HomeMy WebLinkAboutPermit File 2107 Pennsylvania Court 0715504-2 0001 06/0512007 002 4
GAT Y. 4-27.00
City of Anacortes Permit Permit#Oh51'aBLD 2007-0391
904 6th Street Issue date: 05/31/2007
P.O.Box 547 Expire date: 05/30/2008
Anacortes, WA 98221-0547
cagy.,
Job Address: 2107 PENNSYLVANIA AVE Permit Type: Irrigation Permit
ANACORTES WA 98221-4525 Project:
APN:
Remarks: Install landscape irrigation system with backflow preventor.
Owner: D.ALEXANDER KING CONSTRUCTION Contractor:
Address: 13672 ROSARIO RD Address:
ANACORTES WA 98221-8528
Phone: (360)293-5611 Phone:
License#:
General Information: Fees:
#of Backflow Devices 1 Plumbing Permit Fee 27.00
Total Calculated: 27.00
Deposits/Receipts: 0.00
Total Due: 27.00 '
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
PROV SIGNS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR
NOT, HE GRANTING OF ERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER
Yi E 0 LOCAL LAW GULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION
J` BY xe
SIGNATURE 0 NER OR AUTHORIZED AGENT ISSUED BY 1
PLUMBING PERMIT APPLICATION
• t- te' Building Department
P.O. Box 547 Anacortes, WA 98221
ca+'fi: Phone No.: 360-293-1901 FAX: 360.293.1938
SITE ADDRESS: 7/(f gr,ilaSyLVA-NI/H C&iJ _iiiA2v21E4
CONTRACTOR
Name t, A.-`t/C-At4L R K JC CoAt5 - PROJECT DESCRIPTION
Address GO670 SA Its t-✓4Y V iYE-A
City/State/ZipAtJA�Cr'e7 tpiA 9,,,221 tf'I 1RRi67 Tilt) St/51 "t
Phone36,0 421-1 g FAX
g3L o 2 3 r 4 3-- 5 Permit Fee 20.00
State Licence# DA LEAK 15 I jJ L Exp oil/o770 7 Fixture Type Fee Each No. Amount
City of Anacortes Business License# Toilet 7.00
PROPERTY OWNER Bathtub 7.00
Name D. El7ik- h%E KI^'C7 ev1/4
; 7,I Shower 700
Address (PC tGt%) S 5 Veit %1ITe A Dishwasher 7.00
City/State/Zip A-Ail A-Cp%Q'Tvj VIA- 1 ' K" i 11 'tr Hand Sink 7.00
Phone42 I FAX 2 FAX ;a) 3 3g1-6 Kitchen Sink 7.00
E-mail Address Clothes Washer 7.00
APPLICANT Electric HWT 7.00
Name t5- A-L tt-tArih7 Z- 4)Ci Ces-dS — Utility Sink 7.00
Address (`G^ G''c' 5c4 5 V/Ay Xi/117 /t Urinal 7.00
City/State/Zip AVA-Cz.Qcr? c W'P- ?22/ Water Interceptor 7.00
Phone k2-i -iC Cr FAX 7i0 2-g 3-3(-193 Drinking Fountain 7.00
E-mail Address Slop Sink 7.00
CONTACT / Water Piping 7.00
Name D.-PA-EW n n ._ 41.4Ct > t� Hose Bibb 7.00
Address hobo S'n'vt''5 \,i 4k ( Gas � `" Grease Interceptor TOO
City/State/Zip` A{8vkke Vt/ik / 'ZZ-`'\ �7 ram-- Additional Fixtures 7.00
Phone L 1- 1 qI5 FAx ,3�O 2-q3`_J(.�,`�
TOTAL FEES DUE
E-mail Address I
I HEREBY ACKNOWLEDGE I HAVE READ THIS PERMIT APPLICATION AND STATE THE INFORMATION IS CORRECT,AND
AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING ACTIVITIES COVERED BY THIS
PERMIT APPLICATION.WITH S PERMIT ALL CONTRACTORS AND SUBCONTRACTORS SHLL HAVE A CURRENT
WASHINGTON STATE CONT TORS LICENSE AND A CITY BUSINESS LICENSE.STOP WORK ORDERS WILL BE
ISSUED 0 JCt ,SITES WHE CONTRACTORS/SUBCONTRACTORS ARE WORKING WITHOUT PRO ER LICENSE.
V l ��y E7 //.
APPLICANT'S SIGN
Last Updatedll-2s-0s 5 0_ r>20 / — "Cr( ate' d
1
•
G,t•
0 CITY OF ANACORTES
WASHINGTON
9c BUILDING DEPARTMENT
CERTIFICATE OF OCCUPANCY
This is to certify that the(Description of Building or Structure):
11
Single Family Residence
I f
Located At: 2107 Pennsylvania Court
STREET&NUMBER
Owner: D. Alexander
Constructed By: Owner
OWNER OR CONTRACTOR
Bldg. Permit#: 1}3LD-20O7-003 7
Date Issued: January 30, 2007
Occ. Group: R3 Use Zone: R2
Has Been Inspected And Occupancy Is Hereby Authorized.
