2917 PACIFIC AVE 2023-04-25 - Laserfiche WebLink

E • nall P6"6 Arr J4getrty' Notification Case #: 202001274 This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for Inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)). Fee Amount Paid $65.00 Credit Card Transaction # AIDA952157DO Transaction Date 03/13/20 Owner's Name Kaiser Permanente Phone (425) 497-7146 Project Street Address 2930 Maple St. City Everett Zip 98201 Contact Person Rachel Bauer Phone (425) 497-7146 Mailing Address 10230 NE Points Drive *300 Kirkland, WA 98033 This project Includes a demolition. Demolition Start Date 04/13/20 Completion Date 12/31/20 Demolition will be completed by a demolition contractor Demo Contractor NorthStar CG, LP/NCM Contractor Job # 0720124 Contact Amani Moss Phone (425) 881-0623 Mailing Address 8160 304th Ave SE Issaquah, WA 98027 (1) I certify that the information I have provided Is to the best of my knowledge true and accurate. (2) I understand that I must file an Amendment to this Notification If: • The type of project has changed. The project types are asbestos and demolition. • The quantity of friable asbestos to be removed meets a larger project category. • The project's start or completion date has changed. (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Create Another Notification View History Loa Out If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058.