HomeMy WebLinkAboutBLD2024-00180 Cancelled DEMO - BLD Application - 9/4/2024 CANCELLED
coU�T� MASON COUNTY PERMIT NO. I�
COMMUNITY SERVICES DEPARTMENT
BUILDING.PLANNING•FIRE MARSHAL
WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352RECEIVED
Mason County Bldg.#8,615 W.Alder St (360)275-4467 Belfair ext. 352
xs� Shelton,WA 98584 (360)482-5269 Elma ext. 352 FEB 0 9 2024
DEMOLITION PERMIT APPLICATION 615 W. Alder Street
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Mark Churchman NAME:4 SEAS ENTERPRISES
MAILING ADDRESS:414 Kingsway NW MAILING ADDRESS:PO Box 2343
CITY:Bremerton STATE:Wa ZIP:98312 CITY:Gig Harbor STATE:WA ZIP:98335
PHONE:N/A CELL:509.670.2453 PHONE: CELL: 253.606.5272
EMAIL:Markmorrischurchman@msn.com EMAIL :
L&I REG#FOURSE 132CP EXP.
PARCEL INFORMATION:
PARCEL NUMBER (12 DIGIT NUMBER) 12305-21-00102 FIRE DISTRICT
LEGAL DESCRIPTION (ABBREVIATED) PCL 2 of BLA#21-24AF#2178634&REV 1 AF#21484587 PTN OF GOV LOT 2
SITE ADDRESS 132 NE Tiger Lake Rd W CITY Belfair
DIRECTIONS TO SITE ADDRESS:N. on NE Tiger Lake Rd W. approx. 800'to 130/132. This is from Bear
Creek/DeWatto Rd.
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% YES[] NO ❑
IF YOUR PROJECT IS LOCATED ADJACENT TO OR WITHINANAREA 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.)
Vacation Cabin
HOW WILL THE DEBRIS BE DISPOSED OF?:
Loaded into long dump and hauled to WM facility
PROVIDE A PLOT PLAN INDICATING LOCATION OF STRUCTURE TO BE DEMOLISHED
a7m.
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
INSP ,CTION.IN�TIVITY�iF IS PERMIT PPLtCA N OF 180 DAYS WILL INVALIDATE THE APPLICATION.
x ,(% 1-19-24
Signature of Applicant Date
xMark Churchman ✓-JOWNER/M REPRESENTATIVE/ ✓❑CONTRACTOR
Print Name
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
1Vl oyG Coy CANCELLED
1 ggGION CL q! Olympic Region Clean Air Agency
2940 Limited Lane NW
° 1G Olympia,WA 98502
(360) 539-7610•FAX(360)491-6308 Demolition Permit
�! South Bend Office(360) 942-2137
; 'A ;" Port Townsend Office(360)338-6419
www.ORCAA.org
•J fff M, �
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 website.
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.
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