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Home My WebLink About934 E Front St - Building ~ 170RT ~ ~O~., <;,.~ "-~ ~ ~lC~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 "'I ~ ~ I Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr. name Application type description Subdivision Name property Use Property Zonin1 . . . Application valuation Owner SEG Port Angeles, LLC 845 106th Ave NE #100 BELLEVUE WA 98004 (206) 275-2800 Permit . . . . . Additional desc . pe~it pin number Permit Fee Issue Date Expiration Date DEMOLITION 87015 50.00 4/12/07 10/09/07 Qty Unit Charge Per 06-00001013 Date 430677 934 E FRONT ST 06-30-00-7-2-0200-0000- GRAINGER DEVELOPMENT DEMOLITION 4/12/07 COMMERCIAL ARTERIAL 20000 Contractor OWNER Plan Check Fee Valuation .00 o BASE FEE Extension 50.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 50.00 50.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 50.00 50.00 .00 .00 ~ . "2 ~~ ~~ y ~ ~ ~ - \Y ~ ~ ~ ") ~ ~ \I) - t ~ ~ ~ ~\ I ~I 2t ~ Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, jf construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. 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 state or local law regulating construction or the performance of construction. r or Authorized Agent Signature of Owner (if owner is builder) T:\Policies\1102_15 building pennit inspection record05.wpd [1I4/2005J Date '-., ~ BUILDING PERMIT INSPECTION RECORD CALL 417-48]5 FOR BUILDING INSPECTIONS. CALL 4] 7-4735 FOR ELECTR]CAL INSPECTIONS. CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINlMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANJ' WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATJON. KEEP PERMIT CARD AND APPROVED PLANS AT .lOB SITE. INSl'ECTION TYPE LlATE ACCEI'TELl COMMENTS YES NO FOUNl>ATlON: FOOTINGS SHEAR WALLS / WALLS FOUNDA TION DRAINAGE / DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR / SLAB ROUGH.IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR W ALLlHOLD DOWNS WALLS / ROOF / CEILING DRYWALL (rNTERJOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL ROUGH-IN HEATPUMP/FURNACE/DUCTS GAS LINE FINAL DATE ACCEPTED BY: WOOD STOVE / PELLET / CHIMNEY MANUFACTURED HOMES FOOTING I SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMlT#'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - RW. ENGINEERING 417-4807 --. PW / ENGINEERING FIRE 417-4653 1 FIRE DEPT. PLANNING DEPT. 417-4750 / I i PLANNING DEPT. BUILDING 417-4815 -'71I 'II he} H I BUILDING T:IPoliciesll J02 15 building penn it inspection record05.wp(J11f4/2005~ LPj ----- - - I ~ORTANGELES WAS H I N G TON, U. S. A. PUBLIC WORKS & UTILITIES DEPARTMENT April 12, 2007 Todd Peterson S.E. Grainger Development Group, LLC 845 106th Avenue NE, Suite 100 Bellevue, W A 98004 RE: Port Angeles Transfer / Landfill Waste Disposal Application, WDA 07-15; Building demolition at 934 East Front Street, Port Angeles, W A We have received your application for disposal ofbuilding demolition debris from the referenced site and reviewed the testing results for lead and asbestos content. Based on the testing results the debris appears to be acceptable for use in the landfill. A copy of your approved application is attached. This approved application must be shown to the landfill scale attendant at the time of disposal. Please be advised that this disposal application is only for the materials and quantities listed in the application. Materials not listed or in excess of the quantities noted may require separate applications and approval. Please call if you have questions. Very truly yours, ~~~r Gary W. Kenworthy, P.E. City Engineer Deputy Director of Engineering Services GWK;tf Ene!.: WDA 07-15 Copy: Claudia Stromski Fisher & Sons. Inc. Bldg File N:\PWKS\ENGINEERIWDAPPLICI07 -15 File: Landfill Solid Waste Disposal Applications 321 EAST FIFTH STREET · P. O. BOX 1150 · PORT ANGELES, WA 98362-0217 PHON E: 360-417-4805 · FAX: 360-417-4542 · TTY: 360-417-4645 E-MAIL: publicworks@cityofpa us I 04/03/2007 11:54 4254512025 03/23/2007 89:29 3504171467 _____O~/23/200i 08:5~.~AX 360 49l 8306 e~i~7/2e~7 e9:42 4254512e25. OV:t4lZ007 1~!52 FAt ~6~ 4191 83DS ORCAA PAGE 14/15 PAGE el ~002 PAGE 13210:3 I(lIOO! aRCAA COtTlplClICllI 0_ Afttlllftl! 0 51500 2940 8 LImited ",,;me NW olyJllpla, WA. gaso~ Phone: (S60) 586--104-4 Fax: (360) ~1-6308 ~"9RCM.O("Q Permit Applloatian for en Asbestos Project ~~1VEod MAR 7 2007 n1e; 1111...1 Aman~cdl Cl_ .- A. <to 8. ~RI\.. Bllildllli .,IN tlrrTMIAs"Viir/a IJ /I7.!!<IIllm A~~tll"'~:IOII h\llJl~rName~ i'}W))J(t.'1; IllIDO lition I on: PalMlitlllb Contnctor: G. Mbollto(J 'roJect Inror Uenl: ~ JQO"Q - ~: ~,-01 04/03/2007 11:54 4254512025 tI::i/:L::i/:L0A7 11;:1.e 3604171467 ~~/2~/2007 08:~9 FAX 360 491 6306 J~t'1 22 2007 11: 1 0 _~~'_;3!RON PAGE 15/16 2007/JAN/221MS~ ~9:5e AY PAGE: tl:! ORCA! tal 001 OL90N eOI_LIIIIS 50S 3Z8 4 5 ~ cOf.bl CITY OF PA BLD~ DE~T PAX No.-360 417 4711 DI PMMIT.,P"'~1'oo>Olu73. ... APPAOVm_ CONDmORALIY Af'PAOVED ~ NOT ^!lPROVED FOn COMPlJANCE WI'7tf ORGAA AEGU 1 BY; h RECEIVE FEB 1 4 zan : ORCAA' I . Noti.ficat~o:n' of Dcm,olitio:n Permit . . I,) . It ;; lUlJawtlll far 1111)' JletmIl tit e..~e !If aIIo" l!lk. dl2llDDUotl COlt" ~Ilr rmll'\lalSell) or JI'lY anretun lDl1bth: AD A~klJlo . ~ mll'lmdJ:tIWII.hr.*", ,*,"'&I! ~'dllll'anll ~1>~ .1:IID,Ii,be.'. .'CUftr.lt;dlll1l__0t ClOl\lltl\ft\ee OQ ... ....btll:lIOs P~J~ .11(' d~lII~D1I J!IIIdl. flte llWIIer' or oO)l"",,or bU Ctll~ed ,1'ft'Jraln flppfDfel ft~ On.c.v.. A. 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'As~ 5vvey COmpl$tllly .. , .A.1IEPJ..O!rtlflP.dlis.lpact.ar 71.?rz -<dt:.t1 .(j",l!..Ou.1'" - ~OO/'1 rI",,,,,/er C~:QClItiod . /0 1. ., s 19 lii,' ~~ p.nnlt_ be :mil~1r:atllI!.jtlb.!:lIB ElIcloc ~ 1"ro=m:m.a Fez ce:tifl~ or~;;As~sS~mn:t ., =1:l%J'~ 12d.dhml A... o'm~ 294D BI.imIlNJ 1.ltac NW. DIl/llIPlI. 'VI~ ~ "O.$16-~D44 · tOD~2:IoSGl3 · t.u. a ~P1.f'OI 1Itl1D~1 ~A'talI.Dlr · CJlIIliI: .IIIfll@rllGl.~ ~Ajl~ fi,')-A- ~b'1 ')-<9'}$' f19 J.d BUILDING PERMIT. APPLICATION FiU out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for review. If you have any questions, call PERMITS (360) 417-4815 FAX(360)417-4711 Applicant or Agent: "5E.- (,..,o...\t\,,\e\ b<2..\J.c.\b'?MIU\-t Owner: :r.e.\.l;"-l<<: / {:)o,?(e.. - c../o 5E Gr~;A:Je-< {)ere/oI''''fN7 . Address: g<l<;"" !()f;J'f1 /IVe. Pc. :# 100 ArchitectlEngineer: I(!, D Contractor //3 jJ Phone: 2 (/ (0 qc( 1 7 '-fCe) Phone: City: 6 e!! e i/ Ife Zip: '1 i () 0 c.( Phone: State License #: Exp: Phone: Address: City: PROJECT ADDRESS: '73 t/t. F,.eo"/ T 5i~ar , LEGAL DESCRIPTION: Lot: / - ;? Block: 2- CLALLAM COUNTY PARCEL NUMBER: 0 b 3 ()OO - Zip: jJo~r ,4-Al6df'--5 ZONING: . fJ- C/I Subdivision: LJ,I//qM.f ., C/'QMe~,> 7z.o?...oo j 7,-o?~'-I; 72..(20)"; 77..02.10 TYPE OF WORK: SIZEN ALUATION: D Residential D NewConstr. D Re-roof D Stove 3<15"0 SF.@$ 5.g0 /SF.=$ 'Lo,ooo D Multi-family D Addition D MoveD Garage SF. @ $ /SF. = $ D Commercial 0 Remodel '}If Demolition 0 Deck SF. @ $ /SF. = $ D Repair 0 Sign 0 Other TOTAL V ALVA TION $ BRIEF DESCRIPTION OF THE PROJECT: Det-l\t>\\S\\ \S"'\"", "3 ctso ~'i> ~""'\ 13c.{\\6i", Cl..~ Co,,", c,-\1" t.lt. \" ,~ S- 69, '71. fOo\ R~\ L B \A.~ d.. t", v-> \ """ '5,' '^ \e () r " v~ \ (''-'\ "'~ S2-. G=>o..n:..\" S~L.e5. t{j;eftof' 5urvu, COI,d"'cf.~d "'/12 OJ.: 70 -FolIo"';) COMMERCIAL/RESlDENTlAL: Occupancy Group: Occupant Load: Construction Type: No. of Stories: -L Lot Size: .3 5, 0 DO Existing Sq. Ft. :3 c.f> 0 & Proposed Sq. Ft. /356'1 "" TO:r AL Sq. Ft. 1-350 cor Total ]ot coverage ""3"\ % APPROV ALS: PLAN: BLDG: DPWU:_ FIRE: OTHER:_ PLANNING USE ONLY: ESNWetland(s): DYes 0 No SEPA Checklist required? DYes D No Other: V ALUA TION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure wil1 be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: 1fno permit is issued within 180 days of the date of application, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section R105.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once. I hereby certify that I have read and examined this applicati n and know the same to be true and correct. I am authorized to apply for this permit and understand that it is my" spo .. ity to determine what permits are required ,not the City's, and that I must obtain such permits prior to work. Date: 1 JI'f/O[ . I T:\FORMS\BldgPennitAppl.. wpd '~ ~ , ~AX No. 3604174711 LoDA-- 07- 15 P. 002 : 2007/FEB/20/TUE 10:24 AM CITY OF PA BLOC DEPT I . I '---'---'-'-'--~--",,-,-,---_._- -------.- e~ . .Iffiii~# --.-----....---.---------..- .-..-----.-----.---.-.--- PORT ANGELES LANDFILL WASTE DISlOSAL APPLlCAll0N To: City of Port Angeles, City Engineer 321 E Fifth Street P.O. Box 1150 Port Arigeles, Washington 98362 Phone: (3SO) 417-4803 FAX: (360) 417-4109 NOTE: AU questions must be answered for ~ to be approved. 1. Genel'lltor Information: Company Name: Mailing Address: . Contact: Phone: . Project ,Name: Project L'?cation: -io?-c>~ .~~~ M ('!7 ~ t:is~ 4= ., l~2...v ~. c.:-t!'l_F- ~~'C ~. y~ M~~. l.#k.. 4~~-z... ~~ \c::..D,j.o~\ . ~040. 