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HomeMy WebLinkAboutBLD2013-01051 Demo - BLD Permit / Conditions - 12/4/2013 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County Bldg. III 426 W. Cedar P.O. Box 279 Shelton, WA 98584 oto RESIDENTIAL BUILDING PERMIT BLD2013-01051 OWNER: HOOD CANAL HOLDINGS LLC RECEIVED: 12/4/2013 CONTRACTOR: O S G DOZING LLC 1.360.705.4319 LICENSE: OSGDOSG967JL EXP: 4/13/2014 ISSUED: 12/4/2013 SITE ADDRESS: 51 E WATERWHEEL PL SHELTON EXPIRES: 6/4/2014 PARCEL NUMBER: 322335090050 LEGAL DESCRIPTION: SUNNY BEACH LOT:A OF SP#2986 PROJECT DESCRIPTION: DIRECTIONS TO SITE: DEMOLITION OF ABANDONED SFR BROCKDALE RD, MCREAVY RD, R ON DALBY RD, FOLLOW TO ST RT 106, TURN LAND THEN R ONTO WATERWHEEL PL TO SITE ADDRESS ON THE LEFT SIDE General Information Construction&Occupancy Information Square Footage Information No. of Bedrooms: Type of Constr.: Type of Use: SF Insp.Area: No. of Bathrooms: Occ. Group: Lot Size: Deck: Type of Work: DEM Fire Dist.: 6 No. of Stories: Occ. Load: Building: Valuation: Building Height: Occ. Status: Basement: Manufactured Home Information Setback Information Shoreline& Planning Information Make: Length: Ft. Front: Ft. Shoreline: Ft. Water Body: Hood Canal SEPA?: No Model: Width: Ft. Rear: Ft. Slope: Ft. Shoreline Desi Side 1: Ft. 9•: Urban Year: Serial No.: I I Side 2: Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Building State Fee GMM 12/4/2013 $4.50 S1201300000001 Demolition Fee GMM 12/4/2013 $ 117.50 S1201300000001 Total $ 122.00 BLD2013-01051 Please refer to the following pages for conditions of this permit. Page 1 of 2 CASE NOTES FOR BLD2013-01051 CONDITIONS FOR BLD2013-01051 1) The demolition and disposal of debris must meet the regulations of Mason County and Olympic Region Clean Air Agency(ORCAA). It is unlawful for any person to cause or allow the demolition (or major renovation)of any structure unless all asbestos containing materials have been identified and removed from the area to be demolished. Work shall not commence on an asbestos project or demolition project unless the owner or operator has obtained written approval from ORCCA.2490 B Limited Lane NW, Olympia WA 98502, 360.586.1044/800.422.5623 www.orcaa.org X 2) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason C n ordinances and building regulations. ' X • i 3) All permits expire 180 days after permit issuance,or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder have 2re ed action from being taken. No more than one extension may be granted. X OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative, or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION,INACTIVITY OF THIS PERMIT APPLICATION F 180 DAYS WILL INVALIDATE THE APPLICATION. ' 12- q t 3 Signature Date Print Name OWNER - REPRESENTATIVE CONTRACTOR (Circle one to indicate) BLD2013-01051 Please refer to the following pages for conditions of this permit. Page 2 of 2 �P9°N cO°"T� !2 MASON COUNTY PERMIT NO. - " DEPARTMENT OF COMMUNITY DEVELOPMENT D1062 I BUILDING•PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 r Mason County Bldg. III,426 West Cedar Street (360)275-4467 Belfair ext. 352 PO Box 279, Shelton, WA 98584 (360)482-5269 Elma ext. 352 DEMOLITION PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: Task, (, i�►-�) NAME: tvv e d Cu.•�aP ��o�c2� Ll.(, NAME: (9 S G �O Z MAILING ADDRESS: t o Z30 NE (30-vkh Dr 4 2r# MAILING ADDRESS: PO Pig>< 2$K 9 CITY: �+ W& d, STATE: WA ZIP:`1 b 033 CITY: ��� ,Y_STATE: _ZIP: C1$65 PHONE:`I1S Sib 330 CELL: 4 VS 922 $�$� PHONE:�bo �05 y319 CELL: 360 'r8q `13ty EMAIL: 'rac(c� wa rh eirK-- Ilc. (o-vn EMAIL : bw% w� Ilia' L&I REG# D SG D cb(r 96-1J7L— EXP. PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) 3 ZZ33 15 D FIRE DISTRICT LEGAL DESCRIPTION(ABBREVIAT D) : vwn (jtad,% Lorc 11 o4 SP 2186, SITE ADDRESS A,+Cr0 -, L CITY DIRECTIONS TO SITE ADDRESS: C c Q MA-P Yid M G av► C�Y"4 B)A +g Si IE; W w iPr v,M tM wA IS PROPERTY WITHIN 200 FT: SALTWATER[v- LAKE❑ RIVER/CREEK[91�POND❑ WETLAND[] SEASONAL RUNOFF[] STREAM ❑ DOES PROPERTY HAVE SLOPE(S) WITHIN 300 FT OF THE PROJECT- GREATER THAN 14% YES[] NO [►}•� IF YOUR PROJECT IS LOCATED ADJACENT TO OR WITHINAN AREA THAT IS LISTED ABOVE, PLEASE CONTACT THE PLANNING DIVISION OF COMMUNITY DEVELOPMENT PRIOR TO DEMOLITION TO ENSURE REDEVELOPMENT. USE OF STRUCTURE BEING