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Home My WebLink AboutBLD2016-01100 DEMO - BLD Permit / Conditions - 11/9/2016 Inspection Line (360)427-7262 A� �� MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County 615 W Alder St Shelton, WA 98584 'k`� RESIDENTIAL BUILDING PERMIT BLD2016-01100 OWNER: SPOCK LLC CONTRACTOR: LICENSE: EXP: RECEIVED: 11/9/2016 SITE ADDRESS: 191 E NORTH BAY RD ALLYN ISSUED: 11/9/2016 PARCEL NUMBER: 122205022008 EXPIRES: 5/9/2017 LEGAL DESCRIPTION: ALLYN BLK: 22 LOTS: 8-9 &VAC PTN SHERWOOD AVE 10'WIDE ADJ PROJECT DESCRIPTION: DIRECTIONS TO SITE: DEMOLITION OF SFR FOLLOW NORTH BAY RD TO SITE ADDRESS 191 E NORTH BAY RD 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.: 5 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: Rear: Ft. Slope: Ft. SEPA?: Model: Width: Ft. Side 1: Ft. Shoreline Desig.: Year: Serial No.: Side 2: Ft. I I Comp. Plan Desig.: Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Building State Fee GMM 11/9/2016 $4.50 S1201600000001 Demolition Fee GMM 11/9/2016 $ 117.50 S120160000000i Total $ 122.00 BLD2016-01100 Please refer to the following pages for conditions of this permit. Page 1 of 3 CASE NOTES FOR BLD2016-01100 CONDITIONS FOR BLD2016-01100 1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are of risks a pemonetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-80,ql-p Th son signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X CO- 2) 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 refn ved from Pe area to be demolished. Work shall not commence on an asbestos project or demolition project unless the owner or operator as ined i approval from ORCCA.2490 B Limited Lane NW, Olympia WA 98502, 360.586.1044/800.422.5623 www.orcaa.org 3) All building permiV' es ve a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to reques a f' or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mas o orand building regulations. X 4) All permits expire 180 days aft r permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for pe of ex a ing 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit hoIII a ente n from be ng taken. No more than one extension may be granted. X BLD2016-01100 Please refer to the following pages for conditions of this permit. Page 2 of 3 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 fo a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT A PLI ON OF 1 7DAYS WILL INVALIDATE THE APPLICATION. c Signature Date OWNER - REPRESENTATIVE - CONTRACTOR O Print Name (Circle one to indicat BLD2016-01100 Please refer to the following pages for conditions of this permit. Page 3 of 3 r i6[or Olympic Region Clean Air Agency 2940 Limited Lane NW °� �.•.� 1 *'` Ol i WA 98502 ' ymp"a, (360) 539-7610•FAX(360)491-6308 South Bend Office(360)942-2137 Demolition Permit yt, Ia RCA A Port Townsend Office(360)338-6419 s` www.ORC A.org I ] Ow►mr occupied residential dwelling-Permit fee: $36.00-Prior Notice-Nonrefundable �Q Other Structures-Permit fee: $61.00-10 working day wait period -Nonrefundable [ ] Emargency Fee$61.00-must be accompanied by Government Ordered Declaration (other strvcturesonly) PROPERTY OWNER Name: S 1 L-! Phone:_ Cs( ,� Email Mailing Address: Cite: State: zip: Site Address: � �� City: Count}. Count}=: �w / Zi Z tC r" u�1e DEMOLITION CONTRACTOR Check if same as roperty owner information. Business Name: Phone: ( Email: '0 �M4 Onsite Contact: Phone: ( ) Email: �y 34&0 -001-E, �7 ,4zV& D !CC 36-i Ma �Xs. City: / 2 State: Zip: C��L Gt1,A- DEMOLITION INFORMATION #of structw-cs being demolished: Start Date: Expiration Date: Asbestos present? [ ]Yes [ ]No Survey attached? [ ]Yes [ ]No Has all identified asbestos been removed? Yes No DEMOLITION PROJECT CATEGORY (jQ Complete Demolition [ ]Training Fire—Fire Agency,Contact,Phone: Renovation,Alteration,Remodeling,Maintenance,or other Construction I do oertify that I am the owner,authoda d agent of the owner,or authoria d contractor for the property subject to this ORCAA application1permit. I authorize ORCAA staff