HomeMy WebLinkAboutPermit File 1211 16th Street \
Get v o„ CITY OF ANACORTES
WASHINGTON
a m
9col0`' BUILDING DEPARTMENT
CERTIFICATE OF OCCUPANCY
This is to certify that the(Description of Building or Structure):
New 3 Unit Residence
Located At: 1211 16th Street A—B
STREET&NUMBER
Owner: Bob Lambert
Constructed By: Owner
OWNER OR CONTRACTOR
Bldg. Permit#: BLD-2003-9082
Date Issued: 5-17-04
Occ.Group: R3 Use Zone: R2
Has Been Inspected And Occupancy Is Hereby Authorized.
This 8th Day of ept ember 20 05 •
A OR II G OFFICIAL
SEE REVERSE SIDE TO SPECIAL REQUIREMENTS.
TrY OF ANACORTES "AS-BUILT"
Sewer
'-nn
DNTRACTOR: Ste} eph el ExC 4 v 4-i-t on
�AT/DIVIS[ON: BLOCK -
DT ADDRESS: 1.2 I I I C
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ATE: 6'- 30 -6y t C
3RMIT# SIP 2003-9223 SCALE ! / _
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IDICATE DEPTH AND DISTANCES OF CLEANOUTS
ITV OF ANACORTES "AS-BUILT" Sewer
ONTRACTOR: _y1e9kevn Exec et4-tor]
LAT/DIVISION: //'I f BLOCK
DT ADDRESS: 1 2 1 1 ./g+II 4'Cr cb
ATE: Y- '/3 0 I'-o v v t
ERMIT# 31 2003-9273 SCALE N 1 S =
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0 S O�y.,. City of Anacortes Permit#: BLD-2003-9082
904 6th Street Issue date: 05/17/2004
'rw P.O.Box 547
••,,"' " 109s Anacortes, WA 98221-0547 Expire date: 05/17/2005
' kit,,�ry .ss" (360) 293-1901
wr:N.Sd
Job Address: 1211 16TH ST Permit Type: Multi Family Residence Permit
ANACORTES WA 98221 Project:
APN: P55474
Remarks: Construct new 3 unit residence.
Owner: ROBERT LAMBERT Contractor: OWNER
Address: 1308 28TH ST Address:
ANACORTES WA 98221
Phone: (360)293-1252 Phone:
License#:
I
General Information: Fees:
1st Floor Square Footage 3108 Plan Review Deposit 100.00
2nd Floor Square Footage 2230 State Building Code Fee 9.00
Deck Square Footage 150 Building Permit Fee 1,462.50
Garage Square Footage 950 Plan Review Fee 949.98
Building Valuation 250000 Plumbing Permit Fee 300.00
#of Clothes Dryers 3 Mechanical Permit Fees 188.45
#of Bathtubs 5 Park Impact Fee 615.00
#of Clothes Washers 3 Sewer GFC-Residential 4,174.00
#of Dishwashers 3 Sewer Inspection Fee 150.00
#of Gas Fireplace 4 Storm Drain GFC-Residential 1,126.00
#of Gas Piping 1 Traffic Impact Fee 900.00
#of Gas Water Heaters 3 T. i r.,l..,,hloa• 9,974.93
#of Hose Bibbs 6 - m CO 44 ,F Co � 100.00
#Of Kitchen Sinks 3 a v a cn CD cr __
#of Lavatories 9 ^o_- � oo co * - * * C _ 9,874.93
#of Range Hoods 3 w " , � � m * * co "i£ -%
#of Showers 1 "- - * -* * OD `
u r I * -E 3*S- Ef3 f.,
#of Ventilation Fans 3 0 o F T ,« -* -x-
#of Water Closets 9 c�v E oN E .. - i 43-
#of Water Piping 1 0 --* *cx + _ AMI
o a a E
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THIS PERMIT BECOMES NULL AND VOID IF W a�i w cv '� *- '- as a * -s- c. 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR At_ >r ¢ m .- -f - a m c m a COMMENCED I
HEREBY CERTIFY THAT I HAVE READ AND Exgt rc- -* o,_ cc u r -. x Z. o w D CORRECT ALLif
PROVISIONS OF LAWS AND ORDINANCES GOVEI sot °' ,IFIED HEREIN OR I
-NOT, THE GRANTING OF A PERMIT DOES NOT P S OF ANY OTHER
S TE OR u\.CAL LAW REGULATING CONSTRUCT TUN UN I lit rtNr VnlvININ4t Ur UUIw I nu.,I
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED Y
0rt X Ot. City of Anaflrtes Permit'#: BLD-2003-9273 ,
904 6th Street Issue date: 12/17/2003
P.O.Box 547 Expire date: 12/16/2004
". '` 0; Anacortes, WA 98221-0547
Job Address: 1211 16TH ST Permit Type: Single Family Foundation Permit
ANACORTES WA 98221 Project:
APN: P55474
Remarks: New 3-unit residence-foundation only
Owner: ROBERT LAMBERT Contractor:
Address: 1308 28TH ST Address:
ANACORTES WA 98221
Phone: (360)293-1252 Phone: .
