Loading...
HomeMy WebLinkAbout524 N Jones St - BuildingPREPARED 1/29/10 8 32 39 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES ADDRESS 524 N JONES ST SUBDIV TENANT NBR MARY E BROWN CONTRACTOR R J SERV "CES INC PHONE (360) 457 420 OWNER MARY E BROWN PHONE PARCEL 06 30 00 5 3 0200 0000 APPL NUMBER 10 00000076 DEMOLITION PERMIT DEMO 00 DEMOLITION REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL99 01 1/29/10 JLL INSPECTOR JAMES LIERLY DATE 1/29/10 BLDG FINAL January 26 2010 2 53 28 PM 1pangrle ROGER 461 1677 BLDG FINAL DEMOLITION OF THE BURNED HOUSE GARAGE COMMENTS AND NOTES Application Number 10 00000076 Application pin number 944280 Property Address 524 N JONES ST ASSESSOR PARCEL NUMBER 06 30 00 5 3 0200 0000 Tenant nbr name MARY E BROWN Application type description DEMOLITION Subdivision Name Property Use Property Zoning COMMERCIAL OFFICE Application valuation 0 Application desc DEMOLISH THE HOUSE GARAGE Owner Contractor Qty Unit Charge Per 1 00 55 0000 HR PW INSPECTION Other Fees Fee summary T \Policies \I 102 15 [10/08] CITY OF PORT ANGELES PUBLIC WORKS UTILITIES 321 EAST 5TH STREET PORT ANGELES WA 98362 Special Notes and Comments Sewer lateral shall be exposed to the property line an inspection by Public Works Engineering is required The sewer lateral will be capped A 2 X4 X36 pressure treated post painted green and marked S S Stub indicate depth to service to the nearest foot Attach a 12 gauge galv wire to cap and stake Charged Paid Credited Date 1/22/10 MARY E BROWN R J SERVICES INC PO BOX 1671 514 IRVING JACOBS RD PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 457 1420 Structure Information 000 000 DEMOLISH THE HOUSE GARAGE Permit PUBLIC WORKS INSPECTION Additional desc INSPECT AND CAP SEWER Permit pin number 159962 Permit Fee 55 00 Plan Check Fee 00 Issue Date 1/22/10 Valuation 0 Expiration Date 7/21/10 Extension 55 00 STATE SURCHARGE 4 50 Due Permit Fee Total 55 00 55 00 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 59 50 59 50 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 constELcti ature of Contractor ro Authorized Agent Date Signature of Owner (if owner is builder) Date PW UTILITIES (Engineering Division) WATERLINE METER SEWER CONNECTION S ANITAR Y STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB GUTTER DRIVEWAY APPROACH BACK -FLOW DEVICE CONSTRUCTION R.W PW/ ENGINEERING 417 -4831 FIRE 417 -4653 PLANNING DEPT 417 -4750 BUILDING 417 -4815 T \Policies\1 102 15 [10 /08] RESIDENTIAL PERMIT INSPECTION RECORD CALL 417 -4831 FOR UTILITY 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 1 NO COMMENTS FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO CONSTRUCTION R.W PW ENGINEERING I FIRE DEPT I PLANNING DEPT I BUILDING w CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 10 00000076 Application pin number 944280 Property Address 524 N JONES ST ASSESSOR PARCEL NUMBER 06 30 00 5 3 0200 0000 Tenant nbr name MARY E BROWN Application type description DEMOLITION Subdivision Name Property Use Property Zoning COMMERCIAL OFFICE Application valuation 0 Application desc DEMOLISH THE HOUSE GARAGE Owner Contractor MARY E BROWN R J SERVICES INC PO BOX 1671 514 IRVING JACOBS RD PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 457 1420 Structure Information 000 000 DEMOLISH THE HOUSE GARAGE Permit DEMOLITION Additional desc DEMOLISH HOUSE GARAGE Permit pin number 159954 Permit Fee 50 00 Plan Check Fee 00 Issue Date 1/22/10 Valuation 0 Expiration Date 7/21/10 Qty Unit Charge Per Extension BASE FEE 50 00 Special Notes and Comments Sewer lateral shall be exposed to the property line an inspection by Public Works Engineering is required The