTAL DUE. . . . . . . . . . . . . . . . . $104. 50 U Di .ANCES GOVERNI THIS TYPE OF W RI{ WILL l 1-. ..,:, PL WITH WHETHER S C F I�;C FT2 0 -: NOT. DATE � � � RECEIPT # I-ING OFF C 1 i APR-21-2005 12:13 INTEGRAL NORTHWEST \ 425 438 1927 P.01i01 • 1 ji � DEMOLITION CATIO D �PERMIT APPLI 1�� Department of Community Development City of ANtngton•238 N Olympic Ave.•Arlington,WA 98223•Phone (360)403 2431 -FAX(380)403 3441 -TW3APPUCAT1ONUU3rEEACCOMPANlF-0rM(2)SErSOFFUI.LYDIMENISIOXEDjeLOTPLA SAMDSnYCLEAN-UP PLAN,TWO M COP-ES OF AN ASSPSTOS A9ATEUENT REPORT COMPLEM AY AN APPROVeb AGENCY. Type et1 Permit(check one) ( Resitfen6al ( )CommerrJel 31015 Oda. O1t{- 00 Project;Addrese:-k!](OaL,5-VI-g'!� Parcel ID0; �rX•� - ►�-0\41-01 LolS; ko, $ 5ltbdlVlslon: \� m s �N"M Building Area(Sq Ft) No,of floors: Numbet of 8uildl ":. 4 owmr. QLOA ,� off. of o UN\ 1-av hrici Phone Number, Ad4reae: $\\5 ii , bv\k e 51o_q eny; EQ-Lr#- t ' State:�2$._ zip Bode: ContactPeraOh: N\�0." IC,ho�et' AStyoc. LLr 110 tWla- TUM Phone Number. (ya p a5�-a>�ale Cad Phone: _Fax: (410\5> ;sa-qs5\E-man: d`cu,f, h4a ab• c,�►� Address: \ha\ &W, t\ gyc•, stt,. qo\ City:—F-UUa.1l state:.fit ZIDCOde: 2&a° ---- scope ofWork: t m\kim w%& QMou of 400C evik%ig b,t►�dvi�S -to mac way for Contractor: - G Phone Number: o -ZQ 711151 0 9 C) to tfv e v�rs N i9 Zrp.Code: 9 � ` 0 Address: RY o ./` 2 G COfltredOr's L'rcenie Number. l �P� EKpIrjNan:�.r 6 0 i hereby certify ftt the above informeWn is correct end OWthe constWIon on,and the occupancy ehd the use offt Wow - d edbed property will be In seead h the taws./ruler,and regulallons of the Stet of WasNington. LA �OLy� �v C , a Clut . C9G App s Bignalure Date PdM Applicants Name z l S RECEIupYpY VED i . APR 2 2 2005 17" l I•� BU,"ill-NING DEM I TOTAL P.01 �N. 04 DEMOLITION sUBMI'r TAL • CHECKLIST 'P�r�G.�0 Department of Community Development tCity of Arlington• 238 N Olympic Ave. •Arlington,WA g8223 • Phone (360)403 3431 • FAX(360)403 3447 Use this checklist to ensure that all necessary information is provided for review of your project. Re uirements for Submittal ✓ A completed demolition permit application V/ Two (2) sets of accurate fully dimensioned plot plans ✓ Two (2) sets of asbestos abatement reports Required Ins ctions e Termination of Utilities Provide documentation of hazard disposal at final inspection Final site inspection when demolition is completed. 24-hour Notice of Request for Inspection Call the 24-hour inspection line (360) 403 0674 J ON04 DWA FormslchklsUDEMOCH KLST HIGA• BURKHOLDER LJ -D Li L I /-- I L �, L. L l___. RECEIVED LAND USE PLANNING / CIVIL ENGINEERING APR 2 2 2005 LETTER OF TRANSMITTAL COA BUILDING DEPT TO: Linda DATE: April 21,2005 City of Arlington Development Services FROM: Darla Reese RE: Magnolia Meadows Division 2 WE ARE SENDING YOU XJ ATTACHED UNDER SEPARATE COVER VIA THE FOLLOWING ITEMS: (1)Copy-Demolition Permit Application (1)Copy-Demolition Submittal Checklist (2)Copies-Asbestos Survey by Alternative Technologies,LLC (2)Copies-Sheet 2/8-Showing building demensioned plot plan THESE ARE TRANSMITTED: FOR APPROVAL FOR YOUR INFORMATION AS REQUESTED FOR REVIEW&COMMENT FOR REVIEW, SIGNING&RETURNING X FOR SUBMITTAL EVERETT ■ 1 721 Hewitt Avenue ■ Suite 401 ■ Everett,Washington 98201 ■ (425)252-2826 ■ fax: (425)252-9551 SPRINGFIELD 2 150 North 7th Street 0 Springfield, Oregon 97477 0 (541)S88-1862 ■ fax: [541)988-1863 - APR-05-2005 15:30 INTEGRAL NORTHWEST 425 438 1927 P.01 (alternative technologiesLLC "Business Builton Relationships August 24,2004 "ill John Lakhani APR 2 2 2005' SPH Asdets Corporation 8115 Broadway Avenue,Suits 204 Everett WA 98203 C.