304 Longmire ORCAA Permits01116/2007 17.09 FAX 980 491 8909 ORCAA
01/W7 FP" 960 491 6308 ORCAA
JAN 18 2007
OlYh*lc Region Clean Air
2940 -B Umltod Lone NW
Olympia, WA 98502
(360) 586 -1044 or 1- 500 -42
Q"l--Jy�N =0lLdq
PEERRMIII'*
AP RMI) r V
CONDITIONALLY APPROVED
NOT AP'PAOM
WftGMPUAN01 m+
ORCAA FIEGUL
er:
Fax; (360) 491 -6308 www,ORCAA.org
wj V V , .. i
Notification of Demolition permit
It is unlawNl for any peretun to cause or allow the dematitlujI (or major 1'enuvation) of any structure unlwy all asLestos�
cv"tAllLk ttrwter OU lt»ve been removed from tae ama to be demolished. Wurk shnU not cumrranca an an asbodebC project
or delgelitioll aullxe the owner or operator haw obtabied writtmlt uppreval from 011CAA, A wrlttua appgeatiaa for a
d ructtiiusl ahap include a coy "tltitation !hat olat is no known ttsheat-0s�onta3ltlrtg matcriul IvMflining in tDe area of the
etractarrn.
Frgjoct Sitb ,4ddross: 3o+ I--0 W
City: � 1
Slatting Date:
..rcompletiou Data: _ 200
('!"b— ie a l0 wvdeing dbr advance r►otificat'ron ; nrio4 from trooeipt of peantt yppiieatiouJ
Propalty Owner: tT S 'rte r
Ma>1tuE ^�, �r rt y, ! TelepLLQuc' '3 (PO `�9 — 2- 722�ax: 3 fa 0' 4-00 2-7 Z+
Adciress'���j �,,� 47-2-
City,^ Sklo:_ win,
Dba>alitioll CvritYaolpY ,Z lei State Lioanao ?t;�
Mailing Addret39 :_,_�Ct��S��..1��..._^.!!,�'
St®teL. —...�_
Contact Pemon;
YES NO 25�� --h' Fax; e
,�— DvivalltioM by WVreokirlf; or 1 ")ismaKiLi>z 2S.OU fas eGocic �I, hreft►ndable
Tt-aining Fire Decrtvlitian'1 (If yd5, attuah rtr c, 0maent irgiaeNt far traitticlg fire)
RunovtKion, Alteratit;a, Remodeling. Meiptenanoc, or o' tr Construciioa?
Asbe9tosfvmnd or su9pcetvd -, jAc56eSE05
�Aft ORCAA 'Notice of lnlenr la 1t11bOVC or jrarApsulnic Arlrustae•l fum and aippeopHtW Pee a,usr ba aubmiltcd prior to ally oe6eata
rarnovol work Aobaotou rontwrl prl+Jaal# inVOtvblq 40111OU60A Inuit ho prof a7nad by u Csrriftod Adbcatoo Cantmator Uml all C'ialdv or
PMndalty liiablc osbeetol muot be xrnoved befum uny de=1i600 begins. DdCar to OFt^„AA Regulat4ya i Artiulo f4 far uI('i4o11DL
requirvmanto rhni rr,a-e upply.
Asbestos Survey Cumplute(l by
A)tPLA Clerkiiled lfgaipectur.