sewer lateral will be capped A 2 X4 X36 pressure treated post painted green and marked S S Stub indicate depth to service to the nearest foot Attach a 12 gauge galv wire to cap and stake Other Fees Fee summary Charged Paid Credited Permit Fee Total 50 00 50 00 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 54 50 54 50 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 has 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, ^og4 9c r +ti.j l c_L Date Print Name Signature of tractor or Authorized Agent Signature of Owner (if owner is builder) T:FormsBuilding DivisionBuilding Permit Date 1/22/10 STATE SURCHARGE 4 50 Due F naiad 6 `Zq- 10 BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 4815 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING Under Floor Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow Water AIR SEAL. Walls Ceiling FRAMING Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION. Slab Wall Floor Ceiling MECHANICAL. Heat Pump Fumace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting PLANNING DEPT Separate Permit #s SEPA. Parking Lighting 1 1 ESA. Landscaping 1 1 SHORELINE. T:Forms /Building Division /Building Permit FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Electrical 417 -4735 Construction R W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 FINAL Date Accepted by FINAL Date Accepted by Date Accepted By Applicant RS 51.2.4.4,4,s Property Owner ,'y1,g1 Property Owner's Address Contractor eff 5S441101s Contractor's Address /22 s, L J41 Aid 6° RTSI_K t�osoTg Proiect Tvoe Brief Des Check all that apply New Construction Addition Remodel Repair K Re -roof Heat System Other Floor Areas Basement 1 Floor 2 Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other BUILDING PERMIT APPLICATION Print n ink CITY OF PORT ANGELES Attn Building Permit Technician 321 E Fifth St. Port Angeles WA 98362 (360) 417-4815 fax (360) 4174711 l.4ovvev clo"r -cs /4,0 k ,9i►(, 3r3 QIS 1 Existing (sq. ft.) Proposed (sq. ft.) Phone fS7 /vz, Poi S7 Poi ���4GGS LA/4 98z6 z Phone irs'�- cresiz E -mail D.cda R Pear 441 4$, L.44 Expires ///349/24/a PROJECT ADDRESS Z j cam (1 r 4 Parcel Number Lot Zoning cription.'jResidential a Multi- family rL per sq ft. TOTAL VALUATION Total'footprint of structures. sq ft. Lot size ..sq ft. Lot coverage Site Coverage the impervious surface:on.a parcel, including. structures paved: driveways, sidewalks and other impervious surfaces (see PAMC 17'94 135 for exemptions) Site. coverage Max. height of proposed structure. ft. Occupancy group Will a lawn sprinkler system be installed? Occupant Toad. Will a fire sprinkler system.be installed? Construction. type For City Use Only' Date Received -2.7 10 Permit# Date Approved of bedrooms of full baths of half baths Co Commercial Industrial f m 5( 5 D C Lv► —.P lira. k r ,5 Po -7 o r c_ b.A_, House garage other 1 "J‘' tear off re -roof lay over one layer Heat pump wood burning stove gas fireplace pellet stove other patios I have read• and completed this application and know it to' be.true and correct. I am authorized to apply for this permit and understand that it is my responsibility to detemdne what permits are required, and to obtain permits prior to wgrkinp on pr p ecfs. Date ,9 Print Name Rc, G I,U41' t Signature T.Forms /Building Division /Building permit application 1 Horne, 4 bEs (11.0 fl 1224 JAN /22/ 21 1 i1 /FF 111 1H AM ORCuu VA /AA ,iVSV AV .IVV:i VVSY JAN /21/2010/T1U1 09 21 PM ORCAA O RCA13.,� 4/1i11V 1vVL!1VVVV Olympic Region Clean Au Agency 2940 -B Limited Lane NW Olympia, WA 98502 (360) 586 -1044 FAX (360) 491 -6308 Port Angeles office (360) 417 1466 Raymond Office (360) 