(DA I"li,' Re Asbestos Survey—17625 79th Avenue, N.E.,Arlington,WA 98223 Dear Mr. Lakhani, Introduction: Alternative Environmental Technologies (AET) conducted an asbestos survey of the subject site on August 13, 2004. Mr.Alfred Rowe, Ms Aretta Rowe, Mr. Dale Packard, Mr. John Lakhani and Mr. Kamil Lakhani were the site contacts. Mr. Rowe authorized access to the subject site for the asbestos survey. Inspection: Brian Hunt inspected the subject site and took bulk samples for analysis of asbestos containing materials in the single story, 3-bedroom/2 bath single-family residence and a storage and office shed. Tho site also had two trailers, a junkyard containing miscellaneous vehicles; metal and wood scrap piles, and covered work areas, which were not included in the asbestos survey. Two sheds were not' respected, the jewelry.shed with the metal covered built up roof and the metal workshop due to excessive clutter was only visually observed from the SW do6r. Sampling & Analysis: Brian Hunt took a total of 20 samples from various building materials. Modified AHERA methods were used including strict chain of custody procedures f6r labeling, recording, transporting and release of the samples to NVL Laboratories, Inc. The samples were subsequently analyzed for asbestos using Polarized Light Microscopic (PLM) methods. AET building inspectors are AHERA certified and NVL laboratories are NVLAP accredited for asbestos analysis. The user requested the report be provided prior to completion of standard laboratory quality control(QC) review. If the results differ from those found in the draft analytical report, the user Will be contacted by telephone and if necessary a revised report Will be sent by mail, as an addendum, within 10 days. Otherwise, the QC analytical data Will be kept on file at AET and NVL laboratories and copies can be made available upon request. Results: The results can be found attached in the chain of custody and analytical reports. The total materials sampled are listed below in Table 1.The asbestos containing materials for samples taken at the subject site were vinyl flooring materials and mastic. Discussion: Any contractors working with the asbestos containing material should be provided a copy of this report prior to starting work activity. Asbestos-containing materials refers to any material containing more than 1%asbestos. 1. PSCAA Notification: The Puget Sound Clean Air Agency (PSCAA, Regulation Ill, Article 4) requires notification for asbestos removal and demolition and dust control measures for building demolition and remodeling. Questions regarding PSCAA requirements should be directed to Teri Story (x4090) or Larry Vaughn (X4035) at 800.552.3565, or for forms and regulations go online at www.pscleanair,org. ?hone/Fax: 425.514.0444 4917 Evergreen Way#9 Everett,WA 98203 brian@alternative-technologies.com I of 3 www.alternative-technologies.com APR-05-2005 15:30 INTEGRAL NORTHWEST 425 438 1927 P.02 2. Satiety For interpretation of policy and the Department of labor & Industry regulations contact John Stebbins(360.902.5514 or go to www.lni.wa.gov). Where power tools are to be used on non-asbestos containing materials, dust control measures need to be observed. For general information call Labor& Industry at 206.515.2800 for guidelines on the proper use of power tools and dust suppression. For a copy of the regulatory requirements, WAC 2N-62, Part 1-1,go to: htto://www.lni.wa.gov/WIS HA[Ruies/aeneralQ=PationalhealUVHTMll621-1 1.htm 3. Contractors: Certified workers are required for removal of asbestos containing materials as identified In this survey. Recommended asbestos abatement contractors are listed below. Company Contact Telephone Affordable Abatement Larry Whitley 425.303.8072 E-M Eric Maughan 425.867.3269 %Nalker Specialty Construct] I Bill Walker 206.361.8913 4. Wallboaal Systems: According to the EPA notification of clarification to the final rule, regarding the analysis of mu"yered systems, the joint