LQ
CErtificailnn #_OT C' uA 0 10(1+0 1 (2
Et Cer0cadlotl ol'Me Asbtslaq 9urvay must lable atthn,iob wilt, ProceseingPoo a,scomputy this fame
K1.]VtTrrnml�urbo torlDornoPamiCdoo 6w, rlTC: PA�l [ e
p V
TA/10 39VA wo SWJ bzLZe9'C99E 7S -TO L09Z /5T /T0
TO /TO 3E) d doo Pioii :) disriOc) Sm9 vzzz"OOb09 6S:EZ LOOZ /TZ /TO
01/18/007 17:09 FAX 360 491 6308 ORCAA
01/ 360 491 6308 ORCAA
" JAN 18 2007
12001/001
APPROVED /,IK,C? -1
CONDITIONALLY APPROVED
01YM01c Region Clean Air Ag NOT APPROVED - --
2940 -B Umited Lane NVI/ OMPLIANCE irM
01ympia, WA 98502 DRCAA REG TL=2.V
Br-
(360) 586 -1044 of 1-800-4224M)23
Fax' 364
( ) 491 -6308 www,0RCAA.or2
>Yt a Notification $ Demolition �
ttztlaxrful for e �A De Pe m' it`
ountablin Y p r8on t0 cause or 2119W the desnaLitia]° (or major
repoVBtion o
1ru►tewNel, lh C been removed from the area bo be demallshBd, Wark s � f any atruCtUre unless all asLeytos�
or dent olft at Onitss the owner• or operator has o 41hed WVIften Upl)rowal froth 012 commence an an ashe�eoe project
demoGfion ahaA include a eerUrieation Lha.t tl °ere is no konmt ashen '�'°� wrlttbn npi�Nlcation foe- a
Prgjac ton- coutaining taatoripl ►•emaining in the area of the
l'[0)tict u4'1tb'4Sl�rC}S9: � '
City: �"U��'Tp �-, >1 covnty:- ` - v13
Starting Date: S�atc:.__ 1/l/ Lq
*(Thum is a 10 working day advance comple"4011 ]date:
proPelfiy Owner: r aati�ication :.wi f� i.QM roceipt of permit application)
, ° TeIE hone;
Mailing Address__ f��
n fa a ,F Do 2,7 fi t' ax: 3 Q I'P_ 0 -- --7 z -
C #t 2'2-
Db�ol�tioil Cotttraot0r, L j r
Mailiag Address• G7 State 1.irmiac
City; _�-
Contact Persotl: (� States_
.YES �� � ��--. ,.tdL`Taaepllor<4� 'L53 �'.� -� Zip:� 0
�4— Demolition by `4�Vrockixtp or ]'9ismanEtin ', '25.00 fac �fiack }I. _._,___t,oy�t-ef�u•,dabte
Tmiaing rice Dernolition7 (If yds, attach is c
lternov;stipq, Alteration, Rexr�pdelin r 'partrnent requcrt for traittirig tire)
,g, Ma,Dtenmlce, or of tr Constru.ctioll?
--..— Asbestos foaudl or &lxepected- �%2�?5 pew-:
An ORGA.L °Notice of Intent la Remove ar Laacspsulnlc AYbestoa" a Per �(� _ �-L7
farm and a ro
romovpl work Aebaatau mrnavol prOJm,%tQ inYOtVI PR Anbto Yee must be gUbmihcd prior to nny ablkb °GA
porenCially friabic asbnst 4t�mOlitiori InW ho prcfomcd by a Cercifled Aa6cutoa Cansrecror said 11 l9•iablo nr
06 rrtu8� be rrnfoupd before any detnalitica, balms. Aafar Zn ORCAA Regufatinn !Article Iq far g zblunEl
�o4'lil C nts thai may eippiy,
Asbestos Surveil CoInpieted by
ATIER 1 Certitlscl Ynspector
Certificatiol1 # p- "; r f � c1
T'(sie spprbvQd 1�nrntie tnuai
ba available at th�,iob 9iLe
IT -hag"m e25
PrOcesslug Fee
Certificudol] of the Asbesles Survey must
aceompally thin fvmt
N7: 1CO1ufMf .1]VU- rrrcnlaludbp� {o9lDornoP oG � G;'����"a'"
p�
3l fs�'
CK N0. �
Z0 /T0 30Vd NCO Naii :DnNisN[ 'o SwJ
bZLia00!b 03£
i's :TO 2- 90Z/5T/10