45~ . ~ z;:ro. '-?A:U-~c; q~2- ~~L,;- qT. I lUG 2. Other Contacts (If applicable): Phone: . Contractor Name; .~ -e.. C;;~S ,. tuG Contact: S~e:- ~ Phone:. ~ ~EJ. ~1l. \l~ Labo.retory: Contact: Phone: City of Port Angeles -landfill Waste Disposal Application Page -1 ConsultIng Firrt:J: Contact: "'l - 2007/:EB/20/TUE 10:24 AM CITY OF PA BLOC DEPT FAX No, 360 417 4711 P,003 - 3, Source of Waste: . .-., ~- - -- ---.---.------ O1eck the appropriate box beloW and briefly describe the project, process, and/or cleanup that will or has produced the waste requiring ,disposal. Indude the gasoline service station number [If applicaple}." .. - CERCL.AlMTCA Remediation Agency Contact Independent Remedial Action - UST Removal UnU!ed Chemical Product Spill ~ Other Sou~: 6U'l: u:::uJG? - 4~o . , t. ~.l!)'\J~ t1F ~<=;;n tJ:~ \.goO~ ~e: ,~c,\. p- <;~y ~on..t.~ ( Mf"tb'n.J .' . P 1"c\.llAl '- '~ I j...(.u ~L~ . 4. Waste Material Composition: (check alllhat apply and include percent of total) . 5. Waste Material Contaminants: (check all that apply) Gasoline Solvents . Unused Motor Oil , Other Metal$ ..:...- Diesel _ Heatlng Oil _ PCBs Used Motor OilM'aste 0/1 Other Petroleum Product ~ fJ/A f Unknown NOTE: Supply any MSDSinformation with application, if available. City of Port Angeles. Landnll Waste Disposal Application Page - 2 I 2007/FEB/20/TUE 10:25 AM I.~___- . CLrr OF PA BLrX; DEPT FAX 110,360 417 4711 P,004 6, 'Estimated Quantity of Waste for Disposal: - -----..---- ---.---. '~? Cubic yards / , Drums / td:J ' Tons (estImate both) Tons (estlmate both) Other NOTE: Estimated quantity for disposal must b! witl'lin 20% of the quantity actually disposed, (10% for projects over 7,500 tons or'S,OOO cubic yards.) i ! . ; 7. Frequency of DispO$a/: . I, One time _ MonthlY Annual "'=.. 8. Waste Satnpling: Proper characterization of the waste for disposal requires ihe collection of r.epresentative samples. The'methods and equipment necessary for obtaining representative samples of a waste, and the frequency of sampling. will vary with,the type and form of the waste. Check the appropriate box and briefly desaibe how and where the waste was sampled. Include site maps with sampling locations If possible. . Number of COMPOSITE samples' _ ,& number of discrete samples per composite _ Number Of DISCRETE sample" _ , . ~~ M,I~ ~H1 F'St-r- , , , NOTE 1: Unless prior approval has been granted by Port Angeles, the fol/owing sampling frequency wJ1l be used: . 1 composite sample 3 composite samples' 5 composite samples 7 corTlPoslte samples 10 composite samples 10 plus one sample for each additional 500 cubic yardS' ' NOTE 2: One composite sample shall contaIn a minimum of three/maximum of five discrete samples. . 0-25 25 - 100 101 - 500 501 - 1000 1001- 2000 >2000 Cl.lblc yards cubic Y.'!rds cubic yards cubic yards cubic yards cl/blc yards ;:: = z: '" = ;:: CIty of Port Angeles - Landfill Waste Disposal Application Page - 3 2007/FEBIZO/TUE 10:25 AM C 11Y OF PA BLDG DEPT FAX No, 360 4174711 p, 005 i 1.'.- _.___ 9. Waste Analysis: - ---- I I I f j I ~ I I , , The "Dangerous Waste Regula1Jons" CNAC 173-303) shall be utlll;zed to detelTl'line the appropriate analytical requirements for waste characterization. Ecology Publication #91-30 ' (Revised April 1994) "Guidance for Remediation of troleum, Contaminated Soils" ,shall also be used 10 characterize petroleum contaminate oils from UST releases. Submit all laboratory analytical results, QAlQC data, and Chal Custocly sheets along with this application. (NOTE: The laborataty must be accre,d' by the Washington stata Department of Ecology.) . a) List all analytical test metho .' .f ~ i / b} Provide a narrativi to why ~he ~bo meth~ ..Ioded: YES NO 10. Soli Ctasstrlcation: r*FOR PETR MINATED SOilS .ONl V-'") Based ~n the analytical data and Ecology pubiication 1-30, the soil classification is: (check one) Class 1 ---.:- Class 2 _ Class 4 Calculated Hazard Index 11. Dangerous Waste Affidavit Based on a review of the analytical test results, S history, and the applicable regulations, this waste is clas$ifi~ as: (checK one) -: Neither Dangerous Waste (DW) nor mely Hazardous Waste (EHW) Dangerous Waste (DW) and Waste Code: Extremely Hazardous Waste (EHW) and Waste Code: City of Port Angeles - landfill Waste Disposal Applicatlon Page - 4. 2007/FEB/20/TUE JO:25 AM CITY OF PA BLDG DEPT I . 1'--- - I :: ! .~ i I I I 1 . i /, I FAX No. 350 417 471 J P. 005 " 12. Certification: -.- _. - -- . -"---'-- We, THE' UNDERSIGNED. certify tnat this application is true to the best of our knowledge. All Information prQVided is correct and the enclosed analytical results represent the propos~d waste ~~~abi~~. . ," ~ . Waste Generator Slg re ' 7 Ctte-l~ LMlb Printed Name f1,'S~ ~~S, lUc. Company 04-. ll. O"i- Date ---.... ~ '. L ~~&iu~~ ~~ V~~p,,;Z~~.... .~ . ~ ?lace ~ ~ g--lz--C7 . " t2?/,rpt/a/#.P~ due N:\I'OUC'( _Pl111OlUW\1DQgJllWPO City of Port Angeles, - Landlll1 Waste Di5posal Appli~tion Page - 5 :0.. B'1 i B . : ....: ..if.~1 .... rI) ,,~~~fi" .. . ~ ,., ~"'115.~ I' CJ" 1; i Cl'1' '0 .: ,,?,I. ~ .. ..., ~ ..... . '. (lIIII!II'.." , , .. , . 1---' ~'~. "It-li(' ''': ':.'ilfl . ..~:.-:':. '. . CI'. .1'-:0 Ii Q" .i . 1i =.8.1 ' .' '. .., .,.. "'1j:I!~' ., "ci1si 8:ld..li, 'hf~ ~ . : ':~I'h ,~, .' ,6 11 f: : . ',''S < . . . . ~: ' t"'l'; . 0 .', ' i . l:lo ,0 ' . A," J ' . .rs" .....!'lj .' " G.l . aJ,~ ~ "'i.tAO I fIJ ,'. "9 ! I ~ ces. ~ ft) a .~ (.) . .... . . 'f:~" . = ~, 01);" .~ ~ 2007/FEB/20/TUE 10:26 AM CITY OF PA BLOG DEPT r.-~- '-- ~: . ; . ....... ,. "-" , . . A' S". Co>. IIIl · j :-Ij~ ,I }..t!il hUi FAX No. 360 417 4711 P.007 i j ; J'. I , . . a .:., -... '. . .--~: - "I" .' ~ . : .;( , Q ~ C' .. .3.: . . 1:. . .! . ~ a. .f is ii, "'1" 1 . . i '. ! ,'. , I :a ti . I . o .. :z: . . . ~ 1! e~ ..~.i- , 'l! ,~J I" j ~'Ii j. .. :1 I' II! .;i~ i s "11 ~ Ii... t e l ! r~ 11 t ~~ i,~ OnSite Environmental Inc. 14648 NE 95th Street, Redmond, WA 98052. (425) 883-3881 April 1 0, 2007 Todd Peterson S. E. Grainger Development Group, LLC 845 1 06th Avenue NE, Suite 100 Bellevue, W A 98004 Re: Analytical Data for Project Walgreens Drug Store-Front Street Laboratory Reference No. 0704-063 Dear Todd: Enclosed are the analytical results and associated quality control data for samples submitted on April 9, 2007. The standard policy of OnSite Environmental Inc. is to store your samples for 30 days from the date of receipt. If you require longer storage, please contact the laboratory. We appreciate the opportunity to be of service to you on this project. If you have any questions concerning the data, or need additional information, please feel free to call me. Sincerely, David Baumeister Project Manager Enclosures OnSite Environmental, Inc. 14648 NE 95th Street, Redmond, WA 98052 (425) 883-3881 This report pertains to the samples analyzed in accordance with the chain of custody, and is intended only for the use of the individual or company to whom it is addressed. 2 Date of Report: April 10, 2007 Samples Submitted: April 9, 2007 Laboratory Reference: 0704-063 Project: Walgreens Drug Store-Front Street Case Narrative Samples were received by the laboratory on April 9, 2007. They were maintained at the laboratory at a temperature of 20C to 60C except as noted below. General QA/QC issues associated with the analytical data enclosed in this laboratory report will be indicated with a reference to a comment or explanation on the Data Qualifier page. More complex and involved QA/QC issues will be discussed in detail below. OnSite Environmental, Inc. 14648 NE 95th Street, Redmond, WA 98052 (425) 883-3881 This report pertains to the samples analyzed in accordance with the chain of custody, and is intended only for the use of the individual or company to whom it is addressed. 3 Date of Report: April 10, 2007 Samples Submitted: April 9, 2007 Laboratory Reference: 0704-063 Project: Walgreens Drug Store-Front Street TCLP LEAD by EPA 1311/60108 Date Prepared: Date Extracted: Date Analyzed: 4-9-07 4-10-07 4-10-07 Matrix: Units: TCLP Extract mg/L (ppm) Client 10 Lab 10 Result POL PA-TCLP 04-063-01 NO 0.20 OnSite Environmental, Inc. 14648 NE 95th Street, Redmond, WA 98052 (425) 883-3881 This report pertains to the samples analyzed in accordance with the chain of custody, and is intended only for the use of the individual or company to whom it is addressed. Date of Report: April 10, 2007 Samples Submitted: April 9, 2007 Laboratory Reference: 0704-063 Project: Walgreens Drug Store-Front Street TCLP LEAD by EPA 1311/6010B METHOD BLANK QUALITY CONTROL Date Prepared: Date Extracted: Date Analyzed: 4-9-07 4-10-07 4-10-07 Matrix: Units: TCLP Extract mg/L (ppm) Lab 10: MB0410T1 Analyte Method Result Lead 6010B OnSite Environmental, Inc. 14648 NE 95th Street, Redmond, WA 98052 (425) 883-3881 4 PQL 0.20 This report pertains to the samples analyzed in accordance with the chain of custody, and is intended only for the use of the individual or company to whom it is addressed. 