21st June 07
This Day of 20
..gr
AU CRRING OFFICIAL {{�
SEE REVERSE SIDE FOR SPECIAL REQUIREMENTS.
f11
■ ■ '
IFinal Inspection Checklist I
Site Address: 2-it, 7 P100 4y 474nt 4 e"r PermitNo.: O 7 -o ' 3 7
Date Issued: / 3 /
107 Zoning: Occ. Group: 1 nJ Constr. Type: V
Owners Name: p. A 'tic a n der--
Owners Mailing Address: State: Zip:
Variances: No Yes Safety Glass: No Yes C�
Sewer Fee Paid: No Yes Hand Rails: No Yes Pei
1
Sewer Inspected: No Yes Guard Rails: No Yes L
WSEC Compliance: No - Yes Traps: No Yes l/
Attic Access: No Yes ✓ Wood-Stove: No Yes
Smoke Detectors: No Yes ✓ Water Pressure: No Yes
T&P Drains: No Yes tV House Numbers: No Yes li
Insulation Cert.: No Yes ✓V
Site Drainage: No YesCurb Cut: IV No Yes • Crawlspace Insul: No Yes
Bedroom Windows: No Yes t%// Water Heater Strp: No Yes //
Vapor Barrier: No Yes 1// D.W. Air Gap: No Yes_____
Water Meter Box: No Yes ✓ Auto Garage Door: No Yes/�1,7
Exterior Decks/Landings: No Yes // • Outside Caulking: No Yes
Garage/House Door: No Yes v Inspected By:I Cl07
Crawl Space Access: No Yes I Date• c ; /��
Exh. Duct/Dryer Vent Dampers: No Yes v 0 K 6 1( 9107
INSULATION CERTIFICATE
2107 PENNSYLVANIA AVE/ KEYSTONE SKAGIT/ANACORTES WA
Address of Property County Job No.
EXTERIOR WALLS
Type of Material FIBERGLASS Manufacturer: KNAUF Thickness: 5.5 R Value: 21
CEILING BATTS
Type of Material FIBERGLASS Manufacturer: KNAUF Thickness: 12 R Value: 38
UNDERFLOOR BATTS
Type of Material FIBERGLASS Manufacturer: CT/KN/OC Thickness: 10 R Value. 30
CEILING BLOW
Type of Material FIBERGLASS BLOW Manufacturer KNAUF Thickness: 16.75 R Value: 49
2120 Sq Ft Covered 3'9 No. of Bags 29 Wt./Bag
r ,
WASHINGTON INSULATION
CERTIFICATE
I CERTIFY UNDER THE PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OFWASHINGTON THAT THE
FOREGOING IS TRUE AND CORRECT
General Contractor(Builder) Contractors Reg. Number: WASHII`951C8
Licensed Architect/Engineer:
By i TITLE:
Date and Place 3- /6-01
•
Public Works
orks
Engineering and Development Services
Residential Inspection
Address: 0.107 Pen h�,,,)t�,,,,,, 7?[ Date: —7—b7
r:
oa Owner
Vg, K , ,
Contractor: - /
Inspected by: �, �✓c, /dam
1. Water Meter Box
Set firm and level to finished grade or backside of sidewalk elevation.
® Lid and box undamaged.
l] Water meter and customer shutoff installed.
® No debris.
Vl Accessible—no landscape obstruction.
1 Driveway installation has drive-over box and lid.
• Customer gate valve intact.
vi No leaks at connections.
2. Curb and Gutter
No cracks, damage, graffiti, footprints, finishing blemishes, or other objectionable
maths.
If road frontage improvements:
j Expansion joints every 15 feet and at driveways.
• Concrete has broom finish.
r-) No low spot at curb line, especially at driveway cut. Maximum grade change in
`-P 20 feet is % inch.
3. Sidewalk
,i No cracks, damage, graffiti, footprints, finishing blemishes, or other objectionable
marks.
in ADA compliant— 1 percent slope to curb.
If road frontage improvements:
® Expansion joints every 15 feet and at driveways. -
VI Concrete has broom finish
4. Driveway Approaches
No cracks, damage, graffiti, footprints, finishing blemishes, or other objectionable
marks.
�'j ADA compliant.
•
5. Streets
ZA No cracks, blemishes.
If road or alley improvements:
❑ Received proctor and sieve analysis of ballast, crushed rock, and asphalt_
❑ Received passing materials testing reports for sub-grade, ballast, crushed
rock, and asphalt.
❑ Received tonnage tickets consistent with required thickness per approved
. plans.
6. Sanitary Sewer
O Inspection card signed off and/or verified in Building Department database.
m As-built record filed in the address file.
® Screw cap(s) installed on clean-out(s).
