HomeMy WebLinkAboutBLD2015-00173 - 01 PERMIT APPLICATION • •
DEMOLITION PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD15-00173 Received Date 5/27/2015
SITE ADDRESS: Issue Date 6/1/2015
APPLICANT: STATE OF WASHINGTON-NAT RESOUR PHONE:
PO BOX 47014
OLYMPIA WA 98504-7014
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 612044000 Section: 4 Township: 26N Range: 12W
CONTRACTOR: RANDY PARKER LOGGING, INC PHONE: 360-580-0873
76 G L SHAKE RD
FORKS WA 98331
OWNER, STATE OF WASHINGTON-NAT RESOUR PHONE:
if different: PO BOX 47014
OLYMPIA WA 98504-7014
PROJECT DESCRIPTION: DEMO - CONVENIENCE STORE, MOBILE, LAUNDRY BLDG, 4
Directions CABINS, TWO POLE BARNS
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 61112016.
REQUIRED INSPECTION:
FinalApproval:7 111 59—"r
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# BLD15-00173:
1.) H -Prior to finaling this building permit for demolition of the convienience store, mobile
home, laundry building and 4 cabins all septic tanks including from permits SEP94-521,
SEP72-798 and SEP78-180 and any others not permitted or on record must be pumped
by a certified pumper and and properly decommissioned by a certified installer. Installer
shall submit the Tank Abandonment Form for each of the systems decommissioned to
Environmental Health. Afee shall be charged by JC Environmental Health for each of the
systems to verify the completion of the decommissioning. Contact JC Environmental
Health at 360-385-9444 for questions.
2.) Approval by the Health Department for this demolition permit is based on the owners
signed acknowledgement that they will be decommissioning the existing septic systems
prior to final of this building permit. Some records of systems have been found but may
not be complete information. This demolitionn approval 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 6/1/2015
•
DEMOLITION PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD15-00173 Received Date 5/27/2015
SITE ADDRESS: Issue Date 6/1/2015
APPLICANT: STATE OF WASHINGTON-NAT RESOUR PHONE:
PO BOX 47014
OLYMPIA WA 98504-7014
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 612044000 Section: 4 Township: 26N Range: 12W
CONTRACTOR: RANDY PARKER LOGGING, INC PHONE: 360-580-0873
76 G L SHAKE RD
FORKS WA 98331
OWNER, STATE OF WASHINGTON-NAT RESOUR PHONE:
if different: PO BOX 47014
OLYMPIA WA 98504-7014
PROJECT DESCRIPTION: DEMO - CONVENIENCE STORE, MOBILE, LAUNDRY BLDG, 4
Directions CABINS, TWO POLE BARNS
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 6/1/2016.
REQUIRED INSPECTION:
FinalApproval:
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# BLD15-00173:
1.) H -Prior to finaling this building permit for demolition of the convienience store, mobile
home, laundry building and 4 cabins all septic tanks including from permits SEP94-521,
SEP72-798 and SEP78-180 and any others not permitted or on record must be pumped
by a certified pumper and and properly decommissioned by a certified installer. Installer
shall submit the Tank Abandonment Form for each of the systems decommissioned to
Environmental Health. A fee shall be charged by JC Environmental Health for each of the
systems to verify the completion of the decommissioning. Contact JC Environmental
Health at 360-385-9444 for questions.
2.) Approval by the Health Department for this demolition permit is based on the owners
signed acknowledgement that they will be decommissioning the existing septic systems
prior to final of this building permit. Some records of systems have been found but may
not be complete information. This demolitionn approval does not ensure future building
approval. Any future onsite sewage system shall meet code in effect at the time of
application.
11tidemark\data\forms\F_B LD_Perm it_P ropan e.rpt 6/1/2015
BUILDING PERMIT APPLICA•N BLD15-00173
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD15-00173 Received Date: 5/27/2015
SITE ADDRESS:
FORKS, 98331
OWNER: STATE OF WASHINGTON-NAT RESOUR PHONE:
PO BOX 47014
OLYMPIA WA 98504-7014
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 612044002 Section: 4 Township: 26 N Range: 12 W
CONTRACTOR: RANDY PARKER LOGGING, INC PHONE: 360-580-0873
76 G L SHAKE RD
FORKS WA 98331
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP DEMO - CONVENIENCE STORE, MOBILE, LAUNDRY BLDG, 4
CABINS, TWO POLE BARNS
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP DEM MAIN:
VALUATION ADD'L: HEAT TYPE:
CODE EDITION: 2012 HEAT BASE: HEAT TYPE:
OCCUPANCY:
OCCUPANCY: UNHEATED: # OF STORIES:
OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $78.00 JLA 05/20/15 156103 APPROVED
Total: $78.00
JUN / 1 2015
Jefferson County DCD
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