License#:
General Information: Fees:
Building Valuation 7000 Plan Review Fee 40.63 I
State Building Code Fee 4.50 r
Building Permit Fee 62.50
Total Calculated: 107.63
Co ! Deposits/Receipts: 0.00
cn o N * N o * o - Total Due: 107.63
ON ii 7.13 f_ * 0,-
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THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I
HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL
PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR
N T, HE NTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER
S ATE R L AL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRCUpC�TION.
SIG T RE OF WNER OR AUTHORIZED AGENT ISSUE BY `p R�D CO �, !
I
- N0V-6.03 0:S7;
PAGE 2
SENT BY: NORTHWEST AIR POLLUTION AUTHORIT;360 428 1620;
holey Use Only 0 NeRhwnat air Oollgtbn Authori( 1 AGENCYUSEONLY
1600 South Baeo d Street -- i WARS NUMBER
,^rll ^� h Mount Venice WA l627S.4202
CASE!; (2 - o-CJ) '0.00)Ub1e17.sou)1eo)bBdusao .
htt ngvivivt.pwglr.frg
Mctrualio ;
ns ter ooufplreinp this form eta*Atha beets
Please type or stint clearly. l
Application for Resident-Owner Asbestos Project
ENCLOSE S25 PROCESSING
/ Clearly p at yournante and ailing address below '
Name: 1k- La r- Nan\of Perion Conducting c al:
i a.��i 5� c r 11—c Y3c r Zy'i T1E-
Address: Daytime Ph#: 3470—a_cy _ 1 a---• _ •
City, State,Zip; N)Y6 CPS Octic1 . Evening Ph. ii: Cwo
Quantity to be removedle ea'psulated, a) D (sq.ft. (linear a -for pipe work only)
Project starting data' 11)61✓3 temptation auto: ))�6 63
•
la this building scheduled for demolition? *Yes 0 No t'`5 rt csa-c, eirf�A Y _
Sao address:THIS MUST BE COMPLETED (Attach a brill eXplanaaon It sile addrasah dieoient from mailing address.) (1.7
TTQA "\1 570YC1I
ia•II Ib / 5 Ancco e �Zd--a-1 .kkr,•
J w`
Street Oily Zip code County ,
Has material to be removed been sampled and analyzed? liYes 0 No
If Na,Please explain ...
Facility type(check ail that applies): 14Skyle Family 'tear ar more sells
Ca NonOwner Occupied 0 Owner Occupied
Type of rnotedal to be removedlencepsuleted; 0 Popcorn Gelling lit Sheet Vinyl Flooring Vinyl Asbestos Taes
' 0 Cement Asbestos Board ❑D idJFumaoe Wrap ' 0 Boiler inflation 0 Mrg, Pipe Insulation
0 Other Pipe insulation 0 Stucco 0 Plaster 0 Ghat(speelty)
la removal: .. ❑Indoors O Outdoors -
Control meesuraa& Personal Protection Equipment: - !
/`'a Face Respirator Va Disposable Coveralls Eye Protection . QDlsposeble Gloves *Wolfing
0 Rubbor•Boolo T Plastic to`�Contain Debris 0 Wrap&Cut(Pipe Remov7
all)� j"U Other(speedy) ]� d' W 1'r t("ie
•Brlony describe your m method ofreoval: \AN-i nP en+Ire, Sy-¢ [
R i 1hT " d 2W ekm2—. lyh i�rrl'f^ c``��hove.)
S} o toobkk-- Lvrap L mt11 U isjoe><vl i Abe_ }cpg
�� C Bch �+� (low 2o e< I ll
w a, c,e I1 I s-Eos ..
