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Home My WebLink AboutBLD2004-01624 Final Demo - BLD Permit / Conditions - 2/24/2005 So Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 u Mason C y 3 426 W. Cedar P.O. Box 186 X Shelto ,W 98584 J t Lc RESIDENTIAL BUILDING PERMIT BLD2004-01624 OWNER: MICHA CCA RECEIVED: 10/12/2004 CONTRACTOR: LICE EXP: ISSUED: 10/12/2004 SITE ADDRESS: 60 NE ANCHOR WY BELFAIR EXPIRES: 4/12/2005 PARCEL NUMBER: 123305000069 LEGAL DESCRIPTION: BEARDS COVE DIV 3 TR 69 PROJECT DESCRIPTION: DIRECTIONS TO SITE: DEMOLISHING A FRAME HWY 3 TO SAND HILL RD FIRST LEFT ANCHOR WAY TO ADDRESS 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.: 2 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. Comp. Plan Desig.: Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Demolition Fee TW 10/12/200 $95.50 S12004 Building State Fee TW 10/12/200 $4.50 S12004 Total $100.00 BLD2004-01624 Please referto the following pages for conditions of this permit. 1 of 3 CASE NOTES FOR BLD2004-01624 CONDITIONS FOR BLD2004-01624 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 1-800-64 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) In accordance with international codes and Title 14, Mason County Building Code, "Standards for Fire Apparatus Access Roads," all new structures that require an address shall have approved numbers or addresses located at the beginning of long driveways when the address is not clearly visible from the access road. The numbers shall also be plainly visible and legible from the street or road fronting the property and shall contrast with their background. Mason County Building Department requires that this be completed prior to calling for any site inspections. A re-inspection fee based on rates as adopted by the jurisdiction and the international codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting inspections. X 3) Demolition actitvities must conform with all State and local County regulations as a condition to the issuance of this permit. The applicant/owner is directed to conatc Olympic Air Pollution Control Authority at(360)586-1044 or 1-800-422-5623 extension 104 prior to the commencing demolition. X 4) THE DEMOLITION AND DISPOSAL OF DEMOLITION DEBRIS MUST MEET REQUIREMENTS AS PER MASON COUNTY REGULATIONS. X 5) 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 MasortCo my ordinances and building regulations. X fy 6) 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 hay a prevented action from being taken. No more than one extension may be granted. X l BLD2004-01624 Please referto the following pages for conditions of this permit. 2 of 3 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 uct f review and inspection. '.� OWNER OR AGENT: , DATE: ? /0,/ BLD2004-01624 Please refer to the following pages for conditions of this permit. 3 of 3 W r 0 CONCRETE MECHANICAL MANUFACTURED HOME : 0 il Footings I Setbacks Date By Ribbons 0 a, Date By Gas Piping Date B y Foundation Walls Date B y Set-up Date By INSULATION Date By B G / Slab Insulation Floors Final Date By Date By Date By FRAMING Walls FIRE DEPT Date By Date By Date By PLUMBING Attic OTHER Groundwork Date By Date By WALLBOARD NAILING D.W.V. Date By Date By FINAL INSPECTION Water Line Date Z- ,>yY�f—By/�� Date By . "�. �� `,. Date By 1 O O OC G � r � 0 d � 8 � a 0 OCD 0 � l 1 u r 0 1 FORM MUST BE COMPLETED IN INK &JD 2_l0 L(— PLEASE PRESS HARD PERMIT NO.: ` MASON COUNTY �� J DEMOLITION PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner f"1\ fj(,hF rl_ Contractor Name Mailing Address 4-j t t, IA)LJ ( ct_S 7" Sig t' /ej? Mailing Address City�S,lrl�-f.'17�i1- State lj&L Zip Code c7S_;�� City State Zip Code Phone _ E� (,�f,?