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Home My WebLink AboutBLD2015-00173 - 02 DEMO III r 6L-otis - 1i3 r5ON C, w a DEPARTMENT OF COMMUNITY DEVELOPMENT �4 ALA VI Sheridan StTCu,Port Townsend,W.1 9836S -< '1'c1•360.379 4450 I l:-z 360.379.4451 1 Web:f,..a-u: n k iti.v,?Sill..1.:.ke^.lt,-,-.2£:1 L a .IA3k.4 t �1S IN— DEMOLITION DEMOLITION PERMIT APPLICATION Steps in the Permit Process: -Review required submittal items to ensure all information is completed prior to submitting application. -Make an appointment to meet with the Permit Technician by calling 360-379-4450. -Fees will be collected at intake. Additional fees may apply after review and payment is required before permit is issued. For Department Use Only Receipt# Date: I Related Application#s: Payment# Demolition of any structure requires the applicant to receive approval from Olympic Regional Clean ✓ Air Agency(http://www.orcaa.org/services/asbestos-and-demolition or 360-338-6419) prior to obtaining a permit from Jefferson County Dept.of Community Development. Required Submittal Items Iv An approved Demolition permit from ORCAA. QComplete Site plan - Please refer to the site plan checklist to ensure all items are on the site plan. If applicant is different from owner,written authorization from property owner to demolish structure. Building Information Site Address: 175443 Highway 101 Forks, WA. 98331 Assessor Tax Parcel Number(s): 612044002 Present zoning: None shown in Jefferson county parcel viewer Present Use of Property:Vacated Type of Structure to be demolished: CResidence n Garage Li Shed Commercial EV Other What existing buildings will remain? No buildings will remain Is thrnany water on o adjace the property? NO YES Marine iyi Creek CI Pond/Wetland ❑ Lake ❑ Other ( l Sewer disposal method: Onsite septic l Public Sewer-Provider Septic Case# Wastewater-Sewage Disposal co 0 Is there an existing Septic System on the property? Yes _111___ No rn Will you be reconnecting to the existing septic system? Yes ii No Is there an existing well on the property? Yes ❑ No Do you plan on decommissioning the well? Yes t l No n i • Property Owner Name: State Of Washington Department Of Neural Resources-Engineering Division, Facilities Section Address: 111 Washington Street SE Olympia, WA. 98504-7030 Phone#: 360 902-1158 E-mail Address:john.feldert�ia dnr.wa.gov -Ire— Please conta • th wed Agent/Representative with project info. Property Owner Signature: .,�rr�:-�' , Date: 5-Zo—/ Applica»t/Contractor: Authorized Agent/Representative Name: Randy Parker Logging, Inc 76 G L Shake Rd Forks, WA. 98331 Phone#: 360 374-2158 Office 360 580-0873 Cell E-mail Address:grparker72Qgmail.com License#: RANDYPL929DG Expiration Date: 3/7/16 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 making any issued permit null and void. I further agree to that all activities I intend to undertake or complete associated with this permit will be performed In compliance with all applicable federal,state and county laws and regulations and I 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. Applicant may request notice of the County's intent to enter upon the property for visits related to this =.plication and subsequent permit issuance.--r� Signature: • ': ..r♦.'v• Print Name: ._.t�lAirs. � C Date: 5-Z0—i A final inspection must be scheduled once structure is removed to close out case OFFICE USE ONLY Building Permit Fees Demolition Permit Fee $78.00 Environmental Health Review $86.00 i Project Scanning Fee $1930 Total Fees* $183.50 *Additional fees may apply State of Washin Department of Natural Resources, Entering Division DNR 15-E31L, Hoh River Resort,Jefferson County Building Demolition/Site Clearing Project, Limited Public Works Contract Owner's Project Cost Estimate(Base Bid amount,tax not included):$28,000 A non-mandatory pre-bid meeting will be held on April 23,2015 at 11 am,directions to site are attached. Bids are due by May 11,2015,at 2:00 pm. Bids will only be received by the Project Manager via email,or fax(prefer email). Contact information provided below. All work must be completed and all invoices received by June 30,2015. Owner's Project Manager:John Felder-john.felder@dnr.wa.gov,office: 360-902-1158,cell:360-870-5848,fax:360-902- 1778.State of Washington, Dept. of Natural Resources, Engineering Division, 1111 Washington St.,S.E.,Olympia,WA.98504- 7030. Location: 