I , sift ":'ffiof rif fNip•'" iii.o*h tt'y.A i:.,
Asbesfo6 disposal eke: C ����O•( uS' si - „ r7{ "
I CERTIFY THAT I AM THE OWNER OF THIS RESIDENCE AND THAT THE ABOVE I.w1 V i i�2,.,
INFORMATION IS CORRECT. <, ...
..........:::.:.:::..
11 17 b� "::-:: I
Signature :;:i:i•i':%,,:.. 4.iii.:::::,•••••. . . ., :;;;,!::;•,:.:.,:::',l‘ 1\\* V Uetc }�ONNSt•Air r .
' l:1USERS\DAVEWsbestowPragramlAsbestos FotN:4emovaleroc � rl, d l -' '1h,I55tiiiir1rie.i�tigy;IS Sbt1f'pP1_Iil C,°,„ '
Ghe°k"
Gash
600 South 5E.con-160/ 73 5202 l�
. •
J Mount phone 360)4 8'1617 .2-003
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pORLARS
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REGENEB FRO y4EST At pOLLUTiON A� �f J ORtHW f
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PHILLIPS ENVIRONMENTAL SERVICES
29354 BACUS RD.
SEDRO WOOLLEY,WA 98284
360.854-7900 FAX 360-854-7731
November 5, 2003 Survey No. 03099
Bob Lambert
1308 28th Street
Anacortes, WA 98221
360-293-1252
RE: Asbestos Survey: 1211 16th Street,Anacortes,WA 98221
On November 3, 2003, I inspected a single family residence 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 effoi-t 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.
Twelve bulk samples were collected and subsequently analyzed for asbestos content by Polarized Light
Microscopy with Stain Dispersion. Samples#1,2, and 6 were found to contain more than 1.% asbestos.
These materials will require handling/removal by trained asbestos workers (or, in some cases, the homeowner—
contact Northwest Air Pollution Authority for permit) 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 Air Pollution Authority 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,
aRaczeit
Dave B. Phillips
AHERA Bldg. Insp.
Cert.# 03-2687(expires 4-23-04)
enclosure
0
•
PHILLIPS ENVIRONMENTAL SERVICES
29534 BACUS RD.
SEDRD WOOLLEY,WA 98284
360-854-7900 FAX 360-854-7731
Client: Bob Lambert Asbestos Survey- 1211 16th Street Survey#: 03099
1308 28th Street Anacortes,WA 98221
Anacortes,WA 98221
360-293-1252 Survey date: 11-3-03
Homogeneous Material List
Material#&Description Location(homog.area) I Type Friah Cond Qty, Sample it&Location (sec owe.) I Asbestos
1 Vinyl tile& mastic Main house kitchen&bathl misc n f A 140sf I 1 I Kitchen floor Chry, 10"/n*
Asbestos found in tile only, none found in mastic
2 ' Vinyl sheet Main house utility room mist a f 40sf 2 Utility room floor Chry.25"/
3 ' Sheetrock&,jt. comp. Main house walls [mist I n I f I ➢ 3 I Living room wall LChry.<1"/a*
* Asbestos found in it.comp.only at 2%,composite per NESHAP=<1%
4 Vermiculite Main house attic tsi n f 4a Attic N/D
4b Attic N/D
t
4c Attic Neil')
15 Asphalt roof witar Main house rear roof misc n f 5 Main house rear roof ' N./D
6 Vinyl tile&mastic Cottage kitchen floor mist' n f 90sf 6 I Cottage kitchen Door Chry. 1O%*I
* Asbestos found in tile only, none found in mastic
7 Vinyl sheet on Cottage bathroom misc n f 7 Cottage bathroom floor Nt)
c linoleum (linoleum in bed also)
8 Texture on sheetrock Main house walls,ceilings surf n T f 8a Living room E wall Nil 1
I Sb S bedroom N wall HD I
8c N bedroom W wall N%D i
N/D=None Detected Note: Friability assessments were made on these materials in their present undisturbed condition, I
N/T =Not Tested-previous sample tested positive damage or disturbance of any kind may cause some non-friable materials to become friable I