5 Date of Report: April 1 0, 2007 Samples Submitted: April 9, 2007 Laboratory Reference: 0704-063 Project: Walgreens Drug Store-Front Street TCLP LEAD by EPA 1311/60108 DUPLICATE QUALITY CONTROL Date Prepared: Date Extracted: 4-9-07 4-10-07 4-10-07 Matrix: Units: TCLP Extract mg/L (ppm) Lab 10: 04-063-01 Analyte Sample Result Duplicate Result RPD POL Flags 0.20 OnSile Environmental, Inc. 14648 NE 95th Slreet, Redmond. WA 98052 (425) 883-3881 This report pertains to the samples analyzed in accordance with the chain of custody, and is intended only for the use of the individual or company to whom it is addressed. Date of Report: April 10, 2007 Samples Submitted: April 9, 2007 Laboratory Reference: 0704-063 Project: Walgreens Drug Store-Front Street Date Prepared: Date Extracted: 4-9-07 4-10-07 4-10-07 Matrix: Units: TCLP Extract mg/L (ppm) Lab 10: 04-063-01 Analyte Spike Level 10 TCLP LEAD by EPA 1311/60108 MS/MSD QUALITY CONTROL MS Percent Recovery MSD Percent Recovery RPD 6 Flags 9.25 92 9.32 93 OnSite Environmental, Inc. 14648 NE 95th Street. Redmond, WA 98052 (425) 883-3881 This report pertains to the samples analyzed in accordance with the chain of custody. and is intended only for the use of the individual or company to whom it is addressed. 7 OnSite Environmental Inc. Data Qualifiers and Abbreviations A - Due to a high sample concentration, the amount spiked is insufficient for meaningful MS/MSD recovery data. 8 - The analyte indicated was also found in the blank sample. C - The duplicate RPD is outside control limits due to high result variability when analyte concentrations are within five times the quantitation limit. E - The value reported exceeds the quantitation range and is an estimate. F - Surrogate recovery data is not available due to the high concentration of coeluting target compounds. ~ - Insufficient sample quantity for duplicate analysis. H - The analyte indicated is a common laboratory solvent and may have been introduced during sample preparation, and be impacting the sample result. I - Compound recovery is outside of the control limits. J - The value reported was below the practical quantitation limit. The value is an estimate. K - Sample duplicate RPD is outside control limits due to sample inhomogeneity. The sample was re-extracted and re-analyzed with similar results. L - The RPD is outside of the control limits. M - Hydrocarbons in the gasoline range (toluene-napthalene) are present in the sample. o - Hydrocarbons indicative of diesel fuel are present in the sample and are impacting the gasoline result. P - The RPD of the detected concentrations between the two columns is greater than 40. a - Surrogate recovery is outside of the control limits. S - Surrogate recovery data is not available due to the necessary dilution of the sample. T - The sample chromatogram is not similar to a typical U - The analyte was analyzed for, but was not detected above the reported sample quantitation limit. V - Matrix Spike/Matrix Spike Duplicate recoveries are outside control limits due to matrix effects. W - Matrix Spike/Matrix Spike Duplicate RPD are outside control limits due to matrix effects. X - Sample extract treated with a silica gel cleanup procedure. Y - Sample extract treated with an acid/silica gel cleanup procedure. z- ND - Not Detected at POL POL - Practical Ouantitation Limit RPD - Relative Percent Difference OnSite Environmental, Inc. 14648 NE 95th Street, Redmond, WA 98052 (425) 883-3881 This report pertains to the samples analyzed in accordance with the chain of custody, and is intended only for the use of the individual or company to whom it is addressed. II J i I i i:D. i !l l!l !l I !l !l !l I 2 i I I I i i f . il '8 ~ i ; i i n ::r ~ !!!. t8 ii1 . ~ ~ [ ~ ~ o A b ril ~ r r- !o' \. ... ~~ ~ f' L-1 ?\~ ~ ~~ ~ ..,-. t ;;- ~ -t:-I ~:~ ~~ ~ ~....., K~ ., I ~. "'II -a b> ,t-t~t 3 ."" ~~\f~l~f~~ fi: t ""'~. ~ Si\' t "'" r 9," UI' t- n +- it ~ ~ t ~<.;>. ;! r f ~, -r: ~ III f p ~ r--. , ~I ~ l) i- I ~. ~ ' ~ ~ I ~ \ ~ o ODD ~I j r l-.:J i ~ .. fi)~ ~ Uta: ~ 1t8 0 ~ - 6f Co) - f~ i i .!!!. V\ a ::r CIl .:. HelD NWTPH-GxJBTEX NWTPH-Dx Volatiles by 82608 ted Volatlles by 82806 Semlvolatlles by 8270C PAHa by 8270C 181M PCBs by 8082 Pesticides by 8081 A Herbicides by 8151A Otal RCRAMetals (8) "X CLP Uelal8l-etlll> fAlJ'-'( HEM by 1664 VPH EPH %Mojsture n =- 'IL :I sa. J; 11 I I oa- z c :I go :"! . . . ., .e. t p 0>1 t- So 1-- .. " "'"'' ~ / WAL"e~<; The Riley Group Inc. ASBESTOS-CONT AINING MATERIALS SURVEY PROPOSED RETAIL STRUCTURE 934 EAST FRONT STREET PORT ANGELES, WASHINGTON October 6, 2006 PREPARED BY: The Riley Group, Inc. 17522 Bothell Way NE, Suite A Bothell, W A 98011 PREPARED FOR: Mr. David Thompson Columbia Retail Group, LLC 845 106th Avenue Northeast, Suite 100 Bellevue, Washington 98004 Project No. 2006-178 SERVING THE PACIFIC NORTHWEST 17522 Bothell Way NE, Bothell, W A 98011 Tel (425) 415-0551 . Fax (425) 415-0311 TABLE OF CONTENTS 1.0 SURVEY SUMMARY & RESULTS.......................................................! 1.1 SURVEY SUMMARY SHEET ...................................................................................................................1 1.2 RESULTS SUMMARY ... ............................................................................................................ ..............2 A CM SUR VEY RESUL TS................................................................................................................................... 2 ASSUMED A CM. ................. ......... ..................................................... .................. ..... ...... .................. ...............2 2.0 INTRODUCTION ........................ ................. ...........................................2 2.1 PURPOSE.................... ....................... ........... ....................... ...... ...... ............................ ............. ............2 2.2 SITE ACCESS ............................. .............. ....................... ...................... ............ ....................................2 2.3 AUTHORIZATION...................... .......... ...... ............ ............................................... ............... .......... ..... ...2 2.4 BUILDING OBSERVATIONS.... ............................................. ..................... .............................................3 3.0 ME TH 0 DS ...... ..........................................................................................3 3.1 GENERAL ORGANIZATION ....................................................................................................................3 3.2 VISUAL INSPECTION OF SUSPECT ACMs..............................................................................................3 3.3 SAMPLING PROCEDURES (ASBESTOS) ..................................................................................................4 4.0 FIND IN GS & CON CL USI ONS ...............................................................5 5.0 UNIQUE REGULATORY REQUIREMENTS .....................................5 5.1 LOCAL AIR QUALITY BOARD (PUGET SOUND CLEAN AIR AGENCY) ...................................................5 5.2 WASHINGTON DEPARTMENT OF LABOR AND INDUSTRIES (L&I) .........................................................5 5.3 PERMITS ........... ....... ........... ..... ...... ... .............................. .... ........... ...... ............. ..... ...... .... ...., ... ...... .......6 5.4 LICENSES.......... ................ ........ ......... ........... ......... .......................................... .......... ....... .............. .....6 6. 0 WARRANTy.............. ............ ........... ..... .............. ........ ..... ........................6 LIST OF FIGURES Figure 1........................................................................................................................ Site Vicinity Map Figure 2 .................................................................................................................Sample Location Map LIST OF ApPENDICES Appendix A ............................................................................................................ Copy of Certifications Appendix B. ......................................................................... Laboratory Reports and Chains of Custody Appendix C.......................................................................................................... Methods & Procedures Appendix D.......................................................................................................... Codes and Regulations 1 1.0 Survey Summary & Results 1.1 SURVEY SUMMARY SHEET BUILDING INFORMATION: Date of Construction: 1972 Address: . 934 East Front Street Building Size: 3,450 sq. feet City/State/Zip: Port Angeles, W A Asbestos-Containing Materials Survey Date: 09/26106 By Whom: The Riley Group, Inc. Firm Robin Hamlet Inspector #1023519 Certification # Results: (Additional detail provided in Table 1) Number of material types sampled: 8 Number of samples collected: 12 Number of materials testing positive: 2 Number of materials assumed positive: 0 Were roofing materials sampled? Yes. Are there unique state or local requirements? Yes (If Yes, See Section 5.0) Laboratorv utilized: Name: Seattle Asbestos Test, LLC Address: 19711 Scriber Lake Road. Suite D, Lynnwood WA 98036 BuildinQ Access Limitations (if any): None Comments: See report. 