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HomeMy WebLinkAboutBLD2014-00170 SUILDING PERMIT APPLICA•N BLD14-00170 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD14-00170 Received Date: 5/15/2014 SITE ADDRESS: 170 N BAY WAY PORT LUDLOW, 98365 OWNER: OKANOGAN HOLDINGS LTD PHONE: CIO ROBERT LEE WILLIAMS 380 LAMPLIGHTER DRIVE MARCO ISLAND FL 34145-4542 OAK BAY WATERFRONT SUBDIVISION: Block: Lot: PARCEL NUMBER: 976800013 Section: 29 Township: 29 N Range: 01 E CONTRACTOR: PHONE: bt-NO PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI' Demo of 3 out-buildings TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP DEM VALUATION MAIN. CODE EDITION: 2012 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $76.00 MEB 05/13/14 148634 Total: $76.00 APPROVED MAY 202014 Icffersan County DCD \\firlamorL\rlof.3\fnrr-nc\C RI n Ann RId rnf F/1F/')r11A . .5,," ON C'0, JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 4 , '96'11S,+G'i Date: _ I Time Received: /( ' 2_ imam �M y Tue. Wed. Thur. Fri. Date: �'2 ""f BLD: I (1- 17 0 Contact Name: Owner: Contact Number: 360 O / 6375 Address: ('10 2)Ar.,l N 206 Notes: / Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts - Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted n I—I, O. T:L, Ceiling Sally Ellis From: Ron Gregory<builder @cablespeed.com> Sent: Tuesday, April 21, 2015 8:16 AM To: Sally Ellis Subject: FW: BLD14-00170 Attachments: Scan0079.pdf From: Ron Gregory [mailto:builder @cablespeed.com] Sent: Monday, April 20, 2015 7:46 PM To: 'dcd@ co.jefferson.wa.us/communitydevelopment Subject: BLD14-00170 Site has been cleared for months. If there is a question please contact me Ron Gregory builder@cablespeed.com 360-344-2058 LATIUM \gaCIL SI \ emus c� . A.I \ eco n ofrIc �q, cGkin (10L-1-- ■, \()Q-e'' 1 �oS r S-(-6 1r3EPARTMENT OF COMMUNITY DEVELOPMENT -----) ...... ,,,,:aL"9-4450 i F..3U1379.4451 •:,,7_,, •b_co3 Y cn.a•ni,nr,y:A-"sLcQra,,,adc.sjxcul-' F.,trad:juifiLro tclirnon Z.to 15,2015 vOGAN HOLDINGS LTD • ROBERT LEE wLLIAMS AMPUGHTER DRIVE 0 ISLAND FL 34145 42 -45 • SUBJECT: PERMIT To EXPIRE-NOT RENevoortLE RESS: 170 N BAY WAY SITE ADD BLD14 BLOCK:-00170 LOT: PERMIT 4: LEGAL DESCRIPTION: 9768 PROJECT DESCRIPTION: Demo of 3 out-buildings MITE BLD14-00170 WAS ISSUED SY THIS DEPARTMENT ON 5/20/2014,WAS VALID FOR ON R AND IS NOT RENEWABLE.According to our records,a final inspection has either not been doled or has not been passed. iCHIEDULE A FINAL INSPECTION,CONTACT THE DEPARTMENT OF COMMUNITY DEVELOPS 'ECT1ON HOTLINE AT 379-4455 and leave your request after the recorded message. C event a final inspection is not passed,the inspector will give you a written notice of required ictions You must call for a re-inspection to receive final approval. 4AL INSPECTION MUST BE SCHEDULED BY 511612015. se contact the Department of Community Development(360)379-44.50 with any questions. trehi, sit Technician le nodataVorrnsT_ELD_pro_exp_nlc,pt 4(152015 ... K C B WA STATE CERTIFIED ASBESTOS CONTRACTOR # 1 095 'F PHONE#(360)830-5022 P.O. BOX 220 FAX#(360)830-5020 SEABECK,WA,98380 May 3, 2014 Ron Gregory Project: Williams's residence 22 McCurdy Lane 170 N. Bay Way Port Ludlow, WA 98365 Port Ludlow, WA 98365 CERTIFICATION OF COMPLIANCE AND COMPLETION FOR THE REMOVAL OF ASBESTOS CONTAINING MATERIALS On May 1 &2,2014 the identified asbestos containing materials (ACM) which consisted of sheet vinyl throughout the interior of this residence was removed by Washington State Certified Asbestos Supervisors in strict compliance with all regulations pertaining to asbestos remediation in local, state and federal jurisdictions; including by not limited to: • WAC 296.62.077 • ORCAA Regulation 3 • 40 CFR Part 61 Meeting compliance in worker protection; environmental safety; approved abatement procedures; transporting in accordance with DOT; disposal of generated asbestos waste. The material was removed with its adhesive intact by removing it intact on the plywood underlayrnent. The generated asbestos waste was wrapped in 2 layers of 6 mil poly,labeled and will be shipped by an approved hazardous substance shipper by