DEMOLISHED(RESIDENCE.GARAGE ETC.) fah C� i��P.v�GG HOW WILL THE DEBRIS 13 DISPOSED OF PROVIDE A PLOT PLAN INDICATING LOCATION OF STRUCTURE TO BE DEMOLISHED OWNER/CONTRACTOR acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative, or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INS CT- A-ION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL NVA (DATE THE APPLICATION. G�v J ► I 15 I'y Signature f A lica�t n Dat X G Z LU-wNe ( {ifil>°iy�� OWNER/ REPRESENTATIVE /CONTRACTOR Print Name (CIRCLE TO INDICATE) DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT M oA-1� co o CONCRETE MECHANICAL MANUFACTURED HOME Date By Q w Footings/Setbacks Gas Piping Ribbons 0 CD Interior Date By Interior-Date By Date By n ccn Exterior Date By Exterior-Date B D Set-up Z Point Load/lsaiated Footings INSULATION Date 8y BG 1 SLAB INSULATION Date _ By Data By FIRE DEPARTMENT _ _ Foundation Walls Floors Date By 0 Date By Data By DECKS Z FRAMING walls Date By G) N Date By Daty By PROPANE TANKS r PLUMBING Vault Date __�_ _._ ey n Date By OTHER Groundwork Attic Date By Date By Type. Date By D.W.V DRYWALL Type. C Date By int.Brace Wall Date By W CD v - oIQ By FINAL INSPECTION v N Water Line Fire Separation N m Date By Date By Date By O m W o Pass or Request Inspect. b CD of Insp. Fail Date Date Done By Comments o o q /' J - 7 (L] .O N (D y O v O Q d O w s 3 A 0 � U n� CD 0 �GION CL �^'ti� 2940-B Limited Lane NW Olympia,WA 98502 '4•. ORCAA .,°�; R 1-800-422-5623 • (360) 539-7610 '. Fax: (360)491-6308 ORCAA Permit Application Status Permit Status 0 Approved ❑ Disapproved Notes 13ASB004189- asbestos permit 11/08/13 sears Review Date Reviewed by 13DEM0003634 11 /07/13 Permit# Expiration Date Application Received Amount Due $60.00 11 /07/13 ❑ Cash ❑ Check © Credit card Additional notes or permit conditions Port Angeles Field Office: 116 W. 8th St., Suite 113, Port Angeles,WA 98362: (360) 417-1466 Raymond Field Office:301 Ocean Ave., Raymond,WA 98577: (360) 942-2137 Olympic'Region Clean Air Agency(ORCAA) 2940-B Limited Lane NW Olympia, WA 98502 360-539-7610 1 FAX 360-491-6308 Port Angeles Office 360-417-1466 ORCAA Raymond Office 360-942-2137 www.orcaa.org DEMOLITION PERMIT APPLICATION Demolition and renovation projects within Clallam, Grays Harbor, Jefferson, Mason, Pacific and Thurston counties REQUIRE A PERMIT and require that the following permit conditions be met prior to demolition or renovation. Olympic Region Clean Air Agency (ORCAA) regulations define a demolition project as the wrecking, razing, leveling, dismantling or burning (by a fire department for training purposes) of a structure making the structure permanently uninhabitable or unusable. Renovations include the removing of load bearing structural members, but not to the extent to make the structure uninhabitable. The following information is merely a reference guide and not a substitute for agency regulations. 1.A good faith asbestos survey must be conducted by a certified Asbestos Hazardous Emergency Response Act(AHERA) building inspector. Qualified contractors and inspectors may be found in your local Yellow Pages, through the Washington State Department of Labor and Industries, or on ORCAA's website. 2.Asbestos samples must be sent to an NVLAP laboratory(National Voluntary Laboratory Accreditation Program) per 40 CFR 763.87. A list of labs can be found on ORCAA's website. 3. The start date on other structure demolition must be at least 10 working days from the submission date of the complete application and payment. 4. It is the responsibility of the property owner and/or demolition contractor to ensure there is no asbestos-containing material present in the structure to be demolished. 5.Any and all structures on the same parcel of property that are not proposed to be demolished must be identified as such. 6.A copy of the asbestos survey and approved Demolition Permit, as well as any subsequent amendments, must be kept on site and available for review by Agency inspection personnel. 7. Use the Completion Notification and Amendment Form to make changes to the original permit. 