175443 Highway 101, Forks,WA.98380(see attached site location map), Latitude/Longitude: N47.790 W124.251 Project tasks:(all bulleted items below are to be included in the contractor's lump sum base bid line item,also see attached site demo plan and photo sheets,all dimensions/areas are approximate): • Demolish/dispose circa 1950's, 30'x 60', 1-story convenience store(superstructure only)&drive-through roofed "extension"to store. PRESERVE/LEAVE IN-PLACE,THE ASSOCIATED DAYLIGHT BASEMENT FOUNDATION WALLS AND SOIL RETAINING WALLS ADJACENT TO CREEK.Super structure is stick-built,wood framed.Also: o Remove 2 fuel dispensers under extension. Preserve dispenser concrete slab island.Cap/plug any open fuel lines. o Place"Ecology" blocks in front of store basement void immediately following the store superstructure demolition.Assume 60'of store front to be blocked. o Exclude/prevent heavy equipment traffic travel over the underground fuel storage tank, located south of fuel dispenser island. • Demolition of a circa 1980's,24'x 60' mobile "trailer", rear patio and front stair entrance. Leave in-place any in- ground foundation materials. o Coordinate with Owner's asbestos abatement company on trailer demolition,for removal of the asbestos- containing coated roof. Roof removal is Owner's cost& not part of this project. o Cut-off all visible pipes, lines,cables,etc. in and around trailer and bury in-place. o Locate, if possible,septic tank system reportedly north of the trailer. • Demolition of 15'x20' laundry building superstructure, leave in-place concrete slab. o Locate,if possible,septic tank/dry well system(2 dry wells possibly), reportedly south of the laundry building. • Demolition of(4)four-15'x20'cabin superstructures and patios/stairs. Leave in-place any in-ground foundation materials. • Demolition of a 10'x30' pole barn/storage outbuilding, leave slab in-place. • Demolition of a 10'x12' pole barn/storage outbuilding(dirt floor). • At project conclusion, place/extend Ecology blocks from store front,across the driveway entrance,to completely block access to the site.Assume 50'distance from store front, across the driveway entrance.See site demolition plan for additional information. General notes • The onsite mobile trailer cannot be demolished until the Owner's asbestos abatement contractor removes the asbestos containing roof.The demolition contractor is responsible for coordinating with the Owner's asbestos abatement contractor for the roof removal and for obtaining the project demolition permit. Page 1 of 5 RoyAo s CA) Mr/ 3 State of Washu,n Department of Natural Resources, Enikering Division DNR 15-E31L,Hoh River Resort,Jefferson County Building Demolition/Site Clearing Project,Limited Public Works Contract • No demolition activity or generated debris shall be allowed in the creek or within the creek shoreline.Contractor to maintain adequate buffer distance between creek and work activities. • Before building demolition,all glass windows shall be either removed intact for disposal unless demolished in a manner that prevents shattered glass deposits to the ground.Shattered glass or any other demolition waste materials(insulation,vapor barrier paper, roofing,etc.)found on the ground,will be removed by the contractor to Owner's satisfaction. • Existing scattered debris throughout the site,shall be removed for disposal at Owner's direction. • All pipe,conduit,wire,etc.visible on the surface,shall be cut/buried below ground surface. • Provide for"utilities locate"as necessary. Owner-option additive bid times: 1. If located, pump-out&properly decommission adjacent septic tank system thought to be located north of mobile trailer.Tank may be crushed and buried in-place.Abandon leach field in-place. For bidding purposes,assume septic tank to be 1,500 gallons. 2. If located, pump out and properly decommission septic tank/dry well system,thought to be located south of laundry building.Septic tank&dry wells may be crushed and/or buried in-place.Assume septic tank to be 1,500 gallon size and each of 2 dry wells to be 5 ft.diameter and 6 ft. deep. 3. Stormwater sediment runoff does not appear to be an issue at the site, but assume for bidding purposes 100' of erosion control fence will be required, at Owner option. Erosion control fence would remain onsite upon project completion and becomes property of the Owner. 