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HomeMy WebLinkAboutPermit File 2308 E Avenue .8. X, .Q ._ City of Anacortes• Permit#: BLD-2009.0014 904 6th Street Issue date: 01/22/2009 P.O.Box 547 Anacortes, WA 98221-0547 Expire date: 03/23/2009 Iy. (360)293-1901 Job Address: 2308 E AVE Permit Type: Demolition Permit ANACORTES WA 98221-2406 Project: APN: P57566 Remarks: Decomission removal of one 500 gallon undergroun heating oil tank. Owner: MACY LINDA S Contractor: ULTRA TANK SERVICES Address: 2308 E AVE Address: PO BOX 30076 ANACORTES WA 98221-2406 BELLINGHAM WA 98228-2076 Phone: (360)708-8284 Phone: (360)815-5361 License#: ultratso33ck General Information: Fees: Total Calculated: Adjustments: Deposits/Receipts: Total Due: Ili 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. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY Jan 07 09 01:45p Ultra Tank Services, Inc 360-3982311 p.6 IffP fa CITY OF ANACORTE S -:=-: = . , DEMOLITION PERMIT APPLICATION Site Address: -c2.- b U £ k4uc Assessors Account No.: Date: I-o —0 7 Lot(s): Block Addition: Owners Name:(,i Q,.. k rracr 7 Contractors Name: LC Zw�. Address: ro a Sy E lic- Address: (r.J BB•), 300% State: U-iA- Zip: Qrz-u State: um Zip: ifar Phone: 3C — 70t — irz-g , Contractors License: c.,.1-kv9- 4'5 033CK ' Phone: scso -res. - 7S4r0 Have Utilities Been Notified? Description of proposed demolition_ How will materials be 1 disposed? Water Dept.: Ye No Dcto wtau uSS 7e in, fle..weructi c (1.) C o-C., 1 Electric: Yes No Cable: Yes No CO© grgptn ' 1Hdtf �µ rc�edr re � Gas: e No BARRICADES TO BE PROVIDED FOR PUBLIC PROTECTION, AREA MUST BE ROPED OFF! Ca:a r �licant's or Agent's Signature ASBESTOS WARNING Brearh;rig 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 1600 S.2°s Street, t.Vernon,WA 982773 (360) 428-1617. Fire Department Approval: r Date: Police Dept.Approval: 4 (�(� Date: Public Works Department Approval:\ . cK&Z t,..-- Date: 1 '32/Der Comments: _ I L©wlrwtar" ll C 5 ' OcJvver: Div . face.1 Pf4 H3 ‘o — Ft (S - 7SLfo —10 4QUC cc J co E Av J j City of Anacortes Permit#: BLD-2003-8592 904 6th Street Issue date: 04/11/2003 P.O.Box 547 Expire date: 04/10/2004 `,� t/1: Anacortes, WA 98221-0547 I 831 141,r Job Address: 2308 E AVE ANACORTES WA 98221 APN: P57566 Permit Type: Sewer Repair Permit Project: Remarks: Repair water and sewer line at existing residence. Applicant: MACY JAMES W Owner: MACY JAMES W Address: 4501 ANACO BEACH RD Address: 4501 ANACO BEACH RD I ANACORTES,WA 98221 ANACORTES WA 98221 Phone: Phone: Contractor: Addressr: Phone: License#: General Information: Fees: Sewer Inspection Fee 1 Sewer Inspection Fee 50.00 Total Calculated: 50.00 Deposits/Receipts: 0.00 Total Due: 50.00 ,,,' dam. nor-,�.r ..i- ' m .I:.. m ''c'' }: i ? ' ,o x II _4 _i, :L: 1 gib.S+r1 'sI t,. y 'i'3 W _ 'I 1`. °yl ' �., fir. 001c s �n Ln ^"cn en 4-n.:. x Cv'I t'b C3.ix a". 0 - i THIS APPLICATION IS RECEIVED BY THE BUILDING OFFICIAL UNDER THE PROVISIONS OF THE UNIFORM BUILDING CODE, AND SHALL EXPIRE BY LIMITATION AND BECOME NULL AND VOID IF PERMIT IS NOT OBTAINED WITHIN 180 DAYS OF THIS APPLICATION. BY AFFIXING MY SIGNATURE I HEREBY CERTIFY THAT I AM THE LEGAL OWNER OF THE PROPERTY FOR WHICH THIS APPLICATION IS ISSUED OR AN AUTHORIZED AGENT OF THE OWNER.ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT,INCLUDING CALLS FOR INSPECTIONS. At-12 tQ Applicant Signature Issued by oArar 1 nr 9 Ili MECHANICAL PERMIT CITY OF ANACORTES PERMIT NO. : MEC93-0240 P.O. BOX 547 APPLIED: 10/06/93 ANACORTES, WA 98221 ISSUED: 10/06/93 (206) 293-1901 EXPIRES: 10/06/94 SITE ADDRESS: 2308 E AVE ASSESSOR'S PARCEL NO. : 3798-000-037-0007 PROJECT DESCRIPTION: New gas furnace and piping — OWNER — CONTRACTOR JAMES & LINDA MACY LARSON HEATING, INC. 2308 E AVENUE 1482 HONE LANE ANACORTES WA 98221 ANACORTES WA 9821 293-5291 293- LARSON1112ME TYPE OF WORK. . . :ADD BOILERS/COMPRESSORS- DOMES. INCIN • 0 TYPE OF USE •RES 0-3 HP • 0 COMML. INCIN • 0 3-15 HP • 0 RELOC/REPAIR. . . : 0 FUEL TYPES 15-30 HP • 0 CLOTHES DRYERS. : 0 : /GAS/ / / : 30-50 HP • 0 GAS WTR HEATERS: 0 FURN < 100K BTU: 1 50+ HP • 0 STOVE, APPLI. . . : 0 FURN >=100K BTU: 0 AIR HANDLING UNITS-- FIRE LOG/LITE. . : 0 FURN - FLOOR. . . : 0 <= 10000 cfm. : 0 WOODSTOVES • 0 UNIT HEATERS. . . : 0 > 10000 cfm. : 0 OTHER UNITS • 0 VENT FANS • 0 EVAP COOLERS. . . : 0 GAS OUTLETS • 1 VENT SYSTEMS. . . : 0 HOODS • 0 VENT W/O APPLI. : 0 — FEES — NOTES Code Amount---- By- Date---- Receipt PRMT $ 27. 