8. The original demolition permit will expire on the Completion Date. To change the completion date, a Completion Notification and Amendment form must be received PRIOR to expiration. If the permit expires and the project is not complete, you must submit and P P P P 1 P pay for another demolition permit. Under no circumstances will a project be extended beyond 1 year from original start date. ADDITIONAL REQUIREMENTS In addition to Agency requirements, most building departments require a demolition permit(separate from ORCAA's Demolition Permit). The Washington State Department of Labor& Industries may also require notification for asbestos removal projects. "Owner Occupied Residential Dwelling" means any single family housing unit which is permanently or seasonally occupied by the owner of the unit. This term includes houses, mobile homes, trailers, houseboats, and houses with 'mother-in-law apartment' or a 'guest room.'This term does not include structures that are demolished or renovated as part of a commercial or public project; nor does this term include any mixed-use building, structure, or installation that contains a residential unit, or any building that is leased or use as a rental, or for commercial purposes. • PROPERTY OWNER Name Mailing address Hood Canal Holdings LLC 110230 NE Points Drive, Suite 200 City ZIP State Kirkland 1 198033 IWA Site address City ZIP 51 E Waterwheel PI Union 198592 FAX Phone number Other contact number Email 425 828 2969 425 576 3380 425 922 8886 ackl@watermark-Ilc.com DEMOLITION CONTRACTOR ❑ check the box if same as property owner information Business/Contractor Name On-site contact OSG Dozing I Brandy Willie E-mail Mailing address City ZIP bmwillie@comcast.net PO Box 2849 loiympia 198057 Phone number Other contact number 360 705 4319 1360 789 9314 DEMOLITION PROJECT INFORMATION Number of structures being demolished 1 Start date Completion date Is asbestos present? 12/02/13 12/31/13 Yes Attach your asbestos survey below Asbestos Survey Report.pdf Has all identified asbestos been removed Yes DEMOLITION PROJECT CATEGORY ® Complete demolition ❑ Training fire- (complete fields below) ❑ Renovation, alternation, remodeling, maintenance or other construction If training fire, provide fire protection agency name, point of contact and telephone number ❑ Owner occupied residential dwelling - Permit fee: $35.00- Prior Notice- Nonrefundable ® Other Structures- Permit fee: $60.00- 10 working day wait period - Nonrefundable ❑ Emergency Fee $50.00- must be accompanied by Government Ordered Declaration (other structures only) Attach declaration below PLEASE MAKE A NOTE OF YOUR FEE. Applicant name Date Jack Lowe 11/07/13 By checking the box and clicking "Submit' at the bottom of this form, you hereby certify that all identified asbestos in the project area has been removed and the information contained on this form and supplemental data described herein is, to the best of my knowledge, accurate and complete. ® I agree ADVANCE ENVIRONMENTAL Good Faith Asbestos Survey Report Located At: 51 E Waterwheel Place Union, WA 98592 Prepared For: WATERMARK Estate Management Services, LLC Prepared By: Todd Venable AHERA Building Inspector Cert. # 13-1280 Exp. 9/12/2014 October 8, 2013 3620 49th Avenue SW 1 Phone: 360-357-5666 Olympia,Washington 98512 Fax: 360-357-5665 ADVANCE ENV/RONMENTAL INC. Asbestos Survey Report 51 E Waterwheel, Union, WA Purpose This good-faith asbestos survey was performed as part of a pre-demolition assessment to identify the presence, location, and quantity of any asbestos- containing materials (ACM) within the demolition area. The intent of this asbestos survey is to comply with governing asbestos regulations required by Federal Standards and with the Washington State guidelines. Currently, the State of Washington requires a "good faith inspection" for the identification of asbestos- containing materials prior to any remodeling or demolition work. The survey is required to be performed in accordance with 40 CFR 763.86 and WAC 196-62- 07721. These federal and State standards require inspections to be conducted by an EPA Accredited Building Inspector with analysis to be provided by an asbestos laboratory certified by the National Bureau of Standards. All survey work was conducted in compliance with the standards mentioned above. 