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Home My WebLink AboutCOM2012-00062 Final Demo of Olympic Federal Savings - COM Permit / Conditions - 6/20/2012 s -.-qa 1 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Phone: (360)427-9670, ext.352 Ir Shelton, WA 98584 P14 COMMERCIAL BUILDING PERMIT COM2012-00062 OWNER: FIRST OLYMPIC HOLDINGS RECEIVED: 5/9/2012 CONTRACTOR: LICENSE: EXP: ISSUED: 5/9/2012 SITE ADDRESS: 21 NE STATE ROUTE 300 BELFAIR EXPIRES: 11/9/2012 PARCEL NUMBER: 123294200190 LEGAL DESCRIPTION: PCL 4 OF BLA#01-21 PTN OF NW SE SURVEY 26/167 & 168 PROJECT DESCRIPTION: DIRECTIONS TO SITE: DEMOLITION OF EXISTING OLYMPIC FEDERAL SAVING ST RT 3 TO BELFAIR, L ON ST RT 300 TO SITE ON THE LEFT SIDE BANK General Information Construction&Occupancy Information No. of Units: Type of Constr.: Type of Use: BANK Insp.Area: No. Type al uation: of Bathrooms: Occ. Group: Val Work: DEM Fire Dist.: 2 No. of Stories: Exit Design. Load: Building Height: Pre-Manufactured Unit Information Square Footage Information Make: Length: Lot Size: Model: Width: Building: Year: Serial No.: Basement: Parking Spaces: Setback Information Shoreline& Planning Information Front: Ft. Shoreline: Ft. Rear: Ft. Slope: Ft. Water Body: Shoreline Desig.: Side 1: Ft. SEPA?: Comp. Plan Desig.: Side 2: Ft. Fire Protection System Information Auto Fire Alarm System?: Emergency Key Box?: Standpipe?: Auto Fire Sprinkler System?: Access Road?: Fire Extinguishers?: Fixed Fire Suppression System?: Fire Hydrants?: Fire Lanes?: Please refer to the following pages for conditions of this permit. COM2012-00062 Page 1 of 4 'r '„'1 Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Building State Fee moon rl/Qnm 9 ae Fn qt 9ni 9nn Demolition Fee r.mu s;1Q19n19 al17 rn Rignignn Total $122.00 CASE NOTES FOR COM2012-00062 CONDITIONS FOR COM2012-00062 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 potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800-647-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X �- 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 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 3) 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 Cou inances and building regulations. X 4) 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 prevented action from being taken. No more than one extension may be granted. X COM2012-00062 Page 2 of 4 This permit becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for re iew and inspection. OWNER OR AGENT: DATE: S COM2012-00062 Page 3 of 4 n O �1 K CONCRETE MECHANICAL MANUFACTURED HOME Date By N Footings J Setbacks Ribbons o Gas Piping o Interior Date By interior.Date By Date By r— NExterar Date BY Exterior-Pate___.._.__._- By Set-up ic Point Load!Isolated Footings INSULATION Date By lu Date By Data SLAB INSULATION By FIRE DEPARTMENT = Foundation Walls Floors Date By 0 r Date By Data By DECKS 0 FRAMING Walls Date By Z Date By Data By PROPANE TANKS � PLUMBING vault Date By Date By OTHER Groundwork Attic Date By Date By Type- Date By D.w.v DRYWALL Type- 0 Date B Int.Brace Wall Date By 0 y Date By IV FINAL INSPECTION Water Line Fire Separation Date By Date By Data n•—� ��/� By C Pass or Request Inspect. Q Type of Insp. Fail Date Date Done By Comments IN, n� 0 .A I 1�gg61ON CLAD, Olympic Region Clean Air Agency 2940-B Limited Lane NW / Olympia,WA 98502 Port Angeles •FAx 0)41 -146691 08 Demolition Permit Port Angeles office(360)417-1466 �rORCAA Raymond Office(360)942-2137 w . U. ,Mop www.ORCAA.org [ ] O ner occupied residential dwelling-Permit fee: $35.00-Prior Notice-Nonrefundable IL41Other Structures-Permit fee: $60.00- 10 worldng day wait period-Nonrefundable PROPERTY OWNER Name: Phone: Email: E&L D i djn FAX: -] -5 .7 Mobile: S- Mailing Addre s: Ci S t Zi P P C�' u Zip: oi,elAddress 'w I� 3� Ci / t" SAt Zt e DEMOLITION CONTRACTOR Check if same as property owner information B}}Iiness Name: Phone ']- Z Email: K h I J-r�rn Onsite Contact: Phone: - Z, Mobile: 13 n nA P�-I e FAX: (y D(e- $b Mailin Addres : City: State: Zip (l 34. F2 S4_ 7Z(C4'rul W �l d�{ DEMOLITION INFORMATION #of Structures being demolished: I _T Start Date: Completion Date: r/31/ram Asbestos present _ es _No Survey attached _Yes _No Has all identified asbestos been removed Yes -No— DEMOLITION PROJECT CATEGORY [ Complete Demolition ( ]Training Fire-Fire Agency: [ ]Renovation,Alteration,Remodeling,Maintenance,or other Construction Emergency-Additional Fee of$50.00 must be accompanied by Government Ordered Declaration-Commercial only) I have read and will abide by the conditions set forth in this permit and any addendum thereto. 1 do hereby certify that all identiFled asbestos has been removed and the information is this application and supplemental data described herein is, to the best ofmy lavowledge,accurate and complete. "4 4)�Pn, Applicant Name Signature Dite Date Application Received Payment Info. [ ] Approved Asbestos Permit [ ] Cash [ ] Disapproved Permit# ASB00 [ ]Check: # Demolition Permit [ ) Credit Card Review date:_/_/_ Permit# DEM00 Receive date:_/_/_ Reviewed by: Ageng Use On! Agent),Ure On!, A en Use On , A en ,Use On 08/11/11 OVER Olympic Region Clean Air Agency 2940-B Limited Lane NW ` Olympia,WA 98502 Commercial 1 (360) 539 7610•FAX(360)491-6308 cA�� Port Angeles Office(360)417-1466 Asbestos Permit iz. . Raymond Office(360)942-2137 www.ORCA-A.org Commercial Structure [ ] Owner Occupied Residential Dwelling 10 Working Day wait period Prior Notice PROPERTY OWNER Name: Phone: gSrJ— Email:- Fi 64- D( rn )c- t�p j d, FAX: Mobile: ) Mailing Address: City- State: Z' PO t3 aq'7 (fir u>'�N— M+ 9�ir33S Site Contact Person: Ph ne: —g$W Email: Yl q t j FAX: Mobile: ) . t{q I Site Address: City: State: Zip: f 5424e eb5LA -3 00 ( r- ASBESTOS CONTRACTOR Contractor/Business Name: Phone: Email i i ne J,rn-,"gnFAX: 53 — $ Mobile: Mailing Address` J S City- State: Zsp U PROJECT INFORMATION Start ate Compl tioa ate: Work Shift Days: Work Shift Hours: .•22. 5 3 r /z nahose_sU_ �31 #Structures to be abated: Total Quantity to be Square Feett. �n Linear Feet removed I,l � `"[ Dis osal Site: S v, � .� �J Will this structure be demolished after asbestos Will all identified asbestos be A4noved from removal Yes 1/ No_ structure Yes L/- No_ Circle Material being removed: _Boiler/Fumace _putt Insulation _Pipe Insulation _Fireproofing Paints _Plaster _Cement Board _Cement Pipe �onng _Roofing ✓TeRured Coating _i,,6ther ri uitG�s1 J S2a�Ut!1�- ASBESTOS PROJECT CATEGORY NONREFUNDABLE FEE 1- 10-259 linear or 11-159 square feet $150 2- Dq 260-999 linear or 1604,999 square feet $325 3- 1,000-9,999 linear or 5,00049,999 sq feet $650 4- 10,000+linear or 50,000 square feet $1,300 ) Emergency $50 Annual—limit of 260 linear feet or 160 square feet $500 I have read and will abide by the conditions iet forth in this perarit and any addendxm thereto. I do hereby certify that the information in this application and supplemental data described herein is, to the best of ray knowledge, accxrote and complete. Applicant NTame Signature Da Date Application Received Payment Info. Approved Asbestos Permit R CEI 1!t//� f j Cash [ ] Disapproved Permit# L'\5136(� Check: # Demolitiof�Permit APR 2012 [✓]"Credit Card 3� o j,Review date:!/_/_ Permit#1 Permit Lod _ y ' Receive date: U//� Reviewed by: Survey- [►7. Yes [ ] No Use On n Use On# 1 ---Ueng Use On# A&xgUse On lo/kWUAA OVER