942-2137 w w w,O1 CAA.org FA I\1 ,h114L111 H FAX No 3604916308 Commercial Structure Perarit free: $60.00 3,0 wedging day wait period bi Owner occupied residential dwelling Permit fee. $35.00 Prior Notice 7� RoIEI1,TY OWNER NII gs in-ewe Meilin Address: _2'1 N. Site Address- DEMOLITION CONTRACTOR $os' css Name: ,$‘;zui cti5 pm*Conra± Mailing Address: &c¢ik4ti- DEZv!OLITION INPO RMA'I'ION of St Lutes betug demolished: 1 I Asbestos present ,_Yea k No DEMOLITION PROJECT CATEGORY re; Complete Demolition Txainic Eire Etre Agency Renoradon, Alteration, Remodeling, Ma:tnoeztance, of oclat Conitruel on 1 a.racK {ency .a.ddit1ana.1. lac r,f $50.00 (musmbe Acgc+znpmnied by Government Ordered Declaration-Commercial ooly) Y hove mad aid oil' abide by tbi aonditrioa.r s s fora do Oispermit and any addastd✓szF thert.tn. 1 do ,here certzfy that all sdentcfiad arbe.ctas bqs beer; removed and the iaforrneafion in tbzs application and sup ilcznental data described beresn is, to the( beat of my kzea'ledge, accsira ?a and corrlpleta. R y es, C- Applicant Name JAN 2 1 2010 Survey attaaaaed Yese i.gnattuo I Phone: FAX. City: r4•vtd Check if same as property owner uafoxxx3,atio a ?honer (2¢.) 4'J"7.07a FAX. (dip) �,'S7.97 Phone: cddv) FAX. NS'7 J y' I 11.-L r k $varr Data: Pay wet Info. Approved 7Casb I Check Receive date:/ l� Reviewed by`� errcy Ure OrdY 44shry Use Only OVER r 7 Disapproved h.lail. 1 mobile: CA-d4 state! Brnai1. Mobile; SLatc: Date F III I II P (10?. Demolition Permit ?a Zip No) 461 .16 919,3 bz CoCqPia� Date 12-91GO „_No Teas ail identified BabeeFos i,ecz� removed Yeti Asbestos Permit Permit 1 bemiolition Pei Fe =0.1,c 0 C) p 00.3 ens Usc Only 01/21/2010 THU 15 16 [TX /OX NO 5726) /1002 Patrick Bartholick From CLARENCE BROWN To Date 1/21/2010 1 16 PM Page 1 of 1 As Power of Attorney for Mary E Brown, I, Clarence H Brown II hereby grants permission for Financial Freedom Senior Funding Corporation and /or the City of Port Angeles to demolish the remains of the residence located at 524 N Jones St Port Angeles, WA Clarence H Brown II Your E -mail and More On -the Go Get Windows Live Hotmail Free Sign up now. file. //C \Documents and Settings \pbarthol \Local Settings \Temp\XPgrpwise \4B5853AEDO 1/21/2010 1M i N10, Laboratories, Inc. 4708 Aurora Ave N, Seethe. WA 98103 Tel: 206.547.0100 Emerg. Pager 206.344 1878 1.888.NVL.LABS (685.5227) Client Zenovlc Associates, Inc. Street f3\ G 5tc'e-re. JAN 14 2010 2 14PM NVLLAB AUR METALS Dotal Metals TCLP Seq. 1 2 3 4 5 6 7 0 9 10 11 12 13 F 15 Lab ID Dot. Limit Matrix 1t2rp m (AqS) n Air Filter ppb (GFAA) d Drinking water LJ Dust/wipe 0 Soil Print Below Sampled by r �y6 Y 4;AL Relinquished by I-2r l.1! Last Received by Analyzed by Results Called by 1 Results Faxed by l ,4q 64(L1I. "ee Sian Bel CHAIN of CUSTODY SAMPLE LOG Port Angeles Project Manager y �.rii 7 �r doCf� Project Location S 4( t) .J ss s log?' *ars Paint Chips Paint Chips (Area) p Waste Water Client Sample Number Comments /06 06 #644s< r NVL Batch Number Client Job Number Total Samples Tum Around Time Email address Other Types 0 Fiberglass 0 Nuisance Dust Rotometer Calibration Other '(Specify) of Analysts 0 Silica 0 Respirable Dusl Mold/Fungus Condition of Package: 0 Good Damaged (no spillage) Severe damage NO 6136 P 3 BATCH ID 3000428 00 /eQ r 1 -Hr 0 2 -Hrs 014 Days 2 -Hrs Days 5 Days 4P e call orr TAT lesai to H Days His e Zsvo�nc. Alec Phone: (360) 417 -0501 Fax: (360) 417 -0514 In Asbestos Air 10 PCM (NIOSH 7400) TEM (NIOSH 7402)_ (J TEM (AHERA) 0 TEM (EPA Level 11) O Other 10 Asbestos Bulk ID PLM (EPA16001R- 931116) 0 PLM (EPA Point Count) 0 PLM (EPA Gravimetry) TEM Bulk i RCRA Metals All 6 t)ther Alt Metals Arsenic (As) t ead (Pb) U 3 Barium (8ia) Mercury (Hg) Copper (Cu) Cadmium (Cd) Selenium (Se) Nickel (Ni) o Chrarniurn (Cr) 0 Sillier (Ag) Zinc (2n) 4gve.os T 6444 ✓1G j44/4/.