6enero/ On October 3, 2013 Todd Venable, AHERA accredited building Inspector, of Advance Environmental, Inc., conducted an inspection for suspect-ACM of the two story residential structure located at 51 E Waterwheel Place, Union, WA. At the time of inspection, the structure was partially overgrown by surrounding vegetation & appeared to have been vacant for many years. The structure is currently in very poor condition & is scheduled for demolition. Building Description Residential Structure Building Type Residential / Two-Story Exterior Wood Siding, Sheet Metal Roofing, Wooden Framed Windows Interior Wood Interior Walls, Wood Floors with Sheet Vinyl & Vinyl Tile Floor Coverings, & Wallpaper Wall Coverings 3620 49th Avenue SW Phone: 360-357-5666 Olympia,Washington 98512 Fax: 360-357-5665 ADVANCE ENVIRONMENTAL INC. Asbestos Survey Report 51 E Waterwheel, Union, WA Sampling Objective The sampling objective was to determine the quantity and locations) of asbestos containing materials in or on the structure prior to demolition. There were nine suspected ACM's or presumed ACM's in or on the structure, at the above referenced property and thirteen samples were collected. Sampling Protocol This asbestos building survey was adapted from the Asbestos Hazard Emergency Response Act (AHERA) protocol outlined under 40 CFR 763. The protocol is as follows: Sampling Procedure -Spread the plastic drop cloth (if needed) and set up the other equipment, e.g., ladder. •Put on protective equipment (respirator and protective equipment if needed). -Label sample container with its identification number and recording number. Record sample location, and type of material sampled on a sampling data form. -Moisten area where the sample is to be extracted (spray immediate area with water). -Extract sample using a clean knife, drill capsule, or cork-boring tool, to cutout or scrape off approximately one tablespoon of the material. Penetrate all layers of the material. -Place sample into a container and quickly seal it. •Wipe the exterior of the container with a wet wipe or remove any material, which may have adhered to it during sampling. *Clean tools with wet wipes and wet-mop or vacuum area with a HEPA vacuum to clean all debris. -Seal the sampling location with caulking compound, spackle, or duct tape. -Discard protective clothing, wet wipes and rags, cartridge filters, and drop cloths into a labeled plastic waste bag. 3620 49th Avenue SW Phone: 360-357-5666 Olympia, Washington 98512 Fax: 360-357-5665 ADVANCE ENV/RovmENTAI. /Nc, Asbestos Survey Report 51 E Waterwheel, Union, WA Laboratory Analysis The bulk ACM samples are analyzed at Seattle Asbestos Test LLC, 19711 Scriber Lake Road, Suite D, Lynnwood, WA 98036 using polarized light microscopy (PLM) with dispersing staining in accordance with U.S. EPA method 600/R-93-166 as specif led in 40 CFR Chapter I (7-1-93 edition) Part 763, Subpart F, Appendix A, pages 499-504. Polarizing light microscopy quantifies asbestos concentrations at between 100% - 1% detection levels. Level below 1% can be stated as "ND". For samples containing more than one separable layer of materials, the report will include findings for each layer (labeled -1 for layer one, and -2 for layer two, etc.) and a total percentage for the entire sample. The asbestos concentration is determined by visual estimation. For those samples with asbestos concentrations between one and ten percent based on visual estimation, the EPA recommends a procedure known as point counting (NESHAPS, 40 CFR Part 61). Point counting is a statistically more accurate means of quantification for samples with low concentrations of asbestos. Point counting will only be performed at the owner or owner's agent request. Sample Table Sample Location of Friable Asbestos Material Condition Yes/N Number Samples Content 0 1 Window Glaze Metal Framed Poor NA N.D. Window 2 Window Glaze Wooden Framed Poor NA N.D. Window 3 Ceiling System Living Room Poor NA N.D. 4 Sheet Vinyl Kitchen Poor NA N.D. 5 Insulation Utility Floor Poor NA <1% TremoIite 6 Insulation Utility Floor Poor NA N.D. 7 Sheet Vinyl Stairway Poor NA N.D. 8 Vinyl Tile Bathroom Poor NO 2% Chr sotile 9 Ceiling Tile Bathroom Poor NA N.D. 10 Sheet Vinyl Entry Poor YES 50% Chr sotile 11 Wall Paper Bedroom 2 Poor NA N.D. 12 Wall Paper Bedroom 3 Poor NA N.D. 13 Wall Paper Misc, on floor Poor NA N.D. Samples 8 & 10 tested positive for asbestos content. All other samples collected, tested Negative (or less than 1%) for Asbestos Content. Materials containing less than 1% asbestos content, are not considered to be ACM (Asbestos Containing Materials). 