to enter the property listed in this application at reasonable times for purposes of inspecting the work that is the subject of this application/permit and to ensure oompliance with permit conditions,applicable laws and regulations. I understand that granting of this permit by ORCAA does not authorm anyone to violate federal, state,or local laws or regulation pertaining to activities associated with this permit. I haee read and wi II abide by the conditions set forth in this permit and any addendum thereto. I do certify under peralty of perjury under the laws of the state of Washington that the in on in isap lication and supplemental data is,to the best of my knowledge true,accurate and complete. Applicant Name Signature Date Date Application Received Payment Info. [ ] Approved Asbestos Permit [ ]Cash [ ] Disapproved Permit# ASB00 [ ]Check: # Demolition Permit [ ] Credit Card Review date:_/_/_ Pcrmit# DEM00 Receive date:_/_/_ Reviewed by: Ageng Ure Omb Agmy Ure O ,1gemy Use On A Use Oob 07/16 OVER I w 1QN Olympic Region Clean Air Agency 2940 Limited Lane NW Olympia,WA 98502 (360) 539-7610•FAX(360)491-6308�aA South Bend Office(360)942-2137 Demolition Permit o R CA A Port Townsend Office(360)338-6419 www.ORCAA.org �-��nncesoe•w� :.. Demolition and renovation projects within Clallam,Grays Harbor,Jefferson,Mason,Pacific,and Thurston counties REQUIRE A PERMIT and require that the following conditions be met prior to the demolition. 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 is required for any demolition.The 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 websitc. 2. Asbestos samples must be sent to a 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 demolitions 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 must be kept on site and be available for review by Agency inspection personnel. 7. The original demolition permit will expire 1 year from start date.If the permit expires and the project is not complete, you must submit and pay for another demolition permit. Under no circumstances will a project be extended beyond 1 year from original submission 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 and the local fire authorities 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 both prior to and after the proposed project.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 used as a rental,or for commercial purposes. 9� °p4y t ,,pA rf MASON COUNTY PERMIT NO. goI IU - D I Ibn COMMUNITY SERVICES DEPARTMENT BUILDING a PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 Mason County Bldg.#8,615 W.Alder St (360)275-4467 Belfair ext.352 asr Shelton,WA 98584 (360)482-5269 Elma ext.352 DEMOLITION PERMIT APPLICATION r OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: S'PO' LLLa NAME: MAILING ADDRESS: E, 9 MAILING ADDRESS: 60, QdX 1� CITY:,dCLr�.L/Z STATE:_ZIP: CITY: Z STATE:-.I(/A- ZIP: _ PHONE: CELL340-25W-- PHON CELL:360-80/-6 02 EMAIL: EMAIL : 6 N ,6WW L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) FIRE DISTRICT LEGAL DESCRIPTION(ABBREVIATED) gtK: ;-1Lt4 F, SL�fS?X D GB ice€ SITE ADDRESS , A[0W_ "'f 9 CITY DIRECTIONS TO SITE ADDRESS:_4W& _Z 7-* V /ZZ AAl/eeJhZ;-eE60n�Y boa' yes vim! !�� IS PROPERTY WITHIN 200 FT: SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND[] WETLAND[] SEASONAL RUNOFF[] STREAM ❑ DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT- GREATER THAN 14% YESXNO ❑ IF YOUR PROJECT IS LOCATED ADJACENT TO OR WITHIN AN AREA THA T 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.) HOW WILL THE DEBRIS BE DIS130SED OF? PROVIDE A PLOT PLAN INDICATING LOCATION OF STRUCTURE TO BE DEMOLISHED SSE s64f 257T 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 corlstrLJC rk is susp ed fora period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECT .1 rVI,IVITY S PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. Signature of Applicant Date x 4eyt1s OWNER REPRESENTAO iNDICA ONTRACTOR Print Name tF `MtTMP I'll.RRi iE1 .:; t 1 Ii 1'I'I 1 bAlk U BUILDING DEPARTMENT PLANNING DEPARTMENT