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Home My WebLink AboutPermit File 2804 Oakes Avenue (2) ' Y O . City of Anacortes Invoice/Permit#: BLD-2018-0519 �. 904 6th Street Applied date: 08/17/2018 P.O.Box 547 Issue date: 08/27/2018 ►� Co0 Anacortes, WA 98221-0547 Expire date: 08/22/2019 —/ (360) 293-1901 Job Address: 2804 OAKES AVE Permit Type: Demolition Permit ANACORTES WA 98221-1319 Project: APN: P58283 P31570 Remarks: Dismantle/demolish east half of house. Owner: SAMUEL HILL Contractor: Address: 15090 BEAVER MARSH RD Address: MOUNT VERNON WA 98273 Phone: Phone: License#: General Information: Fees: State Building Code Fee Resi 6.50 Total Calculated: 6.50 Deposits/Receipts: 0.00 Total Due: 6.50 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 /Z---611C-752 PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT 'Aix, DEMOLITION & OIL TANK DECOMMISSIONING PERMIT APPLICATION 19 Mailing Address:P.O. Box 547,Anacortes, WA 98221 A\tiw Office Location: 904 6th Street,Anacortes WA 98821 Phone: (360)293-1901, Fax: (360) 293-1938 PLEASE REFER TO THE PERMIT CHECKLIST THAT FOLLOWS FOR SUBMITTAL REQUIREMENTS Byt(DING DEMOLITION: N/A ❑ COMPLETE BUILDING DEMOLITION In PARTIAL DEMOLITION VRRESIDENTIAL 0 COMMERCIAL ❑ F IOOR AREA TO BE DEMOLISHED: 120O 5/ 0 METHOD OF DISPOSAL: t(S&IA IA j L Ja' DATE OF CONSTRUCTION OF STRUCTURE TO BE DEMOLISHED 44,fir- , !j 2-,O' UNDERGROUND OIL TANK DECOMMISSIONING: V N/A 0 REMOVAL ❑ ABANDONMENT IN PLACE(FIRE DEPT.APPROVAL RQD) 0 SIZE OF TANK: ❑ APPROXIMATE AGE OF TANK: ❑ DISPOSAL LOCATON: ❑ DATE OF PUMP&RINSE: 0 ICC CERT#: ❑ IF ABANDONED, SPECIFY TYPE OF INERT FILL: PROJECT ADDRESS(Street,Suite#): PARCEL(S): -0(3'f` O,$i. ' ri-v� )1 n rt. ra S APPLICANT: / Phone: Address(Street,City,State,Zip): E-Mail dcgress: 15 a qqa d,PA-ftP✓ I'orriS4 r 40, WI , 11,_ Set n 1 i..- @ I u 1'C‘ rV Pi PROPERTY OWNER: Phone: 5 A KA oi ( I-1 i I-c.- c O S ~- ffq ea a 2 7 Address(Street,City,State,Zip): E-Mail Address: l 0qa (t,A--(/er wrviricg 2 d AA . v` 470 13 Address(Street,City,State,Zip): / E-Mail Address: CONTRACTOR/DECOMMISSIONER'S FIRM NAME: Phone: S12-t- _ Address(Street,City,State,Zip): E-Mail Address: 1 *All Contractors&subcontractors must have a valid City of Anacortes Contractor's License#: Exp.Date: business license prior to doing work in the City. Contact the City's Business License#: Exp.Date: Finance Department at(360)299-1968. PROPOSED WORK: h 1 ptS1,0git dr i,i C.4 1r ( !1 S e4St f� ob k)KJ.-.e_ f I declare under penalty of perjury that the information I have provided on this form/application is true,correct,and complete,and that I am the property owner or duly authorized agent of the property ow o submit a permit application to the City of Anacortes. Print Name: -,A 14/1 14 LL-- Wit-4' Owner Other 0 (specify): Signature: -trel) Date: ir /I - l S‘ Page 1 of 2 AID q. northwest CleanAir agency DEMOL ISHING ? CHECK FOR ASBESTOS BEFORE YOU START a; Definition of demolition (NWCAA Regulation 570): Demolition means the wrecking, razing, • dismantling, or burning of a structure, making all or part of the structure uninhabitable or unusable. L a) You cannot legally start any demolition project or most renovation projects until certain asbestos requirements are met ... 0 a) Rif #4 DANGER cn v Demolition ASBESTOS o, CANCER AND LUNG C DISEASE HAZARD = Procedures PERSONNEL ONLY RESPIRATORS AND PROTECTIVE CLOTHING Q N THIS AREA KNOW THE LAW PLAN AHEAD Conduct an asbestos survey. The survey must be conducted by an AHERA-certified building inspector. (AHERA stands for Asbestos Hazardous Emergency Response Act.) These inspectors are listed in thephone bookyellow pages under"Asbestos Consultingand Testing" and on NWCAA's p9 9 website at http://nwcleanairwa.gov/permits-and-services/asbestos-and-demolition/. File a Notification of Demolition. A completed notification and fee must be submitted to the Northwest Clean Air Agency (NWCAA). Forms are available online at http://nwcleanairwa.gov/ permits-and-services/asbestos-and-demolition/. Wait. A 10-day, federally