00 MD 10/06/93 1578 TOTAL $ 27.00 I hereby acknowledge that I have read this permit and state that the above information is correct, and agree to comply with aLL ordinances and laws regulating activities covered by this permit. fi x) aPa -\ a Issued by Appl a t or 0 ner's Sig ature 24 Hour Notice Required For All Inspections mecjrmt, Rev: 06/11/92 r • • q > • 3 ®8 Ave- -Site 5tw# . kcyL4cctv,,7r' ., . e ,„,,,:,„‘ w ‘ ,,,_. - ,.., „i1.47,,,,:,,,tt:.,,,t 0,,a 4,,,,, , �'���� •sue ' s. � , a LN ',":::',$.: -,,. „: ry .L4411i.,0".0.:.::!:::,,....,,,,:.,,..:,.,..:E.:,7,.:,':.?.:4..,..41.,,,,...!,:, s• j ?fel75 G • AUK/ Sro 1 _ anA_ K�A/.---'�- -ate E . a �srr,.. 5 JN rv, y Site Address 2308" E Project -�ru�(Zei-s si 7=` ��- r� rns ems, Buildin• Permit#3Lb— 2-O I --0060 �,,�tau e (ec1Tlc� Je •4cr- dc&><.-tasiG-d Department Date Initials Notes Building / 6 r f et)e- � Cl�l i " p rave Public Works Planning f/ }- Stormwater 3/n Fire N/e rFEBEOWir 02 2011 Project Inter-Departmental Plan Review Tracking =� CITY OF ANACORTES GSI Y 0 VP CERTIFICATE OF OCCUPANCY This is to certify that the below listed building or structure has been inspected and occupancy is hereby authorized: Description: Fire damage repair to Family Residence Location: 2308 E Ave. Owner: Gabrielle Glim Constructed by: Kings-men Construction Inc Building Permit#: BLD-2017-0060 Date issued: 02/02/2017 Use Zone: R3 Dated: July 07/2017 Authorizing Official: iik - �. _. A ' O .. Cityof Anacortes Invoice/Permit#: BLD-2017-0060 904 6th Street Applied date: 02/02/2017 `"'II +' P.O.Box 547 Issue date: 02/02/2017 .ix"2 4"/- Anacortes, WA 98221-0547 Expire date: 08/01/2018 ,,1 �f' '` (360) 293-1901 Job Address: 2308 E AVE Permit Type: Single Family Alteration/Repair Permit ANACORTES WA 98221-2406 Project: APN: P57566 Remarks: Repair fire and water damage to SFR, by replacing the charred trusses and all electrical. Owner: GABRIELLE GLIM Contractor: KINGS-MEN CONSTRUCTION INC Address: 2308 E AVE Address: 1560 WEDGEWOOD LN ANACORTES WA 98221-2406 OAK HARBOR WA 98277 Phone: (360) 941-4713 Phone: (360)929-5807 License#: KINGSMC193D7 General Information: Fees: Building Valuation 72095 Building Permit Fee 804.75 #of Ventilation Fans 2 Plan Review Fee 523.09 #of Range Hoods 1 State Building Code Fee 4.50 #of Water Heaters 1 Mechanical Permit Fees 48.65 Plumbing Permit Fee 27.00 Total Calculated: 1,407.99 Deposits/Receipts: 0.00 Total Due: 1,407.99 •:, —a • tar P ..7-n rn ?' MA '' --.1 -,1 C: _ I ' 0 So .y Il. N. —_ I'.) (.•+I .A 1-'• .. :), r. 0 '.4 .-i- r. r*. ,t p.- 1 I Ifi r+ i i n 14 G 1 0I> =, 0 () c) -. .I .. CO 3 '? Ili , 'z `i• R. el- .Ga .. .—• CO1 it' .—2 Co THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 D.S1'Q 0`t CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMNIEI ED,. ; ;1 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 OF t::N6f1:;T GRANTING OF A PER T DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHERip TAT,E QR (7LOCAL REG G CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. .L Y -J CI-.. V Y V — . . .-h r' I ..,0. -4 J 0 IA r_t SIGNATURE OF OWNER OR AUTHORIZED AGENT ED BY it. T Qi • 3,"- -•-"X -C ", CitY of Anacortes invoice/Permit#: BLD-2017-0061 \ 904 6th Street Applied date: 02/02/2017 Y P.O.Box 547 Issue date: 02/03/2017 F''' 10,= Anacortes, WA 98221-0547 r$\, , saw Expire date: 01/29/2018 eo _fr (360) 293 1901 Job Address: 2308 E AVE Permit Type: Demolition Permit ANACORTES WA 98221-2406 Project: APN: P57566 Remarks: Demo interior of SFR where it was damaged by fire and water Owner: GABRIELLE GLIM Contractor: KINGS-MEN CONSTRUCTION INC Address: 2308 E AVE Address: 1560 WEDGEWOOD LN ANACORTES WA 98221-2406 OAK HARBOR WA 98277 Phone: (360) 941-4713 Phone: (360) 929-5807 License#: KINGSMC193D7 General Information: Fees: Dwelling Units 1 Total Calculated: Adjustments: Deposits/Receipts: Total Due: 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 DO S NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL f;REGUTATI G NSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SIGNATURE OF 0 ER OR AUTHORIZED AGENT q El 7 Klir, cop , 5 1 do 0 f fie:. r ITY, & ECONOMIC DEVELOPMENT DEPARTMENT ` ^` DEMOLITION PERMIT APPLICATION ,--. Mailing Address: PO. Box 547, Anacortes, WA 98221 I y ' c ' Office Location: 904 6th Street,Anacortes WA 98821 Phone: (360) 293-1901, Fax: (360) 293-1938 LEASE REFER TO THE DEMOLITION PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS BUILDING DEMOLITION 'I4, UNDERGROUND TANK REMOVAL/DECOMMISSIONING 0 PROJECT ADDRESS(Street,Suite#): Parcel(s)#: 230 Cr , AG Subdivision/Lot#: APPLICANT: �f(1( s""f v��-K) o t3 riAc T(c N _LM C 360 ()Jett -6 00 7 366- 5- ig1)2 Address(Stree-, City, State Zip): r E-Mail Address: CUMC,�sr; t�&O ( 2G 00 c( C,1 (�,w prk2a*!