3620 49th Avenue SW d Phone: 360-357-5666 Olympia, Washington 98512 Fax: 360-357-5665 ADVANCE ENwRONMENrAL /Nc. Asbestos Survey Report 51 E Waterwheel, Union, WA Quantif ication Table The following table indicates the approximate quantity of asbestos containing material identified in the structure. Snm Numbers Material Location of Material Approximate Quantity 8 Vinyl Tile Bathroom: on wood 20 square feet 10 Sheet Vinyl Entry <1 square foot Recommendations A copy of this report must be provided to any employee or contractor conducting renovation or demolition activities at the subject property. Regulated ACM are required to be handled in accordance with Washington State Regulations prior to any demolition, renovation, or remodeling that would disturb these materials. Washington State Department of Labor and Industries require that the abatement be performed using Certified Asbestos Workers under the direct on site supervision of an AHERA Supervisor. The only exemption of this is for residential owners performing removal of asbestos materials other than furnace interiors, or direct applied mudded asbestos insulation. The requirements for handling, packaging, and disposing of asbestos-containing materials can be found in WAC Chapter 296-62, Volume I, Part I-1. ACM with less then the regulated level of one percent asbestos is not required to be abated by certified asbestos workers or abatement contractors. However, ACM with less than one percent asbestos does require all workers to have Asbestos Awareness Training prior to handling or abatement work. Washington State Labor and Industries regulations regards ACM material with less than one percent asbestos as a health hazard because it is possible that total exposure levels for workers will exceed the Permissible Exposure Limit (PEL). Personal air sampling is a requirement for the first day of the abatement project to ensure that the exposure levels are below the PEL. Precautions should be taken to ensure worker protection and abatement procedure should include engineering controls to limit workers exposure concentration (i.e. wet techniques, half-face respirator, protective clothing). 3620 49th Avenue SW Phone: 360-357-5666 Olympia, Washington 98512 Fax: 360-357-5665 ADVANCE ENVIRONMENTAL INC. Asbestos Survey Report 51 E Waterwheel, Union, WA Conclusion Asbestos surveys are non-comprehensive by nature and subject to many limitations as described below. Our assessment has considered risks pertaining to asbestos, however, this survey is limited to only those locations sampled. This survey was not designated to identify all potential concerns or eliminate all risk associated with potential asbestos containing materials (PACMs). Evaluation of other risks, such as toxic and hazardous substances in (or in contact with) soil and ground water, structural, electrical, mechanical, radon gas, slope stability, building settlement, moisture, or site-drainage/flooding, have not been included. No warranty, expressed or implied, is made. The site visit consisted of a through visual walk-through of the subject area for the purpose of viewing and sampling PACMs. Advance Environmental Inc. is not responsible for materials, which require destructive means to access, or materials that are hidden from sight, those materials hidden behind walls or materials, which cannot be found with reasonable diligence. Advance Environmental Inc. performed this survey in accordance with the generally accepted standards of care in the sampling profession in Washington State at the time of this study. This asbestos survey was performed in preparation for a demolition of the subject structure. Advance Environmental Inc. Todd Venable Advance Environmental Inc. AHERA No: 13-1280 Expiration bate: September 12, 2014 3620 49th Avenue SW R Phone: 360-357-5666 Olympia, Washington 98512 Fax: 360-357-5665 ADVANCE ENV/RONMENTAL INC. Asbestos Survey Report 51 E Waterwheel, Union, WA Appendix A: Laboratory Results/ Documentation 3620 49th Avenue SW 7] Phone: 360-357-5666 Olympia,Washington 98512 Fax: 360-357-5665 ADVANCE ENV/RONMENTAL INC. Asbestos Survey Report 51 E Waterwheel, Union, WA Appendix B: Photos Sample # 8 Floor Tile / Bathroom _ h1� 1 Sample # 10 Sheet Vinyl / Entry 3620 49th Avenue SW Fq I Phone: 360-357-5666 Olympia,Washington 98512 Fax: 360-357-5665