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Home My WebLink AboutBLD2021-00092 - 01 Permit applicationDemolition 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 Farm and cidery 4 All other structures on site map will remain 4 4 SEP16-09 Agricultural 4 901151004 124 Center Road, Chimacum, WA 98325 4 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 $97.00 Environmental Health Review $141.00 Project Scanning Fee $24.00 Technology Fee – 5% $13.10 Total Fees* $275.10 *Additional fees may apply 360-821-1611 cara@seedalliance.org eric@finnriver.com 2/16/21 124 Center Road, Chimacum, WA 98325 4 Cara Loriz Finnriver North LLC NA Cara Loriz Digitally signed by Cara Loriz Date: 2021.02.16 13:18:41 -08'00'Cara Loriz 631-566-2742 See Letter 2/16/21 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.