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Home My WebLink AboutBLD2020-00487 - DEMODemolition Permit 1 DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street, Port Townsend, WA 98368 Tel: 360.379.4450 | Fax: 360.379.4451 Web: www.co.jefferson.wa.us/communitydevelopment E-mail: dcd@co.jefferson.wa.us 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: Related Application #s: Payment #  Demolition of any structure requires the applicant to notify the Olympic Regional Clean Air Agency (https://www.orcaa.org/asbestos-demolition-programs/demolition-notification/ or 360-338-6419) prior to obtaining a permit from Jefferson County Dept. of Community Development. Required Submittal Items Proof of notification and payment receipt from ORCAA. Complete 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: Assessor Tax Parcel Number(s): Present Zoning: Present Use of Property: Type of Structure to be demolished: Residence Garage Shed Commercial Other What existing buildings will remain? Is there any water on or adjacent to the property? NO YES Marine Creek Pond/Wetland Lake Other Sewer disposal method: Onsite septic Public Sewer - Provider Septic Case # Wastewater - Sewage Disposal Is there an existing Septic System on the property? Yes No Will you be reconnecting to the existing septic system? Yes No Is there an existing well on the property? Yes No Do you plan on decommissioning the well? Yes No 4 4 None 4 None 4 4 SOM92-00371 Rural Residential 4 702231030 295541 Hwy 101 Quilcene WA 4 4 4 Demolition Permit 2 Property Owner Name: Address: Phone #: E-mail Address: Please contact Authorized Agent/Representative with project info. Property Owner Signature: Date: Applicant / Contractor: Authorized Agent/Representative Name: Phone #: E-mail Address: License #: Expiration Date: 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 application and subsequent permit issuance. Signature: Print Name: Date: A final inspection must be scheduled once structure is removed to close out case OFFICE USE ONLY Building Permit Fees Demolition Permit Fee $96.00 Environmental Health Review $139.00 Project Scanning Fee $24.00 Technology Fee – 5% $12.95 Total Fees* $271.95 *Additional fees may apply 3605312048 9/24/2020 kenmcedwards@gmail.com Ken & Julie McEdwards Kenneth McEdwards 9/24/2020 Asbestos in Your Home Helpful Hints & Project Planning • Include the appropriate fee • Ensure the Start Date is after the 10- day or 14-day waiting period • Include the complete survey for demolition projects ORCAA offers many of its pertinent documents and forms through its website: • Link to a list of Certified Asbestos Inspectors and Contractors • Link to NVLAP Accredited Laboratories • Do-it Yourself Resources • Removal Instructions for various materials • Program Forms: ͦDemolition Notification ͦAsbestos Notifcation ͦAmendment Request Before demolishing a structure… An asbestos survey and ORCAA Notification must be completed. Only Certified Asbestos Building Inspectors can do the survey for demolitions. If asbestos was detected in the survey… The asbestos material must be abated prior to demolishing the structure. This requires an Asbestos Notification and fee. See Asbestos Projects below. Projects are considered “Asbestos Projects” if… The project includes more than 48 square feet or 10 linear feet (pipes) of asbestos-containing material. In these cases, a Notification must be filed with ORCAA at least 10 days before work begins unless the project meets ORCAA’s definition of an Emergency*. The Notification must have the start and end dates noted, as well as the location of the property. * ORCAA can waive the 10-day notification under certain conditions. Contact ORCAA Compliance Staff for details. Homeowners wishing to remove asbestos should… Review ORCAA’s three guidance documents for the most common do-it- yourself abatement projects. To determine if there is asbestos… If a structure is being demolished, a Certified Asbestos Building Inspector needs to conduct the asbestos survey. If the structure is not being demolished, submit samples to a National Voluntary Laboratory Accreditation