Quantities shown are approximate-field verification recommended
1
PHILLIPS ENVIRONMENTAL SERVICES
29354 BACUS Ro.
SEDRO WOOLLEY,WA 98284
360-854.7900
FAX 360-854.7731
ASBESTOS BULK SAMPLE ANALYSIS
Client Name: Bob Lambert
1308 28th Street Survey fr:03099
Anacortes,WA 98221
360-293-1252
Source of Samples: 1211 16th Street,Anacortes,WA 98221 Date Reed: 1➢-3-03
Analytical Method: Polarized Light Microscopy with Dispersion Staining(PLM-DS Method)
Sample No.: I Analysis: Asbestos: Chrysotile 8-10%(tile)
Lab No.: 19420B
Location: Main house kitchen floor Other fibers: Cellulose
Description: Pink vinyl tile w/black mastic
Y Note: Asbestos found in tile only at 10%,none found in mastic
--------------------------------- ------------------------------------------------
Sample No.: 2 Analysis: Asbestos: Chrysotile 20-25%
Lab No.: 19421 B
Location: Main house utility room floor Other fibers: Cellulose
Description: Beige vinyl sheet w/grey fibrous backing
Note: Asbestos found in paper-like fibrous backing material
Sample No.: 3 Analysis: Asbestos: Chrysotile<1%
Lab No.: 19422B
Location: Main house living room wall Other fibers: Cellulose
Description: Sheetrock w/joint compound
30 Note: Asbestos found in joint compound only at 2%, none found in sheetrock—composite of'wall system' is less than -"/o
----------
---------------------------------------- - --------------------------------
Sample No.: 4a Analysis: Asbestos: None detected
Lab No.: 19423B
Location: Main house attic insulation Other fibers: Cellulose
Description: Vermiculite
Sample No.: 4b Analysis: Asbestos: None detected
Lab No.: 19424B
Location: Main house attic insulation Other fibers: Cellulose
Description: Vermiculite
Sample No.: 4c Analysis: Asbestos: None detected
Lab No.: 19425B
Location: Main house attic insulation Other fibers: Cellulose
Description: Vermiculite
Sample No.: 5 Analysis: Asbestos: None detected
Lab No.: 19426B
Location: Main house rear roof Other fibers: Cellulose
Description: Asphalt roof w/tar
f
Analyst: G � t11 Date: ((— c os ave 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 pony
PHILLIPS ENVIRONMENTAL SERVICES
29354 BACUS RD.
SEDRO WOOLLEY,WA 98284
360-854-7900
FAX 360-854-7731
ASBESTOS BULK SAMPLE ANALYSIS
Sample No.: 6 Analysis: Asbestos: Chrysotile 8-10 A (tile)
Lab No.: 19427B
Location: Cottage kitchen floor Other fibers: Cellulose
Description: Tan vinyl tile w/black mastic
• Note: Asbestos found in tile only at—10%,none found in mastic.
Sample No.: 7 Analysis: Asbestos: None detected
Lab No.: 19428B
Location: Cottage bathroom floor Other fibers: Cellulose
Description: Blue vinyl sheet w/white fibrous backing on linoleum wiblack fibrous backing
------------------------- ------------------------
Sample No.: 8a Analysis: Asbestos: None detected
Lab No.: 194318
Location: Main house living room E wall Other fibers: Cellulose
Description: Sheetrock wltexture
Sample No.: Sb Analysis: Asbestos: None detected
Lab No.: 19432E
Location: Main house S bedroom N wall Other fibers: Cellulose
Description: Sheetrock wltexture
Sample No.: 8c Analysis: Asbestos: None detected
Lab No.: 1943313
Location: Main house N bedroom W wall Other fibers: Cellulose
Description: Sheetrock wltexture
Analyst: �—Yr- 1%2LI Date: it—5-- 0S
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.
A . n0
A.
FLOW TEST INFORMATION SHEET ;%�tf�, , \
1. Reason for Test: Bid information 0 Design Base r L
Other �-'-� ...,..::....a<,..,ee.,.,<
2. Location of Property k 71.1 k �-, £T �) OPT6S r �4c f 1 j T
IAaaressi , f 1Cdy) ISule) I unryi.
3. Date & Time of Test: + Date: 11--�[-o?� Tom : i c5 am (pm)
4. Test Conducted by: �[ �i T if b (d71v^trtrl2fAf�.c Ft_� _To t'E c"'('tot.1 Itom..
Mane Tine waren
5. Test Witnessed by:
Name Tele AuNliaaon
6. Source of Water Supply: Gravity e% Pump ❑ Other:
7. Name of Water District cST C, Fire District Arkill$Cl'9W"TE-S
8. Is water supply provided with PRV STA's Yes ❑ No 0
(If so what is PRV outlet setting? PSIG
i
9. Area Map: (Draw Sketch showing property location; bounding streets and names, north arrow, hydrant locations 1
and identification numbers, distances kern hydrants to property elevations of hydrants and property
floors or grade, all water mains and sizes and interconnection valves.etc.)
a
i • ,
at!