�.,`-k `, Ac ., k,e v� C-Or) f f���ca v1 c;� id PROPERTY OWNER: Phone`: Fax: Address(Street,Ci ,State,Zip): E-Mail Address: c��r 23o- pcv i:kke ,Naco -ri25, I(1A, `977 CONTACT P RSON: Phone: 0,ti Z-C!- 07Fax: (�t,A�u D {,ti' I KAN by Pel U&s 3,I,'7�7- o 50I 36o ._ �-�5- ic)- Address (Street,City, Statg,Zip). E-Mail Address: �7iNIKAST, ia,o (.L�eiSP_Wood L►J OAK O-A RA g6a-a ktvIc�s.we„)coA v- `rUvL ',act CONTRACTOR:* } Phony': Fax: Kq C.5 - Vt0vu UO 1Z- a(z ay-. 360_4 2ct-5Lc -7 ?moo - 6.-7 -- c"r2- Address(Street, City, State,Zip): { } E-Mail Address ^�,()UIIC;g N j55&(� il,Je(bC,�-(iav)� LA� O--ik(� kA- -8oR, [.OA,q )--) i N�c . ,co {rtActo'rn �l o t *All Contractors&subcontractors must have a valid City of Contr. for s License# Exp.Date: Anacortes business license prior to doing work in the City. Business License#: Exp.Date: Contact the City's Finance Department t(360)299-1968. n PROPOSED WORK: t o SEL c~( N e —bVLe. t O_ it O ( (k(M ( ���G'4/( Ma 0 Z Ll`At'2uZ N< 0u f2:a- P(Pc' 03 ((4e- Cer[7rJJ� (D(Af2(�J bp)3 C1 (101,0 5 Petl, . A5he. A F-A-T(_ Q.a•T f C o /`P /wti-te j ,M[-('c 2 Q i 112A)) Ou 1. K c-,-- o k V-> STA 0,117 J (iJc UTILITY DISCONNECTION: Water Department Yes In No 0 Electricity Yes l No 0 Gas Yes 0 No D Cable TV Yes 0 No 0 I declare under penalty of perjury that the information I have provided on this foi,_u/application is true, correct,and complete,and that I am the property owner or duly authorized agent of the property owner to submit a permit application to the City of Anacortes. Print Name: 01- 0-D7,D. „10 Owner X' Ag nt E (specify): Signature: 0,0 V 1AWk- 060 Wi S `1 ieks Date: '2- Z 0 E 1 Page 1 of 3 FOR OFFICE USE ONLY: FIRE DEPT.APPROVAL: / J--� DATE: 3 / 7 POLICE DEPT. APPROVAL: r DATE: PUBLIC MaKS DETP4APPROVAL: DATE: MUSEUM APPROVAL: 40— II;1 DATE: 2/l /22 l'7 L BUILDING DEPT. APPROVA \ /I , DATE: WV/ 7 Page 3 of 3 , •:4" p,it 11 V C 4 2 2011 Et1VIRtONNMENTAt. [;e.,•• CITY OF ANACOF10ES December 9, 2016 Bryce Muller Project Manager Alpine Cleaning and Restoration 1620 75th Street Southwest Everett,WA 98203 Phone: 425.348.7387 Email bryce.muller@alpinecicaning.net Subject: Asbestos Contamination Evaluation Report Insured: Gabrielle Glim 2308 E Avenue,Anacortes,Washington Pemco Claim.No.: #11004253029 Dear Bryce: On December 1, 2016,Rose Environmental collected settled particulate samples for asbestos fibers within the detached single-family dwelling located at 2308 E Avenue in Anacortes, Washington. The purpose of the inspection was to determine whether collapsed ceiling paneling with an asbestos-containing "popcorn" surfacing material (due to a recent house fire and t wetting from fire department emergency response procedures)had resulted in elevated indoor concentrations of asbestos fibers on occupant contents and/or settled dust. BACKGROUND The 2308 E Avenue residence is a wood-framed single-story building originally built in 1958. Exterior finishes include lapped wood and wood panel siding and a pitched roof with asphaltic composition shingles. Interior finishes include painted gypsum wallboard(GWB)walls and ceilings, acoustical "popcorn" ceiling treatment on most ceilings,wood trim, and hardwood, sheet vinyls and tiled floors. According to Ms. Gabrielle Glim, the home owner,the Anacortes Fire Department responded to a recent house fire at the dwelling and utilized fire hoses to douse the fire, resulting in widespread water damage to sections of GWB throughout the dwelling, as well as the subsequent collapse of the GWB ceiling above the Living Room and the Bathroom. PAGE 1 OF 6 Rose Environmental reviewed NVL Bulk Sample Analysis Report(provided by Alpine Cleaning and Restoration, see NVL reports#1623602 &#1623735) which confirmed the presence of 6% chrysotile asbestos in the acoustical "popcorn" ceiling surfacing material in the Living Room, as well as 2% - 3% chrysotile asbestos within the joint compound layers of the Bathroom ceiling and Living Room/Kitchen ceiling GWB. . Visual Inspection Rose Environmental observed large areas (>10 SF) of damaged asbestos-containing materials (ACM—i.e., ceiling GWB)within the Living Room and Bathroom. Evidence of foot traffic through the ACM debris, and on floors throughout the dwelling, as well as exterior to the dwelling,was also present. Photos 1-3: Large Areas (>10 SF) of Ceiling Demolition and Debris at Living Room and on Living Room/Kitchen Bar Counter (L) and Bathroom (C), and Ladder with Debris in Kitchen (R) _ I.. ....:,. ..„ ,,. ,.,,, . . ,. ., ., 5„, .,. • __ , .i.,,• •. - . 40 • . immo it ;,4.3.14 1 ), it I ... { .... ., ._- VIP.