HomeMy WebLinkAboutBLD2001-00403 •
DEMOLITION PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD01-00403 Received Date 7/10/2001
SITE ADDRESS: 2190 OLD GARDINER RD Issue Date 9/16/2002
SEQUIM, 98382
APPLICANT: RICHARD A DENNIS PHONE: (360)797-7875
CORINNE DENNIS
2190 OLD GARDINER RD
SEQUIM WA 98382-8704
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 002353010 Section: 35 Township: 30N Range: 02W
CONTRACTOR: BISHOP BROTHERS CONSTRUCTION PHONE: (360)385-2441
PO BOX 417
PORT HADLOCK WA 98339
Contractor's License BISHOBCO93D6 Expires 12/14/2002
OWNER, RICHARD A DENNIS PHONE: (360)797-7875
if different: CORINNE DENNIS
2190 OLD GARDINER RD
SEQUIM WA 98382-8704
PROJECT DESCRIPTION NO MLA REQ'D - DEMOLITION OF RESIDENCE
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 09/16/2003.
REQUIRED INSPECTION:
[ FinalApproval:
BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. - 4:30 p.m.
HOT LINE AVAILABLE 24 HOURS A DAY
is\F_BLD_Permit_Propane.rpt 10/29/19
. . UILDING PERMIT APPLICPION Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00403 Received Date: 7/10/2001
SITE ADDRESS: 2190 OLD GARDINER RD
SEQUIM, 98382
OWNER: RICHARD A DENNIS PHONE: (360)797-7875
CORINNE DENNIS
2190 OLD GARDINER RD
SEQUIM WA 98382-8704
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 002353010 Section: 35 Township: 30 N Range: 02 W
CONTRACTOR: OWNER PHONE:
REPRESENTATIVE(S):
PROJECT DESCRIPTIO NO MLA REQ'D - DEMOLITION OF RESIDENCE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP DEM
VALUATION MAIN:
CODE EDITION: 1997 ADDI: HEAT TYPE
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: Exist: Wetland Erosion
Prop: Prop: Seismic Streams
Total: Total: Flood Way Floodplain .
F&W Landslide
Routing Date: Shoreline Aquifer
— �`�� Forest: Commercial Rural
Proximity Plat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $48.00 MAM 07/10/01 29005 AP p O\ / -f
State Building Code $4.50 MAM 07/10/01 29005 �/r �'�'
6 '
Total: $52.50
APPROVED n County Plannm
\ & Built. 1 u, nt
SEP 1 6 2002 4 le �., 44
Jefferson County Planning �;�:° i'v�,0�`-�—'���,
& Building Department Utz /'
JEFFERSON COUNTY COMMUNITIRVELOPMENT, 621 SHERIDAN ST, PORT TOWNSIOWA 98363 PH: (360) 379-4450
DEMOLITION PERMIT APPLICATION
SITE ADDRESS: c90
�L�(�911#/ROAD NAME / / 2(� �A �s// 7 / t/C/ /1- ZIP %O 3 Fa9 DIGIT PARCEL ID NUMBEROD 3 3 -r 0/0
Legal Description:
Subdivision Name • CO . --C_7/0 Block Lots)
Section - Township 0 North, Range C') Z WM
APPLICANT -e- %la ®� PHONE 36 9 '2— 6 25-
MAILING ADDRESS 711C., O'd ' / ,
l c.Ci+ i �L/ i ZIP 92 - Z
PROPERTY OWNER -Cg.--y-7--e---- PHONE
MAILING ADDRESS
ZIP
CONTRACTOR C� -' 'Z(2 PHONE 3 ' GZ^
MAILING ADDRESS
ZIP
STATE LICENSE # EXP. DATE
FEDERAL I.D. #
By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any
material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being
null and void.
I further agree to save, indemnify and hold harmless Jefferson County against all liabilities, judgments, court costs, reasonable attorney's fees and
expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agree to provide access and right of entry to Jefferson County and it's employees, representatives or agents for the purpose of application
review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during
regular business hours.
APPLICANT SIGNATURE DATE C:::› / 246/ 7. )/
FOR OFFICE USE ONLY .-
BASE FEE </6"--60 " , RECEIPT# 6)05
STATE SURCHARGE 4.50_ "�� \CnASH/CK Se
# , -lr
TOTAL Jc�C-`��0 `� et 0 QATE F ✓ / / ��
c
} v '"Y fit' •
J
H:\HOME\PLNCNTR\FORMS\DEM010/99 �' �- ��'i,� � � �
D
27
•
Approved 1)0' Permit# 1 ' . k. -' ,., -tPMr;,S,t,, , - ,_''',:7,•44!,,6,,0I,..i,.
'4,-
St
Approved Bt Wlth6''
Svciai 0:ndt.)rs Noted � ?,! - �
Not fapr rc:e;1 For .. illi Mir -at
F .,. C,:,:-,: ;..r,:e ',;,1; r,.g. OLY M PI - ikEC°
OAP
AIR POLLUTION CONTROL AUTHORI Ina
rótification of Demolition Pe it pcix
OP
It is unlawful for any person to cause or allow the demolition (or major renovation) •• . • structure unless all asbestos-
containing materials have been removed from the area to be demolished. Work shall not commence on an asbestos project or
demolition unless the owner or operator has obtained written approval from OAPCA. A written application for a demolition
shall include a certification that there is no known asbestos-containing material remaining in the area of the structure.
Project Site dress: 90
County fir
City ' Lac, State (� )/9-
ak-
Starting Date: N __ -. Completion Date:
s
Property Owner: ��:r=-4�i�c3 /// , Telephoner! --'7- ,7e7S
Mailing Address: /( 2> d4 ' _---- r
City -zee c. State l{,/,i Zip 1Cs ,p.�
o2
Demolition Contractor: ( / '72.e,? State License #
Mailing Address:
City State Zip
Contact Person.
`,.c-� Telephone, D - 2�->-c v /
YES O
Demolition by Wrecking or Dismantling? ($25 fee)
Training Fire Demolition? (If yes, attach fire department request for training fire)
Renovation, Alteration, Remodeling, Maintenance, or other Construction?
r/ Asbestos found or suspected*
*An OAPCA"Notice of Intent to Remove or Encapsulate Asbestos" form and appropriate fee must be submitted prior to any asbestos
removal work. Asbestos 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 OAPCA Regulation 1 Article 14 for additional
requirements that may apply.
AsbestosCo
mpleted
y by
AHERA Certified Inspector / Ze)%-rli/��a •
Certification # /52
This approved permit , Certification of the Asbestos l';
Enclose $25 f Survey must accompany this `
must be available at ther
job site Processing Fee form
909 Sleater Kinney Rd SE,Suite#1,Lacey, Washington 98503
360-438-8768 * 800-422-5623 * fax 360-491-6308
homepage:www.oapca.org * email: info@oapca.org