rail to Columbia Ridge Landfill near Arlington, Oregon for permanent disposal(burial). A permit was obtained prior to starting this project from Olympic Region Clean Air Agency and a copy is included in these documents for your files. All identified asbestos containing materials have been removed from this structure and it can be demolished and hauled to a transfer station if the ORCAA permit to demolish has been obtained. This document should be taken to the transfer station verifying that all ACM has been removed from the building. Jeanie Taylor, Coordinator,KCB, Washington State Certified Asbestos Contractor#108 WA STATE LICENSED GENERAL CONTRACTOR #KCB****922J5 "s%wGe 1.56 ff t i 1 ORCAA Permit Application Status I Permit Status 0 Approved 0 Disapproved Notes i 4 04/18/2014 Review Date Reviewed by CK Permit# 14ASB004398 Expiration Date 05/03/2014 Appiica ion Received 04/18/14 $325.00 04/17/14 Amount Due 0 Cash l]Check 0 C dit card Additional notes or permit conditions I I I I p61), PARTIVNT OF COMMUNITY DEVELOPMENT •c,...60.3,9 4-1541., 161■-,) ,, ,0 ,_, 4'0 TfA-4.nn,g1,2,1comnurtndorclr,,pr,alt ',I NUN r,mad: 15,2015 YOGAN HOLGINGS LTD BERT LEE WILLIAMS AMPLiGHTER DRIVE 2C)ISLAND FL 347454542 SUBJECT: PaRMIT TO EXPIRE-NOT RENEWADLE 170 N BAY WAY Silo ADDREssi -14-00170 LOT: PERMIT 8Ln 4: BLOCK: LEGAL DESCRIPTION'. 97E0 PROJECT DESCRIPTION: Demo of 3 out-buildings MIT B ELD14-00170 WAS ISSUED BY THIS DEPARTMENT ON 5/20/2014,WAS VALID FOR ON R AND IS NOT RENEWABLE. ccording to our records.a final inspection has either not been duled or has not been passl. ICHEDULE A FINAL.INSPECTION,CONTACT THE DEPARTMENT OF COMMUNITY DEVELOPS 'ECTION 1-10TUNE AT 379-4455 and leave your request after the recorded message. a event a final inspection is not passed.the inspector will give you a written notice of required ictions.You must call for a re-inspection to receive final approval. .IAL INSPECTION MUST BE SCHEDULED BY 5/16/2015. se contact the Department of Community Development(340)379-4450 with any questions. rrely, fit Technician le ricdatCfcgrisf_EILD_pro_esp_nIc el 41152015 .4 K C B a WA STATE CERTIFIED ASBESTOS CONTRACTOR # 1085 a'. PHONE#(360)830-5022 P.Q. BOX 220 FAX#(360)830-5020 SEABECK,WA.98380 May 3, 2014 Ron Gregory Project: Williams's residence 22 McCurdy Lane 170 N. Bay Way Port Ludlow, WA 98365 Port Ludlow, WA 98365 CERTIFICATION OF COMPLIANCE AND COMPLETION FOR THE REMOVAL OF ASBESTOS CONTAINING MATERIALS On May 1 & 2, 2014 the identified asbestos containing materials (ACM)which consisted of sheet vinyl throughout the interior of this residence was removed by Washington State Certified Asbestos Supervisors in strict compliance with all regulations pertaining to asbestos remediation in local, state and federal jurisdictions; including by not limited to: • WAC 296.62.077 • ORCAA Regulation 3 • 40 CFR Part 61 Meeting compliance in worker protection; environmental safety; approved abatement procedures; transporting in accordance with DOT; disposal of generated asbestos waste. The material was removed with its adhesive intact by removing it intact on the plywood underlayment. The generated asbestos waste was wrapped in 2 layers of 6 mil poly, labeled and will be shipped by an approved hazardous substance shipper by rail to Columbia Ridge Landfill near Arlington, Oregon for permanent disposal (burial). A permit was obtained prior to starting this project from Olympic Region Clean Air Agency and a copy is included in these documents for your files. All identified asbestos containing materials have been removed from this structure and it can be demolished and hauled to a transfer station if the ORCAA permit to demolish has been obtained. This document should be taken to the transfer station verifying that all ACM has been removed from the building. Jeanie Taylor, Coordinator,KCB, Washington State Certified Asbestos Contractor#108 WA STATE LICENSED GENERAL CONTRACTOR #KCII****922J5 asi,wce ij&y" ORCAA Permit Application Status Permit Status a Approved ❑ Disapproved Notes 04/18/2014 Review Date Reviewed by C K 14ASB004398 05103/2014 04/1 8/14 Permit# Expiration