1
I 1 1 l I
10. Flow Test Data N\M z 7R HIi&=iW 1-15=,36 i.=74
I FLOW AT STATIC AT STATIC RESIDUAL FLOW OUTLET ADJUSTED
HYDR.NO. HYCR NO. PSIG PSIG GPM COEFFICIENT GPM
121 _ _ 1191 ' an_
12Li '. 65 50* 1
I
11. See reverse side for graph,
12. Signed ""% E% ,
Witness (, 4 4 i " . � / 4
amo<s.o-re Sw na ei 4scae.om ioc .�—_ -
I id31 ve aaa So,5-ma Outs Square and panel Square and Sharp Omrei d C2ei and
Calla, tam7SIl5 q Li' -d( �� WMecr� 070arrel Coal Coe* 080 Rounded Gel aso
i],e1 N9 5565 li .y �i�yOV 1 8 71-1M�
l`,- i�=,1. Pi -- 'I I�u 4,,,.„,LL uh__'1�-
Hydrant Outlet LC} Pilo; f re so , o,x 1--;csldu ,l fate, C3 Tnr t -, : `5;iSA+✓\ Cant . Il No. - I
NU• tnches_� ;tit ciPlr ;I__,I _. .." t"�
12.34 y" `4M NMy- tie1° 1 `_ 0 Cont . Name:57-ciL s),,Slh t3E-1'2T - - 1
9i
2 Address: "7 i6 `T� 5--� —
W"i Total Flow ctrtry Wuc I''re 8 psi Flow @ _0 p51 L tlC,nj
— 71 T i m t o 1 t r u 1 r 1 I I r t r i I i i I r I t I 1`T -- "T--r`T"i`t I rrnTTTFT(T{l I Ff 11 I i "TT1T111 T11
OM- 2 {20 . - of 1
R= 105 -
L
100 r _.-_._ _- -. - •MIPIC•M In
u, — _ SPAIN u�asof l•, MC
95 --_ 90 - :
85 _ I
— 80 _ -It I I
75 : - - {
a , J b 4 1 L-Iit i '- L,---A 1 1" 13
65 f'1 ?
a 60 _ . .
F H DP NT
55:
5° � I-1c5r1 fi+ 63, F T� I r
--1 45_ — '
e --- ..= 135S _ . _
_ . 30
n8, ',--,-- \
I�
B '-hil, -. -
i' 15 l- _ - �� a _
3
to
5 =
r.
-1 I I [mini on.lill - MOI Ni
A 0 100 200 300 400 500 600 TOO 600 900 1
Scale A 1600 2
Scale BC 200 -100 600 b00 1070 1-100 I-100 1600 4
Scale C
100 S00 i200 1600 2DT.) 2-100 2800 3200 3600
AMLRIGAII FIRE SPRINKLER ASSOCIATION
Water Flow nnm „ „ M,..,, s...,
-
., Cit% y of Anacortes Permit#: BLD-2003-9246
• 904 6th Street Issue date: 12/08/2003
P.O.Box 547 Expire date: 02/06/2004
t0 ' Anacortes, WA 98221-0547
I,: k`} (360) 293-1901
Job Address: 1211 16TH ST Permit Type: Demolition Permit
ANACORTES WA 98221 Project:
APN: P55474
Remarks: Demolish single family residence.
Owner: LAMBERT ROBERT A Contractor: STEPHEN EXCAVATION
Address: Address:
Phone: Phone: (360)293-9552
License#:
General Information: Fees:
Total Calculated:
Adjustments:
Deposits/Receipts:
Total Due:
II
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I
HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL
PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR
NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER
STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
eM 'r'o a P11tt-C1..Q�t�L.A.