•c Acr IVV Special Instructions Unless requested in writing. all samples will be disposed of two (2) week8 after analysis. !AIR Time .o cx 01/14/2010 THU 14 20 [TX /RX NO 5722] 11003 JAN 14 2010- 2 14PM NVLLAB AUP. NVL Laboratories, Inc 4708 Aurora Ave. N. Seattle, WA 98103 Tel. 206.547.0100 Fax: 206.634 1936 www.nvllabs.com Client: Zenovic Associates, Inc. Address: 301 E. 6th St Suite 1 Port Angeles, WA 98362 Attention' Mr Tracy Gudgel Project Location: 524 N Jones St, Port Angeles Lab ID Client Sample 30002591 10008A Sampled by Client Analyzed by Brittany Vogel Analysis Report Date Analyzed: 01/14/2010 RL mg/ 0.5 NO 6136 -P 2 WA DOE C1765 ApO AIHA -IH #101861 Toxicity Characteristic Leaching Procedure Lead (Pb) Results in ma /L 05 mg/ L Milligrams per liter ppm parts per millio►1 Note Method QC results are acceptable unless stated otherwise. Unless otherwise indicated, the condition of all samples was acceptable at time of receipt. Bench Run No 30- 0113 -06 Batch 3000428 00 Matrix: Bulk Method. EPA 1311/70008 Client Project* 10008 Date Received: 01/13/2010 Samples Received: 1 Samples Analyzed' 1 DRAFT Results in Opm 05 RL Reporting Limit Below the reporting Limit Page 1 of 1 01/14/2010 THU 14 20 [TX /RX NO 5722] lI002 JAN 14 2010 2 14PM NVLLAB AUR NVL Laboratories. Inc. 4708 Aurora Ave. N. Seattle, WA 98103 Voice: 206,547.0100 Fax: 206.634.1936 DESCRIPTION OF DOCUMENT (S) Results for NVL Batch 3000428.00 COMMENTS FAX COVER SHEET To Tracy Gudgel Company' Zenovic Associates, Inc Fax number (360) 417 -0514 Tel number (360) 417 -0501 Email address tracy©zenovic net Date 1/14/2010 From Brittany Vogel Total pages 3 Privileged and Confidential Laboratory- Client Communications NO 6136 P 1� L A B S Ramout „r„MM,4 This facsimile message is privileged and confidential and is intended solely for the use of the individual named above. If you are not the intended recipient, you are hereby advised that any dissemination distribution or copying of this communication is prohibited If you have received this Fax in error immediately notify sender by telephone and return the original Fax message to sender by mail_ If all pages are not received, please notify sender as soon as possible at (206) 547 -0100 01/14/2010 THU 14 20 [TX /RX NO 57221 a 1 NVL Laboratories. Inc. 4708 Aurora Ave N, Seattle, WA 98103_ Tel: 206547.0100 Emerg. Pager 206.344 1878 1.888.NVL.LABS (685.5227) Client Zenovic Associates, Inc. street 3O\ G G� S�ce& Port Angeles Project Manager '7-Ice eV' 4 /3afX- Project Location 52 It .4 70- Phone: (360) 417 0501 Fax: (360) 417 -0514 10 Asbestos Air 1 PCM (NIOSH 7400) TEM (NIOSH 7402) U TEM (AHERA) TEM (EPA Level 11) 0 Other 10 Asbestos Bulk! PLM (EPA/600/R- 931116) PLM (EPA Point Count) PLM (EPA Gravimetry) 0 TEM Bulk METALS ❑,total Metals IETCLP Other Types 0 Fiberglass of Analysis Silica Condition of Package: 0 Good 0 Damaged (no spillage) Severe damage (spillage) Seq. #1 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Det. mit Matrix ppm (AAS) n Air Filter ppb (GFAA) 0 Drinking water Ll Dust/wipe Soil Lab ID 1 Client Sample Number 1 /0boS Print Below Sampled oY l Ti q€ Relinquished by i---4 e d Received byl Analyzed by 1 Results Called by I Results Faxed by I NVL Batch Number Client Job Number Total Samples Turn Around Time S�. g r 444k Email address O Nuisance Dust Rotometer Calibration 0 Other (Specify) O Respirable Dust Mold/Fungus CHAIN of CUSTODY SAMPLE LOG Paint Chips Paint Chips (Area) Waste Water Comments RCRA Metals Arsenic (As) o Barium (Ba) Cadmium (Cd) Chromium (Cr) /d 1 1 -Hr 2 -Hrs 4 Days 2-Hrs Days 0 5 Days O 4-Hrs 0 3 Days 6 to 10 Days Please call for TAT less than 24 His %ocY a 2T—o ne, Air/7 All 8 E -Lead (Pb) Mercury (Hg) Selenium (Se) Silver (Ag) Acvt_$s Tccj' 6444 Com y 1 i 4 t c 1 701 *Sao Lc 1 Date, Special Instructions Unless requested in writing, all samples will be disposed of two (2) weeks after analysis. 