1- 2 1.2 RESULTS SUMMARY ACM SURVEY RESULTS The following homogeneous building material types were sampled as part of this survey and their results are summarized in the table below: SAMPLE MATERIAL DESCRIPTION LOCATION F/NF CONDo < % ACMo ESTIMATED 10 QUANTITY PA-01 Plaster/leveling Room #2-vacant F Good White leveling N/A compound on wood office/storage compound ND oanellina PA-02 Popcorn ceiling material Entire structure F Fair Popcorn ceiling -3,400 s.f. PA-04 material: PA-05 5% Chrysotile 3% Amosite PA-03 Allie insulation Allie NF Good Pink insulation ND N/A P A-06 White sheet vinyl & gray Bathroom- Room # 5 F Good Vinyl: ND 30 s.f. mastic Mastic: 50% Chrvsotile PA-07 Gypsum Wallboard Entire structure F Good Wallboard: ND N/A P A-OB PA-09 PA-10 Black asphalt shingles Roof F Good Asphalt shingles ND N/A PA-11 Black tar paper Roof F Good Tar Paper ND N/A PA-12 Black tar patch Roof F Good Tar Patch ND N/A - - .. F - Fnable, NF - Non-fnable, Fnablllty IS further defined In AppendiX C. 2 Condo = Condition of materials either Good, Fair or Poor. 3 All identified ACMs are chrysotile asbestos except where noted. ND = None Detected; N/A = Not Applicable ASSUMED ACM There were no materials assumed to be asbestos containing. 2.0 Introduction 2.1 PURPOSE The Riley Group, Inc. (Riley) conducted a asbestos-containing material (ACM) building survey at the property located at 934 East Front Street in Port Angeles, Washington (see Figure I). The purpose of this study was to identify those building materials that contain asbestos. Riley understands that the Client intends to remove the structure for future construction. Therefore, this survey addressed all building materials that were accessible during the Site visit. 2.2 SITE ACCESS Riley had unlimited access to all spaces of the subject building. 2.3 AUTHORIZA nON Authorization to perform this study was given by Mr. David Thompson of the Columbia Retail Group (Client) on September 9,2006. This report has been prepared for the exclusive use of the Columbia Retail Group, LLC and affiliates thereof. 3 2.4 BUILDING OBSERVATIONS The building is an approximately 3,450 square foot, one story, wood-framed structure. Interior finishes included painted sheetrock (gypsum), wood-paneled walls and ceilings, and wood flooring. The wood floors are finished with carpet, linoleum and ceramic tiles. Except for the bathrooms, the ceilings throughout are covered with painted "popcorn" material. Materials observed for the ACM survey included attic insulation, linoleum, roofing materials, surfacing materials and sheetrock (gypsum) walls and ceilings. 3.0 Methods Inspection and sampling procedures were performed in accordance with the guidelines published by the Environmental Protection Agency (EPA) in 40 CFR Part 763 Subpart E, October 30, 1987. Sampling procedures include collection of one or more samples of suspect friable and non-friable materials. The ACM survey consisted of: visual inspection, sampling, and quantification of building materials. Riley's survey protocols are detailed in Appendix C. 3.1 GENERAL ORGANIZATION The survey consisted of three major activities: visual inspection, sampling, and quantification of building materials. Although these activities are listed separately, they are integrated tasks. 3.2 VISUAL INSPECTION OF SUSPECT ACMs An initial building walkthrough was conducted to determine the presence and condition of suspect materials which were accessible and/or exposed. Materials which were similar in general appearance or in date of construction were grouped into homogeneous sampling areas. . Homogeneous Material Classifications A preliminary walkthrough of the building was conducted to determine areas of materials which were visually similar in color, texture, general appearance, and which appeared to have been installed at the same time. Such materials are termed "homogeneous materials" by the EP A. During this walkthrough, the approximate locations of these homogeneous materials were also noted. Following the EPA inspection protocol, each identified suspect homogeneous material was placed in one of the following EPA classifications: 1. Surfacing Materials (spray or trowel applied to building members) 2. Thermal System Insulation (materials generally applied to various mechanical systems) 3. Miscellaneous Mater:ia1s (any materials which do not fit either of the above categories) . Friability Classifications A regulated asbestos-containing material (RACM) as defined by National Emissions Standard for Hazardous Air Pollutants (NESHAP) is any (a) Friable asbestos material, (b) Category I non-friable ACM that has become friable, (c) Category I non- friable ACM that will be or has been subjected to sanding, grinding, cutting, or 4 abrading, or (d) Category II non-friable ACM that has a high probability of becoming or has become crumbled, pulverized, or reduced to powder by the forces expected to act on the material in the course of demolition or renovation operations. Following the EP A. inspection protocol, each identified suspect homogeneous material was placed in one of the following EP A classifications: . Friable Materials NESHAP defines a friable ACM as any material containing more than one percent asbestos, which, when dry, can be crumbled, pulverized, or reduced to powder by hand pressure. . Category I Non-friable NESHAP defines a Category I non-friable ACM as packing, gaskets, resilient floor covering (except vinyl sheet flooring products which are considered friable), and asphalt roofing products which contain more than one percent asbestos. . Category II Non-friable NESHAP defines a Category II non-friable ACM as any material, except for a Category I non-friable ACM, which contains more than one percent asbestos and cannot be reduced to a powder by hand pressure when dry. 3.3 SAMPLING PROCEDURES (ASBESTOS) Following the walkthrough, the inspector collected selected samples of accessible materials identified as suspect asbestos-containing building materials (ACM). Samples were collected by Riley's asbestos building inspector, certified under the EPA AHERA regulation 40 CFR 763, Subpart E (AHERA certification attached in Appendix B). Sampling was consistent with the requirements of NESHAPs and AHERA as well as meeting the requirements set forth by State and local regulatory agencies. A total of 8 suspect ACMs (homogeneous materials) were observed within the inspected areas of the site. Riley collected a total of 12 samples of suspect ACM from homogeneous materials identified in the site building. The laboratory reported analytical results for layered materials present in one sample as separate results (such as floor tile and mastic). Suspect ACM samples were submitted to Seattle Asbestos Test, LLC of Lynnwood, Washington for analysis. Samples were analyzed by PLM/DS. Seattle Asbestos Test, LLC is AIHA and NVLAP accredited. The following suspect materials were sampled during this survey (please refer to Figures 2 and 3 for bulk sample locations): ~ Plaster leveling compound; ~ Popcorn ceiling material (surfacing material); ~ Vinyl sheet flooring (linoleum); ~ Mastics; ~ Gypsum wallboard; ~ Roofing materials (Asphalt shingles, tar paper & tar patch); and ~ Attic insulation (vermiculite). 5 4.0 Findings & Conclusions Based upon Riley's asbestos building survey and bulk sample analysis, the following . ACMs have been identified for the Site: );> Popcorn ceiling material );> Gray mastic under the vinyl sheet flooring (linoleum) Any untested suspect materials encountered during site renovation work should be analyzed before proceeding with such work. If additional ACM is confirmed during site renovation activities, work should be performed by a qualified contractor according to the recommendations in Section 5.0. 5.0 Unique Regulatory Requirements If the hazardous building materials identified in this report will be disturbed through future maintenance, renovation or demolition activities, they will be subject to the requirements set forth in all applicable local, state, and federal regulations. Materials that were not sampled are presumed to contain asbestos and will be subject to these same requirements until tests are performed to confirm the absence of asbestos. The following notices, permits and licenses are necessary for renovation and/or demolition work as of the date of this report. The contractor is cautioned to verify these requirements as applicable to the final project scope and confirm that no new requirements exist. 5.1 LOCAL AIR QUALITY BOARD (PUGET SOUND CLEAN AIR AGENCY) Written notification is required to the local Air Quality Management District at least 10 days prior to beginning any work on friable asbestos-containing materials. This requirement is also enforced by the EP A. In addition, notification is required for all demolitions involving structures with a projected roof area greater than 120 square feet, even if no asbestos-containing material is present. Asbestos removal and disposal requirements are outlined in PSCAA's Asbestos Control Standards (Regulation III, Article 4). 