compound/tape applied to the wallboard becomes an integral part of the wallboard and in effect becomes one material forming a wall system and a composite analysis should be conducted. According to Larry Vaughn, PSCAA, there are no requirements for removal and disposal when the wallboard system is intact and the composite sample is<1%asbestos. The WISHA Regional Directive (WRD 23.30-Asbestos-Containing Joint Compound In Wallboard Systems, 12/28100)states that where the full depth of the wallboard system has been sampled and the results are less than 1 % asbestos, the work will not be considered an 'asbestos abatement project". However, WISHA enforcement staff may elect to collect samples of dust or debris from the workplace or sample specific materials to make an assessment of the hazard represented by these materials. 5. Lead: The residential building was built prior to 1978. The paint on the buildings was not sampled for lead analysis and therefore painted surfaces should be assumed to contain lead. In the state of Washington any level of lead is regulated. Therefore, contractors should be notified prior to demolition for worker protection. Warranty: Contractors will need to do their own asbestos containing material take offs for bid purposes. Work activities that create dust may require worker protection, training and air monitoring to demonstrate that there has been no worker exposure to asbestos or lead in construction during demolition activities. The jewelry shed was not sampled and the built up roof was covered with metal. The asbestos survey covers the residence, office and east sheds. The contacts and regulations provided herein should not be considered comprehensive and have been included for user review and use if there are any questions concerning worker safety and notification requirements. Summary. Asbestos containing materials were reported for the subject site was mainly in the flooring materials. The material was in fair condition but may become friable upon removal. Asbestos is regulated and the information for required notification and worker protection have been provided and recommended. You have been provided two copies of this report A copy of this report should be given to any contractors working in the areas described above which will potentially disturb asbestos containing materials. If you have any questions regarding this report,you can contact me at 425.232.9860. Sincerely, Brian Hunt, Project Manager, Sr. Environmental Consultant AHERA Building Inspector Certification#3509-03-C81-01,exp 8/26/04 End. NVL Analytical Results 8 Chain of Custody;BI Certification 2 of 3 APR-05-2005 15:31 INTEGRAL NORTHWEST 425 438 1927 P.03 The Rowe Residence Asbestos Sample Date: 8113/04 AET Report Date: 8/24/04 Table 1: Sample dr Analytical Results S l S Material %Asbestos Comment 1 Wenpaper ND Residence NW Bdnn/Closet ceilin 2 Wall Texture ND Residence NW Bdrm E.WAIM C.Bdfm 3 9'Green VAT 3%Chrysotile Residence W.Central Bdnn Closet-NF-16 fr 4 12'Calflng Tile ND Residence W.Central Bdrm 5 Gypsum Wallbbard Composite <1%Chrysotile Residence Hell outside NW Bdrm-Friable 6 Vinyl Sheet- a eNmastic 55%Chrysofile Residenoe Bathroom off NE Bedroom-Friable-72 fr 7 9'brown VAT 4%Chrysotile Residence Plano Rrn--mastic ND-NF-315 fr 8 9'brown VAT 3%Chrvsotle Residence Hall/Central Bath-mastic ND-NF-16 fe 9 Coiling wallpaper ND Residence Central Bathroom cabinet 10 Vinyl sheet. ND Residenoe Central Bathroom-C brown&tan Peftm 11 MasUc ND Residence Central Bathroom-pink wall file 12 BI ray wallpaper ND Residence water heater room 13 9'VFT&Vinyl sheet ND Residence Kdchen&Dini area NF--315 R` 14 Ceffing wallpaper ND Residence under plywood panel 15 Attic insulation ND Residence above east bade porch 16 Vapor barrier ND Residence exterior siding 17 Roofing material ND Residence 3 tab composMon&vapor banier 18 Roofing material ND Fast shed 19 Roofing material ND Office shed(suspect mold on shee"&inside shed) 20 G um wallboard ND Office shed composite F Friable I NF Non-friable ND None detected 3 of 3 APR-05-2005 15:31 INTEGRAL NORTHWEST 425 438 1927 P.04 NVL Laboratories, Inc. adp 4708 Aurora Ave. N., Seattle,WA 98103 #102063 Te1: 206.547www. Fax: .e34.