4 4_4cl._ /44Sr uRd (IL ee 114\ L A 1 B S Other Metals U All 3 Copper (Cu) O Nickel (Ni) Zinc (Zn) I AIR Time 2 3o44„j 3 =e21 1 NORTHWEST ASBESTOS CONSULTANTS Surveys, Inspection, Sampling AHERA Building Inspector Mgmt. Planner EPA Certification WAMOA -0042 406 Reed St. Port Townsend, WA 98368 northwestasbestosconsultants @cablespeed.com 360 -385 -0584 Date: 1 /11 /10 Job Location. 524 N Jones St. Port Angeles, WA 98362 Contact: awner: Subiect: Inspector: Tracy Gudgel P.E. Zenovic and Associates 301 E. 6th St. Suite #1 Port Angeles, WA 98362 Mary E. Brown Demolition of fire damage home. Bob Witheridge AHERA Building inspector Management Planner WAMOA 0042- 10230901 Expires 10/23/10 Scone of work 1) Good faith inspection for asbestos containing building materials (ACBM) 2) Survey, sample and record suspect materials. 3) Report to Tracy Gudgel P.E. with results of testing by Northern Industrial Hygiene, Inc. In pection Report The inspection started with a visual survey looking for Asbestos Containing Building Material (ACBM) This single story home was heavily fire damaged. Cement foundation, brick, stone and wood siding materials. Wood shake roof, metal clad windows, fiber glass and rock wool insulation. Carpet and tile flooring. Electric forced air heating. Sample results are as follows. Sample #1. Living room ceiling and walls. Wall plaster Sample #2. Attic rock wool insulation. Sample #3. Hallway sheet rock. Sample #4. Homogeneous floor tile. Red Sample #S. Paper under roofing material. Samples were sent to lab See results. To Northern Industrial Hygiene, Inc Date: 1/7/10 Job Location. 524 N Jones St. Port Angeles, WA 98362 Contact: Sample #1. Living room ceiling and walls. Wall plaster Sample #2. Attic rock wool insulation. Sample #3. Hallway sheet rock. Sample #4. Homogeneous floor tile. Red Sample #5. Paper under roofing material. liaspectoli Bob Witheridge AHERA Building Inspector Management Planner WAMOA 0042- 10230901 Expires 10/23/10 Please call with test results when completed. See attachment. Thank you, Bob Witheridge, EFM NORTHWEST ASBESTOS CONSULTANTS Surveys, Inspection, Sampling AHERA Building Inspector Mgmt. Planner EPA Certification WAMOA -0042 406 Reed St. Port Townsend, WA 98368 northwestasbestosconsultants @cablespeed.com 360 -385 -0584 Tracy Gudgel P.E. Zenovic and Associates 301 E. 6th St. Suite #1 Port Angeles, WA 98362 Northwest Asbestos Consultants 406 Reed Street Port Townsend, WA 98368- Project Location: 524 N. Jones SL, Port Angeles Client Sample Number 1 Client Sample Description: Plaster Client Sample Location: Living Room, Ceiling and Wall Sample Comments: Gray smoke residue on white paint and white lumpy powder Asbestos Fibrous Components: Non-Asbestos Fibrous Components: Non-Fibrous Components: No Asbestos Detected 2% Cellulose 3% Misc. Particles 25% Paint 70% Filler and Binder Layer 2 Tan paper and white compressed powder Asbestos Fibrous Components: Non-Asbestos Fibrous Components: Non-Fibrous Components: Fetsyy qt, Abt* On, 44 No Asbestos Detected White loosely compressed fibers with dark gray residue Asbestos Fibrous Components: Non-Asbestos Fibrous Components: No Asbestos Detected ItIft AL:ink 417;44%, Client Sample Number 2 