HomeMy WebLinkAboutBLD2006-00558 10/30/2006 15:04 FAX��60_491 e8 ORCAA f�j001
•
• OCi 3 0 2aofi -
PERIArri,
'•►� APPROVED C , 30 D(;G�
awe' • 1.. o Olympic Region Clean Air Ag 9 ONAUYAPPROVED
2940-B Limited Lane NW
41k, Olympia, WA 98502 NOT APPROVED
WITH
ORCAA � ) 58 -1044 or 1�00-�22-5 �p
., ,,.0�, Fax: (360)491-6308 www.O WAA.orq K. C
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 shalt 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 aertifieation that there is no known asbestos-containing material remaining in the area of the
structure.
Project Site Address: 311 VorkIlia Loop — - - County: Jefferson
City_ Pon Townsend State: WA Zip; 33368
Starting Date: Completion Date: February t.2007
*(There is a 10 working day advance notification period from receipt of permit application)
Property Owner: ► ro)cent Telephone: 96O 73°187 Fax:
Mailing Address: 311 Victoria Loop
City: Port Townsend State:ova Zip: 38388
Demolition Contractor. °'wre State License#:
Mailing Address:
City: State: Zip:
Contact Person: Telephone: Fax:
YES NO
X Demolition by Wrecking or Dismantling?($25.00 fee)check# nonrefundable
• Training Fire Demolition? (If yes,attach fire department request for training fire)
• Renovation,Alteration, Remodeling,Maintenance,or other Construction?
X Asbestos found or suspected*
*Au ORCAA"Notice of Irbt bo Remove or Eomparlate Asbestm"form aid apppoluiatc fee must to submitted prior to any asbestos
removal work_ Asbmaos 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 l Article 14 for additional
requirements that may apply.
Asbestos Survey Completed by
AHERA Certified Inspector Bob Witherldge
Certification# WAMOA-0042-05
This approved permit must Enclose S25 Certification of the Asbestos Survey must
be available at the job site Processing Fee accompany this form
MO F:ICO.tMNNFor msla�+il,cstoslOemoPetvaitdoe a; •
-,� GK.No RECEIIVM)
DATE
NOV 0 12006
+FFFFHSI1k i'0IIN1y OCO