mandated waiting period applies to all asbestos demolition projects except in emergency situations with prior agency approval. This gives NWCAA a chance to review and/or inspect projects to ensure compliance. Homeowners doing their own work are required to submit a 24-hour asbestos removal notification but must still wait 10 days after submitting a Notification of Demolition. Properly remove asbestos. All asbestos-containing materials identified in the AHERA survey must be removed from the structure by a certified asbestos contractor prior to demolition, but after submitting a Notice of Intent to Remove Asbestos and observing a 10-day waiting period. For more information: This document contains only a brief summary of asbestos requirements. For full details, contact the Northwest Clean Air Agency at http://nwcleanairwa.qov/ or call 360-428-1617. Failure to comply with the asbestos requirements of NWCAA Regulation 570 may result in penalties. Note to contractors: Check with L&I for additional requirements at www.lni.wa.qov. External-Message - Ff)rmst FILE c,1,3py . „4 r L, Formstack Submission For: _ _ Submitted at 08/17/18 9:07 AM - 18-3'93 Date and tirnc.-: Aug 17. 2018 08:46 AM $85 Paid 05251P 143., Customer and project information - - Asbestos removal with demolition _ _ - (Survey required-and all asbestos r- role-ct:- - - must be removed 10 days prior to demolition) Was an asbestos survey conducted? : Yes . •- , • - • Resident owner performing my Check the box that best describes you.: own asbestos abatement(does NOT apply to rental properties) - - - will pphcatio i - I agree_ , _ at tills - _ • • • • - , - - ,. •. _ . • PHILLIPS ENVIRONMENTAL SERVICES 29354 BACUS RD. SEDRO WOOLLEY,WA 98284 360-854-7900 FAX 360-8547731 August 14, 2018 r yti Survey No. 18119 F !IL t'� Samuel Hill / ?..3 15090 Beaver Marsh Rd. Mt. Vernon, WA 98273 605-890-0027 sdh a;'v.va vccab1 e.corn RE: Asbestos Survey: East portion only of 2804 Oakes Ave.,Anacortes,WA 98221 On August 13, 2018, I inspected the east portion of 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. This inspection was limited to the east portion of this home for current demolition plans and is not intended to represent any other materials or areas within this building. 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 termed ACM (Asbestos Containing Material) and must be handled in accordance with Federal, State, and Local regulations. Surveys are based on'visible and accessible materials' and although reasonable effort 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. Twenty-two bulk samples were collected and subsequently analyzed for asbestos content by Polarized Light Microscopy with Stain Dispersion. Sample#12 was found to contain more than 1% asbestos. This material will require handling/removal by trained asbestos workers (or, in some cases, the homeowner—contact Northwest Clean Air Agency (NWCAA) at 360-428-1617 to inquire about a homeowner permit)prior to any remodeling, renovation,or demolition that will lead to the disturbance or removal of asbestos. Prior to removal of this material, ten-day notices must be filed with the local Clean Air Agency and the State Department of Labor&Industries (L&I notification not required if a NWCAA permitted homeowner project). 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, Dave B. Phillips AHERA Bldg. Insp. Cert.# 164373 (expires 11-22-18) enclosure • PHILL,IPS ENVIRONMENTAL SERVICES 29354 BACUS RD. SEDRO WOOLLEY, WA 98284 360-8547900 FAX 360-854-7731 Client: Samuel Hill Asbestos Survey - 2804 Oakes Ave. Survey#: 18119 15090 Beaver Marsh Rd. Anacortes, WA 98221 Mt. Vernon, WA 98273 605-890-0027 Survey date: 8-13-18 East Wing- Homogeneous Material List Material # & Description Location (homog. area) Type Friab Cond Qty. Sample# & Location Asbestos 1 Drywall &jt. comp. Kitchen area walls Misc N F 1 Kitchen, S. wall N/D 2 Ceramic tile grout, Floors E. of kitchen Misc N F 2 Floor E. of kitchen N/D mastic and base 3 Plaster on drywall East wing walls, ceilings