HomeMy WebLinkAboutCOM2008-00048 Final Tank Removal - COM Permit / Conditions - 4/9/2008 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Inspection Line(360)427-7262
� Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Phone: (360)427-9670,ext.352
' Shelton, WA 98584
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COMMERCIAL BUILDING PERMIT COM2008-00048
OWNER: BE FAIR LLC RECEIVED: 4/7/2008
CONTRACTOR: LICENSE: EXP: ISSUED: 4/7/2008
SITE ADDRESS: 23960 NE STATE ROUTE 3 BELFAIR EXPIRES: 10/7/2008
PARCEL NUMBER: 123294190230
LEGAL DESCRIPTION: TR 23 OF NE SE LOT: B OF SP#1059
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
TANK REMOVAL 23960 HWY 3 IN BELFAIR SPACE A& B EMPTY BUILDING NEXT TO
SANDES BOAT WORK IN BELFAIR
General Information Construction &Occupancy Information
Type of Use: Insp.Area:
No. of Units: Type of Constr.:
of Bathrooms: Occ. Group:
Type of Work: OTH Fire Dist.: 2 No.
Valuation: No. of Stories: Occ. Load:
Building Height:
Pre-Manufactured Unit Information Square Footage Information
Make: Length:
gt 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?:
COM2008-00048 Please refer to the following pages for conditions of this permit. 1 of 3
Plumbing Fixtures Mechanical Fixtures FEES
j Type Qty. Type Qty. Type By Date Amount Receipt
` Demolition Fee KS do/,?nnR R1R75n C1gnnRnn
Building State Fee KS AnnnnR Id sn C17nnAnn
Total $162.00
CASE NOTES FOR
COM2008-00048
CONDITIONS FOR
COM2008-00048
1) Tank removal permit is approved pending approval and monitoring by DOE or other approved agency. Conformance to all applicable WA State
laws/regulations for tank removals is manditory and an Undergound Storage Tank Site Assessment Report must be submitted for file records prior
to final inspectionX „--
2) 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 rson signing this condition is either the homeowner, agent for the owner or a registered contractor according to
WA state law. X ;���
3) Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title
14.28.
X
4) 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 County ordinances and building regulations.
X 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 fo review and inspection. �(
OWNER OR AGENT: "`'v'Z'� DATE: 1117 DU
COM2008-00048 2 of 3
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CONCRETE MECHANICAL MANUFACTURED HOME m
p
ep Footings/Setbacks Date By Ribbons D
b Gas Piping
o inter+or Date By interior.Date By Date By
Exterx( Date By Exterior-Date B .�
Point Load!isolated Footings INSULATION Date By ,
BG 1 SLAB INSULATION
Date By Date By FIRE DEPARTMENT
Foundation Walls Floors Date By
Date By Data By DECKS
FRAMING walls Date By
Date By Date By PROPANE TANKS
PLUMBING Vauk Date By
Date By OTHER
�Groundwork A
Dates By Date _r By Type.
Dato By
D.w.v DRYWALL Type n
Int.Brace Wall O
Date By
Date By Date By FINAL lV
Water Line Fire Seperation _ 40
Date By Date By Dato -��� B� co
O
Pass or Request Inspect. o
Type of Insp. Fail Date Date Done By Comments ccoo
oASe)OW06 Sy
a✓ >°r>' S oy-o9-o$ o _09 Dg GL /, NS �� -L-o of
M�S�✓ co�„�r � �j r�`T tea.
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From: 05/01/2008 10:54 4728 P. 004/004
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DISPOSAL CERTIFICATION
April 11.,2008
f
Kane Environmental, Inc:
3031 Stone Way No.
Seattle, WA 98103
To whom it may-concern,
This is to certify-that Langseth Environmental Services, Inc. has received the foilovVing
tank for cleaning;rind disposal m.accordance with all federal, state., and-local
rule6ftboUlations.
I
One (1.) 5a0i4allon Underground Diesel 1011
Storage Tank sized at 455"x 72"
Date,Received: April 11, 2008
Date Cleaned: April 11,200.8
Date of Disposal: April,1.1.,;2008
Method of'Disposal;Scrap°.5teel (Schnrtrei:Steel)
To Location: 23940 N.E. Hwy. 3
Belfair,,WA
If you have any questions or request for services,, please feel free to contact this office at
(253) 536-69:61.
Sincerely, n
Ashley Ruhl; Owner
Langseth Environmental Services, Inc.