+93e Bulk Asbestos Fibers Analysis wuvw.nvllabs.com By Polarized Light Microscopy Client Alternative Technologies Batch M 2411509.00 Address: 4917 Evergreen Way #9 Client Project#:2267 Everett, WA 98203 Samples Received: 20 Attention:,Mr.BrFan Hunt Samples Analyzed: 20 Project Location: Rowe/ Arlington Method: EPA/600R-93/116 Lab ID : 24064189 Client Sample #:1 Location: Rowe/ Arlington Layer 1 of 2 Description: Brown fibrous material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Fine partides,Paint Cellulose 75% None Detected ND Layer 2 of 2 Description: Brown fibrous material with asphaltic mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Fine partides,Asphalt/binder Cellulose 85% None Detected ND Lab ID : 24064190 Client Sample #:2 Location: Rowe/Arlington Layer 1 of 1 Description: White compacted powdery material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Paint,Binder/Filler Cellulose 3% None Detected ND Lab ID : 24064191 Client Sample #:3 Location: Rowe/ Arlington ayer 1 of 2 Description: Green tile Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder Cellulose 2% Chrysotile 3% Layer 2 of 2 Description: Black asphaltic fibrous felt with mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/binder,Fine particles Cellulose 15% None Detected ND Lab ID : 24064192 Client Sample #:4 Location: Rowel Arlington Layer 1 of 1 Description: Brown fibrous material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Paint,Fine particles Cellulose 65% None Detected ND Lab ID : 24064193 Client Sample #:5 Location: Rowe/ Arlington Comments:Composite result for whole sample is less than I% asbestos Layer 1 of 2 Description: White compacted powdery material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder,Fine particles Cellulose 2% Chrysotile 2% Sampled by: Client Analyzed by: Steve Zhang Date Analyzed: 08/17/2004 DRAFT— Note: If samples are not homogeneous,then subsamples of the components were analyzed separately.All bulk samples are analyzed using EPA 6001R-93H 16 Mothod 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. Page 1 of 5 APR-05-2005 15:31 INTEGRAL NORTHWEST 425 438 1927 P.05 NVL Laboratories, Inc. 4708 Aurora Ave. N., Seattle, WA 98103 #102083 Te1: 206.547 Fax:206.634.,938 www.nvllabs.com Bulk Asbestos Fibers Analysis www. By Polarized Light Microscopy Client:Alternative Technologies Batch #: 2411509.00 Address: 4917 Evergreen Way #9 Client Project#:2267 Everett, WA 98203 Samples Received: 20 Attention: Mr.Brian Hunt Samples Analyzed: 20 Project Location: Rowe/Arlington Method: EPA/600R-93/11.6 Layer 2 of 2 Description: White chalky material with paper Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Fine particles,Calcareous binder Cellulose 250/6 None Detected ND Lab ID : 24064194 Client Sample #:6 Location: Rowe/Arlington Layer 1 of 2 Description: Tan vinyl Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder None Detected ND None Detected ND Layer 2 of 2 Description: Gray fibrous backing with mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: Fine particies,Mastic/binder Cellulose 25% Chrysotile 55% Lab ID : 24064196 Client Sample #:7 Location: Rowe/Arlington Layer 1 of 3 Description: Brown tile Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder None Detected ND Chrysotlle 4% Layer 2 of 3 Description: Black asphaltic mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder,Flne particles Cellulose 3% None