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISS ED BY
" _. .,,:„:w .•y,_.. .^�",'--r'w- - ? =i ^_:= -.x_ 7r 3�` =wz._ %,zsH'T'i:%tea;?�:i: ii<
Wrik�: ,a 11,.rat:_,---vrr-emu;" ,- .s :.;.'.:: ' 'fir ;-. 5itmo { .fi,:-.Y-- 3`rewe<. atatfr.i=-Si
sid
` sui « Y R T
SWAT Mairreassa
h ¢ 4< r �ua' s = N:e. &: _ r u< yo:^ "R yYys
Site Address: \ 34\ 1& 5+ Date: J P)9'D3
Assessors Account No.: :fl i al)i 21 D D l
.Lot(s): G 7 2 Block li Addition: I�enc 15- mitt
Owners Name: Lc Contractors Name: S fe.E1�1efc,� ,csv�v
Address:\\13$ a-E 5-�-� Address: Li 5 1) 5�� l sZ'a �vL.
State: Na a, Zip: t Z State: t w o Zip: ��2 z-1
Contractors License: 5-1-e 1\EC, 1 atZ 1
Phone: 3b�. '�"_I� - I�A___ P
Phone: . 3-6v -a t3-- c cc3--
i
All W 1lI be. CWCallhtSjek '
Have Utilities Been N•tified? Describe Work&Tools To Be Used. How Will •
Water1 o t to v30\-k ,. 1 "1\ . Materials Be Disposed?
ater Dept.: i No
Electric: No it 0,..c. LL-— c -\be_
Cable: No
Gas: No 51 1 4, Qrmt>ve--- 1 D V c, (�
, 'wlpSTer
Phone: No J Y
BARRICADES TO BE PROVIDED FOR PUBLIC PROTECTION,AREA MUST BE ROPED
OFF SE EtTIUN 4409 U.B.C.
- \�� 007 06 20 ii iti(Applicant's or Agent's Signature)
ASBESTOS WARNING __ - -
Breathing asbestos is hazardous to your health. Before starting a renovation or demolition project,survey for
friable asbestos materials. Notify Northwest Air Pollution Authority prior to asbestos removal or containment.
201 Pioneer Bldg.,Mt.Vernon,WA 98273. (360)428-1617
Date: / 0— g-m3
Fire Department Approval:
Fire Chief or Fire Ma al)
Police Dept.Notification: Date:
Public Works Dept: Ar;4414- Date:/O -9 - Q 3
/ (Speed Garrett)
Comments: _
_ 1
12)11_ PAGE 1 Or
1(0-)
,
'. t/ h SJ` lt;,.
h- FLT•N '
• ' I ,_:
c i• s (:UNC . NALL END .
oN WEST 4/W
• I - A , D E S G R I P T I O N PER "STATUTORY WARRANTY DEED" AUDITOR 'S 380 . 00 (MEAS . 3 /9 . 65) . 40 Ol P
y' ` 1 fill I STREET lB}) ' R/l`) • ( 719 . 29 ) y0\' . P FILL S `rBI:R : 9904150061 :
3Q , r rl1SsIv; i
Y�i CDNC,RETE IXISIIN6 0 I ; "L�' IS 6 , 7 AND 8 , INCLUSIVE , BLOCK 84, "CITY OF ANACORTES" ,
SLAB IXISI EVERGREEN BUSH
0 ACCORDING TO THE RECORDED PLAT THEREOF IN THE OFFICE OF THE
90 .00 ( 8BUSH •. . 1P ... 150 . 00 ( 149 . A2) I AUDITOR OF SKAGIT COUNTY , WASHINGTON, IN VOLUME 2 OF PLATS ,
60 . 00 (59 . 93) _ . 40.00 PACE 4 . "
30.00 " n I. n 30.00
" ) ) yI'S ) I I SUBJECT TO EASEMENTS RESTRICTIONS RESERVATIONS ETC . , OF RECORDS (IF ANY) .
?: - I SITUATED IN THE CITY LIMITS OF ANACORTES, SKAGIT COUNTY. WASHINGTON.
_ f I -
r
- a CI: rn O r
10 s 9? 8 7 6 Q 3 4 s 3 2 1 •
L
c lo - 0 ; W, Z•• I
'- M c_- . c 0 :
Fs wi o
c
H 0 Iv GENERAL I N F O R M A T I O N r
4
-
t29. `}6) -,.r ( 29 . 96 ) > I c sn • 1 ) S'. '•t\ EY of SUBJECT LOTS AND 'Plat. PREPAREATION OF THIS "SURVEY MAP" WAS
30.00 n n n n n n n n 30 00 c BASED ON THE. FOLLOWING SOURCES :
( 59 . " ' ) 150 . 00 ( 149 . 81) • • ;, Iy � I A) INFORMATION SHOWN ON THE ABOVE "STATUTORY WARRANTY DEED" .