Client Sample Description: Rock Wool Client Sample Location: Attic Areas Sample Comments: Client Sample Number Client Sample Description: Client Sample Location: VENC A.11.1w41 60% Cellulose 3 Plaster Sheet Rock South Hallways Sample Comments: Materials distinguishable but inseparable Sampled by Bob Witheridge 117/2010 Received by Jude Cummings 1/8/2010 Reviewed by Jude Cummings 1/11/2010 215 SW 153rd Street Burien, WA 98166 OFFICE: (206) 988-1746 FAX. (206) 988-1978 NVLAP Lab Code: 200511-0 Bulk Asbestos Analysis Report NH Batch Number 10-00017 Client Job Number Tum Around Time: 5 Day Samples Analyzed: 5 Lab Sample Number 10-00017.0001 Checked If Sample Not Analyzed 40% Filler and Binder „ef 7 1 4 Apti "Air :h A '117 aCIA. 411.0.1.,.. A.2a1.4gx. AA.A.44Aitn 3% Cellulose 95% Mineral Wool and Beads tiv404/4ext (Sample results continued on next page.) Lab Sample Number 10-0e017.0002 Checked If Sample Not Analyzed EI Non-Fibrous Components: 2% Miscellaneous Materials '141, ,q6 1, 11.4A0 '471.,CV A X 'ipv, SAT: e0 WS Lab Sample Number 10-00017.0003 Checked If Sample Not Analyzed IA e Jude Cummings, Laboratory Manager Page 1 Bulk Asbestos Analysis Report 215 SW 153rd Street Burien, WA 98166 OFFICE: (206) 988 -1746 FAX. (206) 988 -1978 NVLAP Lab Coda. 200511 -0 Northwest Asbestos Consultants N1H Batch Number 10-00017 406 Reed Street Client Job Number Port Townsend, WA 08368- Turn Around lime: 5 Day Project Location: 524 N. Janes St, Port Angeles Samples Analyzed: 8 Tan paper and white compressed powder Asbestos Fibrous Components: Non Asbestos Fklrous Components: Non Flrous Components: No Asbestos Detected 23% Cellulose 77% Filler and Binder Client Sample Number 4 Lab Sample Number 10- 00017.0004 Client Sample Description: Floor Tile Client Sample location: Homogeneous Sample Comments: Checked If Sample Not Analyzed d Layer 1 Red ceramic material Asbestos Fibrous Components: Non- Asbestos Fibrous Components: Nonfbrous Components: No Asbestos Detected 30% Fine Grains 70% Filler and Binder Layer 2 Black fibrous materiel Asbestos Fibrous Components: No Asbestos Detected Non Asbestos Fibrous Components: Non-Fibrous Components: 5% Cellulose 85% Fiber and Binder 10% Mineral Fibers Client Sample Number g Lab Sample Number 10-00017.0005 Client Sample Description: Roofing Paper Client Sample Location: tinder Wood Shake Roofing Sample Comments: Checked If Sample Not Analyzed 0 Black asphalt material Asbestos Fibrous Components: Non- Asbestos Fibrous Components: Non- Fthraus Components: No Asbestos Detected 35% Cellulose 65% Asphalt Filler and Binder Sampled by: Bob Witheridge 11712010 Le- C 4r Received by Jude Cummings 118/2010 Reviewed by Jude Cummings 111112010 Jude Cummings, Laboratory Manager Page 2 SymmaLv of Insnection This survey includes all areas of inspection with report results from Northern Industrial Hygiene, Inc Sample #1. Samnle #2. Sample #JL Sample 14, Sample #5. All asbestos containing building materials with a reading greater than 1% is considered a hazardous material if disturbed. If removed a certified abatement contractor must follow the rules of the EPA and governed by Olympic Region Clean Air Agency During demolition it is possible that additional suspect asbestos containing building material (ACBM) may be found. Should such suspect material be discovered an AHERA certified inspector will have to sample and test the material to prove it is of non asbestos. Northwest Asbestos Consultants is not responsible for identification of hidden materials that are not identifiable with reasonable diligence. Thank you, Bob Witheridge, E.F.M. Living room ceiling and walls. Wall plaster No asbestos detected. Attic rock wool insulation. No asbestos detected. Hallway sheet rock. No asbestos detected. Homogeneous floor tile. Red No asbestos detected. Paper under roofing material. No asbestos detected. 