▪ Clean-out(s)set at finished grade.
7. Storm Drainage
® Inspection card signed off and/or verified in Building Department database.
] As-built record filed in address file.
® Not blocked or diverted to adjacent parcel.
8. Public Utilities Out of Traveled Way
VA ❑ Concrete collars around City utilities.
• Final grading ok.
K] Restored to prior condition or better.
9. Landscape
❑ Bonded for completion at later date.
Verified against approved landscape plan:
® Installation.
❑ Type and quantity of plants.
® Sod or seed in place.
❑ Root barrier(receipt filed).
10.Erosion Control Measures .
BMPs removed.
�C All debris removed. Site dean.
0 Permanent vegetation established.
0 702'902-2 0130 01/.330/2007 001 1
erra?Y Fees 0073466 $10,551.45
Gl" Y Ofi., City of Anacortes Permit#: BLD-2007-0037
', 904 6th Street Issue date: 01/30/2007
P.O.Box 547 Expire date: 01/28/2008
'.' . Anacortes, WA 98221-0547
4' 1.
(360) 293-1901
Job Address: 2107 PENNSYLVANIA CT Permit Type: Single Family Residence Permit
ANACORTES WA 98221 Project:
APN:
Remarks: Construct single-family residence
Owner: D.ALEXANDER Contractor:
Address: 13672 ROSARIO RD Address:
ANACORTES WA 98221-8528
Phone: Phone:
License#: l
General Information: Fees:
Building Valuation 240000 Sewer GFC-Residential 6,397.00
# Forced Air Furnace <=1,000 1 Plan Review Deposit 100.00
#of Bathtubs 2 Building Permit Fee 783.00
#of Clothes Dryers 1 Plan Review Fee 408.95
#of Clothes Washers 1 Mechanical Permit Fees 142.00
#of Dishwashers 1 Plumbing Permit Fee 125.00
#of Gas Fireplace 2 State Building Code Fee 4.50
#of Gas Piping 6 Sewer Inspection Fee 50.00
#of Gas Water Heaters 1 Storm Drain GFC-Residential 1,126.00
#of Water Piping 1 Park Impact Fee 615.00
#of Hose Bibbs 2 Traffic Impact Fee 900.00
#of Kitchen Sinks 1 Total Calculated: 10,651.45
#of Lavatories 3 Deposits/Receipts: 100.00
#of Range Hoods 1
#of Showers 1 Total Due: 10,551.45
#of Ventilation Fans 6
#of Water Closets 3
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
ST�OCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
g
SIGNATURE OF OWNE AUTHO {ZED AGENT ISSUED BY
LAPJQ C.A.Q i:. PLAN
CD c av IFECz izz v fix cPuPee M J a s L. smut
D DEUU:vaiG iii.CE
W,. L Uea M J. Carr 2 _
OUStESai ;i.f r,":,'7a 2 GtU s rttJ at?, 5 y' C ANbSL.AYE WALL
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2107 Pennsylvania Ct. Lot Size:8801 &F
Lot 9 Anse ,WA
D. Outtguetioa, Garage 674 S.F.
13672 Rondo Rd Covered Area 216 S.F.
Aaaoortee,WA 98221 Total 3076 S.F.
360.293.6611 ,
1
5 , 1 07 P hh5j/64Gi 4- rot'ct/
M Mitchell Engineering, Inc.
7821 - 168th Ave NE FM1
Redmond, WA 98052
(425) 747-1500 • Fax (425) 747-5403
To: Date: Pda41./Ait--( i 247-'7
001.--1 /4,144) Job#: 0 7-if
1 � (G72 {2AV/10 I¢y,4i, Job Name: • 4� 2.I�Cr 1
/a I-I A oit-r 1 A • �.C22) Subject: � cl�w4 A4YYY�Fbr -
( 3c,� l2i3— 45
Fax: 3� � .I
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`EXPIRES: 00
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CITY OF ANACORTES BUIDLING DEPARTMENT RESIDENTIAL
CHECKLIST
(This form is to be completed�- 1 prior to issuing the building permit)
'
Site Address: /0L (D 7\1/2.Jna..L' M,cti L,J o-i./y Date: 1- Sep -0')
•
Contact Person: Thor-) Phone No.;- %' •-S`6/
-
Assessors No.: Lot Block: Addition:
(Building Department Checklist for Completeness)
OK NA OK NA
❑ Fire Department Access 0 ❑ Fire Hydrant Located within 250 feet
❑ Fire Flow Required 0 0 Shoreline or Wetlands
O Site Plan ❑ 0 Covenant Approval
❑ Variance Required 0 0 Regulated Slopes
❑ 0 Plat Facts and Findings Compliance 0 0 Survey in File
❑ 0 Fill on Site
Received and Reviewed by: Date:
(Engineering Department Checklist for Completeness)
OK NA OK NA
O ❑ Water Extension/Meter ED 0 Sewer Extension/Connection
❑ ❑ Street Improvements/Sidewalks 0 0 Site Drainage Plan
O Covenant Not to Oppose Future LID 4 ❑ Latecomers Agreement
O Street Drainage E ❑ Driveway location,slope,culvert
❑ Storm Drain Extension P-rr
Received and Reviewed by: \✓ Date: 1 _30—07
FURTHER COMMENTS
Zoning. Pa -,
Lot Size: V' rn r S
Coverage Allowed: j10 g c7 Sic.