4. Purchase straw mulch at Owner option/direction, to cover any bare soils or disturbed ground surface from demolition activities. For bidding purposes,assume 3"of mulch cover will be required for the mobile trailer,4 cabins, small pole barn and daylight basement exposed footprints. Assume total of 5,000 square feet for mulching. Mulch shall not be spread before Owner's inspection of the site grounds. Straw mulch shall be air dried and free from undesirable seed & coarse material. If stored onsite, mulch will be on pallets and tarp covered (or substantially equivalent method). Other project requirements/information: • The project work site is open access and not secured by fence or gate. • Work may be performed dawn-to-dusk on any day of the week. • Any variance to the contractor submitted project schedule(see item B. below) must be approved by Owner's project manager. • The contractor is responsible for all project related permits. • All demolition debris shall be properly transported and disposed to an approved solid waste facility as per all applicable regulations. o Waste materials for this project become the property of the demolition contractor upon removal from the site. o All demolition-waste invoices&shipping papers shall be provided to Owner,upon completion of project. • It is the contractor's responsibility for all ground transportation related matters,such as safe ingress/egress from the project work site to/from public roadways.Sight distance is limited at the site entrance,up and down highway 101. • All electric facilities have been removed from the site. • There is no water well onsite. • No water or toilet facilities will be available. • All work shall comply with applicable state laws and local codes&ordinances,and shall include all labor,materials, tools,equipment,and facilities to complete the project. Page 2 of 5 State of WashDn Department of Natural Resources, Erering Division DNR 15-E31L, Hoh River Resort,Jefferson County Building Demolition/Site Clearing Project, Limited Public Works Contract • Payment of current L&I fees for filing the Statement of Intent and Affidavit of Wages Paid,as described herein, is required. • Project will not be considered complete until Owners'final approval is given. Contractor shall schedule a final inspection with the Owner's project manager. • Any questions related to this project may be directed to the Owner's project manager.Onsite demolition oversight to be conducted by DNR Region representative. Provided by Owner: • Asbestos Good Faith Survey and asbestos abatement report. • All utilities will be disconnected. • Removal of trailer roof. BASIS OF AWARD The award of this contract shall be based on the total of the "Bid items"and those"Owner-option additive bid items" selected by Owner. COORDINATION OF WORK Contractor shall: A. Notify Owner at least 5 business-days before mobilizing to the site,to initiate contract work. B. Provide a project schedule to Owner,within 5 business days of"Notice to Proceed". C. Maintain adequate supervision during all aspects of work. D. Not encroach on neighboring private property. Contractor to complete bid line items below. Do not add tax. Payment shall be for all labor and material to complete the project. Bid items: Contractors Base Bid (lump sum) $ Minor Change-item Cost(1) $ 3,000 Total Contract Amount(lump sum) $ Owner-option additive bid items: Pump-out& properly decommission trailer septic tank system (lump sum) $ Pump-out&properly decommission laundry bldg.septic tank system (lump sum) $ Erosion control fencing(lump sum for 100'distance) $ Purchase straw mulch,transport to site(lump sum for 5,000 sq ft area) $ Page 3 of 5 State of Washirilln Department of Natural Resources, Engering Division • DNR 15-E31L, Hoh River Resort,Jefferson County Building Demolition/Site Clearing Project, Limited Public Works Contract (1) Minor Change-item Cost:At the discretion of the Project Manager, payments or credits for changes may be made for work not described above.The Contractor will be provided a copy of the completed Field Order for a Minor Change. The agreement for the Minor Change will be documented by signature of the Contractor. Contractor shall not proceed with changed work until a Field Order for Minor Change is signed by the Owner's Project Manager.To present a common proposal for all bidders,Owner has entered an amount($3,000)for Minor