° lb ET . ALLEY ttLCICK al I — —
fI 30.00 I. I, II " I, " 1/ Of 30.00 r aI' B) APPLICABLE INFORMATION SHOWN ON THE "MAP of THE CITY OF ANACORTES"
r�i , Cl STREET_ _ MONUMENTS AND SURVEY MARKERS FOUND AS SHOWN ON THIS DRAWING.
I • . , ,^ I � (LOT llIMENSIONS L:CRF, ,1D.7USTED ACCORDINGLY) .') . - ---� --- -'-- -
I D) INFORMATION SHOWN ON APPLICABLE RECORDED SURVEY MAPS:
•I • vt ^ a I � 2) _IMPROVED LOTS WITH EXISTING RESIDENCE .
► 11 12 13 t 14 15 = 16 t 17 18 : 19 20 .. a 3) THE NORTHERLY APPROX. TEN FEET OF THE EXISTING WOODEN BOARD FENCE IS
•
• 0 0 -0
COa I BUILT ON THE COMMON LINE OF LOTS 8 AND 9 . ALSO, THE EXISTING NARROW
I CONCRETE SLAB IS BUILT ON THE NORTHWESTERLY ONE FOOT OF LOT 8 AND ON
THE R/W OF 1_6T_H_STREET AS SHOWN ON THIS DRAWING .
I I I 4) NO UNDERGROUND CABLES. UTILITIES, AND/OR EASEMENTS (IF ANY) WERE
I
L LOCATED OR SHOWN ON THIS DRAWING .
. 30.00 " n " n n n n n 30.00 -- ---
I 40.00 I • 51 SURVEY EQUIPMENT USED: HEWLETT-PACKARD 3810-A (TOTAL STATION) .
`\ 0 1 ?TH STREET ( 80 ' R/W) - --
C\ d —
1 :
4Z.- •- -- — . _ . ._ . — . — . — . - .— . _.— . _ . . . . . ._.—. — . _ . _ . _ . _ ._.- . — _760 .00 ( 759. 15 )
380 . 00 (MEAS . 379 . 58)•. . . . CN +
f
• c
! •
•
0 0.
C I N
11 1 8'l 11 S I R ._►
I,
; Y `1 B O I. S :
0 BA!: & CAP ( SEi 10/ 25/03) B A S I S 0 r B E A R I N C t
CNO= CONCRETE NAIL FOUND 0 ' 50 ' 100 ' 150 ' 200'
PKOe PK NAIL FOUND
in0= IRON PIPE FOUND SCALE : 1 " • 40 ' MAP OF THE CITY OF ANACORTES`
0= STREET MON (FOUND IN CASING) a �� yRn
NOV 18 2003
tJ
SURVEY IN SE IN. T— SEC _ 24--err WV" _ 35N— RNC1- _ 1 E , W _ M _
AUDITOR'S CERTIFICATEi LAND SURVEYOR'S CERTIFICATE: ROBERT A . & BRII)CL11F, LAMBERT'
FILED FOR RECORD ON THIS DAY OF 2003 THIS MAP CORRECTLY REPRESENTS A SURVEY MADE BY PREPARED FOR: I31 .4 .." 'fll S1 ':1'E.1'
'- ME OR UNDER KY DIRECTION IN CONFORMANCE WITH �j� J. �/,, ANACORTES , WA 98221 TEL : ( 360) 293-1252
AT M. , IN VOLUME OF SURVEYS AT PAGE THE REQUIREMENTS OF THE tSURVEY IRECORDING ACT AT �� V1iy 7, BCALEr 1" • 40' DRAWN BY: ill JOB NO: 2108-03
UNDER AUDITOR'S FILE NUMBER: THE REQUEST OF:
ON: OCTOBER 3 , 2003 RE 4 DATE: I1 / 7 /O3 APPROVED BY: 1C DRAWING NO: - " -
AT THE REQUEST OF JOHN J. VADAI. DATED IN ANACORTES, ,2003 1, DESCRIPTION:
SEE ABOVE
JOHN J. VADAI 5 ASSOCIATES j1ERIDIAN3
SKAGIT COUNTY AUDITOR BY: DEPUTY AUDITOR JONN J. VADAI Phone: (360) 293-9591 6060 SANDS WAY - SUITE F, Anacorsits, WA. EE ABOVE
CERTIFICATE NO. 9636
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