Actual Coverage: 3,0 1 - , , -��.
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Penni3Tviiiiii Ct.
2107 Pennsylvania Ct. Lot Size: 1 S.F.
Lot 9 Anaeortes,WA I Impervious:
House 2186 S.F.
D.Alexander Consultation,Inc. Garage 674 S.F.
13672 Rosario Rd Covered Area 216 S.F.
Anaeortes,WA 98221 Total 3076 S.F.
360-293-5611
. I
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o Cnabonita c nom I G1\un0 art I' 30
im-; —_Soo oo ii.,000 Coo 0 00011
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2107 Pennsylvania Ct. Lot Size: 8801 S.F.
Lot 9 Anacortes,WA Impervious:
House 2186 S.F.
A Alexander Construction,Inc. Garage 674 S.F. 1
13672 Rosario Rd Covered Area 216 S.F.
Anacortes,WA 98221 Total 3076 S.F.
360-293-5611
APPROVED PLANT KEY
SYMBOL LATIN NAME COMMON NAME i SIZE
_ , Cow-Onus carotiniana ; -_-- American Hornbeam --_ (min. 1 1/2' caliper)•
'' 'i ' -ACER rubrum 'Red Sunset' 1 Red Sunset Ma (min. 1 1/2' caliper)
Amaton•_inierr o. x gran 1Saskatoon Setvicebeny (min. 1 1/2' caliper)
f"rn gnus amer'Saratoga'
cnna g - ---_ - -- American White Ash -- - - - -- - (min. 1 1/2' caliper) ,
�A Ginkgo bfloba Sornto c' MaidenhairTree
O 1 Chamaecyparis obtuso 'Criu-ilis'j Hinold False Cypress _ - ---(min. 1 1/2' caliper),
0 i Acer circinaturn Vine Maple (min. 1 1/2' caliper)
e 1 -Cistus purpureus Orchid Rackrose (min, 1 gallon pot size)!
--— 0 i Cistus corbarlensis Nfiite Rockrose -_ (nu/ I gallon pot size)
• Abelia gra. 'Sherwoodi' Gluey Abele (min. I gallon pot size) ;
p -Physocarpus opuliFotius 'Diabulo'i Common Ninebark (min. I gallon pot size)t
® MAGNOLIA stettata 'Royal Star`. Royal Slar Magnolia (min, I gallon pot size)i
• ! Ceanothus impressus 'Victoria' Santa Barbara Ceanoihus ! Cyan. 1 gallon pot size)
Luon mtis °rota torpor_tl�s'i Ytk Spindle Tree � (min. 1 gallon o
Y ( need pi J pot size) '
• Vibur num plico turn torten tosun •i Japanese Snowball <min, 1 gallon pot size)
• Arbutus unedo 'Compr.cta' Strawberry Tree (min. 1 gallon pot size) i
• -pins nugo 'Puvitlo' Dwarf Mountain Pine (min 1 gallon pot size)
_ Pinus strof,us 'liana' - - _ - -
• Eastern Wbfle Pine (min. t gallon pot size)
• Nandina dories tics 'Coif Stream:- Sacred Bamboo (min, 1 gallon pot size>
o ' Crico cornea 'Vivelir Dailey Dale Heath (min. I gallon pot size)
O t:UTPhi ASTER dormer Bearbeny Cotordraster + (man, 1 gallon pot sizes
p Arctostophylos uva-ursi Bearbeny (man. 1 gallon pot size)
O Ceanott:us lop. 'Vnndenbr,rg' VandenburgCeanoihus tnin. 1 gallon pot size)
._ , - - .. - - 1 . .. . .
• 1other gills gardcnfl 'littee Mist" Dwarf Arndt Alder (min. 1 gallon pot size)
0 Mahonia :-epees - - Embeds Repens (min. 1 gallon pot size)
# Phormium Lenox 'Rubrun' Cockspur Hawthorne (min. I gallon pot size)
• Care:, girtuca Heath Sedge (min. 1 gallon pot size)
• Hetictotrichon seMpervirens Slue Oat Grass ; (min. 1 gallon pot size)
• i Carex testaceo Orange New Zealand Sedge (min, 1 gallon pot size)!