Changes in the proposal to become a part of the total bid by the Contractor. The cost basis of a Minor Change shall be time and materials cost, plus a markup for overhead and profit. Contractor shall submit documentation of costs prior to payment for Minor Change. Prevailing Wages:The CONTRACTOR shall pay the applicable prevailing rate of wages in effect to all workers, laborers,or mechanics employed in the performance of any part of the Work in accordance with RCW 39.12 and the rules and regulations of the Department of Labor and Industries(L&I). A copy of the applicable wage rates can be found at: http://www.lni.wa.gov/TradesLicensing/PrevWage/WageRates/default.asp and is available for viewing at the local region office. Upon request,the STATE will mail a hardcopy of the applicable wage rates to CONTRACTOR. CONTRACTOR shall file a Statement of Intent to Pay Prevailing Wages with L&I and the Owner and send a copy of the approved Statement of Intent to Owner. Copies of the approved Statement of Intent shall be posted on the job site with the address and telephone number of the L&I Industrial Statistician where a complaint or inquiry concerning prevailing wages may be made. CONTRACTOR shall pay current L&I fees for filing the Statement of Intent and Affidavit of Wages Paid. For questions,call L&I Prevailing Wage Section: (360)902-5335. Sales Tax Applies to Entire Contract Amount:This contract is subject to state and local sales tax which will be paid directly to the Contractor by the Department of Natural Resources on the base bid amount. Do not include sales tax in the base bid amount. Tax rates may change during the course of the project. Insurance:All insurance coverages shall be endorsed to include the STATE as an additional named insured for Work performed in accordance with this Contract,and all insurance certificates shall evidence the STATE as an additional insured. All insurance certificates shall name the STATE project number and project title. The CONTRACTOR shall provide proof of the Commercial General Liability(CGL) Insurance Employers Liability(Stop Gap) Insurance General Aggregate Limit $1,000,000 Bodily Injury: Products-Completed Operations Limit $1,000,000 By Accident $1,000,000 Personal and Advertising Injury Limit $1,000,000 Each Employee By Disease $1,000,000 Fire Damage Limit(any one fire) $ 50,000 Policy Limit By Disease $1,000,000 Medical Expense Limit(any one person) $ 5,000 Business Auto Policy(BAP) Insurance(Required for all Contracts) Bodily Injury and Property Damage, Each Accident $1,000,000 insurance coverages and limits specified below: Responsibility Criteria: 1. Contractor shall not have been debarred by any public agency within the last two(2)years. In accordance with RCW 39.06.010 and RCW 39.12.065(3). 2. At the time of bid submittal,Contractor shall have a certificate of registration in compliance with chapter 18.27 RCW. 3. Contractor shall have a current state unified business identifier number(UBI). Page 4 of 5 State of Wasfon Department of Natural Resources, leering Division DNR 15-E31L, Hoh River Resort,Jefferson County Building Demolition/Site Clearing Project, Limited Public Works Contract 4. If applicable,Contractor shall have industrial insurance coverage for the bidder's employees working in Washington as required in Title 51 RCW;an employment security department number as required in Title 50 RCW; and a state excise tax registration number as required in Title 82 RCW. Execution:The CONTRACTOR, Contractor's agents or employees shall abide by all laws, rules, regulations,or ordinances applicable hereto.The CONTRACTOR will protect,save and hold harmless the State of Washington, Department of Natural Resources, its authorized agents and legal employees from all claims,costs, damages, or expenses of any nature whatsoever arising out of,or in connection with the activities covered by this Contract. IN WITNESS WHEREOF,the parties hereto have executed this contract as of the day of , 2015. CONTRACTOR STATE OF WASHINGTON DEPARTMENT OF NATURAL RESOURCES Signature: Signature: Name: Name: Title: Dale Mix, PE Company: Division Manager Contractor's Licenses No.: Employment Security No.: UBI No: Address: Phone: E-Mail: Page 5 of 5 • • c4gGiONCtEq, - - - � l 3----1(-v,r ,„„.. - ��Q� vvra ?=3 � 2940-B Limited Lane NW °~ "...