/951Other Ph.( Ph.( Other Ph.(� Lien/Title Holder Contractor Reg. # Address Expiration PARCEL INFORMATION-12 digit Tax Parcel Not /12.33C, / ,SO / coo t,c> Fire District / Legal Description U)Oc �17�t.�IS►n;�! .3 1-9- 0 Site Address(include street name and city to AI£ .4n)C_440A ii,14Y. �(L. Directions to site: Is your property within 200' of the following: Body of Water(Name) /I10^16 Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs If 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? 17�c ►►a.ST c/2 5 What is the use of the building being demolished? -%►J6-- 6 V*z- 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 aRp oval. be made without first obtaining approval. XJ� Cls •✓' ate L' /,.Z ze) X Date Provide a plot plan indicating location of improvements and structure to be demolished. 7-C S*V P 1. ! LEFT PA) sA'VL> ( RD o A)-ro f}NC-No 9- tv,4 FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED CONDITION CODES Building Department Occ Grp Type of Const Planning Department _ Fire Marshal FEES Building Permit Fee Other Violation Fee Other Site Inspection Pre-Paid at Submittal ::. :<YY:::•»::.:::::::.::•.;•.<:,: ::. TOTAL FEES .k .............•.:•...:::.::.::.�:::::::::.�.. ..... . C.ION GLE r— > >; r n 426 W. CEDAR ST'. Notification of Demolition Permit 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 removed from the area to be demolished. Work shall not commence on an asbestos project or demolition unless the owner or operator has obtained written approval from ORCAA. A written application for a demolition shall include a certification that there is no known asbestos-containing material remaining in the area of the structure. Project Site Address: L �4/li �l Q f^ lZ.r�t� County: City: 2�3 State: GtlrQ . Zip: Starting Date: Completion Date: *(There is a 10 working day advance notification period from receipt of permit application) Property Owner:/1")I XP t Dlo j /iTelephone: Fax: Mailing Address: �y�v /y1N� G(�5�� Oj 1 tTY City: 5I1v t rdg �� Zip: 8 L� State: Demolition Contractor: QLJ,y6(R_ State License#: Mailing Address: City: State: Zip: Contact Person: Telephone: Fax: YES NO Demolition by Wrecking or Dismantling? ($25.00 fee)check# Training Fire Demolition? (If yes,attach fire department request for training fire) Renovation,Alteration,Remodeling,Maintenance,or other Construction? __gf Asbestos found or suspected* *An ORCAA"Notice of Intent to Remove or Encapsulate Asbestos" form and appropriate fee must be submitted prior to any asbestos removal work. Asbestos removal projects involving demolition must be preformed by a Certified Asbestos Contractor and all friable or potentially friable asbestos must be removed before any demolition begins. Refer to ORCAA Regulation 1 Article 14 for additional requirements that may apply. Asbestos Survey Completed by „CJCN/vi)Cj_<L /n. %F_rANy) AHERA Certified Inspector 455ae6-p f, u,11_i7'y �N�1�oNMty%A� �G• Certification# 3509-041-0 3--0 This approved permit must Enclose$25 Certification of the Asbestos Survey must be available at the job site Processing Fee accompany this form 2940 B Limited Lane NW,Olympia,Washington 98502 360-586-1044 * 800422-5623 * fax 360491-6308 homepage:www.orcaa.org * email: infona,orcaa.org Rev.07/11/02 RECEIVED OCT 12 2004 ASSURED QUALITy426 W. CEDAR ST. ENVIRONMENTAL INC. SITE INSPECTION REPORT ASBESTOS "GOOD FAITH" SURVEY PROPERTY 60 Anchor Way NE Belfair, Washington PREPARED FOR: Diane McCann Introduction On September 27, 2004 Assured Quality personnel conducted a "Good Faith' asbestos survey (per U.S.E.P.A./ A.H.E.R.A. guidelines as designated and specified by Puget