- i i ! -• Vacuum Sampling of Soft Contents for Asbestos Fibers Rose Environmental collected settled dust samples for asbestos fibers using short 45-degree- angled tubing nozzles attached to 37-mm mixed cellulose ester(MCE) filter cassettes (of 0.8 µm pore size)with high-flow GAST pumps. Vacuumed settled dust samples were collected by vacuuming approximately 700 square centimeters of accessible furnishings or clothing within the Living Room, Kitchen, Bedrooms, Closets, and within the dressers in the Bedrooms. Samples were sampled in accordance with American Society of Testing and Materials (ASTM) Standard D5755-03, Standard Test Method for Microvacuum Sampling and Indirect Analysis of Dust by Transmission Electron Microscopy for Asbestos Structure Number Surface Loading. Samples were submitted to Electron Microscopy Services Laboratory(EMSL) for analysis by transmission electron microscopy(LEM) in accordance with ASTM D5755. (See attached EMSL Report#511601891) PAGE 2 OF 6 Results of Analysis for Soft Contents Settled Dust Sampling Sample- Location/ Total Area Total Fiber Number - Description' Vacuumed Concentration (cm2) (s/cm2) MCE- Northwest and Southeast 700 <30 CLNWS Bedroom Closet Soft Contents (Clothing) MCE-BRS Southeast Bedroom (Couch, 700 <30 Ottoman, Pillows, Blanket, Curtains, etc) MCE- Dressers and Closet in 700 <30 DCSW Southwest Bedroom (Clothing, Drawer Lining, Miscellaneous Items) MCE- Southwest Bedroom (Bed, 700 <30 BRSW Clothing, Blankets, Pillows, etc) MCE- Northwest Bedroom (Bed, 700 <30 BRNW Clothing, Blankets, Pillows, etc) MCE-LRK Living Room/Kitchen/Hallway 700 <30 Closet(Curtains, Towels) Background Level in Non-ACM Buildings: <1000 Level Confidently Above Background: >10,000 Level Associated With Significant Abatement Release: >100,000 Notes: s/cm'=asbestos fiber structures per square centimeter ACM=asbestos-containing material Comparison concentrations taken from Millette,J.R.,and Hays,S.M.(1994)Settled Dust Sampling and Analysis,Lewis Publishers,CRC Press In summary, the settled dust sampling results reveal that recoverable asbestos concentrations were below background in all samples collected from soft contents throughout the areas of the residence not directly affected by collapsed ceiling debris. Notably, soft content sampling was not conducted within the Bathroom due to heavy visible contamination of all surfaces. Tape-lift Sampling of Non-Porous Surfaces for Asbestos Fibers Rose Environmental collected composite surface sampling of settled particulate in the Living Room/Kitchen, Bedrooms, Bathroom, Laundry Closet, and from within one box of assorted makeup in a box within the Southwest Bedroom, to determine whether any amount(e.g.,trace) of asbestos fibers were present. The samples collected were submitted under strict chain of custody procedures to EMSL, a qualified independent laboratory for analysis. EMSL is a member of the National Voluntary Laboratory Accreditation Program (NVLAP 200613-0). The asbestos samples were analyzed using polarized light microscopy (PLM)with dispersion staining in accordance with US EPA method 600/R-93/116 as specified in 40 CFR Chapter I (7- 1-93 edition)Part 763, Subpart F,Appendix A,pages 499-504. Polarizing light microscopy PAGE 3 OF 6 quantifies asbestos concentrations at between 100% and 1% detection levels. Levels below 1% can only be stated as "trace." Asbestos Sampling Results - Satnple ID Material Description Location Asbestos Content Tape-lift sample of settled dust and debris from various Southeast No asbestos ANA-BRS horizontal surfaces throughout the Southeast Bedroom Bedroom detected (top of TV,table,dresser,occupant contents,etc.) Tape lift sample of settled dust from various horizontal Southwest No asbestos ANA-BRSW surfaces throughout the Southwest Bedroom(top of Bedroom detected dressers,mirror,basket, occupant contents,etc.) Tape lift sample of settled dust from various horizontal ANA-BRNW surfaces throughout the Northwest Bedroom(top of Northwest No asbestos dresser,shelves,stool,occupant contents,etc.) Bedroom detected Tape-lift sample of settled dust and debris from various No asbestos ANA-BATH horizontal surfaces throughout accessible surfaces in Bathroom detected the Bathroom(top of vanity cabinet) Tape-lift sample of settled dust and debris from various No asbestos ANA-LAUND horizontal surfaces throughout the Laundry Closet(top Laundry Closet detected of Shoes, Cleaning Supplies,Litter Box,Washer, etc.) Tape-lift sample of settled dust and debris from <1% ANA IQ,I various horizontal surfaces throughout the Kitchen Kitchen/Living Chrysotile and Living Room(top of stove,counters,furniture, Room Asbestos etc.) Detected Tape-lift sample of settled dust and debris from various Makeup in Box No asbestos ANA-MAK horizontal surfaces