Detected ND Layer 3 of 3 Description: Brown mastic with fibrous material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Fine particles,Mastic/binder Cellulose 15% None Detected ND Lab ID : 24064196 Client Sample #:8 Location: Rowel Arlington Layer 1 of 2 Description: Tan tile Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder None Detected IUD Chrysotile 3% Layer 2 of 2 Description: Black asphaltic mastic with fibrous material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder,Fine particles Cellulose 25% None Detected ND Lab ID : 24064197 Client Sample M 9 Location: Rowe/Arlington Sampled by: Client Analyzed by: Steve Zhang Date Analyzed: 08/17/2004 DRAFT_ Note:If samples are not homogeneous,then subsamples of the components were analyzed separately.All buck samples are analyzed using EPA 600/R-93/116 Method with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%,100/6=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 imited 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 NVL.AP or any other agency of the US Government. Page 2 of 5 APR-05-2005 15:32 INTEGRAL NORTHWEST 425 438 1927 P.06 NVL Laboratories, Inc. abate 4708 Aurora Ave. N., Seattle,WA 98103 #102063 Te1: 206.547.0100, bsc83 8. 4.1936 www.nvuabs.comom Bulk Asbestos Fibers Analysis By Polarized Light Microscopy Client:Alternative Technologies Batch #: 2411509.00 Address:4917 Evergreen Way #9 Client Project#:2267 Everett, WA 98203 Samples Received: 20 Attention: Mr.Brian Hunt Samples Analyzed: 20 Project Location: Rowel Arlington Method: EPA/600R-93/116 Layer 1 of 1 Description: Brown fibrous material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Paint,Fine paMdes Cellulose 85% None Detected NO Lab ID : 24064198 Client Sample #:10 Location: Rowel Arlington Layer 1 of 3 Description: Grey vinyl Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type:.% VmyVbinder Cellulose 2% None Detected ND Layer 2 of 3 Description: Brown mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/binder Cellulose 2% None Detected ND Layer 3 of 3 Description: Black asphaltic fibrous backing with mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder,Mastic/binder Cellulose 45% None Detected ND _Lab ID : 24064199 Client Sample #:11 ,)cation: Rowe/ Arlington Layer 1 of 1 Description: Brown brittle mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/binder,Fine particles Cellulose 3% None Detected ND Lab ID : 24064200 Client Sample #:12 Location: Rowe/ Arlington Layer 1 of 1 Description: Gray fibrous material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Paint,Fine partides Cellulose 75% None Detected NO Lab ID : 24064201 Client Sample #:13 Location: Rowe/ Arlington Layer 1 of 5 Description: Brown fibrous material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Fine particles Cellulose 85% None Detected ND Layer 2 of 5 Description: Grey vinyl Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder None Detected ND None Detected NO Sampled by: Client p /� Analyzed by: Steve Zhang Date Analyzed: 08/17/2004 D RAFT Note:If samples are not homogeneous,then subsamp{es of the cwWnents were analyzed separately.All bulk samples are analyzed using EPA 600/R-93/116 Method 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 NIILAP or any other agency of the US Government Page 3 of 5 APR-05-2005 15:32 INTEGRAL NORTHWEST 425 438 1927 P.07 NVL Laboratories, Inc. p��p 4708 Aurora Ave. N., Seattle,WA 98103 #1102063 Te1:206.547www. Fax: 634.1936 Bulk Asbestos Fibers Analysis www.nvllabs.00m By Polarized Light Microscopy Client:Alternative Technologies Batch #: 2411609.00 Address:4917 Evergreen Way #9 Client Project#:2267 Everett, WA 98203 Samples Received: 20 Attention: Mr. Brian Hunt Samples Analyzed: 20 Project Location: Rowe/ Arlington Method: EPA/600R-93/116 Layer 3 of 5 Description: Brown mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % MasticIbinder Cellulose 2% None Detected ND Layer 4 of 5 Description: Beige vinyl Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % VinyVbinder None Detected ND None Detected ND Layer 5 of 5 Description: Black asphaltic fibrous backing with mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Fine particles,Mastic/binder Cellulose 45% None Detected ND Lab ID : 24064202 Client Sample #:14 Location: Rowel Arlington Layer 1 of 1 Description: Gray fibrous material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Paint,Fine particles Cellulose 80% None Detected ND Lab ID : 24064203 Client Sample #:15 )cation: Rowe/Arlington Layer 1 of 1 Description: Gray fibrous material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Fine particles Cellulose 85% None Detected ND Lab ID : 24064204 Client Sample #:16 Location: Rowe/Arlington Layer 1 of 1 Description: Black asphaltic fibrous felt Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalbbinder,Fine particles Cellulose 85% None Detected ND Lab ID : 24064206 Client Sample #: 17 Location: Rowe/Arlington Layer 1 of 2 Description: Black asphaltic material with mineral grains Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder,Fine particles Glass fibers 25% None Detected ND Layer 2 of 2 Description: Black asphaltic fibrous felt Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder,Fine particles Cellulose 85% None Detected ND 01 Sampled by: Client p /� Analyzed by: Steve Zhang Date Analyzed: 08/17/2004 D RAFT .10 Note:ff samples are not homogeneous,then subsamples of the components were analyzed separately.All bulk samples are analyzed using EPA 600/R-93/116 Method 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 Page 4 Of 0 APR-05-2005 15:33 INTEGRAL NORTHWEST 425 438 1927 P.08 NVL Laboratories, Inc. ada 4708 Aurora Ave. N., SeatUe, WA 98103 #102083 Te1:206.547www. bs.com8.834.,938 Bulk Asbestos Fibers Analysis wtuw.nvllabs.com By Polarized Light Microscopy Client:Alternative Technologies Batch #: 2411609.00 Address:4917 Evergreen Way #9 Client Project#:2267 Everett, WA 98203 Samples Received: 20 Attention: Mr.Brian Hunt Samples Analyzed: 20 Project Location: Rowe/Arlington Method: EPA/.600R 83/116 Lab ID : 24064206 Client Sample #:IS Location: Rowe/Arlington Layer 1 of 2 Description: Black asphaltic material with mineral grains Non-Fibrous'Materials: Other Fibrous Materials:% Asbestos.Type: % AsphalUbinder,Mineral grains Glass fibers 25% None Detected ND Layer 2 of 2 Description: Black asphaltic fibrous felt Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalbbinder,Fine particles Cellulose 75% None Detected ND Lab ID : 24064207 Client Sample #:19 Location: Rowe/Arlington Layer 1 of 1 Description: Black asphaltic material with mineral grains Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder,Mineral grains Glass fibers 25% None Detected ND Lab ID : 24064208 Client Sample #:20 Location: Rowe/Arlington ayer 1 of 1 Description: White chalky material with paper Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Fine particles,Calcareous binder Cellulose 35% None Detected ND Sampled by: Client Analyzed by: Steve Zhang Date Analyzed: 08/17/2004 DRAFT Note:If samples are not homogeneous,then subsamples of the components were analyzed separately.Ali bulk samples are analyzed using EPA 600YR•931116 Method with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%,1 0%=5-15%,20%=10-30%.50%=40-60%).This report relates only to the items tested. 