Date Applica ion Received Amount Due $325.00 e C dit card 04117/14 ❑ Cash U Check Additional notes or permit conditions • , ,, , • -n+6 V lwr-- (-----0 ______________ __________— 7:1__"\ ¢SON c JEFFERSON COUNTY A— DEPARTMENT OF COMMUNITY DEVELOPM ►�•� °`` 621 Sheridan Street Port Townsend,WA 98368 Web:www.calefferson.wa.us/communitvdevelopment '4 9skrxo�° Tel:360.379.4450 l Fax:360.379.4451 I Email:dcd nco.lefferson,wa.us Ito Building Permits&Inspections I Development Consistency Review I Long Range Planning I Watershed Stewardship Resource Center Master Permit Application MLA: Project Description(include separate sheets as necessary): try— \A,,.c ry v'k w ..4 l�,`"1 r . Tax Parcel Number: 97600013 & 7 0 cbts Property Size: 1.1 (acres/square feet) Site Address and/or Directions to Property: 170 Bay Lane N, Port Ludlow, WA 98365 Property Owner(s)of Record: Okanogan Holding Ltd,Robert L.Williams Telephone:+-44 534 85322 Fax: email: atcsea@gmail.com Mailing Address: La Fallue,rue de la Pouclee,St Martin,Jersey,Channel Islands JE3 6 DU Applicant/Agent(if different from owner): Telephone:Ronald J Gregory Fax: email: builder @cablespeed.com Mailing Address: 22 McCurdy Lane,Port Ludlow,WA 98365 What kind of Permit?(Check each box that applies ❑Lot or Road Segregation ❑Bfilding ❑Critical Areas Stewardship Plan ii Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) O Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home ❑ Modular ❑Discretionary"D"or Unnamed Use Classification ❑ Commercial* ❑Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach ❑Short Plat** ❑Home Business ❑Cottage Industry ❑Binding Site Plan** ❑Propane ❑Long Plat** ❑Sign ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration** ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use IR Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre-Application Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference Please Identify any other local,state or federal permits required for this proposal,if known: Ronald J Gregory DESIGNATION OF AGENT I hereby designate //�� , a to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE i '1- t/ A.4...a.-,.....,.. , Date: J 9 -51‘e-,,,,f=' 2 U1. By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application he or she wants prio ace. Signature: IBS-,1 G,,.--? -.1 Date: ' ' vr''ems / The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable responsibility fora eying,o nd complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: ->,- d3>�rVe — Date: /5 5 ,lf Z�-'3 �7 07/24/2013 J l • sir? (,,./ • • ' 2940-B Limited Lane NW Olympia,WA 98502 �-, ©RCA A , 1-800- ?2-623 • (.360) 539-7610 Fax: (360) 491-6308 ORCAA Permit Application Status Permit Status el Approved s ❑ Disapproved Notes Survey submitted. ACM present. Abatement Completed on 5-2-14. Review Date -9-14 Reviewed by Mike S h u lts 14DEM003747 04/10/14 Permit# Expiration Date Application Received Amount Due $60.00 04/10/14 ❑ Cash ❑ Check 0 Credit card Additional notes or permit conditions r ,i Angel 11,,;(i C>i.>>e; '1 1F�kA„. 8th Ste, 5saitc I 13, 13or-f r4n;el s,ttA 08 0 2 i_3€,E?'.-4{7 1466 E*:cryttienc k r,kl (?th(e: 3t}1 f)e ee,n Ave., R,>vmerne) WA 3183,77-: 36(1) ),a?-:'1 3- Olympic Region Clean Air Agency (ORC 2940-B Limited Lane NW Olympia, WA 98502 360-539-7610 I FAX 360-491-6308 Port Angeles Office 360-417-1466'" `� Raymond Office 360-942-2137 ORCAA www.orcaa.org 1 DEMOLITION PERMIT APPLICATION Demolition and renovation projects within Clallam,Grays Harbor,Jefferson, Mason, Pacific and Thurston counties REQUIRE A PERMIT and require that the following permit conditions be met prior to demolition or renovation. 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 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 an 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 demolition 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, as well as any subsequent amendments, must be kept on site and available for review by Agency inspection personnel. 7. Use the Completion Notification and Amendment Form to make changes to the original permit. 