within a collection of women's within Southwest detected makeup kept in box within the Southwest Bedroom Bedroom In summary, laboratory analysis of settled dust samples collected from horizontal surfaces within the Living Room/Dining Room/Kitchen revealed the presence of less than 1% chrysotile asbestos. All remaining samples, collected from the Bedrooms, Bathroom,Laundry Room, and from a box of makeup in the Southwest Bedroom, were non-detect for asbestos. However, it should be noted that the majority of horizontal surfaces in the Bathroom were covered in debris from material already determined to contain asbestos content. Therefore the Bathroom sample was collected to determine if airborne dispersal of asbestos fibers had occurred from areas of known contamination to adjacent surfaces not directly affected by debris fall. PAGE 4 OF 6 Conclusion and Summary In conclusion, laboratory results revealed asbestos fibers within the settled dust in the Living Room/Kitchen area only, and did not reveal any asbestos fibers in the settled dust and vacuum samples collected from within the Southeast Bedroom, Southwest Bedroom,Northwest Bedroom,Laundry Closet,Bedroom Closets, Bedroom Dressers,non-debris-contaminated hard surfaces within the Bathroom, and from within a box of makeup, located in the Southwest Bedroom at the time of our survey. Remaining areas of(1) affected GWB with asbestos-containing acoustical popcorn ceiling treatment, and(2) any areas of GWB with asbestos-containing joint compound that is spread across the entire surface, should be removed by State of Washington Certified Asbestos Workers under the supervision of a Certified Asbestos Supervisor. Following debris removal and cleaning, in accordance with ASTM Method El 368-14: "No dust, dirt, or debris should be visually detectable upon the final inspection of the work area." This should include, at a minimum, a final cleaning to remove settle dust from all horizontal and vertical surfaces within the Kitchen, Living Room, and Bathroom, as well as all flooring surfaces throughout the dwelling. Asbestos-containing materials are required to be removed and disposed of in accordance with Washington State Regulations prior to any demolition,renovation, or remodeling that would disturb these materials. Washington State Department of Labor and Industries and PSCAA require that the abatement be performed using Certified Asbestos Workers under the direct on- site supervision of a Certified Asbestos Supervisor. Materials that contain less than 1% asbestos are not regulated for disposal purposes. However, removal of materials containing less than 1% asbestos is considered an unclassified asbestos operation by OSHA and the State of Washington Division of Occupational Safety and Health (DOSH of L&I). Unclassified asbestos operations cover employees who may, depending on the activity,be exposed in excess of the permissible exposure limit(PEL), and who are performing operations not covered by work Classes I through IV. For construction work involving unclassified asbestos, the applicable requirements include: an exposure assessment, use of vacuum cleaners equipped with HEPA filters,use of wet methods and prompt cleanup of debris, use of respirators and protective clothing, training, and record keeping. • PAGE 5 OF 6 Limitations of Survey Asbestos inspections are non-comprehensive by nature and our assessment is limited to only those locations inspected and sampled. This survey was not designed to identify all potential concerns or eliminate all risk associated with abatement. No warranty, express or implied,is made. Rose Environmental LLC is not responsible for materials which require destructive means to access, or materials which are hidden from sight, those materials hidden behind walls, or materials which cannot be found with reasonable diligence. Rose Environmental LLC performed this inspection in accordance with the generally accepted standards of care that exist in the industrial hygiene profession in Washington State at the time of this study. It has been a pleasure working with you. Please call me at your earliest convenience with any questions you may have regarding this report. Respectfully, Reviewed by, Tyler Stevens Martin Rose, CIE Industrial Hygeinist Principal/Senior Consultant Rose Environmental LLC Rose Environmental LLC Attachments: EMSL Laboratory Reports 511601890 & 511601891 Photographic Contact Sheet iEVERRI i-11 FEB 022011 CITY OF ANACORTES PAGE 6 OF 6 EMSLEMSL Order: 511601890 Analytical, Inc. Customer ID: RSEE42 Etia��w9 3317 3rd Ave S,Suite D 2nd floor Seattle,WA 98134 Customer PO: r� Tel/Fax:(206)269-63101(206)900-8789 httpi/www.enisl.com I seattlelab@nrnsl.com Project ID: Attention: Martin Rose Phone: (206)679-0699 Rose Environmental LLC Fax: 2208 NW Market St.