1 sample was not collected by NVL personnel,then the accuracy of the results is Irnited 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 rage 0 or 0 APR-05-2005 15:33 INTEGRAL NORTHWEST 425 438 1927 P.09 NVL Laborvit©ries� inc. CHAIN of CUSTODY 6ATCH ID 4708 Aurora Ave N.Seattle,WA 96103 �+ V o Tel: 200-547.0100 Emwp.1"A 204.344.1b78 SAMPLE LOG 241150 Fax:20tl.034AM 1.8U.NVL,LAS9(ea5.5227) clan!AtUmadve Teohnolo9les _ NVL Batch Number ------ ltrsat 4917 Evsr"n-Way 09 Client Job Number Everett,WA 48203 Toth Saviss Pro)sat Yanapw Boom-Hunt - — Turn Around Time 2t+ a z4 M j 4Hn ❑2 6 �- _ C7 4-Hro 0 3 Ot PryN!Loconn / —"' P1nse ad 1br TAT let Mn V We 9=0 address OM4 80I.COM phww: (426)614-0444 Pax: (425)514-0444 _ call:(425)232-9860 Aebeefoo Alr 10 PCM IDt3H 7400 O TE.tA(1410SH 7402) 0 TEMP TEM(EPA Level iq 0 Other Aabestoe Wik PLM(LP/VMR-931118) ❑PLM(EPA PoW 0ourtt) p PLM(EPA GnMmet y) Cl TEM Bulk ❑MCI ❑Mold Air Mold Bulk Rotomgor Calibration MST 1 U Meft RC Metals NI 8 r M s ❑TOW M41118 ❑FAA(ppm) r LjPaKQvMinaM0Mwlc ) C7 Mercury(h0) (CU) *TCLP ❑ICP ) D Drinkkig water ❑Worts water O Barium(Ba) ❑Sslwtium(60) MCW M (]oFA7►(pob) O du*Wps(Area) 0 00w C7 Cadmk►m(0d) ❑Over(4) ❑M Cl chromium(Or) O Paint Chips In% ❑Lead(Pb) ❑Othw Types _J Flberylass O Nulssnco Dust D 09W(Specify) o1 An*Ws 3 Silica ❑Respirable Dust .._. Condition of Packapr D Good ❑Dameped(no apolsge) O Severe darfwps(spite) yq.d Lab 10 CIIeM Sample Number Comments L9=ample tree,Sample Volume,eta 4 6 1 -Nun" ch d Irfy f'I L e ✓ ! - " 7 rl �... 9 Roo,jet 11 13 1, all �. , 14 if I PAM Below- ��A. low_. r . Mpany Date T inn R*Nnqulsmd by' 0 Anal d _ _ -- Rasults Called b,y __ ---- - Rasulte faxed _ _ .__. _..,._ _ -•---._.. _ _ -- Special Instructlone: Unless requ ed h writing,ea samples oral be disposed of two 2)weeks after analysis, APR-05-2005 15:33 INTEGRAL NORTHWEST 425 438 1927 P.10 NVL Laboratories, Inc. CHAIN of CUSTODY BATCH III 4708Aurors Ave N,9aittM;WA�103 2411509.00 Tel: 20d,547.0100 Emsrp.Pepsr:20OM4.18n SAMPLE 1.00 Few M.t134.19118 1.fW9.WlLLAB8(W.522-n CNam Altem dv0 T ti►LoIO�IPa .._..1---•-• NVL IWch Number ....._... ._...._.. ... .. flnst 4917 Ev_erq .Wsy ttt8 Client.lob Number ---- - .---E ToW Samples verett,WA g82t}3 .. ---....__..... .... Caroled Manapw Brl!n H t^- _ _ Turn Around T1ma []1+Ir C:24-Mrs LI Project Location - ; 1. - --- Cl44tt L!ll - --- d:pxwos�q Please all for TAT we tllalt 24 Hm Rmall address _ Phons: (_425)514-0444 Fru_t: (425)814-0444 _ C*N;(425)232.WO lJ Asbestos Alr PCM(NIOSH 7400) --TEM(NI09H 7402) 1.1 TEM(AHERA) [!1FM�EPA Level II)»L Other ^- t1C/LL/'JIiLL:J.]�LYfa�loll.V.1JItRutT—����• .-_ -__ 'lam' _ ._ hbeetas Bulk (EPA�80WR-9S/118) F1 PLM(EPA Point Count..—. - - - - _ - _ ) f]PLM(EPA Gravimetr�+) t_1 TEM Bulk 1 .._ -'-.raga R'n --"-'-•_—'-_'-•--___.1...._..___._.•=•=•_-+m----_.. .. CJ ItloldlFungus C t1Aok1 Air (]Mold Bulk -l.l Rotom•t•r Calibration __�--•---.._.__-_.._-_.... MET�u.e •tiio.e umii�Mairs�i`�. _ _.. _. aciU►M _.._� arit. tcl - etats �lAN L.:.ffatalMetals _ OFAA ArFlkii_. _TTFfaTnf�hlpsT cm ;: ----- _. _._.. (PPm) I Ar,i•n ci-(Aar - �;Mercury(Hqq) -� � C7 ICP(ppm) rJ Drinklrq water l'1 Waste water �*--I Badurn(Be) C]3etentum(3e) I Copper(Cu) LI GFAA(ppb) U OuWwipe(Area) (.)Athw I_.Cadmium(Cd) n Oliver(lip) 7 Nlakel(NI) 0 Sol 'F]Chromium U Paint Chlpe In% 17 Load(Pb) (Cr) I Zhic ) rOtherTipq �Flbefglaq CNulSanceDust rl0ther(3pedty) �_a.sm•eurfsr9 -af An#malik__0 Silks I..1 Respirable Dust ORWIllon of Package:[7 Good ❑Damaged(no eplpaps) 17j8evere damage(soliaps) Lab ID CIfMt Sampl•Nurnbsr 1 Ccmmonb(•. Sam )ears,a,ampte Vaunwr•tom — -� _ A/R_.---- - - - -.. . .. _--- --- -- --- . •(,ss.9 S&• p - -_... -� u • 2 - --- -• .---_ ....-��--•--•--- 1?�A•t'N, .1���:�s-s�G.M� ��� •�v✓ lj�da✓--..f�F''r��'f' ... 5 1 _^ , _`' l3 12 14 19 .%gH Lod.. __ Comp�rtf!__. 9 _T.i►rllt____) =s I•d Rsltnqulshed_ R•a•Ivedb yy Ron ults Faxed Results Called Speoial Instructions: UnlsaS requested In wrtting,ell gam keswill be disposed of two(2)2eks after analysts. APR-05-2005 15:34 INTEGRAL NORTHWEST 425 438 1927 P.11 V /et C ■� cD C 3 ca U C E C as 0 Co '0 C W p Q � �j V o C,a? L 0 C: LD co FA IUL t— m m Lq 1co IM � 4 Cc N off- E w � aidSLb _ c Q m P � co 5 TOTAL P.11 ,. City of Arlington 1.frrifir-�: oil/ Building Department REQUEST FOR REVIEW FORM NAME: �(1L(J!