5.2 WASHINGTON DEPARTMENT OF LABOR AND INDUSTRIES (L&I) F or any activity involving greater than 48 square feet or I O.linear feet of ACM that may release asbestos fibers into the air (i.e. demolition, renovation), written notification must be given to the L&I regional office by the qualified contractor no later than 10 days prior to the start of the project (WAC 296-65-020). For activities impacting composite wallboard systems with less than 1% asbestos content, the renovation contractor will need to follow work practice requirements as given in WAC 296-62-17712(2), particularly use of wet, non-aggressive methods and prompt clean-up. Vacuums used must be HEP A filtered. Worker training must include 2-hour asbestos awareness training. Respiratory protection must be based on overall dust levels. A competent person on the job site must be assigned and trained under the requirements ofW AC 296-62-07728. 6 5.3 PERMITS Contractor must obtain all building and special permits required for the asbestos abatement work. Of note, prior to abatement activities within the building(s), a permit is required by the Uniform Fire Code (UFC). (e.g., work plans and drawings of containment's with entrances and exits clearly marked). 5.4 LICENSES Contractor must maintain current licenses as required by applicable state or local jurisdictions for the removal, transportation, disposal, or other regulated activity. 6.0 Warranty Riley warrants that the findings contained herein have been prepared with the level of care and skill exercised by experienced and knowledgeable environmental consultants who are appropriately licensed or otherwise trained to perform asbestos and lead in paint assessments pursuant to federal, state and local requirements as applicable. This inspection is not intended to address the potential for exposure to any other hazards or hazardous materials during renovation or demolition. The survey included inspection of accessible materials such as above or behind suspended ceilings or other non-permanent structures. Riley did not inspect or sample inaccessible areas such as behind walls or within ductwork and did not dismantle any part of the structure to survey inaccessible areas. Inaccessible is defined as areas of the building that could not be tested (sampled) without destruction of the structure or a portion of the structure. In the event that access to a portion of the building was not obtained (which otherwise would have been tested), such limitations are specifically identified in the Survey Summary Sheet of this report. No sampling protocol is 100% "fail-safe," according to the U.S. EP A. Samples collected are indicative of the material sampled. Riley has indicated which samples are considered representative of adjacent or similar-appearing materials. These conclusions are not meant to be, and may not be, relied on by client as representations or warranties by Riley. Any given material, other than the exact sample, is or is not, asbestos containing. This report is not intended to identify all hazards or unsafe conditions, nor imply that others do not exist. This report does not provide an evaluation, assessment or analysis of health risks, environmental impact, usage limitations or mitigation options. This report has been prepared for the exclusive use of the Columbia Retail Group, LLC and affiliates thereof. Results are based solely on the methodology stated in this report and the report should be relied upon in its entirety. Any reliance a third party makes of this report is the responsibility of such third party. 7 Should you have any questions regarding this report or if we may be of additional service, please do not hesitate to contact us at (425) 415-0551 at your convenience. Sincerely, THE RILEY GROUP, INC. ~/~ Robin Hamlet, L.G., L.H.G. Senior Project Manager AHERA Building Inspector #1023519 /~~~ ~~e Smlth~ Project Manager Attachments Report Distribution copies) Mr. David Thompson, Columbia Retail Group, LLC (l electronic draft, 3 1,200' , Approximate Scale In Feet o 300' 600' USGS, 1985, Port Angeles, Washington 7.5-Minute Quadrangle N + . The Riley Group, Inc. 17522 BOTHELL WAY NE BOTHELL, WASHINGTON 980 II Proposed Retail Structure Figure 1 Project # 2006-) 78 Site Vicinity Map Site Address: 934 E. Front Street, Port Angeles, Washington OI)E .g oA III o\::::.J Ill~ :::E III 01) ~ ... o ~ fo- ~ ~ ~ f0- r/) fo- Z o ~ U- fo- r/) -< UJ - III i:: U@ ~ ~ CO g...... >0 - III i:: u ~~fr::\ U......V >0 III ~@ o \L ~~ I ~ CIl III U &:: o III U &:: o @ III U &:: o ~ ~ E ~~E g ='0:: U- B '" .( a.. CIl III U ~ ...... o @ III ~E) o III ~e o III 01) ~ ... o V) * <]~ a.. III ~8 o CIl CIl III U U -< u "E -< * .,. '" .( a.. i:: o 'E- III u III 0:: E BEl III 0 ~@ 0 0:: ~ 0 0 >-. i:: 0 0- =:0:: ~I 0 U U- 4: "-<] --. ~ o 4: "-<] ~ o ti III ..0 CIl -< CIl III o t: <l) Cl i:: t., .2 ... 1<j III U ..0 t: 0 E .2 ..J '- ::s ..... 0..> ] Z ~ c.. ~ Cl .3 ~ Z 11) 11) r/) E c.. c.. "-' o E ~ g 1 ~~r/)O:: :::: * ~ fc0o<]<] ~ v , ~ ~ C""l ~ :..... ~ ~ i:: 6\0 ...~ Q~ <\)0 .... ...... I::s Q ~ :..... ;:::: ...... \..:l ;:::: .b VJ ~ s:: ~ .9 ...... t:s <:..) <:) ......:J b{) ~ .:.; .... - CiS ~ c55 s: o ~ ~ "'" "" 0\ -.. .~ ...... ~ er:: "'\:$ ~ c.:J o ~ :..... Q., 00 l:'.. -, I \Q a a C""l :j:j: t,; ~ :f5 '1:3 ""l:: ~ t;s ...... \..:l ~ .C' :..... Q., ~ ~ ... 0"- ~~5 =:Zfo- C>-o ;..,-<~ ~~::r: ..Jr/) -::".....l-< ~UJ ~ "'-ooio::r: . ..... fo- ..J ~O.....l ~C:O~ ", N ::r: "WNfo- -- V> 0 ~~c:o II o co z+ I I i I I SEATTLE ASBESTOS TEST, LLC Page 1 of 3 19711 Scnber Lake Road, Suite D, Lynnwood, W A 98036, 425.673.9850 NVLAP ACCREDITATION LAB CODE: 200768-Q ANALYTICAL LABORATORY REPORT PLM by Method EPN600/R-931116 Client The Riley Group, Inc. Address: 17522 Bothell Way NE Bothell, WA 98011 Client Job #: N/A Laboratory Batch #: 200620802 Date Received: 9/2712006 Samples Received: 12 Date Analyzed: 9/28/2006 Samples Analyzed: 12 Client Project #: N/A Attention: Mr. Robin Hammlet Project Port Angeles Lab ID I Client Layer Description % I Asbestos Non-Fibrou8 % Non-asbe8tos Sample ID Fibers Comoonents Fibers 2006203606 PA-01 1 White powdery None Binderlfiller, Paint 5 lceilulose material with paint \detected 2006203607 PA-02 White powdery 5 Ichrysotile material with paint and white lumpy Binderlfiller, Synthetic ~ellulose 1 oam material oam, Paint 4 3 ~mosite 2006203608 PA-03 1 Pink fibrous material None Binder/filler 95 IGlass fibers detected 2006203609 PA-04 White powdery 5 Chrysotite material with paint and white lumpy Binder/filler, Synthetic 1 'oam material foam, Paint 4 Cellulose 2 lUnosite 2006203610 PA-05 White powdery 5 Chrysotile material with paint and white lumpy Binder/filler, Synthetic Cellulose 1 oam material foam, Paint 4 2 Amosite 2 White chalky None Binder/filler, Paint, 35 Cellulose material with paper detected Gypsumlbinder 2006203611 PA-06 1 White sheet vinyl None IvinyUbinder None detected detected Analyzed by: Weilong Tai ~/~C-. ReVIewed by: Steve (Fanyao) Zhang, President SEATTLE ASBESTOS TEST, LLC Page 2 of 3 19711 Scriber Lake Road, Suite D, Lynnwood, WA 98036, 425.673.9850 NVLAP ACCREDITATION LAB CODE: 200768-0 ANALYTICAL LABORATORY REPORT PLM by Method EPA/600/R-93/116 Client The Riley Group, Inc. Address: 17522 Bothell Way NE Bothell, WA 98011 Client Job #: N/A Laboratory Batch #: 200620802 Date Received: 9/2712006 Samples Received: 12 Date Analyzed: 9/2812006 Samples Analyzed: 12 .Client Project#: N/A Attention: Mr. Robin Hammlet Project Port Angeles Lab 10 Client Layer Description % Asbestos Non-Fibrous % Non-asbestos SamDle 10 Fibers ComDOnents Fibers 2 Gray fibrous material 50 Chrysotile Binder/filler, 27 Cellulose with mastic Mastic/binder White powdery None Cellulose 2006203612 PA-07 1 material with paint ~etected Binder/filler, Paint 35 and paper 2 White chalky None Binder/filler 25 Cellulose material with paper ~etected Gypsumlbinder White powdery None Cellulose 2006203613 P A-08 1 material with paint !detected Binder/filler, Paint 35 and paper 2 White chalky None Binder/filler 25 Cellulose material with paper Idetected Gypsum/binder White powdery None Cellulose 2006203614 PA-09 1 material with paint ~etected Binder/filler, Paint 35 and paper 2 White chalky None Binder/filler 25 Cellulose material with paper Idetected Gypsum/binder Black asphaltic None Asphalt/binder, Sand Glass fibers 2006203615 PA-10 1 Ibrous material with Idetected 25 sand 2006203616 PA-11 1 Black asphaltic lNone Asphalt/binder, 70 Cellulose fibrous material Idetected Binder/filler 2006203617 PA-12 1 Black asphaltic None Asphalt/binder 27 Cellulose material detected Analyzed by: Weilong Tai ~L~ Reviewed by: Steve (Fanyao) Zhang, President 09-28-200G 18:07 SEATTLE AS8ESTOS TEST 14256739810 ~ z,i)S'()~ SEATTLE ASBESTOS TEST, LLC CHAIN OF CUSTODY PAGE2 WE TREAT CUENTS BETI'ERI TYPE ~ NW. \'818; BULK ASIJESTOS TEST x.. POINT COUln (AOllJ-.,. POINT COUNT (500'--' POINT COUNT (tlM>>L- The Riley Group, IDC. 17S22 Bothell Way NE, Bothell, W A 98011 Phone: (206) 417-0551 Fax:(425) 415-0311 Exnail::?JW"'l.e7tG3~UY~Il6u,,('on, Project Location: ~~ Avt;e I_~~ Project Manager:~b.."