#207 Received Date: 12/01/2016 5:00 PM Seattle,WA 98107 Analysis Date: 12/02/2016 Collected Date: 12/01/2016 Project: Test Report:Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized Light Microscopy Non-Asbestos Asbestos Sample Description Appearance %Fibrous %Non-Fibrous %Type ANA-BRS TanllNhite 100%Non-fibrous(Other) None Detected Non-Fibrous 511601690-0001 Heterogeneous ANA-BRSW Gray/White 10%Cellulose 75%Non-fibrous(Other) None Detected Fibrous 15%Glass 511601890-0002 Heterogeneous ANA-BRNW White 40%Cellulose 60%Non-fibrous(Other) None Detected Fibrous 511601890-0003 Heterogeneous ANA-BATH GrayllAfrdte/Black 10%Cellulose 70%Non-fibrous(Other) None Detected Fibrous 20%Glass 5116918904004 Heterogeneous ANA-LAUND Tan 30%Glass 08%Non-fibrous(Other) None Detected Fibrous 2%Hair 511601890-0005 Heterogeneous ANA-KLI TanANhite/Black 20%Cellulose 80%Non-fibrous(Other) <1%Chrysotile Non-Fibrous 511601890-0006 Heterogeneous ANA-MAK White/Red 40%Cellulose 60%Non-fibrous(Other) None Detected Fibrous 511601890-0007 Homogeneous rinni FE O2 Nil CITY OF A VACVRTES Analyst(s) � Ct,C7L-iV Rudy Baum(7) Lauren Kerber,Laboratory Manager or Other Approved Signatory EMSL maintains liability limited to cost of analysis. This report relates only to the samples reported and may not be reproduced,except in full,without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. Interpretation and use of test results are the responsibility of the client. This report must not be used by the client to claim product certification,approval,or endorsement by NVLAP, NIST or any agency of the federal government. Non-friable organically bound materials present a problem matrix and therefore EMSL recommends gravimetric reduction prior to analysis. Samples received in good condition unless otherwise noted Estimated accuracy,precision and uncertainty data available upon request Unless requested by the client,building materials manufactured with multiple layers(i.e.linoleum,wallboard,etc.)are reported as a single sample-Reporting limit is 1% Samples analyzed by EMSL Analytical,Inc.Seattle,WA NVLAP Lab Code 200613 initial report from:12/02/2016 13:16:01 AS.D PLM 0CR8-1.71 Printed:12/2/2016 10:16 AM Page 1 of 1 EMSLEMSL Order: 511601891 Analytical, Inc. Customer ID: RSEE42 • i 3317 3rd Ave S,Suite D 2nd floor Seattle,WA 98134 Customer PO: • Phone/Fax: (206)269-6310 1(206)900-8789 Project ID: httpalwww.emsl.com 1 seatttelab«Glemsl.com Attention: Martin Rose Phone; (206)679-0699 Rose Environmental LLC Fax: -2208 NW Market St.#207 Received Date: 12/01/2016 5:00 PM Seattle, WA 98107 Analysis Date: 12/08/2016 Collected Date: 12/01/2016 Test Report: Asbestos Analysis via Transmission Electron Microscopy ASTM Method D5755 Area Sampled Asbestos Asbestos Sensitivity Concentration Sample ID (cm') type Structures (strlcm') (strlcm') Comments MCE-CLNWS 929 None <3 10 <30 Detected 511661891-0001 MCE-BRS 929 None <3 10 <30 Detected 511601691-0002 MCE-DCSW 929 None <3 10 <30 Detected 511601891-0003 MCE-BRSW 929 None <3 10 <30 Detected 511601891-0004 MCE-BRNW 929 None <3 10 <30 Detected 511601891-0005 MCE-LRW 929 None <3 10 <30 Detected 511601891-0006 Analyst(s): Lauren Kerber(3) Lauren Kerber,Laboratory Manager or other approved signatory The above report relates only to the items tested_This report may not be reproduced,except in full, without written approval by EMSL Analytical,Inc.Samples received in good condition unless otherwise noted. Samples analyzed by EMSLAnalytical,Inc.Seattle,WA Initial report from:12108/2016 18:24:06• , Printed 12/812016 3:24:09PM Page 1 of 1 EMSL Anal tical Inc, EMSL Order: 511601891 y Customer ID: RSEE42 3317 3rd Ave S,Suite D 2nd floor Seattle,WA 98134 Customer PO: Phone/Fax: (206)269-6310 I(208)900-8789 Project ID: hltp://vrv�v.emsl.corn!seattlelab@emsl.com Attention: Martin Rose Phone: (206)679-0699 Rose Environmental LLC Fax: 2208 NW Market St.