Surf N F 3a E. family room wall N/D 3b E. entry room, W. wall N/D 3c Upstairs main bath wall N/D 4 Texture on drywall Upstairs rooms Surf N F 4a Upstairs SE bed,N wall N/D 4b Upstairs NE bed, W wall N/D 4c Upstairs SE bed, S wall N/D 5 Ceramic tile grout& Upstairs master bath Misc N F 5 Upstairs master bath N/D mastic 6 Ceramic tile grout & Basement bath Misc N F 6 Basement bath N/D mastic 7 Texture on drywall Basement walls Surf N F 7a Basement S. center N/D room, S. wall 7b Basement bed, E. wall N/D 7c Basement S. center N/D room, E. wall 7d Basement sun room wall N/D 8 Panel mastic Basement S. center room Misc N F 8 Basement S. center N/D backsplash room backsplash 9 Mastic Basement, edge of floating Misc N F 9 Basement, edge of N/D floor floating floor 10 Vinyl sheet Basement furnace room Misc N F 10 Furnace room floor N/D N/D=None Detected Note: Friability assessments were made on these materials in their present undisturbed condition, N/T=Not Tested-previous sample tested positive damage or disturbance of any kind may cause some non-friable materials to become friable. Quantities shown are approximate-field verification recommended PHILLIPS ENVIRONMENTAL SERVICES 29354 BACUS RD. SEDRO WOOLLEY, WA 98284 360-854-7900 FAX 360-854-7731 Material # & Description Location (homog. area) Type Friab Cond Qty. Sample# & Location Asbestos 11 Drywall &jt. comp. Basement area walls Misc N F 11 Basement furnace room N/D wall 12 Styrofoam & black Basement crawlspace Misc N F TBD 12 Basement crawlspace Chry. 15%* mastic interior walls interior walls * Asbestos found in black mastic at 15%, none found in Styrofoam 13 Carpet mastic Basement sunroom floor Misc N F 13 Basement sunroom floor N/D 14 Non-skid coating East deck Misc N F 14 East deck N/D 15 Cement shingle Roof Misc N F 15 Roof N/D N/D=None Detected Note: Friability assessments were made on these materials in their present undisturbed condition, NIT=Not Tested-previous sample tested positive damage or disturbance of any kind may cause some non-friable materials to become friable. Quantities shown are approximate-field verification recommended PHILLIPS hJSIVIRONMENTAL SERVICES 29354 BACus RD. ' SEDRO WOOLLEY, WA 98284 360-854-7900 American Industrial Hygiene Association Lab I.D.# 102950 FAX 360-854773 1 ASBESTOS BULK SAMPLE ANALYSIS Client Name: Samuel Hill 15090 Beaver Marsh Rd. Survey #: 18119 Mt. Vernon, WA 98273 605-890-0027 sdhill@wavecable.com Source of Samples: 2804 Oakes Ave., Anacortes, WA 98221 Date Rec`d: 8-13-18 1 rvr.rr�.vtirtivN.v�+r.wN .w/r�r�N- ram:.vow•r.vNNrv�+N.�Nve�N.�rti�+.vNrv.vrw�.�N.v�rvv. + rw./.w+. /.vN.�.vvn..�.r�.v.-�.w�vv.vry Analytical Method: Polarized Light Microscopy with Dispersion Staining (PLM-DS Method) �N�,, r..M.w Sample #: 1 Lab No.: 92524 Location: Kitchen S. wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 2 Lab No.: 92525 Location: Ceramic tile floor E. of kitchen Layers Description: Non-Fibrous Material: Other Fibrous Marl: % Asbestos Type: % Layer 1 of 3 Grey ceramic tile grout Binder/fine particles/sand Cellulose trace None detected Layer 2 of 3 Light grey cement-like set material Binder/fine particles/sand Cellulose trace None detected Layer 3 of 3 White hard cement-like material Binder/fine particles/stones Cellulose trace None detected Sample#: 3a Lab No.: 92526 Location: E. family room wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White plaster Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 3b Lab No.: 92527 Location: E. entry room, W. wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White plaster Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected i Sample#: 3c Lab No.: 92528 Location: Upstairs main bath wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White plaster Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 4a Lab No.: 92529 Location: Upstairs SE bedroom N. wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected O , e a2t,4: Analyst Date: 8-14-18 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. iP -iI I1 f 1�" i flllJTAJL; ' { V