_ I~.~ . .~./~f b . iJl~ .-=tlllt-&.aJ1" Turn Around Tlm~ ----F- Num er of Samples ~ ClIent Job # Sample Condition: Good ....- Damaged Severe Damage(Spillage) SEOM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 -19 20 CLIENT SAMPLE # FA -0 1 ?I't- -tP:2 rr>A--e>3 9",- ~~I 7A- -I'J~ rA-- f::'{,. 91\-- .&' '7 ?A-~ t:>jg ~fr-o-=t .?..-:"'/~ 91\-11 '1'.4-1 ~ AIR "?1..~""\'~ L~"*'-~~- ~ 7.. 9L~"'''' ~.-. - ~ . ' LABID ~U/~go'-( (:1"7 pt' 9 C; SAMPLE DESCRIPTION 1...__" .J ~IIU S ....c... - y....Q L....!l.1It L r"!'"1', ,0.. do <";>.o't>/_o... ~e-iLI~4 I .-- \ _.- I ~,.... I .. . ,t.L... ~ -- IA)-"'LL ~ ..'\...u '1\_.u:>-:--, I~ II ?srh~.~ \ 1 '"J ,1 \~ (T~ ':)'. o. -'"> \ 1<')(1 "I ("T~?~7LH.) { LV ( ( \ '2.. l} t'-/ vS.' tb ,-I "v? ~ The Riley Group Inc. ASBESTOS-CONT AINING MATERIALS SURVEY METHODS & PROCEDURES SERVING THE PACIFIC NORTHWEST Main Office: 17522 Bothell Way NE, Suite A, Bothell, W A 980 II Tel (425) 415-0551 . Fax (425)415-03] I . Seattle Tel: (206) 417-0551 1-- Inspection and sampling procedures were performed in accordance with the guidelines published by the Environmental Protection Agency (EPA) in 40 CFR Part 763 Subpart E,' October 30, 1987. Sampling procedures include collection of one or more samples of all suspect friable and non-friable materials. GENERAL ORGANIZA nON The survey consisted of three major activities: visual inspection, sampling, and quantification of building materials. Although these activities are listed separately, they are integrated tasks. VISUAL INSPECTION OF SUSPECT ACMs An initial building walkthrough was conducted to determine the presence and condition of suspect materials that were accessible and/or exposed. Materials that were similar in general appearance or in date of construction were grouped into homogeneous sampling areas. . Homogeneous Material Classifications A preliminary walkthrough of the building was conducted to determine areas of materials which were visually similar in color, texture, general appearance, and which appeared to have been installed at the same time. Such materials are termed "homogeneous materials" by the EP A. During this walkthrough, the approximate locations of these homogeneous materials were also noted. Following the EP A inspection protocol, each identified suspect homogeneous material was placed in one of the following EP A classifications: 1. Surfacing Materials (spray or trowel applied to building members) 2. Thermal System Insulation (materials generally applied to various mechanical systems) 3. Miscellaneous Materials (any materials which do not fit either of the above categories) . Friability Classifications A regulated asbestos-containing material (RACM) as defmed by National Emissions Standard for Hazardous Air Pollutants (NESHAP) is any (a) Friable asbestos material, (b) Category I non-friable ACM that has become friable, (c) Category I non-friable ACM that. will be or has been subjected to sanding, grinding, cutting, or abrading, or Cd) Category II non-friable ACM that has a high probability of becoming or has become crumbled, pulverized, or reduced to powder by the forces expected to act on the material in the course of demolition or renovation operations.. Following the EP A inspection protocol, each identified suspect homogeneous material was placed in one of the following EPA classifications: . Friable Materials NESHAP defmes a friable ACM as any material containing more than one percent asbestos, that, when dry, can be crumbled, pulverized, or reduced to powder by hand pressure. . Category I Non-friable NESHAP defines a Category I non-friable ACM as packing, gaskets, resilient floor covering (except vinyl sheet flooring products which are considered friable), and asphalt roofing products which contain more than one percent asbestos. . Category II Non-friable NESHAP defines a Category II non-friable ACM as any material, except for a Category I non-friable ACM, which contains more than one percent asbestos and cannot be reduced to a powder by hand pressure when dry. THE RILEY GROUP, 1Ne. ,---- SAMPLING PROCEDURES Following the walkthrough, the inspector collected selected samples of accessible materials identified as suspect asbestos-containing building materials (ACM). Samples were collected by Riley's asbestos building inspector, c~rtified under the EPA AHERA regulation 40 CFR 763, Subpart E (AHERA certification attached in Appendix B). Sampling was consistent with the requirements of NESHAPs and AHERA as well as meeting the requirements set forth by State and local regulatory agencies. QUANTIFICATION Quantities of accessible and/or exposed building materials which were found to contain asbestos were estimated. This estimation was performed by taking approximate measurements in the field. Drywall, joint compound, plasters, and ceiling and floor tiles, were measured in square feet of surface area. Piping insulation (if any) was measured in linear feet. LABORATORY PROCEDURES Method of Analysis Samples were analyzed by an accredited laboratory, specified in Section 3.0 of this report. A cbain-of-custody, documenting the possession of the samples from the time they were collected until they have been analyzed and stored, accompanied the materials at all times. All bulk samples were analyzed by Polarized Light Microscopy (pLM) with dispersion staining as described by the method for determination of asbestos in bulk insulation, EP A/6001R-93/116, July 1993. This is a standard method of analysis in optical mineralogy and the currently accepted method for the determination of asbestos in bulk samples. It should be noted that some ACM may not be accurately identified and/or quantified by PLM. As an example, the original fabrication of vinyl floor tiles routinely involved milling of asbestos fibers to extremely small sizes. As a result, these fibers may go undetected under the standard polarized light microscopy method. Transmission Electron Microscopy (TEM) is required for a more definitive analysis of these materials. For bulk samples which are found to contain <1 % asbestos, Point Count Analysis as described by the method for the determination of asbestos in accordance with Environmental Protection Agency's (EPA) "Interim Method for Identification of Asbestos in Bulk Insulation Samples" (40 CFR 763, Appendix A, Subpart F), is often utilized. Follow-up Point Count Analysis was not conducted for this project unless specified in Section 3.0 of this report. THE RILEY GROUP, INC. . . ..~.:-.:..:....' -, CODES AND REGULATIONS - ASBESTOS FEDERAL Federal regulations which govern asbestos abatement work or hauling and disposal of asbestos waste materials include but are not limited to the following: u.s. Department of Labor, Occupational Safety and Health Administration: I'. c. Asbestos Regulations Title 29, Part 1910, Section 1001 of the Code of Federal Regulations Final Rule Title 29, Part 1926, Section 1101 of the Code of Federal Regulations f. h ~,:','. p. Resoiratorv Protection Title 29, Part 1910, Section 134 of the Code of Federal Regulations Construction Industry Title 29, Part 1926, of the Code of Federal Regulations I',,' " , t Access to Employee EXpOsure & Medical Records Title 29, Part 1910, Section 20 of the Code of Federal Regulations ;. t~,;:,' f' Hazard Communication Title 29, Part 1910, Section 1200 of the Code of Federal Regulations Specifications for Accident Prevention Signs and Tags Title 29, Part 1910, Section 145 of the Code of Federal Regulations t Environmental Protection Agency (EP A) including but not limited to: Worker Protection Rule 40 CFR Part 763, Subpart G CPTS 62044, FLR 2843-9 Federal Register, Vol. 50, No. 134, 7/12/85 P28530-28540 , t i, i ~~\ ~( f. Regulation for Asbestos Title 40, Part 61, Subpart A of the Code of Federal Regulations National Emission Standard for Asbestos Title 40, Part 61, Subpart M of the Cod,e of Federal Regulations including NESHAP Revision; Final Rule, Federal Register; Tuesday, November 20, 1990. Asbestos Hazard Emergency Response Act (AHERA) Regulations 40 CFR 763 Subpart E t. . . '~:.':'~' ~ U.S. Department of Transportation (DOT) including but not limited to: Hazardous Substances: Final Rule Regulation 49 CFR, Parts 171 and 172 Uniform Fire Code: Asbestos Removal UFC Section 87.106,87.102 Standards which govern asbestos abatement work or hauling and disposal of asbestos waste materials include but are not limited to the following: American National Standards Institute (ANSI) Fundamentals Governing the Design and Operation of Local Exhaust Systems Publication Z9.2-79 Practices for Respiratory Protection Publication Z88.2-80 STATE Washington State Department of Ecology Dangerous Waste Regulations WAC 173-303 Washington Labor & Industries (WISHA, L&I) Asbestos. Tremolite. Anthophvllite. and Actinolite WAC 296-62-077 through 07761 Safety Standards for Asbestos Removal and Encapsulation WAC 296-65-001 through 050 Respiratory Protection WAC 296-62-071 through 07121 WISHA Regional Directive - Occupational Exposure to Asbestos WRD 23.10 . April 30, 1997 WISHA Regional Directive - Asbestos-Containing Joint Compound in Wallboard Systems WRD 23.30 December 28,2000 Local Air Pollution Control Authorities (e.g. Puget Sound Clean Air Agency) c1 PORT~... !:~~ U~~ L -=..JIr ~ "",-;--~ CITY OF PORT ANGELES DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application description Subdivision Name Property Zoning . . . Application valuation 03-00000764 Date 10/07/03 934 E FRONT ST 06-30-00-7-2-0200-0000- SIGN PERMIT SIGNS 500 Owner Contractor I R V RENTALS INC 934 E FRONT ST PORT ANGELES WA 983624015 ADVERTISING SALES & MORE 1327 E. 1ST STREET PORT ANGELES PORT ANGELES WA 98362 (360) 452-7785 Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL SIGN PERMITS SIGN/ JOHN L SCOTT SIMPSON ELECTRIC 35.30 plan Check Fee 10/07/03 Valuation 4/05/04 .00 500 ~ ~. Qty Unit Charge Per 1.00 35.3000 ECH EL-COMM-1ST SIGN Extension 35.30 Fee summary Charged. Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35.30 35.30 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 35.30 35.30 .00 .00 - \'\ ~ C '\ ~ Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of ,180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. 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 state or local law regulating construction or the performance of construction. - Signature of Contractor or Authorized Agent. Date Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\1102.15 [4/2002] r- "~I BUILDING PERMIT INSPECTION RECORD CA LL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO - FOUNDATION: FOOTINGS WALLS FOUNDA TION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I I PLUMBING - UNDER FLOOR 1 SLAB ROUGII-IN WATER LINE GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING I FRAMING JOISTS 1 GIRDERS SHEAR WALL WALLS 1 ROOF 1 CEILING DRYWALL T-BAR INSULATION SLAB WALLI FLOOR 1 CEILING MECIIANICAL - . HEA T PUMP WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT Ws: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT Ws SEPA: PARKING/LlGIITING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESJOENTIAL OATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 II).../). -/)~ Jtfu~ ) ELECTRICAL LIGHT DEPT CONSTRUCTION R.W.! PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\PLANNING\FORMS\l102.15 [4/2002J CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr. name Application description Subdivision Name Property Zoning . . . Application valuation 03-00000764 Date 9/18/03 934 E FRONT ST 06-30-00-7-2-0200-0000- SIGN PERMIT SIGNS 500 Owner Contractor I R V RENTALS INC 934 E FRONT ST PORT ANGELES WA 983624015 ADVERTISING SALES & MORE 1327 E. 1ST STREET PORT ANGELES PORT ANGELES WA 98362 (360) 452-7785 Permit Additional desc Permit Fee Issue Date Expiration Date SIGN 30.00 9/18/03 3/17/04 Plan Check Fee Valuation .00 500 Qty Unit Charge Per 1.00 30.0000 PER S- SIGN LES THAN 25 SF Extension 30.00 Fee summary Charged Paid Credited Due ----------------- ----------~----------- ---------- ---------- Permit F.ee Total 30.00 30.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 30.00 .00 .00 ~ \>J ..:t.. \t-\ \'\ d ~ -f ~\ Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. 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 state or local law regulating construction or the performance of construe' Date Signature of Owner (if owner is builder) Date T.\PLANNrNG\FORMS\II02.15 [4/20021 BUILDING PERMIT INSPECTION RECORD CALL417-4815 FOR BUILDING INSPECTIONS PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED YES I NO COMMENTS FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE f)bffCJ.. CO Iv~ Ffct..- \. p-fJ J.). 1-1(-03 t;.O>l 2$" ~ "'- ELECTRICAL ROUGH-IN PLUMBING UNDER FLOOR / SLAB (LIGHT DEPT) SEPARATE PERMIT: # I ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING I FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECIIANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engmccnng DIvIsIOn) SEPARATE PERMIT #'s. WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s PARKING/LIGHTING LANDSCAPING SEPA: ESA RESIDENTIAL SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL LIGHT DEPT CONSTRUCTION - R W PW / ENGINEERING FIRE DEPT. PLANNING DEPT BUILDING ~~II:d.i RV ELECTRICAL - LIGHT DEPT. 417-4735 CONSTRUCTION R.W./ PW/ ENGINEERING 417-4807 FIRE 417-4653 PLANNING DEPT 417-4750 BUILDING 417-4815 l' \PLANNING\FORMS\1102.15 [4/20021 PREPARED 9/18/03, 12 06 00 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 2 9/18/03 ADDRESS TENANT, NBR CONTRACTOR OWNER PARCEL APPL NUMBER 934 E FRONT ST SIGN PERMIT ADVERTISING SALES & MORE I R V RENTALS INC 06-30-00-7-2-0200-0000- 03-00000764 SIGNS SUBDIV PHONE PHONE (360) 452-7785 PERMIT, SIGN 00 SIGN REQUESTED INSP TYP/SQ COMPLETED RESULT DESCRIPTION RESULTS/COMMENTS BL6 9/18/03 ~ BUILDING POST/COLUMN FTG Post Hole by Mlke Mlller @452-7785 ------------------- --- -------------- COMMENTS AND NOTES -------------------------------------- 01 PLETEL Y and in INK. Your application and site plan MUST BE ETE to be accepted for review. If you have any questions, call (360) 417-4815 FOR OFFICIAL USE ONLY Date Rec <5 - t --03 PermIt # -, 6 <( Date Approved: Date Issued' : BUILDING PERMIT - APPLICATION Dept. of Community Development Applicant or Agent: ~ S l'-'\. oS: \ G?:r.,.J ~ Phone: 4 s:- 2. - I '1 Ss s: Owner: ~.t;).~cs;. '"I::.Q.v'---s~ I ~o'^~ 1-. ~c-C'7'7 Phone: l../Ij{- 95<is Address: \ '\ ~ ~OJ (L" c:> ,.."... ~ ~a..s~ CIty: S' €'Q.,)...","\ Zip: <=1 y.'J r3 Architect/Engineer: p... ~,...,.\ C l fb,.j ~ Phone: Contractor ~~,....., oS: \ (!, ,,-...i .( State License #: CJ~ r: c...." Exp: Phone: Address: PROJECT ADDRESS: ~ '54 c: . LEGAL DESCRIPTION: Lot: \ ~ '2 CLALLAM COUNTY PARCEL NUMBER: City: Zip: ZONING: SubdiVIsion: 0 I ~ I t:).--S ~ \c::....~~ ~\.u<..... ..-. ,- (2...c)~--;- Block: 2- o G,'Z C> 0 ~ (2.D'2-oc::::> Credit Card Holder Name: Billing Address: Credit CardType VISA TYPE OF WORK: o Residential 0 New Constr. 0 Re-roof o M~lti-farmly 0 Addition 0 Move -,' 0 CommercIal 0 Remodel 0 Demohtion o Reparr ':iZ! Sign BRIEF DESCRIPTION OF THE PROJECT: City: MC # Exp. Date: CD~I.:> n.... SIZEN ALUATION: o Stove SF. @ $ /SF. = $ o Garage SF. @$ /SF. = $ o Deck. ' SF. @ $ /SF. = $' . ~ Other TOTAL VALUATION .,<;;: 00 ~ ~ ~"..., ~__ OrJO . .p(<...e<5:~-U::>N~,,<< ..\'~c...J ~<d7 d-Vtl ~~J(LJ)cL c:;;,;~ C)1l 'COMMERCIALIRESIDENTIAL: Occupancy Group: Occupant Load: ConstructIon Type' = TOTAL Sq.Ft % No. of Stories: Lot Size: EXIsting Sq. Ft. & Proposed Sq. Ft. Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage AP~ PLAN:~ BLDG. DP . FIRE: OTHER:_ PLANNING USE ONLY: ESAlWetland(s): 0 Yes 0 No SEPA Checkhst requrred? 0 Yes 0 No Other: BillLDING PERMIT APPLICATION SUBMITTAL: The Budding DIViSIOn can proVIde you WIth informatIOn on the apphcatIon and plan subrmttal requirements If you have questions. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be revIewed and may be revised by the Buildmg DiviSIOn to comply with current fee schedules. Contact the Perrmt Coordinator at 417 -4815 for aSSIstance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the trme the buIlding permit apphcation and constructIon plans are submitted. All other permit fees are due at the tIme of perrmt issuance. EXPIRATION OF PLAN REVIEW: If no perrmt is issued within 180 days of the date of application, the application will expire. The BUlldmg OffiCIal can extend the tIme for actIon by the applIcant up to 180 days upon wntten request by the applicant (see Section 107.4 of the Uniform Butldmg Code, current edltlon). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct. I am authonzed to apply for this permit and understand that it is my responsibility to determine what permits are required ,not th y s, an ust obtain such permits prior to work. r'\FORMS\APPS\BUlldmgpermlt wpd Apphcant: Date: is- ~ \, 0'3. VI \' \3 ~ ~ ~ J c ~ ~ v, S \U 0 -l ~ t- rll "2 .q- 1 ~ (r 1) (J)<= LU~ I!:!!::!.l ...J a. ('\"') LUE ~ <<:::) (!)Q> C) z~ C".I <(0 = - 1->- ~ l ~~! 0:" Ei ~ ~ D.. E! u..o QU ~ < >-'0 1-- ~ a. OeD 0 :<"" I I I ~---- ... 00 , ;'(, ... ~ J I I I I I I . i I , I I I I : i I , i I I I I I ) I i I I j \ '\. ~ ~ ".~, .) ro,) "> . ~Jl~ ,.. ~ I I" L. (;\ ~ -~~~ i 1 ~J ---- "-1' \if ~ ~ t1 .J ~ ~ ~ ~ <t ~ 0 J- I' ~ -\... \' j <t "'.l :1 , i CI F PORT ANGElES - Construction Plans: The I S Jance of this permit based upon thebe plans. specl"- catlo s and other data shall not prevel( the building official from t lereafter requiring the correcllon. Qf errors In said plan, jSP€CI!icatlOns and other data, or lfrom preventing b~iI( Ir~. operations being camed on thereunder when In Vir:' :, n of ailtjt^Odes 'nO ordlnal1C~S flthlS lunsdlctlOn (. . i.1 3031c) . I In' ,or. 13U1ld1P; Cod I! "e "" J',le - -~~ ~ I j \ I I I ! cl .