#207 Received Date: 12/01/2016 5:00 PM Seattle,WA 98107 Analysis Date: 12/08/2016 Collected Date: 12/01/2016 Test Report: Asbestos Analysis via Transmission Electron Microscopy ASTM Method D5755 Area Sampled Asbestos Asbestos Sensitivity Concentration Sample ID (cm') Type Structures str/cmz '( } (strlcm J Comments MCE-CLNWS 929 None <3 10 <30 Detected 511601891-0001 MCE-BRS 929 None <3 10 <30 Detected 511601891-0002 MCE-DCSW 929 None <3 10 <30 Detected 511601891-0003 MCE-BRSW 929 None <3 10 <30 Detected 511601891-0004 MCE-BRNW 929 None <3 10 <30 Detected 511601891-0005 MCE-LRW 929 None <3 10 <30 Detected 511601891-0006 Analyst(s): Lauren Kerber(3) Lauren Kerber,Laboratory Manager or other approved signatory The above report relates only to the items tested.This report may not be reproduced,except in full, without written approval by EMSLAnalytical,Inc.Samples received in good condition unless otherwise noted. Samples analyzed by EMSL Analytical,Inc.Seattle,WA (Initial report from:12/08/2016 18:24:06 - Printed 12/8/2016 3:24:09PM Page I of 1 OrderID: 511601891 Asbestos Chain of Custody EMSL ANALYTICAL, INC. EMS!: EMSL Order Number(Lab Use Only): 3317 3Rt3 AVE S, SUITE❑ . SEATTLE,WA 98134 5 1 1 6 0 1 8 9 fq PHoNE:(206)269-6310 EMSL ANALYTICAL,iNC. • - FAX:(206)900-8789 u o er.wro nr.won�cTa.ru w w a i { • J ( //��� M. , -� EMSL-Sip to�Same ❑Different Company` J 1"u If Bill to is Different ote instructions!n Comments" Street: 1 LT.-- Third Party Billing requires written authorization from third party City: State/Province: Zip/Postal Code: Country: Report To(Name): Fax II: Telephone#: - Email Address: Project Name)Number:Please Provide Results: ❑ Fax iEniail Purchase Order: U.S.State Samples Taken: W Turnaround Time TAT Options*-Please Check , El 3 Hours ❑6 Hours ❑ 24 Hrs ❑48 Hrs ❑ 3 Da s D 4 Days ( 5 Days El 10 Days *For TEMAir 3 hours/6 hours,please call ahead to schedule.*There fs a premium charge for 3 Hour TEM AHERA or EPA eve I TAT. You will be asked to sign an authorization form for this service. Analysis completed in accordance with EMSL's Terms and Conditions located in the Analytical Price Guide. PCM-Air TEM-Air TEM-Dust ❑ NIOSH 7400 0 AHERA 40 CFR,Part 763 MQVIicrovac-ASTM D 5755 ❑ w/OSHA 8hr.TWA ❑ NIOSH 7402 0 Wipe-ASTM D6480 PLM-Bulk(reportincr limit) 0 EPA Level II , ❑Carpet Sonication (EPA 600/J-93/167) ❑PLM EPA 600/R-93/116(<1%) ❑ ISO 10312 Sofr/RockNermiculite El PLM EPA NOB(<?%) TEM-Bulk 0 PLM CARS 435-A(0.25%sensitivity) Point Count ❑TEM EPA NOB 0 PLM GARB 435-B(0.1%sensitivity) ❑400(<0.25%)El 1000 (<0.1%) ❑NYS NOB 198.4(non-friable-NY) ❑TEM CARB 435-B (0.1%sensitivity) Point Count wlGravimetric ❑Chatfield SOP ❑TEM CARB 435-C(0.01%sensitivity) ❑400(<0.25%)❑ 1000(<0.1%) ❑TEM Mass Analysts-EPA 600 sec_2.5 ❑ EPA Protocol(Semi-Quantitative) 0 NYS 198.1 (friable in NY) TEM-Water: EPA 100.2 ❑ EPA Protocol(Quantitative) El NYS 198.6 NOB (non-friable-NY) Fibers>10pm 0 Waste 0 Drinking Other: 1 ❑ NIOSH 9002 (<1%) All Fiber Sizes ❑Waste ❑Drinking j] ❑ Check For Positive Stop Clearly Identify Homogenous Group Samplers Name: l Samplers Signature: Volume/Area(Air) Date/Time Sample# Sample Description HA#(Bulk) Sampled —PCs,") ) i yew Client Sample#Ss - /et, Total#of Samples: Relinquished(Client); J E-- { �jt t,C Date: t2-0 Time: �.Received(Lab): bate: 1.z/ /( (-1_ Time: §-_co CommentslSpec I ctions: Conlio0eti DMnlen1—Ashoslns CDC—el-311=09 Page 1 of pages Page 1 Of 1 Kingsmen From: Lon Craig [Lon.Craig@pemco_comj Sent: Monday, November 28, 2016 10:22 AM To: 'Kingsmen' Subject: RE: Glim Gabrielle Sketch FEB 2 Nil Attachments: 1623602d -asbestos test results.pdf CITY of ANA TES Hi Randy, FYI-There is a continuous popcorn ceiling in the living room, dining room and down the hallway. Bryce Muller at Alpine Restoration had asbestos tests done on the popcorn and ceiling drywall.They came back positive (asbestos test results attached). Most of the ceilings in this home are wet and need to be removed which means removing the attic insulation. Bryce will be bringing in an abatement company to remove the ceilings and attic insulation. He will try to save any ceilings that are not wet. Bryce also indicates that the furniture/contents in the living room and dining room will also need to be wiped down by the abatement company before Bryce can move all the contents to their facility in Everett, If you have any questions for Bryce his cell #is 425-327-5981. Lon J. Craig, AIC I Senior Property Claims Adjuster J PEMCO Mutual insurance Co. 425.7112.7741 I fax 206,676.3622 i lon.crai r s7.-!m:'rco,com WE'RE A LOT LIKE YOU. A LITTLE DIFFERENT. From: Kingsmen [rnailto:kirrgsrnepconstructioonJ6,>comcast.i t] Sent: Monday, November 28, 2016 8:19 AM To: Lon Craig<Lon,Craig@Oen co.com> Subject: RE:Glim Gabrielle SKetch Thanks! I have a site inspection schedule for today at 1pm. I will not be in the office Tuesday 11/29 as 1 will be in a Meeting all day Randy Pegues Kingsmen Construction, Inc 360 720-0501 From: Lon Craig [mailto:Lon.Craig©pernco.com] Sent: Monday, November 28, 2016 6:30 AM To: 'Kingsmen' Subject: FW: Guinn Gabrielle SKetch FYI Lon J. Craig, AIC I Senior Property Claims Adjuster I PEMCO Mutual Insurance Co. 425.712.774.1 I fax 206.676.3622 I lon.cni,j ..emco.corn WE'RE A LOT LIKE YOU, A LITTLE DIFFERENT. 