� L&Vl�jlmj P BP #: 05-1&4/q lAL420 &b l DATE: 4 a-SI O cZ— RETURN THIS FORM BY: 5-W.L PROJECT SUMMARY: u. WUD of- S RESPONDING DEPARTMENTS: ❑ TOM C., FIRE ---KAREN L., UTILITIES ❑ DERYL T., UTILITIES ❑ BILL B., NATURAL RESOURCE U YVONNE P., PLANNING ❑ GREGG E., ENGINEERING ❑ JIM T., CONSULTANT CHUCK W., CONSULTANT 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. 11 ( ❑ COMMENTS FOR THIS REVIEW ARE IN ATTACHED MEMO ❑ NO COMMENTS FOR THIS REVIEW, OKAY TO ISSUE PERMIT ❑ COMMENTS REVIEWED BY DATE DepartmentCity of Arlington Utilities Me' mo To: David Anderson, Building Official From: Reta Shepard, Utilities Specialist CC: Earl Anderson,Virgil Renfroe Date: April 29, 2005 Re: Building Permit#05-6419-6422 demos at 17625 79''Ave The demo permit for BP#05-6419—6422 has been reviewed by the Utilities division. If there are existing wells or septic systems we have the following comments: WELL: Any drinking water wells located on the property must be decommissioned per Department of Ecology(DOE) regulations and evidence of DOE inspection and acceptance must be provided within 14 days of completing well decommissioning. SEPTIC SYSTEM: Any septic systems located on the property must be decommissioned per Snohomish Health District(SHD) regulations and evidence of SHD inspection and acceptance must be provided within 14 days of completing septic system decommissioning. Inspection by Virgil Renfroe of the Utilities Division of City of Arlington must be completed also. Send evidence of decommissioning, insepction and acceptance to Reta Shepard at City of Arlington Utilities Division, 154 W Cox Arlington WA 98223. 0 Page 1 EX. OUTFALL� I I 6 I I IE = 373.99 .. ... - .., G ;.It:� I �� I I i�ii::i�::i��ai i�i_r • i :ii lii.•• •....a_,i ii::iri.i *4eF. F LIMITS 0 C RING :II ; A.-F 1 iI`;:; , ;.ct.F LEA 36" .. Syr FILTER FENCE ;; C. _ NO '2 '4 "E 3 6. 9'IF IF 00 Or F F F 3 F F _:_• _: - - - - — I r^ Z 20' "C. A 'EX. 8`'SD. y r ^� 30'C.{r GRADING 0 BE f;; „s7s I..... \-. ... . ADJUSTED AS NEEDED p 376 . . \ r% 3s'c. AROUND XISTING p0� 244 F ID � ;ry O TREES TO REMAIN-- �2'0- '4HO ORANGE BARRIER Fa, � 30% WY tpFENCING AROUND TREESTO REMAIN TYPICAL 6'C.IE - 374.14 ��� CHICKEN 6 C. ` COOP O ;?2•STUMP Q F-- - -I _...._ \ o �gH 4 + Z m 24"H. '3� ALL EX. STRUCTURES TO BE REMOVED 9 FILTER FENCE W APR 2 2 � •H. ui ' i 2005 0 -H 20•Ii. o I'- LIMITS OF CLEARING I r 1 24'H. t q C) �� I y \ y EX. OUTFACE i bUiLDiNG 00-ILDING REMOVAL op w ' IE = 374.46 3js SUBJECT 0 DEMOLITION 1�H o PERMIT TYPICAL I UD \ I �• F•• y 36"H.= 24"C• B 16�X16 OCD EX..'8uSb- 18'C. 3�' . �x r r? { EX. INTAKE �'1 1P 2 C. '�r!,�� -EX., 24'H. IE 374.60 -36'C. 24'C. �'� 3o"C. GARAG EX. IOU \ SHE - II MAW 7+0O 79TH DRIVE N.E. 14"I4. �' ►C ' 20"C..,�• IP 16-C ,��'`'4. 12-H. ! . . . . �i P s r a ` 24'C g 14 C. t i I 16'M. 20-C R -24" I t '12'H. . =16"C. 30"C. �M r' 36 U. • t a 36"C 6�4 l 24"Hr: - . CA STABILIZED(BLIT—EMPDRARY 2a C. 3o'C." E,iw ---- ---= ---------�--- CONS UCTION ENTRANCE ,' 16 H :'18"F. t - o EX. SHED EX. GRAVEL ACCESS AND • �31 '� ® EX. WELL :s"C.' 36"C. r T, C) PAVEMENT TO BE REMOVED HOUSE ga5ry 6__..-"� ryr% i ' f UPON COMPLETION OF NEW eu 36- GOLF u�w%g '���� •�' I CONNECTION'TO GLENEAGLE c t r� GOLF COURSE FROM ALL EX. GRAVEL ROADS EX' j b I �� LEAN-TO :` MAGNOLIA MEADOWS TO BE REMOVED EX. OVERHEAD POWER -'1 I I TYPICAL EX. WELL TO BE �,sw%• s-c TO BE RELOCATED i .31 � � 32 CAPPED AND EX. 40' E. 3Y PURVEYOR TYP DRAINFIELD TO EX ~ _ . _..........� ` . .' _.....-.._...•-- 374• .I. . PAVEMENT BE ABANDONED Og TO BE REMOVED r SEX. 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