( 1,--N yci � ,;�s� Olympia,WA398:05239.7610 ORCAA ,� . f �1 � , 1-Boa-422 5623 • 60 �' r x .. '' Fax (360) 497-0308 ORCAA Permit Application Status Permit Status o Approved ❑ Disapproved Notes Approved. DNR-Hoh River abatement 3-10-15 Mike Shults Review Date Reviewed by 15ASB004756 03/09/15 Permit# Expiration Date Application Received $325.00 03/09/15 Amount Due CI Cash ❑ Check a Credit card Additional notes or permit conditions Port Angeles field Office: 116W. 8th St., Suite 113, Port Angeles,WA 98362 (3 601 41 74 466 Raymond Field Office:301 Ocean Ave., Raymond,WA 98577:(360 942-2137 t • • Attach your survey Hoh River Resort Survey.pdf ASBESTOS PROJECT CATEGORY Project category and fees ❑ 10-259 linear or 11-159 square feet-$150 ® 260-999 linear or 160-4,999 square feet-$325 ❑ 1,000-9,999 linear or 5,000-49,999 square feet-$650 ❑ 10,000+ linear or 50,000 sq.feet-$1300 ❑ Emergency-$50-letter explaining the emergency is required—must be signed by owner/manager of property ❑ Annual-limit of 260 linear or 160 square feet-$500 PLEASE MAKE A NOTE OF YOUR FEE Applicant name Date KD&S Environmental/Kyla Gerber I 03/09/15 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. This permit is not valid until fees are paid and permittee receives an approved permit.Please contact ORCAA during normal business hours (M-F,8-4:30 p.m.)at 360.539.7610 to arrange payment on your permit application. Permit fees are non-refundable. nupaiwww.im.wa.govisatety/topics/atoz/asbestos/FormDataDisplay a. • • racility ype:Commercial ,ge: Unknown ize: Unknown ype of activity: Demolition ?uantity of Asbestos to Be Removed Outdoors Indoors ivantity: 2310 square feet feet vinyl oofmgMastic& Sheetrock ivantity: linear feet 'ontrol Measures eg.pres. enclosure 'et methods EPA vacuum ritical barriers anual methods espiratory Protection ill face APR pe C pressure demand omments: e have remove everything from this project except the roofing. We will return when the demolition is started to take the roofing. ease put this on hold until the new date is established.Thank you ate/Time Submitted 20/2015 11:04:23 AM 2 3/20/2015 11:04 AM • • ,�gECi04 ctE44' ..,,x . " r "4:1"_yy � otia '?> � a t h _ 2940-13 Limited Lane NW 1,1 Olympia,Olympia,WA 98502 ORCAA 5; `1 �� x g � k 1-800-422-5623 • (360) 539-7610 • re tWrt.tr_G:t.uYt' ir^a'� p ` }'t <' s^ST.t'kt Y Fax: (360) 491-6308 ORCAA Permit Application Status Permit Status IS Approved ❑ Disapproved Notes First Amendment DNR Review Date 03/16/15 Reviewed by CAD 15ASB004756 Permit# Expiration Date Application Received Amount Due ❑Cash ❑ Check ❑ Credit card Additional notes or permit conditions DNR O ,., Oil Port Angeles Field Office: 116 W. 8th St., Suite 1 13, Porr Angeles, WA 98362:(360)417-1466 Raymond ield Office:301 Ocean Ave., Raymond,WA 98577: (360)942-2137 • • KD&S ENVIRONMENTAL, INC. CONTROL PROCEDURES ROOF REMOVAL IN CONJUNCTION WITH BUILDING DEMOLITION DNR H R ER RESORT Dean Wilson, KD&S AHERA PROJECT DESIGNER BI/PD-NES-01-26-15-03 Expires 1/26/16 • • TABLE OF CONTENTS SECTION 1 3 SUMMARY OF SCOPE OF WORK 3 SECTION 2 3 SUMMARY OF CONTROL MEASURES 3 SECTION 3 3 SUMMARY OF WORK PRACTICES/EMERGENCY CLEANUP 3 II II II ICI S I SECTION 1 SUMMARY OF SCOPE OF WORK 1) Demolition and transport a) Roof Demolition,mobile home b) Load material c) Transport material SECTION 2 SUMMARY OF CONTROL MEASURES 1) Designated area will be established around the building. a) The area has been demarcated with asbestos danger tape. b) Water will be used to control dust. c) Impermeable 6 mil ground cover will be used to receive roof. 2) Everyone working within the area will be, at minimum, a class I abatement worker. SECTION 3 SUMMARY OF WORK PRACTICES/EMERGENCY CLEANUP 1) KD&S employee will establish and enter regulated area wearing PPE. 2) Employee will use water hoses to control dust. 3) Employees,using reciprocating saws to cut below roof line, will separate roof from mobile home. 4) Roof, as a unit,will be wrapped in double layer 6 mil poly, folded to fit container, then placed in container for transport to landfill. 5) When work area is clean, regulated area is inspected and any debris will be picked up. 6) Regulated area is dismantled and work area turned over to demolition contractor. 7) Employee will HEPA vacuum outer clothing,remove and dispose as contaminated waste. 8) Workers will proceed to wash station to wash hands and face,before leaving work site. KD&S Environmental, Inc. Date