4 ti t �p'k�i7ia. z n l y 1 l `!a. b► r ly� r �i k ..R a�+ _Y Q p'--.» e•a1o'o'o•e'o•a:a ;oro'a a o o o'o•o•o•o•o:o'a a •oo'o'e`eb'o'a o• a'o o a o o n a•e"e:a•e'a'e'e .o .0 'o WASHINGTON ASSOCIATION of MAINTENANCE and OPERATIONS ADMINISTRATORS Bob Witheridge Participated in the EPA AHERA INSPECTOR, MANAGEMENT PLANNER Refresher Course offered by the WASHINGTON ASSOCIATION of MAINTENANCE and OPERATIONS ADMINISTRATORS The full day training program covered all topics specified in the Model Accreditation Plan under Section 206 of Title Il of TSCA The course was taken on October 23, 2009 in Silverdale, Washington Certificate #10230901 oe Ex ir= on October 23, 2010 Colin MacRae Course Administrator 2714 228th St. SE, Bothell, WA 98021 (425) 485 -6980 THIS IS TO CERTIFY THAT Clallam County Assessor Treasurer Property Details 61766 MARY E BROWN for Clallam County Assessor Treasurer Property Search Results 61766 MARY E BROWN for Year 2010 2011 Property Account Property ID Geographic ID' Type: Tax Area: Open Space: Historic Property' Multi Family Redevelopment. N Location Address: Neighborhood: Neighborhood CD' Owner Name: Mailing Address: Taxes and Assessments Due Statement Year ID 2009 617662008 2009 617662008 2009 617662008 2009 617662008 2009 617662008 2009 617662008 2009 617662008 2009 617662008 2009 617662008 NOTE due Values Market Value: Productivity Loss: Subtotal: Senior Appraised Value Non Senior Appraised Value: Total Appraised Value: Senior Exemption Loss: Exemption Loss: Amount Due if Paid on. 7" J. 61766 Legal Description: 0630005302000000 Real 0010 N N PA 121 PORT ST CNTY H2 L Land Use Code DFL Remodel Property' 524 N JONES ST PORT ANGELES, wa 98362 Cycle 5 Res 10955130 MARY E BROWN PO BOX 1671 PORT ANGELES, WA 98362 Property Tax Information as of 01/21/2010 First Half Base Taxing Jurisdiction Due ST SCH STATE SCHOOL CC -GEN COUNTY PORT PORT PORT ANG PORT ANGELES SD #121 SCHOOL DISTRICT #121 NTH OLY LIB NORTH OLYMPIC LIBRARY HOSP #2 HOSPITAL #2 CITY_STORMWATER CITY STORMWATER WEED_CONTROL WEED CONTROL 2009 617662008 TOTAL. If you plan to submit payment on a future date make sure you enter the date and RECALCULATE to obtain the correct total amount �O 0 Improvement Homesite Value: Improvement Non Homesite Value: Land Homesite Value. Land Non Homesite Value: Curr Use (HS): Curr Use (NHS): N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Agent Code: Mapsco: Map ID' Owner ID' Ownership' Exemptions' $79.54 $40.26 $5.70 $88,30 $98.33 $11 70 $16.51 $36 00 $0 81 $377 15 Ag Timber Use Value N/A N/A P S CO -OP COLONY SUBDIVISION LT1 &S2 ST ABTG LTS1 3 EX PTS 11 N N 15761 100.0000000000% Second Half Base Due $79.53 $40.24 $5.70 $88.27 $98.39 $11.69 $16.51 $36.00 $0.82 $377 15 Penalty 50 00 $0.00 $0.00 $0.00 $0 00 $0.00 $0.00 $0.00 $0.00 $0.00 Interest $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Base Paid $159.07 $80.50 $11 40 $176.57 $196.72 $23.39 $33.02 $72.00 $1 63 $754.30 Amount Due $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Page 1 of 4 n 9,, sc3 (02>a hcinc 0. 1 &a- �Y j� lS e W 1 pIl01Yv1- p er'" v_ http. /vpn.clallam.net 8084/ propertyaccess /Property.aspx ?cid =0 &year= 2010 &prop_id =61 1/21/2010 I CIIY OF PORT ANGELES tIGHT DEPARTMENT I N~ 17625 ELECTRICAL PERMIT Port Angeles, washlngton.__.m.t:...-=-~J.::.....mm.......mm......m, 19.r? I In aocordance with the City Ordinance to regulate the Installation, extension, or repair of elec- trical equipment In, on, or about any building or other structure In the City of Port Angeles, per- mission Is hereby granted to dO electrical work as listed below. Address ._-;:;j___i?.