Residential Mechanical Fixtures
Fuel Type
Natural Gas 0 Electric ❑ Wood 0 Propane Gas 0 Other
Type of Equipment Number of Type of Equipment Number of
Fixtures Fixtures
Furnace<=100K BTU / Clothes Dryer /
Boilers/AC/Heat Pump ;-- - Gas Water Heater /
Gas Outlets *(p Gas Fireplace
Ventilation Fans (p Fireplace Insert
Stove,Appliance I Other Units
Range Hood
Residential Plumbing Fixtures
Type of Fixture Number of Type of Fixture Number of
Fixtures Fixtures
Toilet :✓ Clothes Washer ,(
Bathtub 2- Electric Water Heater
Shower / Utility Sink
Dishwasher ( Hose Bibb
Hand Sink Water Piping /
Kitchen Sink w/Disposal ! Additional Fixtures •
I HEREBY ACKNOWLEDGE IF HAVE READ THIS PERMIT APPLICANT AND STATE THE INFORMATION IS CORRECT,AND AGREE TO COMPLY
WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING ACITIVIES COVERED BY THIS PERMIT APPLICATION. WITH THIS PERMIT ALL
CONTRACTORS AND SUBCONTRACTORS SHALL HAVE A CURRENT WASHINGTON STATE CONTRACTORS LICENSE AND A CITY BUSINESS
LICENSE,STOP WORK ORDERS WILL BE ISSUED ON JOB SITES WHERE CONTRACTORS/SUBCONTRACTORS ARE WORKING WITHOUT
PROPER L CEijSE. - _
2C/7
APPLICANT'S SIGNATURE DA
Si e.wtic 'SeD&, ,
Coct ivec(torc)
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1.T Y 9 , City of Anacortes Permit : BLD-2005-0678
904 6th Street Issue date: 09/01/2005
't P.O.Box 547
f;y . Expire date: 10/31/2005
• 'G?:. Anacortes, WA 98221-0547
Job Address: 2107 PENNSYLVANIA AVE Permit Type: Demolition Permit
ANACORTES WA 98221-4525 Project:
APN:
Remarks: Demolish existing residence and barn.
Owner: FRANK B. LEWIS Contractor:
Address: 2518 WASHINGTON BLVD Address:
ANACORTES WA 98221-4831
Phone: (360) 588-9030 Phone:
License#:
General Information: Fees:
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 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 ISSUE BY /C��
M. & D. SERVICES, INC.
P.O. Box 242
Burlington, WA 98233
Ph. (360) 755-0216 Fax (360) 755-0684
e-mail:mndserv@hotmail.com
August 5 , 2005 '
Eagle Ridge
Frank Lewis
Ph. 360-588-0620
Fax 588-9030
Ce11805-404-4316
RE: Removal of Asbestos
2107 Pennsylvania Ave.
Anacortes , Wa. 98221
Mr. Lewis :
On August 4 and 5, our firm performed asbestos abatement
on the property identified above. The acm (asbestos containing
material)- r•emoved. was , identified on the good faith, survey as
Cement Asbestos Board (CAB) siding on the exterior of the south,
east and north sides of the house, and acm sheet vinyl in the
kitchen.
Visual inspection of piping system in basement did not
show any Thermal System Insulation (TSI) nor were there other
suspect materials noted in the survey .
If , during the demolition process any material is uncovered
that may have been hidden in walls or ceiling that appears suspect,
process should stop and material be tested prior to finishing.
No suspect material noted on outbuildings .
This note along with the Good Faith Inspection report pre-
viously submitted and the notifications included herein should
be adequate documentation for line item checkoff for demolition
permit.
Thank-you for using our firm for your abatement needs .
Respe tfu ® i
Michael S. Weidkamp
y-24(µ '1..m M ► 202 CASE a:
, _ ph 3604261617 We evelelene to thie Inlonesseen uss NAPS I:
St MA8J620 ilMEINIMICSablialealalsa
• ,,,,a,4„k,,eB PJs(Kira Font tao,570.5) FOR AGENCY USE ONLY
•
Notice of intent to Perform an Asbestos Project
Typo*I Frei Propel calisety peek advent) AS..a t.U11as"en Paded NWAPA Fes(I) .
