1105 14TH ST 2016-09-14 - Laserfiche WebLink

1/22/2015 Approved Transaction psclean air.org Puget Sound Clean Air Agency ;2 ' L( O Notification Case #: 201500261 I- -- v 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 # VSYFCA491901 Transaction Date 01/22/15 Owner's Name Port of Everett Phone (425) 922-8032 Project Street Address 1105 14th street City Everett Zip 98201 Contact Person Elise Gronewald Phone (425) 922-8032 Mailing Address P.O. Box 538 Everett, WA 98206 This project includes a demolition. Demolition Start Date 02/09/15 Completion Date 06/30/15 Demolition will be completed by a demolition contractor Demo Contractor Clearcreek Contractors, Inc. Contractor Job # Contact Dave Hamacher Phone (360) 659-2459 Mailing Address 3919 88th street ne marysville, WA 98270 (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 Log Out If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. httnc UQ/ i irc ncrlcanair nrn/Achc tnc/Annrn%cH acnv 1/1