1 fi.�Aboratories, • 4703 Aurora Ave N,Seattle,WA 98103 ' p 206.547.0IGO I 1206.634.1936 I www,cwIlabs.corn L f\ 3 S Bulk Asbestos Fibers Analysis By Polarized Light Microscopy Client: Alpine Cleaning & Restoration Batch #: 1623602.00 Address: 1620 -75th St. SW Client Project#: Glim Everett, WA 98203 • Date Received: 11/28/2016 Attention: Mr. Bryce Muller FEB 0 2 17 Samples Received: 2 Samples Analyzed: 2 Project Location: 2308 E Ave Anacortes, WA 98221 Method: EPA16001R-931116 CITY OF ANACORTES & EPA16001M4 82-02o Lab ID: 16294865 Client Sample#: BA1 Location: 2308 E Ave Anacortes, WA 98221 Comments: Sample was dried prior to analysis. Layer I of 2 Description: Off-white compacted powdery material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Calcareous particles, Calcareous binder, Paint Cellulose 4% Chrysotile 3% Layer 2 of 2 Description: White chalky material with paper Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Gypsum/Binder, Binder/Filler Cellulose 28% None Detected ND Lab ID: 16294866 Client Sample#: LR1 Location: 2308 E Ave Anacortes,WA 98221 Comments: Sample was dried prior to analysis. Layer 1 of 3 Description: Off-white lumpy foamy material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Calcareous binder, Synthetic foam, Paint Cellulose 5% Chrysotile 6% Layer 2 of 3 Description: Off-white compacted powdery material with paper Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Calcareous particles, Binder/Filler Cellulose 33% Chrysotile 2% Layer 3 of 3 Description: White chalky material with paper Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Gypsum/Binder, BinderlFiller Cellulose 26% None Detected ND Sampled by: Client r Analyzed by: Jacob Laugeson Date:11/28/2016 -.. Note: if samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA 600/R-93/116 and 6001M4-82-020 Methods with the following measurement uncertainties for the reported%Asbestos(1%=0-3%, 5%=1-9%, 10%=5-15%, 20%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government. page 1 of 3 MIL Laboratories, Inc. ASBESTOS LABORATORY SERVICES 4708 Aurora Ave N,Seagle,WA 93103 p 206.547,0100 I 1206.611..1936 %vtvw.rivIlabs cam L A B Company Alpine Cleaning &Restoration NVL Batch Number 1623602.00 Address 1.620-75th St. SW TAT 2 Hrs.. _ No Everett, WA 98203. Rush TAT Project Manager Mr.Bryce_Muller.. Due Date 11/28/201.6_17ime 10:00 AM. Phone (425)7744826 Email bryce.muller@alpineoLeaning.n.et Cell (425)_327.-_5.981 Fax (425)356-2699. . Project Name/Number:Glim _ .... Project Location: 2308_E Ave Anacortes,_WA_98221 . _ Subcategory PLM.Bulk • Item Code ASB-02 EPA 600/R-9.3_41_6 Asbestos by PLM <bulk> Total Number of Samples 2 Rush Samples _ Lab ID Sample ID Description AIR I 1 16294865 BA1 A 2 16294866 LR1 A Print Name Signature Company Date Time Sampled by Client Relinquished by Drop Box Office Use Only Print Name Signature Company Date Time Received by Jacob Laugeson 1NVL 11/28/16 800 Analyzed by Jacob Laugeson NVL 11/28/16 Results Called by 111 Faxed E Emailed Special Instructions: Dab :11128/2016 Time:8:58 AM Entered By:Jacob Laugeson page 2 of 3 a, Turn Around Tit 6236 02 i v ASBEST•S J1Slaur L ABS p y�g k2 Hours ,U 2 Days _I 5 Days INDUSTRIAL CHAIN OF CUSTODY • 4 Hours LI3Days =10Days FIYGIENE Please call for TAT less than 24 Hours SERVICES Laboratory I Management I Tr,inirtg - Company Alpine Cleaning & Restoration Project Manager Bryce Muller Address 1620 75th St SW Cell ( 425 ) 327 5981 Everett WA 98203 Email Bryce:mulier@alpinecleaning.net Phone (425) 348-7387 - F,T ( 425 ) 356- 2699 Project Nane/Ntinber(, j 0/1 Project Location . ( 0 E gilt l? A :t CQd 6 1\ U PCM Air(NIOSH 7400) U 'TEM(NIOSH 7402) U TElvi(AHERA) LI TEM(EPA Level II Modified) PLM(EPA 600/R-93-116) 0 EPA 400 Points(600/R-93-116) LI EPA 1000Points(600/R-93-1:16) �I PI_M Gravimetry(600/R-93-116) U Asbestos in Vermiculite(EPA 600/R-04/004) (.J Asbestos in Sediment(EPA 1900 Points) U Asbestos Friable/Non-Friable(EPA 600/R-93/116) U Other Reporting Instructions .PIeas-1 email results U Call r�f LA ( 1 LI Email(-f �� 1..X�� :`� ! % rax .- --- 7 67i11 Numbcq.of Samples Sample ID Description A/R 1 3 5 4 6 8 -- —19 0 1.1 1.2 1314 15 Pi ink Name Sj mature f Company Dale f Time ` _r,11 Sr I �{,1y fin' !1 r'/ 'i�ii / llni Sampled by l��I�� 4) i �'1i�� 1 V'l C �i� ' V\ I l 1--1.�r ' /z . 9�f • Relinquish by 'i G J °,fr �r.vi �-� y 1r 1 A/14 Office Use Only Print Name Signaiurc,. /J Company Dale Time Received by i�:raf, r �' ,,. t 1 0 Analyzed byeCalled by Faxed/Email by —_ 4708 Aurora Ave N,Seattle,WA 98103 1 p 206.547.0100 I f 206.634.1936 I www,nvllabs.cotn page 3 of 3