A.0 Emsnincy IXtilrotdu6W(any amntkwtsr-000tpW) Ptb►Nolilloslbn 25.00
Q]( DemoNon 2.0 10 59insetfst 3WoddngDrys- 150.00
C.CI Renovation4&150 mums test
5.0 250.1,000 Maw bet 10 Woddnp Days 800.00
D.0 Meintanaros 9504.000 Kim 2 at
E.Q Entepwstlon 4.0 Moro t an1,000 truer het 10 Milos Days 500.00
Mors thin 5,000 square last
F.0 Endows 5,Q fey Peer Notllkellon Addt lee equal to project fee 1
O.0 O1le(spsoly): S.Q Ammtinet PtbrNotlHoetlon 25.00
Ouantlq+te he rem�tMd: ./ O square et. sr it W yy : Th F as flu
PISS resits deem O8/PS//0S-/ Cemple66n eis eye �4 r%'C Weikel*MAW:aged /
Cal
Wee addres address 2Y,o7 Aire teiAtt�lpeat- .. .Artitcei z, ,5�,Sheet ow . 2S
l owelen et asluam C/,rd riel,:r e r 4a e >� dBa',3'ire c
Preleadrredpe ere. K-12 Schoen"Q Yee.Stir Sos - Fates*facility or neater/ CI Yee*No
COWS&demot tincture Yea 0-No Admit&army Conducted? Yee Q No
Fatly type:4;r di Apr: • 6r3 Ski atraSeem 1'
Type et atetwiel to be neenreeftempeWeReh - /AOes - -
CI zNot Pjer 0 Maj intimation': a'Air ail Q CA Vinyl
Q YAT -intuition -. Q'Dua'tape Q:f mprcoHng = Q P.c eslUts *'GAB . Si sn.a
pipe' O VAT - 9 Other(epaelryr)
-israinavat: *tttdoete *Outdoors 1
Cetera msetwee 4 PstsottM Pronto/on 6g01pmslk
Q N.P.autos to 0 Glove btu 0 Mini enclosure 0_Wisp add- *Wass , HEPA We Q Type Cont.-flow
AIM mask APR 0 Full has APR 0 PAPR 0 Type C P.dsnstd O=Other(specify)
Aswan*opines; M. & D. Services. Inc. Coottctort 1018 •
Mph; P. 0. Box 242 , Burlington 98233 Skagit
Nast City Zip County
Mike Weidkamp CetdSssst. 007579 Phone 360-755-0216
chmeran Mike Weidkamp Tea: President FAX 360-755-0684
Property omen ireet t.tC' teesi) t.c ConbaotorJob t SSare G p one: V 4 f '0 2
MaNhp admen: Z®7�.sedesgiak reset,Are I.�'Dts �Ps 9e weer Sie r
,o.Strait 00
Bits as* //2t#t # • nos: dL.rJirer PAont . sort.
Aebamoedaponiet* Rabanco Transfer
Estimates twat of stbsettitsbatementproject lief erect .
I DOlIBRaRYCMTIFYTFL&TTHBIN ORMATfON CONTAINED IN NM APPt1Cn1ON RECEIVEDl3,10TIEBESTOFMY ACCURATE AND IZIS - 1
, � ®7/1 /4b-c' JUL 2 5 7005
Signature Data NORTHWEST
President M. & D. Services , Inc. CIERN AIR AGENCY
The - Repmeentti - - -
1
AGENCY USE ONLY
Agency Use Only
Northwest Clean Air Agency
Case No. 1600 South 2M Street•Mount Vernon,WA 98273-5202 I'
(360)428-1617 or 1-800-622-4627 2'
Amendment No.: Fax(360)428-1620 3.
4.
AMENDMENT
TO
NOTICE OF INTENT TO PERFORM AN ASBESTOS PROJECT
• IF A FEE IS REQUIRED, FAXED COPIES WILL NOT BE ACCEPTED
Use this form only when the following changes occur:
1.Project Category or Project type 5.Address correction due to incorrect information
2.Quantities exceeds more than or less than 20% 6.Contractor or Property owner information
3.Project Start and/or Completion date 7.Disposal Site
4.Work Shift Days and Hours
Do not amend minor changes such as job site supervisor
AGENCY CASE#: 0 p5:3.fl CONTRACTOR.JOB#: ,Chef cif
JOB SITE ADDRESS: 7i'/tO 17 �,�jdedt..y Ves• djJt.4+ Q, ���&
PLEASE INDICATE ONLY THE CHANGES BELOW Whatis your Current Project Category?
® TYPE OF PROJECT: PROJECT CATEGORY:
U ADDITIONAL QUANTITY TO BE REMOVED: SQUARE FT LINEAR FT
- i(NEWOOOTAGE'TOTALS . - - '- SQ FT - - LN/ FT)
%PROJECT STARTING DATE: yg( t1 ,S COMPLETION DATE: 0 9 O y'/o
*WORK SHIFT DAYS: M T W 610 SA SU WORK SHIFT HOURS: 0 COO —• /ZOO
❑ JOB SITE ADDRESS:
+REASON FOR ADDRESS CHANGE:
U DISPOSAL SITE:
U CONTRACTOR OR PROPERTY OWNER: (INDICATE NEW INFORMATION BELOW):
❑ ADDITIONAL COMMENTS(ATTACH ADDITIONAL SHEET IF NECESSARY):
1
I DO HEREBY CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION AND SUPPLEMENTAL DATA DESCRIBED HEREIN
IS,TO THE BEST OF MY KN WLEDGE,ACCURATE AND COMPLETE.