~ 'l ~ ~ JRo .:... ~ <:0:--- ~~ J 1 '.. ~ l.o\ fl 1 ~ oJ ~ ~ o '1 "cC 1. ~ b -"? ~ .. cr l\ \" 'wf olll o \II ~ ~ \0 ~ ,t .s- f' ~ 1 "()! ~ ~ "Ill N .J ). n S. ~ 0t 'u t ~. \) 1 o o '>1 ::I) (- ~-~ ~.... ~J ~; -\. ~ ....,S) >! [ffi fE ~ fE ij \\II fE ~ I AUG - 1 2003 I CITY OF PORT ANGELES De~~~_omm_unlty Development ~ ~o~~ l- ~ C\::1't .s'~'2 "'l "":? 6 ~....("7 .{ll!)()..Jt__, ~'-S , , . : ~ ~ ~ J (l S^ 1 {\ 'b >- J VI'~~~ ~ ( I he:.' v-1 ~Slll. t ~ C-, ... ..( ~ t ~ -,0<..(1 ~tL .s \~~ '. "... / A ~ I) }) r \\ t l ~tJ /' ?7 07/' o ~ ~ ~ ~ORTNGBLES 1Prl ~.lGlfUWl ~ IDJ f AUG - 5 2003 I CITY OF PORT ANGELES Dept. of COlYlmunity Development ... ......~--.,~ ~H.~ ___ ~....._ ... WAS H I N G TON, U. S. A. PUBLIC WORKS & UTiliTIES DEPARTMENT DATE: August 5, 2003 To: BRAD COLLINS, COMMUNITY DEVELOPMENT DIRECTOR FROM: JIM MAHLUM, CiVIL ENGINEER (TRAFFIC ENGINEE~"" "'-- SUBJECT: PROPOSED SIGN FOR 934 E. FRONT STREET (JOHN L. SCOTT) I field reviewed the location of the proposed sign for the new location of John L. Scott. My observation was done with a small sized truck. I also included driving out of the driveway immediately west of the building. I do not see any conflict with traffic on Washington Street and did observe that there is good visibility coming out of the driveway to the west. Because the sign will be located on the west side of Washington Street and Front Street is a one-way street, in my professional judgment I believe that a deviation of the visibility triangle policy should be granted in this situation. If you have any questions please feel free to call me at ext. 4701 ~ -10 ~ bwL--~ +-~t- ~y~~ ~ ~ ~ W.'c.. Wrrt-~$ <trl'~ ~ <tJvz-- r.Fr~ W~S ., ~ ~ 5fr~ ~ ~~;~ r ~ \r\{';'~ ~~ ~y..IbY 6f ~t2+~ ~ 1'\ ecA-~ $ i--r7 . ~ N.\PWKS\ENGINEER\TRAFFIC\slgns\John L Scott SIgn vIsIble deVIatIon rtf -....-.. ~~: -~.I!!> 1"lP'~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application description Subdivision Name Property Use Property Zoning . . . Application valuation 04-00000399 Date 5/10/04 .224075 934 E FRONT ST 06-30-00-7-2-0200-0000- JOHN L SCOTT REALESTATE COMM REMODEL Owner Contractor P~li ~p tlDO .0;\ 9/0~ r>t COMMERCIAL ARTERIAL 2000 I R V RENTALS INC J R CUSTOM & SON INC 934 E FRONT ST 141 PATRIOT WAY PORT ANGELES WA 983624015 SEQUIM WA 983820136 (360) 461-1911 Structure Information ADD TWO WINDOWS Construction Type . . .. TYPE V NON-RATED Occupancy Type . . . .. BUSINESS:OFF/PRO/MED/REST permi t BUILDING PERMIT - COMMERCIAL Additional desc ADD TWO WINDOWS Permit Fee 92.75 Plan Check Fee 60.29 Issue Date 5/10/04 Valuation 2000 Expiration Date 11/06/04 Qty Unit Charge Per Extension BASE FEE 47.00 15.00 3.0500 HND BL-501-2K (3.05 PER C) 45.75 --L "\.>' --...;... Other Fees STATE SURCHARGE 4.50 ~j Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 92.75 92.75 .00 .00 Plan Check Total 60.29 60.29 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 157.54 157.54 .00 .00 ~ . , ,} ~ '-. -------- Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. 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 state or local law regulating construction or the performance of construction. ~',-or~ Date Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\J 102.]5 [I J/]4/2003] >------~~ _. BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS WALLS FOUNDA nON DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING I FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING ~AI/o4- R-v DRYW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING MECHANICAL HEAT PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: P ARKING/LlGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. 1 PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 4 I 7-481 5 BUILDING T:\PLANNINGIFORMS\I 102.15 [lI1l4/2003] BUILDING PERMIT - APPLICATION FOR OFFICIAL USE ONLY: t , Date Rec.: c.-5"~ /6 -- b ., Permit #: 04 - .5 99 Date Approved: Date Issued: Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for review. If you have any questions, call PERMITS (360) 417-4815 FAX(360)417-4711 Applicant or Agent:~..11 ... Owner: ~I~ ~v\u6 Address:~ 931 &. Pri)......~ Q-, Phone: 'f(R{ -' (9 II L67, 343D Zip: 7~3v/L Phone: City~ A-~~~ Architect/Engineer: Phone: t. . . . .' cp"l Contractor~. (~b. . ~ -:r....x:..State LIcense #:-Je.,,~O Exp: Address: iLl/ "7.Arf~ Wf:>.\1 City: '5Goh~t,,", PROJECT ADDRESS: t:t-'3t../ &. Fi-o...rf- S-l-. Phone: Lfbl ~ I<f II Zip: q~3~ ZONING: LEGAL DESCRlPTION: Lot: Block: CLALLAM COUNTY PARCEL NUMBER: Subdivision: Credit Card Holder Name: Billing Address: Credit CardType VISA MC # TYPE OF WORK: o Residential 0 New Constr. 0 Re-roof 0 Stove o Multi-family 0 Addition 0 Move 0 Garage o Commercial 0 Remodel 0 Demolition 0 Deck o Repair 0 Sign 0 Other BRIEF DESCRIPTION OF THE PROJECT: ~~ p I i,)'~D,~S . COMMERCIALIRESIDENTIAL: Occupancy Group: City: Exp. Date: SIZEN ALUATlON: SF.@$ /SF.=$ SF. @ $ /SF. = $ SF.@$ /SF.=$t ~ TOTAL VALUATION $;;ZCCO -=---- .9 - G.A: ~ ) ..r~ .;:>- ..vl!5"c.J,) Occupant Load: & Proposed Sq. Ft. Constmction Type: No. of Stories: Lot Size: Existing Sq. Ft. Total lot coverage = TOTAL Sq. Ft. % ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: APPROVALS: PLAN: BLDG: DPWU: FIRE: OTHER:_ PLANNING USE ONLY: BillLDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on tlle application and plan submittal requirements if you have questions. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Coutact the Pennit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the tin1e the building permit application and construction plans are submitted. All other pemrit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days ofthe date of application, the application will expire. The Building Official can extend the tin1e for action by the applicant up to 180 days upon written Iequest by the applicant (see Section 107.4 of the Uniform Building Code, cunent edition). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required ,not the City's, and that I must obtain such permits prior to work. nFORMSWPSIB,ildiogp"mi<wpd APpl;;;;;nt, ~~ <.(~ Dol" S ~ 10- 0"; ,~9/30/2003 20:52 4579270 SIMPSON ELECTRIC PAGE 01 . ti .,.._......~"._----_..~... wll\ ELECTRICAL PERMIT APPLICATION ~':);II.Y'l;iCi^~. tl::.ro Ot'lI.Y ! '~~iCI:;:~:~ _._.____~_ ! !);;f.'I:;,; .,...~".--- i :~~I<: .".:.')1.",..;:.1: ._,...~.~..--- J ;.'~'" ),,~-,'.i' __'___'___~ _.-,--",."..--.-_._.-.0 . , Pllt~ l~ or r0pnnt In Ink. ~'you hAVe enyquIst'onat pl&Qf!o coil {_~i6'J, 41.T,.~.;.:~t fI/'l, -:JI: 7 b L{ . fa. numbo" (380) 417-4711 b '", Cell : <{-~o -10lf' Owner Of Elee, Oonlroolor Agent:~.s..o..I:1--El~_ Phon.: !d..5_1::.'1J..7..();'", Property Own.r: de; ~ V\ L_.s.G.6.rr R ~ Ifj ...___.._ fW'", ? '--! <E G. .----C_:f.... ~ r- T _Clty'.----=.:pp Electrloal COmMie'or: I'm ~___.._ Ekcfr-iC. Llc.nae#:~1!lffl_Er.r-:__"___Q,~",,, !::"U'''''__''_~___ lI,jdraM: d'-l3o-3 b (9./ fA.) CIty: pr -(Lr:r 6~ ,__.___________.__",P.__.!:!._f3 ~3__. 'n~ltl E',IB'iUicr..1 Perr.'lll A~p\lcallQn mmr.t bft tilled out G1:Iro~ :5~~~ ,'1,$..1.:1:..5. ~~.. ..... "" ...11ik..L... ,~darElBlB: INSTAlUlTION WIRED BY: o OWNER o 6LECTRICAl CONTA.~CTOA Credit CIlrd Hold9r Name: __________ 8/i11ng Addrea8; City: '. "'''..' ..~;:"(f.~.' ....~._.__~_._~__.,. Credit Card Number: __________________If!xp_ Dais' .... .....,_... 'i;i.fSfi,,;..,.__MC:__..., PROJECT ADDRESS: 9 '$''1 _~<is~t'''I.-T ---.--...-.... ....-..... ....-.... -..,. _.._~.-._-~. iYP~ OF WOAK; C.'1eck .f!li thei ~pply: 0 New o AlteralloJ'\/Additlc~ [J Resldentsl 0 Multi-family CJ Commercial 0 Mobile Home Sq: Ft._.~_..._........._..._.._.___ o Remote Meter 0 Detached gAr~\_~0 [J HOT Tub [] SwIm Pool 0 SeptIc' rump [j L{K;V ~l~-:;;:'.y:: C~:: ';.0:r~:;cm. 0 Sign i\\.Irt\b@lrof Clroults added or elt\!red: ____.__ r /) h. VI- e c.- L .s J~--Cc)~J0..<;,v.::.o.f..b.(:~..d J.!.~ nl'SCRIPTION OFTHE ELECTRICAL PF\O,I!:C'T: ---_._---,.,..,.,.._..~,..,-".._,-",.,..'"_. -.-----.....-".--,.-- ~clll Heal Load Addltllll!~ <<(0 -trf .~.~.lJIW.1!.JJlt<!!f!):i,:jl):','I, S 53 '0 C1 Besetlaard [) Fumsce o Heat Pump o Fan-Wall _KW _KW _KW -KW [] Over~..d Service o Temp Ser"lcQ o Und9r~rcund Servlca \'(;:lr~qi:': [)r.,cl:-t.':: :: i ~ 1.'.1 ".: S$lvll~-:! ~::;::i,I,:::. ... ..'. ".''', rt~!l-c!(';' :~:?'.;.':...~,. .n,_..".., PAMC 14.06.060(6): For IndIJ8triar, (;O."'i'HTlZ:G:OJ, & reald6lntl~1 pro/E!C1~ larger thRr;' fl'd~p!ex\ ~ on(~ _ H!l(~ ~,~r,-i':'"'l:-ir:~~; 111 \~1r.: f.;~~r;tr!~;SJ SsrvlC12 8. F~eder., building alzQ (sq. ft.), lomd color;i"jion.. L\n'" :h. type 8. of conductors and/orrsceway is "~qlJim:; :,1 "i) "I..,:,:: .:J-'>::r,;"1P~rN thl) EleOlrlcal Permll application. . I hereby certify that I have read and examined this application and know Ihat6l1l1l'Je -to b"! I'f'Ue:' Imd ~;om"cl, ana I am authOf/zed to apply for /hIs permit. Il.Indl'Jrsts.nd It Is nor the Clty's legs.1 r'Jspcmslbillty 1'0 u'ne','[nine Wh$t ;:Jermifs '" ;~: ~ ..-, "" """be. ffl'PO",,""lty ~ de"""m' who' p'<ml" ,~ ~"'" 'II' ",' ". ",.,; ,""', th - Crooit CIi.'d Ho,d~;'e Signature; ~I"!W_,"_____ / /~/o'$ . ':,J!;t1.f,f;'.:._____._.... 'W-9019 c/~:~I.~;~t~t~~ ?tJliU {Jt., C ~ 111/..41.-