y-�pp�� 29354 BAcus RE). SEDRO WOOLLEY, WA 98284 36O.3.54-79QO American Industrial Hygiene Association Lab I.D. 4 102950 FAX 36O 3 4 G 7 3 1 ASBESTOS LULK SAMPLE ANALYSIS Sample #: 4b Lab No.: 92530 Location: Upstairs NE bedroom W. wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% No e detected Sample #: 4c Lab No.: 92531 Location: Upstairs SE bedroom S. wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected I Sample#: S Lab No.: 92532 Location: Upstairs master bath Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 Off white ceramic tile grout Binder/fine particles Cellulose trace None detected Layer 2 of 2 Yellow mastic Mastic/binder Cellulose trace None detected Sample#: 6 Lab No.: 92533 Location: Basement bath Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 Dark brown ceramic tile grout Binder/fine particles Cellulose trace None detected Layer 2 of 2 Yellow mastic Mastic/binder Cellulose trace Note detected _nr Sample #: 7a Lab No.: 92534 Location: Basement S. center room S. wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected __ Sample #: 7b Lab No.: 92535 Location: Basement Bedroom E. wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample#: 7c Lab No.: 92536 Location: Basement S. center room E. wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall _ — T Gypsum/fine particles Cellulose 20% _ _ Note detected_ Sample#: 7d Lab No.: 92537 Location: Basement sun room E. wall Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected -- An aly st:_ -41 ---- e ,-. . Date: 8-14-18 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. Pj=u '1.,N ' RO .h , 1 i fl _ k. )11 1 - I r.` 29354 BACUS RD. SEDRO WOOLLEY, WA 98284 36O.854-7 9OO American Industrial Hygiene Association Lab 1.D. # 102950 FAX 3SO-E54 7731 AS tESTOS I JLK SAMPLE ANALYSIS _ Sample #: 8 Lab No.: 92538 Location: Basement S. center room back splash mastic Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer I of 1 Yellow mastic Mastic/binder Cellulose trace None detected Sam,.le#: 9 Lab No.: 92539 Location: Basement stair landin, edge of floating floor Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 1 Yellow/brown mastic Mastic/binder Cellulose trace None detected Sample #: 10 Lab No.: 92540 Location: Basement furnace room floor Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: %Layer-1 of 3 Off white vinyl sheet Vinyl/Binder None detected None detectedone detected Layer 2 of 3 Tan fibrous paper-like material Binder/Fine particles Cellulose 60%, Glass 10% N Layer 3 of 3 Yellow mastic Mastic/binder Cellulose trace None detected Sample #: 11 Lab No.: 92537 _ Location: Basement furnace room wall �- Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White compacted powdery material Binder/fine particles Cellulose trace None detected Layer 2 of 2 Drywall Gypsum/fine particles Cellulose 20% None detected Sample #: 12 Lab No.: 92542 Location: Crawlspace inside walls, Styrofoam mastic _ Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 2 White Styrofoam insulation Styrofoam Cellulose trace None detected Layer 2 of 2 Black mastic Asphalt/fine particles Cellulose 2% Chrysotile 15% Sample #: 12 Lab No.: 92542 Location: Crawlspace inside walls, Styrofoam mastic Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 1 Yellow/brown mastic Mastic/binder Cellulose trace None detected Sample #: 13 Lab No.: 92543 Location: Basement sunroom floor, carpet mastic Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: "/o Layer 1 of 1 Yellow mastic Mastic/binder Cellulose trace None detected Sample#: 14 Lab No.: 92544 Location: East deck ~ Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 1 Off white hard resin w/sand surface Binder/sand Cellulose trace None detected Sample #: 15 Lab No.: 92545 Location: Roof Layers Description: Non-Fibrous Material: Other Fibrous Mat'l: % Asbestos Type: % Layer 1 of 1 Grey cement-like material Binder/fine particles/sand Cellulose trace None detected (-I;-,--), e ,. / Analyst:_ Date: 8-14-18 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.