8. The original demolition permit will expire on the Completion Date.To change the completion date, a Completion Notification and Amendment form must be received PRIOR to expiration. 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 start 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 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.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 use as a rental, or for commercial purposes. I • PROPERTY OWNER Name Mailing address Robert L Williams 380 LOamplighter Drive City ZIP State Marco Island 34145 FL Site address City ZIP 170 Bay Lane Port Ludlow 98365 FAX Phone number Other contact number Email 360-344-2058 360-301-6375 builder@cablespeed.com DEMOLITION CONTRACTOR ❑ check the box if same as property owner information Business/Contractor Name On-site contact Shold Excavating Tim Johnson E-mail Mailing address City ZIP PO Box 179 Port Hadlock 98339 Phone number Other contact number 360-385-0480 DEMOLITION PROJECT INFORMATION Number of structures being demolished 3 Start date Completion date Is asbestos present? 04/22/14 04/25/14 No Attach your asbestos survey below Has all identified asbestos been removed Yes DEMOLITION PROJECT CATEGORY ® Complete demolition ❑ Training fire-(complete fields below) ❑ Renovation, alternation, remodeling, maintenance or other construction If training fire, provide fire protection agency name, point of contact and telephone number ® Owner occupied residential dwelling-Permit fee: $35.00- Prior Notice-Nonrefundable ❑ Other Structures- Permit fee: $60.00- 10 working day wait period- Nonrefundable ❑ Emergency Fee$50.00- must be accompanied by Government Ordered Declaration (other structures only) Attach declaration below PLEASE MAKE A NOTE OF YOUR FEE. Applicant name Date Ronald J Gregory 04/09/14 I do certify that I am the owner, authorized agent of the owner, or authorized contractor for the property subject to this ORCAA application/permit. 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 compliance with permit conditions, applicable laws and regulations. I understand that granting of this permit by ORCAA does not authorize anyone to violate federal, state, or local laws or regulation pertaining to activities associated with this permit. I have read and will abide by the conditions set forth in this permit and any addendum thereto. I do certify under penalty of perjury under the laws of the state of Washington that the information in this application and supplemental data is,to the best of my knowledge true, accurate and complete. ® I agree • • DEMOLITION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD14-00170 Received Date 5/15/2014 SITE ADDRESS: 170 N BAY WAY Issue Date 5/20/2014 PORT LUDLOW, 98365 APPLICANT: OKANOGAN HOLDINGS LTD PHONE: C/O ROBERT LEE WILLIAMS 380 LAMPLIGHTER DRIVE MARCO ISLAND FL 34145-4542 SUBDIVISION: OAK BAY WATERFRONT Block: Lot: PARCEL NUMBER: 976800013 Section: 29 Township: 29N Range: 01E CONTRACTOR: SHOLD EXCAVATING PHONE: (36)385-0480 PO BOX 179 PORT HADLOCK WA 98339 Contractor's License SHOLDI*224LT Expires 7/9 /2014 379-6892 OWNER, OKANOGAN HOLDINGS LTD PHONE: if different: C/O ROBERT LEE WILLIAMS 380 LAMPLIGHTER DRIVE MARCO ISLAND FL 34145-4542 PROJECT DESCRIPTION: Demo of 3 out-buildings Directions To Site: THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 5/20/2015. REQUIRED INSPECTION: FinalApproval: 13 LE IiLcf, //Atilt nr-ttJ /4t- kfr)VP BUILDING INSPECTION HOT-LINE 379-4455. REQUESTS MUST BE RECEIVED BY 3 PM THE DAY BEFORE THE INSPECTION IS NEEDED. Office Hours 9:00 a.m. -4:30 p.m. Monday -Thursday SPECIAL CONDITIONS APPLY - SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS FOR CASE# BLD14-00170: 1.) Approval by the Health Department for this demolition permit is based on the owners signed acknowledgement that they will be decommissioning the existing septic system prior as conditioned undeer SEP13-99. This approval for demolishing the residence does not ensure future building approval. Any future onsite sewage system shall meet code in effect at the time of application. \\tidemark\data\forms\F_BLD_Permit_Propane.rpt 5/20/2014