__:(7!J!74~<n---mnn--.........-- OccupancY__T"",.".1?~m__n__""hm... Owner __m.__m.~m..UZ.~.m.mm..nm.m-menantm.----m.m--....---...--h----m--m-mm._m..m__mm____ Wiring C;ntractor(~C,.':':I.e.-<'.Z'~.~~:.:~m.-n--~ By..........._.__.mmm.m__mmnm..__m___...._h_...._...__ . v ;;J CJ /cJ 0 / cf' c,L 6 Ll'ght Outlets_n..........m....._........._.._..... Service, volts .........._...................._....... Type or Wiring: Receptacle outlets__..~::?....._........ No. wires .....;!............_.--.u7..~.... Armored Cable .........___m........_.____ D KW ~ Si I ye/O tfJ-{/ Non.Metalllc ............------...........--.. rye'. ............/.___..:;I.__.----.---.....nn-- ze w res.../a~.;--A...;---....--.-.. ~ .~ f/ Knob & Tube...mn..........m..........._ Rcpge, KW....._......___n__...__.__nn__n__..._. Main fuse ..~__.........__.__n............... Water Heater:9; /' Enclosure ____.S;.....________....__........ Kw.n.....------JE---2 ___...__.__.__.______ Type of wiring: Hdat: KW....../..C ........___. ......mm... Entrance Cable __....m_ ..n.............. Motors size VOlts;md phase Rigid ConduIt ..........m.. ...--i~--.I-LL.-- ..__ . __:. ...... Metamc Tubing ....------ --....---------- Rigid Conduit ........_..........__.......... Metallic Tubing m.........m............ Circ~:~;~:~~:t'";t:.:.....:........::~...::.. Current transformers: No. & Size.............._.............. ::tge ..~:~~~~~:::::~:~~~~~:~~~:::~~:~:~::~:: ~ Water Heater ~m.m.......m......... SeT. No............................................... Motor .---.........................-.............. Se,. No. .......---..............-------............. ~:,:~~~~:::::::::::::::~::::::.::~::::~ SeT. No.............................................. ~ / Total Load....___..___................. Se'. No. .____.___.............___...........__....... Tot:l 0....__<:::'__..____....._______... Remarks: ......n_..n.m.~~_~.n_.___...~.~!.c......__._.........m.............................m..m.......:.m.... , -....--..-.-----.--.-.------.--...---------------.--.-.----.----.--..-....---.-.-..-....-.-----.--.-.....-..-.----.-.-----....-.-.--------------.--.------------......---------. .;~~i~~...~nm.......m.nhn;~~~~:.~~~~;~~....-..........mmm..m....m:"'2~.~l<~'lI~&..-A~... $.,...,.=<..t...L?............... No............................. By ..._~...........'lf;;...~....~....__.mm'm~..."\____" / / NOTICE-Current must not be turned on until Certificate of Inspeetion has been issued. If work is to be con. ceq.led due notiee must be given the Inspector so that work may be inspeeted before coneealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION N~ 1 7 6 2 5 ELECTRICAL PERMIT Adllress.........._........_.............................................................................__............__......................Date..._......_.._.._.._........---......-......-......... O"l\.ner.......................__.....---.._......_.._......_......____...........................................................Tenant.................._.....................-........................... Wiring Contractor....................................-........................................................__........................... Hy.............................................................. NOTICE-Current must not be turned on until Cert1flcate of Inspeetlon has been issued. If work Is to be con. ... "eeqled due notice must be given the Inspector so that wOTk may be Inspected before eoneealment.' \ ' 1M Olympic Printers, Inc.