-ice � � /�r74 AGENCY USE ONLY
SIGNATURE DATE �
CONTRACTOR: �.� 1'rX�Q "> --rn- ,,,
Phone: 3.erO 7Cc'-0 gard
Fonn p5f0.$
MISERS\DAVENebrslosPogrenMsbes ae Fame\A EsND.DOC -
Labor and Industries
Industrial Hygiene ''-`°'_ NOTICE OF
Compliance r ',
(Reg`o and phone ASBESTOS ABATEMENT
numbers on page 2) PROJECT
THIS NOTICE MUST BE RECEIVED NO LATER THAN 10 CALENDAR DAYS PRIOR TO THE START DATE
COMPLETE ALL APPLICABLE BOXES-INCOMPLETE OR ILLEGIBLE NOTICES WILL NOT BE ACCEPTED
MAIL OR FAX TO THE REGIONAL OFFICE-CIRCLE CHANGES ON AMENDED NOTICES
Notice date: /Q< Initial ktAmendedk IL Work Hours Su Mo Tu We
a
.. Start 03 7 On Hokl a offHoid o amar am — T it l
Complc '.. Orics5-45 Emergency ■ .,
pm Project oaten and Work !!r!"er± :c[
CONTRACTOR PROPERTY OWNER
Company Name Name
M & D SERVICES, INC. se Zell*C
r i
Contractor Certification Number Owner's Agent
SignFt��G� _ / e4� �/Xe�2.1�'e
% ,-�/ ‘ 1 mP�Y
Printed Name �� fi Address il
Michael S. Weidkamp �,sp , i ��.e
Phone Number City
(350) 755-02 ZIP-1-4
16
Job Site C.A S. �ir�.CGrQS �"`�.' . "-Oy iz/
Phone
Mike Weidkamp nu[n6er�L/ /yw /f
JOB SITE FACILITY
Address
al At-
BuildingName p P
/dam, i _._g Room A��l S , 5
Giry P�f��.,
�deic en- ' WA 0 Remodel )(Demolition
ZIP+4
re'woGr' County JX jr$ . ❑Repair 0 Maintenance
QUANTITY OF ASBESTOS TO BE: ►• REMOVED ❑ENCAPSULATED
Quantity /4* square feet =Indoors tOutdoors
0 Fireproofing 0 Boiler insulation CONTROL MEASURES
0 Neg.pies.enclosure El &cut
❑ Popcorn ceiling ❑ Duct paper
*CAB 700 0 VAT 0 Glove bag *Wet methods
0.Sheet vinyl - ❑ Roofing 0 Mini enclosure rf4 HEPA vacuum
❑ Asbestos paper 0 Other 0 Critical barriers Igt,Manual methods
Quantity linear feet ❑ Other ❑ Other
❑ Meg.pipe insulation 0 Cement asbestos pipe RESPIRATORY PROTECTION
❑ Air cell pipe insulation- 0 Mudded pipe ins. lit 'h mask APR 0 Type C continuous flow
❑ Ducting/duct insulation 0 Duct tape 0 Full face APR El Type C pressure demand
❑ Other 0 Other 0 PAPR ❑ Other
F413-025-000 notice ofasbestos abatement project 1 l-01 For clean copies go to http:IIwww_lni.wa goviformsl
CITY OF ANACORTES
BLDG. A PLUMBING El MECHANICAL ❑
PERMIT I'L.
Telepho 293-5173 ,
ANACORTES, WASH. DATE / 19
PERMISSIO.4S HEREBY GRANTED TO: A
''' OWNER /44 Mt A 2 • Altfig
a
STREET 4 :
ADDRESS "'cc, 7 131,4 fej-in-1--c
LOCATION WERE WORK IS TO BE DONE
F
CONTRACTOR /0`44/1`-e-
TO ERECT U INSTALL D OR tREPAIR 0
IN HE 1 e ALLOWING MANNER: c i J I lc+�-f 1 7/. y! zu ,
a lira,.. V - 0,••f 4. › .__<...f.. et. ..a .l �"U11 1 2411 1.
-. rlk" F., 1 cl i if 'J
PERMIT EXPIRES ONE YEAR FROM DATE ISSUED
PLANS FOR CONSTRUCTION WERE NOT ❑ SUBMITTED
a_ WERE 14...
WORK TO BE DONE BY OWNER ZI CONTRACTOR 0
RECEIPT OF FEES tS ACKNOWLEDGED AS FQLLOWS:
N. TYPE APPROXIMATE VALUE PERMIT FEES j
OF WORK 1
ISSUING
j BUILDING -.recta" CO :..
GAS PIPING
. PLUMBING AND W.S.
-
1 SEWER CONNECTION INSP.
i MECHANICAL -
PLAN CHECK FEE 1
" a
.,
r MISC. ./ -/ ( fC.�,Y <' lin,'.d; j .e i
TOTAL / !s ,..✓ a a Y Z. .'
t
'x 3
- LECiR�"DESGRi�'ION,.��. Sr
,'
rTh
CITY OF' ANACOHT'ES,WASI I I N( ;Jr(_)N
9 M 2 2 I
December 13, 1983 - C+®
Mrs. Sandy Barber
2007 Anacopper Mine Road
Anacortes, WA 98221
Dear Mrs. Barber:
This letter is your home occupation permit to operate a miscellaneous crafts
and hobby business on your property.