Program (NVLAP). Find a link to a list of these at www.ORCAA.org. Residents who want to do the abatement work themselves… Owners of a single family residence may do the work themselves. Guidance documents are available at www.ORCAA.org. Olympic Region Clean Air Agency 2940 Limited Lane NW Olympia, WA 98502 (360) 539-7610 Best practices for planning your home improvement projects Asbestos may be present in several locations in your home, but it is not a cause for concern as long as it is not disturbed. The graphic above shows some of the more common areas in which asbestos may have been used in your home so that you will be aware of its presence should you need to repair or replace any of the items listed. If any of the items that might contain asbestos are broken or damaged, treat it as if you know it DOES contain asbestos until you can prove otherwise. SI TE PLANSITE PLAN SCALE: 1 inch = 50 feet ABBREVIATED LEGAL DESCRIP TIONABBREVIATED LEGAL DESCRIP TION S23 T27 R2W TAX 34 PARCEL NUMBERPARCEL NUMBER 702231030 SI TE ADDRESSSITE ADDRESS 295541 Highway 101 Quilcene, WA 98376 OWNER/APPLICAN TOWNER/APPLICAN T Kenneth L & Julie McEdwards PO Box 15 Brinnon, WA 98320-0015 NOTESNOTES Septic system location is approximate – based on SEP92-00371 ("no permanent markes to measure septic tank from"). Mobile home to be removed is a double-wide in two separate pieces. It was never assembled when it was moved onto the lot by the previous owner. Approved by: Approved Signatory Amber Rutter Report for: Chad Witheridge NW Asbestos 97 fir circle Port Hadlock, WA 98339 Regarding:Project: 295545 HW 101 Quilcene WA EML ID: 2429726 All samples were received in acceptable condition unless noted in the Report Comments portion in the body of the report. The results relate only to the samples as received. The results include an inherent uncertainty of measurement associated with estimating percentages by polarized light microscopy. Measurement uncertainty data for sample results with >1% asbestos concentration can be provided when requested. Eurofins EMLab P&K ("the Company") shall have no liability to the client or the client's customer with respect to decisions or recommendations made, actions taken or courses of conduct implemented by either the client or the client's customer as a result of or based upon the Test Results. In no event shall the Company be liable to the client with respect to the Test Results except for the Company's own willful misconduct or gross negligence nor shall the Company be liable for incidental or consequential damages or lost profits or revenues to the fullest extent such liability may be disclaimed by law, even if the Company has been advised of the possibility of such damages, lost profits or lost revenues. In no event shall the Company's liability with respect to the Test Results exceed the amount paid to the Company by the client therefor. Dates of Analysis: Asbestos PLM: 06-29-2020 Service SOPs: Asbestos PLM (EPA 40CFR App E to Sub E of Part 763 & EPA METHOD 600/R-93-116, SOP EM-AS-S-1267) NVLAP Lab Code 500053-0 EMLab ID: 2429726, Page 1 of 2EMLab P&K, LLC Eurofins EMLab P&K 4955 Yarrow Street , Arvada, CO 80002 (800) 651-4802 Fax (623) 780-7695 www.emlab.com Client: NW Asbestos C/O: Chad Witheridge Re: 295545 HW 101 Quilcene WA Date of Receipt: 06-25-2020 Date of Report: 06-30-2020 ASBESTOS PLM REPORT Total Samples Submitted:4 Total Samples Analyzed:4 Total Samples with Layer Asbestos Content > 1%:1 Location: S1, ACT Lab ID-Version‡: 11589492-1 Sample Layers Asbestos Content Brown Ceiling Tile ND Composite Non-Asbestos Content: 90% Cellulose Sample Composite Homogeneity: Good Location: S2, Front Bed Vinyl Lab ID-Version‡: 11589493-1 Sample Layers Asbestos Content Multicolored Sheet Flooring with Fibrous Backing 20% Chrysotile Composite Non-Asbestos Content: 10% Cellulose Sample Composite Homogeneity: Good Location: S3, Back Bath Floor Lab ID-Version‡: 11589494-1 Sample Layers Asbestos Content Beige Sheet Flooring with Fibrous Backing ND Brown Wood ND Composite Non-Asbestos Content: 25% Cellulose Sample Composite Homogeneity: Moderate Location: S4, Flooring Lab ID-Version‡: 11589495-1 Sample Layers Asbestos Content Beige Sheet Flooring with Fibrous Backing ND Composite Non-Asbestos Content: 20% Cellulose Sample Composite Homogeneity: Good EMLab ID: 2429726, Page 2 of 2EMLab P&K, LLC The test report shall not be reproduced except in full, without written approval of the laboratory. The report must not be used by the client to claim product certification, approval, or endorsement by any agency of the federal government. Eurofins EMLab P&K reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Inhomogeneous samples are separated into homogeneous subsamples and analyzed individually. ND means no fibers were detected. When detected, the minimum detection and reporting limit is less than 1% unless point counting is performed. Floor tile samples may contain large amounts of interference material and it is recommended that the sample be analyzed by gravimetric point count analysis to lower the detection limit and to aid in asbestos identification. ‡ A "Version" indicated by -"x" after the Lab ID# with a value greater than 1 indicates a sample with amended data. The revision number is reflected by the value of "x". NWA ENVIRONMENTAL Surveys. Inspections. Sampling AHERA Building Inspector / Mgmt Planner EPA Certification AHERA1016201580 97 Fir Circle Port Hadlock WA 98339 chadwitheridge@gmail.com (360)531-4636 Date: 7/3/2020 Job location: 295545 HW 101 Quilcene WA Owner: Edwards Subject: Inspection for Demolition Inspector: Chad Witheridge EPA AHERA - Building Inspector #1016201580 Expires- 10/20/2020 Asbestos Bulk Sample Data NWA ENVIRONMENTAL Surveys. Inspections. Sampling AHERA Building Inspector / Mgmt Planner EPA Certification AHERA1016201580 EPA Certification WAMOA-0042 97 Circle Port Hadlock WA 98339 chadwitheridge@gmail.com (360)531-4636 Samples were sent to EMLAB P&K Dates: 6/25/2020 Job location: 295545 HW 101 Quilcene WA Owner: Edwards Subject: Inspection for Demolition Samples S1: ACT S2: Front Bed Vinyl S3: Back Bath Vinyl S4: Flooring Inspector: Chad Witheridge EPA AHERA - Building Inspector #1016201580 Expires- 10/20/2020 Scope of Work: 1) Good faith inspection for asbestos containing building material (ACBM). 2) Survey, sample and record suspect materials of requested area only. 3) Report to Edwards with results. Inspection Report: 1200 square foot double wide residential mobile home. Wood siding, composition roof, metal windows. Vinyl flooring and carpet inside. Mobile home is damaged but all materials are identified. NWA ENVIRONMENTAL Surveys. Inspections. Sampling AHERA Building Inspector / Mgmt Planner EPA Certification AHERA1016201580 EPA Certification WAMOA-0042 97 Fir Circle Port Hadlock WA 98339 chadwitheridge@gmail.com (360)531-4636 Date: 7/3/2020 Job location: 295545 HW 101 Quilcene WA Owner: Edwards Subject: Inspection for Demolition Inspector: Chad Witheridge EPA AHERA - Building Inspector #1016201580 Expires- 10/20/2020 Summary: ND= No Asbestos Detected S1: ACT ND S2: Front Bed Vinyl 20% Chrysotile S3: Back Bath Vinyl ND S4: Flooring ND All asbestos containing building materials with a reading greater than 1% is considered a hazardous material if disturbed. If removed the owner or certified abatement contractor must follow the rules of the EPA and governed by Olympic Region Clean Air Agency. During renovation it is possible that additional suspect ACBM may be found. Should such suspect material be discovered an AHERA certified inspector will have to sample and test the material to prove it is of non asbestos. Northwest Asbestos Environmental is not responsible for identification of hidden materials that are not identifiable with reasonable diligence. Thank you, Chad Witheridge Building Inspector EPA Certification AHERA10162015 NWA Environmental 406 Reed Street Port Townsend, WA 98368 (360) 531-4636 chadwitheridge@gmail.com Invoice 1385 BILL TO Edwards 295545 HW 101 Quilcene WA DATE 07/08/2020 PLEASE PAY $535.00 DUE DATE 07/08/2020 ACTIVITY QTY RATE AMOUNT Asbestos Inspection Asbestos Inspection, Survey and Report 1 395.00 395.00 Asbestos Sample 4 35.00 140.00 TOTAL DUE $535.00 THANK YOU.