751 T Ap)tlair A.Yenuc,Suite A, Taconru,'WA 98404 • Phone (253) 536496I •Fax: (253)548-0.201
E:Mail:Zarngsethe*,. n_a l.com
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From:
�� g pwGL�'" 1 A; hlR- 05/01/2008 10:52 U728 P. 0011004
l-asa; j - o330
Mason County Fire Marshal
426 W Cedar Street `• P.O. Box 186
Shelton, WA 98584
Phone (360) 427-9670 ext. 273 ❖ Fax (360) 427.,77M
UNDERGROUND STORAGE TANK REMOVAL CHECKLIST
Instructions: Complete the Underground Storage Tank (UST) checklist below. Return the completed
checklist and, if required, site assessment reports necessary for Dept. of Ecology compliance, to the
Mason County Permit Assistance Center, ATTN: Fire Marshal, within 15 days after the UST is removed.
Parcel Numberwhere tank s located: G CIO
-36
Legal description: .
PCB o � 8L x1 58
Directions to site:
-To '-&e I F&wry, �'1 Crio �-ra�rv� �A�tt t
Address: a-;�e,ld n C- V#'-3 , Date of Removal:
Name of Property Owner: Q _ ?'Gz.�r: • _ L LG
L7 c
Name of Contractor removing the tank: 41f 5e-f-A 16 N rioin
Contractor Phone: (Z 3) �3�_6 Contractor license#: L 077PY
,�c-::I Tank Removal Certification#(include a copy of license): o DS TS—z 6
Where was UST taken when removed? Include parcel number address name of disposal site, etc.:
L4yySe�► �'j, 7�� Poc-fl�,� e
I.co*Olt
Tank Information
O Tank cleaned on site Method used for cleaning tank(s):
Tank cleaned off site
How and where were tanks disposed of: Include parcel number, site address, etc.; (1,�;
How was sludge disposed of? Vie r
O � o.�, wJ A Z Z
Type of product in tank:
r+rt / e /h D
Tank capacity: .500' v Estimated age of tank: !` o
h
Is tank being replaced? es ANo
If yes, identify type and capacity oft nk. Note:A permit is required forremoval and installation of each tank.
I certify that the information provided is true and correct. The UST was removed in accordance to current
Washington State regulations and Mason County ordinances.
L.
Date: /1 Db Signature:
L / 15
FORM MUST BE N INK
PL PERMIT rf0.: v ��
MASON COUNTY
ppk 0 7 DEMOLITION PERMIT APPLICATION
426 W.Cedar/P.O.Box 186,Shelton,WA 98584
COUN ton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968
APPL ANT INFORMATION CONTRACTOR INFORMATION
Owner J�-= '-Li..-'L L-L C Contractor Name
Mailing Address 4 Mailing Addr ss 3/ S�-r��✓ Y �(.'
City State WA ip Code City ck Statek,0 Zip Code S�iC�3
Phone Other Ph.C____) Ph. 'ek -by7 Other Ph.(
Lien/Title Holder Contractor Reg. #
Address Expiration
PARCEL INFORMATION-12 diolt Tax P c I No. / / `{�' Fire District
Legal Description C:l.. OV 6L- 4 7-
Site Address(include street na a and city Z3 .y0 w o/ If//' W
Directions to site: L-,,`,, G� _ w •w �c.t
IC K-V
Is your pr rty within 200' of the following. Body of Water(Name) If yNSaltwater
Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or
Bluffs /f your project is located adjacent to or within an area that is listed above, it is advisable to contact the Dept.
of Community Development regarding future development prior to demolition; since removal of an existing structure could
affect future building locations.
How will the debris be disposed of?
What is the use of the building being demolished? (A4,
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the
information provided is accurate and grants employees of Mason County access to the above described property and structures for review and
inspection of this project. Acknowledgment of such is by signature below:
OWNER AFFIDAVIT-I certify that I am exempt from the requirements of CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a
the Contractor Registration Law RCW 18.27 and am aware of the contractor in the State of Washington and that I am aware of the
ordinance requirements for which this permit is issued and that all work ordinance requirements regulating the work for which this permit is issued
will be done in conformance therewith. No changes shall be made without and all work shall be done in conformance therewith. No changes shall
first obtaining approval. be made without first obtaining approval.
X -Date X j` Date
Provide a plot plan indicating location of improvements and structure to be demolished.
15111160
FOR OFFICIAL USE BEYOND THIS POINT
Accepted byLILi I Date- Submittal Amount Due 112 .O0 Receipt No.
DE RT ENTAL REVIEW APPROVED DENIED CONDITION CODES
Building Depzktme t
Occ Grp Type of Const.
Plar)n g Department
it Marshal
FEES
Building Per 't Fee Other
Violation Fee Other
Site Inspection Pre-Paid at Submittal ( )
TOTAL FEE S