Sound Clean Air Agency and Washington State Department of Labor and Industries) at 60 Anchor Way NE in Belfair, Washington. This survey purpose is to identify any Asbestos Containing Materials that may be present and require professional removal prior to demolition and or commencing any major renovations of a structure. Narrative of Findings Basic Construction: The residence is a one story, residential structure. Roofing is three- tab composite. Attic and Wall insulation: No related suspect ACM located. Plumbing System: No related suspect ACM located. Heating system: No related suspect ACM located. Interior Construction, Finishes, and miscellaneous: Inside construction is wood paneling. Vinyl flooring materials with relating backings and mastics were also sampled as per homogeneous area. Asbestos Summary Six samples were collected at this residence. Of the six samples, none tested positive for asbestos containing materials. The attached lab data contains the laboratory analytical data for each material collected. Any and all materials identified as ACM or PACM in this report(and additional materials associated with the structure that may be discovered and later identified as ACM or PACM), must be professionally abated by a licensed professional asbestos abatement contractor. Some sample analysis listed may be a representative analysis of individual and separate samplings and analysis of homogenous materials, as prescribed by AHERA protocol. Samples taken are listed with their corresponding analysis. If asbestos is detected, those samples containing asbestos are listed first and noted with initials"ACM". If during demolition or renovation, any additional hidden or covered suspect materials similar to those identified in the survey are located (may include but not limited to: sheet vinyl flooring, tile flooring, wall or ceiling texturing or paints, concrete siding or skirting, cement pipes, cement wallboard, electrical cloth, electrical wiring insulation, thermal paper, wallboard, joint compounds, vinyl wall coverings, spackling compounds, or any other suspect TSI (Thermal System Insulation), they should be treated as Asbestos Containing Materials unless determined to be non-asbestos by laboratory analysis. Note: Assured Quality Environmental does not guarantee approximations of quantities of ACM, which may be listed with the analysis. It is therefore recommended professional abatement price and/or disposal quotes be obtained by inquiring as to fees per area of specific ACM material (i.e. square or linear foot, etc.), or by site assessment. Any and all materials identified as ACM in this report must be abated prior to ACM disturbance, renovation, or demolition. All materials identified as ACM must be professionally abated by a licensed asbestos abatement contractor prior to any disturbance. Inifer Ti ny RA ding Ins ector 3513-04-03-01 Expiration Date March 30, 2005 UUI, 2. 1UU4 1;4/AV N0. 8034 P. 2/8 IA►ICI. International Asbestos xctsting Laboratories 16000 llurvott Way Unit 100 Mt.Laurel.NJ 08034 Tdcphorse:956.231-9449 Fax'836-231.9818 CERTIFICATE OF ANAL'YSIS Client: Assured Quality Env. Report Date: 10/2/2004 2702 A Street Project: Diane McCann Tacoma, WA 98402 Project No.: BULK SAMPLE ANALYSIS SUMMARY Lab No.: 2090046 Description/Location: Black Shingle Clicnt No.: 60-01 Roofing d ftlos Type Ye Nwt• Sbestow Fibrous Mgernl T —yl- %Nm-Elkous Mntcria Nona Detected None Detected 5 Cellulose OS Trace Fibrous Glass .............. .......... .................. ................ I............... ............ ........... Lab No.: 2080047 Description/Location: Black Tar Paper Client No.: 60-02 Aabcdo Lm! !LNon-Asbestos Fibtuus Materiel LTC %Non-F'ihrous Material None Detected None Detected 90 Cellulose 10 ................ .......... ...... .. ...................................... . ............... . .............. .............. _............ ............. ........ Lab No.: 2080048 Description/Location: Tan Vinyl Sheet Flooring Client No.: 60-03 Uundry °c Asbestos Tvnc 9:Non-Aihe.stos Fibrous Material TIVOO Nan-Fihrnuc Material None Detected None Detected None Detected None Deteced 100 Lab No.: 2080048 Description/Location: Tan Mastic Layer No.: 2 Client No.: 60-03 Laundry %Asbestn" hT, %Non-AAheg0t Ftbrou.Matcri►l TYPO %Non-Fibrous Material None Dc(cctod None Dctcctcd None Detected Nona Detected 100 •••.... ...... ............................................ ------- — ............... ............... MIST-NVLAP No. 1165 NY-DOH No. 11021 AHHA Lab No.444 7*)m cmOdendol ropo.t«fares oelr w chats,u--6s kskd end d"t nm rcpcto,r on ewortaeaa„t by MST-JJUp.'UNA or ay IgRney ttJ ttie US aowrolmam yMs rapers Adn roe bt reprodaood eree/w orlon,wuhoet wrirrw apprvrel of the lobwewry. Analysis Method EPA600/R-93/116 cos ds4 (PC)iadiasa Shocked Poet Cvwa b6cthod padbaaed McVtod eat perfom,ed wiles shed SmIN-6-ws fibers may bt maned by PIM dun to mwivuoa lim,tu,an of the opuW mkrossopn Tltucfora uea.tjve PLN mutts tanwut be euruuccd Rkcwn Microscopy can be used as a wn5rm nii ie iun qw Rcguluory Lunit is baud uj, the sample matr x Qewntfic�tiow at<it�try volume n pnrnblc s+itG,Lit mubod Aualysis ittchtdes aid dtuitut sepvat>tc layers n aoeadaeoe ts,d,bPA 600)Ietl,od If twt«poncd a att,a.,tx tweed layer is/whts not a or the&'w"apedticatty regaaaeea cSu it twc be amst vA Analysis Performed By: R. Caran Approved By: Date: 10/l/2004 Ftiarilc E.Ehrenfeld,III Page 1 of Laboratory Director QC1. 2. 2004 /:4/AM NO. 8034 P. 3/8 l ne 08 Testing Laboratories 16000 Hotimn Vay Um 100 Mc Gwrt NJ 011054J1TL Tdlephone:g56-231-9a49 Fax:356-231-9919 CERTIFICATE OF ANALYSIS Client: Assured Quality Env. Report Date: 10/2/2004 2702 A Street Project: Diane McCann Tacoma, WA 98402 Projcct No,: BULK SAMPLE ANALYSIS SUMMARY Lab No.: 2NON9 Description/Location: Off-White Vinyl Sheet Flooring Client No.: 60-04 Bath sbAs satpf � '1G NotrAstasres Fibram Material Tim %Non-ribrous M31triAl None Deteacd None Delecud 1 ribrous Out 99 ................... ................I ................ .............. ............. Lab No.: 2080050 Description/Location: 00-White Vinyl Sheet Flooring Client No.: 60.05 Kitchen % ns 1w M Noe f4bestns Fibmw Materl,t %Non-Fibmus Material Now Detected None Doweled 5 Fdxous Glass 95 ................. ............... .............. Lob No.: 2090051 Description/Location: Oreen Vinyl Sheet Flooring Client No.: 60-06 Living Room %Aftws SfNon Rbcaps FibrousMawriaj 3�n %Nat-A"bmusMaterial Nom Deteted None Detected 70 Cellulose 30 N1ST.NVLAP No. 1165 NY-DOH No. 11021 AMA Lab No.444 Tea rgat nsofsr atlp to fides-ftw&j ten 4"d rba kW Mpe MK ae e..dsrsrssnrbr.l ff-VKAP.AM orOW Waxy of ASe Ef I gowrnara r►itrhy�e.tsAaMaorJanproauarererarptij6u�.u.t»+ieanr ofdelohorraah! A-41is Method: UA 600/R 93✓116 Cee.w.e�ts (PC)Ind�osfesStratiGedPo6ttCoaaeMcdadpsrCormed Mahodoa p*famed uNrts sutwl StaNi rbeemr G6ai aoay be mis+ed br PLN daa m�aoeMWim haaatiovs of We optics!aaaosnope 7Lo.fae,saptire PLIa re.�Nr car,tsr be pursssod.Ekararbiaosmptr qo lu ttsoa a a aa�C it.epdstayl.:mi u<bead dr s etst 6lvoLnes�osn3le tri6 drs aeswd. A..iys:..wt.aes sa iwata sop:sble rya.to s�rsace,ar>,EPw ti001.kdwd 1f set.�a m aotcd, um a eitba anc pre>aa or me elimt hr spsgJio roquestcd t6r a oa be snolyxel `p°rte Analysis Performed By: R.Caran Date: 10/1/2004 Page 2 of 2