I attach a copy of the conditions that regulate home occupation permits together
with the procedure involved.
The permit will become effective with five days from today unless an appeal is
filed with City Council . I should add that if the home occupation is found to
be having a detrimental impact on the surrounding neighborhood upon thirty days
notice we can revoke or place additional restrictions on the permit.
Sincerely,
CITY OF ANACORTES
Ian S. Munce
Planning Director
cc: Adjacent Property Owners
James Rice, Mayor I
\JRay Iversen, Building Inspector
Enclosure
'I1
ADMINISTRATION FIRE DEPARTMENT POLICE DEPARTMENT PUBLIC 1 1BRARY MUSEUM OF HISTORY
P.O.BOX547 1011 12TH STREET 1011 12TH STREET 1209 9TH STREET 1305 8TH STREET
12661 293 6131 12061 1 4684 12061293-4684 12061 293-2700 12061293-5198
(Sitil0
ANACORTES PUBLIC WORKS DEPARTMENT
P.O. BOX 547, ANACORTES, WA 98221
9a DAVID M.FORD, JR.,P.E.,DIRECTOR
4000
February 6, 1991
Mr. & Mrs. Thomas More
2007 Anacopper Mine Road
Anacortes, WA 98221
Dear Mr. & Mrs. More:
Mayor Rice referred your letter of January 21, 1991 to Ed Frank,
Building Official, and myself for comments. After reviewing and
approving our response, the Mayor further asked me to transmit to
you our comments on your questions.
Question 1. Why was the acreage located in the southwest corner
of Section 23, Township 35, Range 01, EWM, City of Anacortes,
allowed to be divided without short plat or survey?
Answer: In 1971 Alexander Myers Company sold the property you
presently own to Mr. Stan Sandvik. A separate warranty deed was
provided by Alexander Myers Company to Mr. Sandvik for that
property. In 1976 Alexander Myers Company, by contract, sold to
Mr. Sandvik the property presently owned by Mr. & Mrs. Ben
Worthington. In October of 1979, Mr. Sandvik fulfilled his
contract to Alexander Myers Company and obtained a separate
— warranty deed for the present Worthington property.
It has been our policy that where parcels had been divided and
sold by separate description and deed prior to the date of
approval of the short plat ordinance that no short plat of the
property is required. The short plat ordinance was approved by
the City Council on December 3, 1979 under Ordinance No. 1805.
This policy fits the case of the two properties that you refer
to.
As regards the suvey, Mr. Frank notes that the applicant (Mr.
Worthington) submitted a copy of a survey by Semrau & Lisser
dated July 1988. Review of the drawing shows the survey to be
for the property now owned by the Worthingtons, but the survey
was not necessarily made for the Worthingtons. The drawing
could, without close examination, leave one to believe it to be a
survey. Mr. Frank also states that at this time he would not
speculate as to how the survey paper was received. In property
sales as described in the first paragraph above, surveys are not
always performed although it is highly recommended that surveys
be accomplished before sale of property. However, this is not
mandatory.
Mr. & Mrs. Thomas More February 6, 1991
Page 2
Question 2. Why was the building permit issued to the
Worthingtons and signed off for occupancy without a boundary
survey?
Answer: A part of this question is answered in Question 1 above.
Also the plot plan presented to the City by Mr. & Mrs.
Worthington indicated that there was substantial setback of the
proposed dwelling unit from any property line. This is the case
even though an error of 5 ' or 10 ' might be discovered. The
Worthington' s parcel is acreage consisting of approximately 1. 76
acres and is not a small 10, 000 to 12,000 square foot lot where
setback dimensions could be very critical.
Question 3 . How did the Worthingtons obtain a permit to locate a
double wide trailer on a residential lot in the City of
Anacortes?
Answer: The unit was represented as a factory built housing unit
constructed to Uniform Building Code requirements. Such units
are permitted in the City as long as all Uniform Building Code
requirements for the occupancy use are met. In this case the
factory built housing unit was inspected and found to meet all
Uniform Building Code requirements. Trailers and/or mobile homes
which do not meet UBC standards are only allowed in recognized
mobile home parks and/or subdivisions.
Question 4. Why has 4 months passed with no work being started
on the relocation of the water main and water lines?
Answer: The delay in starting the water main and water line
relocation and replacement is due mainly to poor planning and
scheduling on my part and inclement weather through the months of
November and December.
I hope this answers the questions that you posed in your letter.
If you have further questions, comments, or would like additional
information on the information presented, please let me know.
Sincerely yours,
CITY OF ANACORTES
David M.M. Ford, P.E.
Director of Public Works
( 206 ) 293-1919
DF:cm
cc: Jim Rice
Steve Mansfield
Ed Frank J