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Home My WebLink About1203 Campbell Ave - Building ,----- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 05-00000541 Date 240043 1203 CAMPBELL AVE 06-30-14-5-3-0340-0000- DEMOLITION 7/01/05 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation RESIDENTIAL HIGH DENSITY 7200 Owner Contractor Meehan Sandra K. / Thomas K. 1203 CAMPBELL AVE PORT ANGELES WA 983622708 LAHREN CONSTRUCTION 3.65 OLD SCHOOL HOUSE ROAD SEQUIM, WA SEQUIM WA 98382 (461) 1905 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date DEMOLITION 53611 47.00 7/01/05 12/28/05 plan Check Fee Valuation Qty Unit Charge Per Extension 47.00 BASE FEE Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 47.00 47.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 47.00 47.00 .00 .00 .00 o ~ 7 czt: /, (0'-/ 'l, V O<f ~ & ~ s: "\j ~ \1\ ~ ~ ~ Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether sp cified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or al law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date T:\Policies\1102_15 building pemlit inspection record05.wpd [1/4/2005] Date L I-~ BUILDING PERMIT INSPECTION RECORD CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE 1 DOWN SPOUTS PIERS pOST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR W ALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR I CEILING MECHANICAL HEAT PUMF 1 FURNACE 1 DUCTS GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY COMMERCIAL HOOD 1 DUCTS MANUFACTURED HOMES FOOTING 1 SLAB BLOCKING & HOLD DOWNS SKlRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: P ARKINGILIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTIONR.W.I PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 ~ FIRE DEPT. PLANNING DEPT. 417-4750 J \ ~ PLANNING DEPT. BUILDING 417-4815 I III", 'i 1\\\ "- BUILDING T:\Policies\1102_15 building permit inspection record05.wpd [I 4/2105]'" v \\\J ~t ;",'l>';.:~n:~ ?' :;::~{:~tf1!;~: ~ ';':;f}~:~;:1t,,~ .....J~-" ":C'_ .~'.>~J,.!-/:r;;' ~ORTANGELES W . ASH I NG TON , U.S. A. Public Works & Utilities Department July 1, 2005 . Sandra K. Meehan 2140W est 4th Street Port Angeles, W A 98362 RE: Port Angeles Landfill Waste Disposal Application, WDA 05-21; Building demolition at 1203 Campbell Ave, Port Angeles, Washington We have received your application for disposal ofbuilding demolition debris from the referenced. site. Based on the information submitted, the debris appears to be acceptable for use in the landfill. A copy of your approved application is attached. This approved application must be shoW!l to the landfill scale attendant at the time of disposal. Please be advised that this disposal application is only for the materials and quantities listed in the application. Materials not listed or in excess of the quantities noted may require separate applications and approval. .. Please call if you have questions. Very truly yours, 'J/ZMU-~ ~uUln- krv , GaryW. Kenworthy, P.E. () City Engineer Deputy Director of Engineering Services GWK:tf Enc!.: WDA 05-21 Copy: Ken Loghry N:\PWKS\ENGINEERIWDAPPLlC\05-21,WPD FILE: Landfill Solid Waste Disposal Applications Phone: 360-417-4805 / Fax: 360-417-4542 Website: www.cityofpa.us / Email: publicworks@cityofpa.us 321 East Fifth Street - P.O. Box 1150/ Port Angeles, WA9S362-0217 "':;,] ... . ~ ~.: . , i'~} PORT ANGELES LANDFILL WASTE DISPOSAL APPLICATION vVDA- os-- L l Phone: (360) 417-4803 FAX: (360) 417-4709 To: City of Port Angeles. City Engineer 321 E Fifth Street P.O. Box 1150 Port Angeles, Washington 98362 NOTE: All questions must be answered for waste to be approved. 1. Generator Information: Company Name: Mailing Address: Contact: Phone: Project Name: Project Location: fYlt ~ f+-/trlO ~ >7 -,LJ '.:) I{ \ 1-<1 (J S-'5" ~9~.~~~ {' 2. Other Contacts (if applicable): Consulting Firm: Contact: Phone: Contractor Name: Contact: Phone: Laboratory: Contact: Phone: L.A-+-IIC~ L-fh<i b bev- Page - 1 City of Port Angeles - Landfill Waste Disposal Application , . 13. Source of Waste: Check the appropriate box below and briefly describe the project, process, and/or cleanup that will or has produced the waste requiring disposal. Include the gasoline service station number (if applicable). CERCLAlMTCA Remediation Agency Contact: Independent Remedial Action Unused Chemical Product Spill UST Removal Other Source: 4. Waste Material Composition: (check all that apply and include percent of total) 5. Waste Material Contaminants: (check all that apply) Gasoline Metals Diesel Solvents Unused Motor Oil Other Heating Oil PCBs Used Motor OillWaste Oil Other Petroleum Product Unknown NOTE: Supply any MSDS information with application, if available. City of Port Angeles - Landfill Waste Disposal Application Page - 2 '. .. r~sti~-~t~'d-QUantity of Waste for Disposal: Cubic yards / Drums / Tons (estimate both) Tons (estimate both) Other NOTE: Estimated quantity for disposal must be within 20% of the quantity actually disposed. (10% for projects over 7,500 tons or 5,000 cubic yards.) 7. Frequency of Disposal: One time Monthly Annual -Mer ) 8. Waste Sampling: \ Proper characterization of the waste for disposal requires the collection of representative samples. The methods and equipment necessary for obtaining representative samples of a waste, and the frequency of sampling, will vary with the type and form of the waste. Check the appropriate box and briefly describe how and where the waste was sampled. Include site maps with sampling locations if possible. Number of COMPOSITE samples & number of discrete samples per composite Number of DISCRETE samples NOTE 1: Unless prior approval has been granted by Port Angeles, the following sampling frequency will be used: o - 25 cubic yards = 1 composite sample 25 - 100 cubic yards = 3 composite samples 101 - 500 cubic yards = 5 composite samples 501 - 1000 cubic yards = 7 composite samples 1001 - 2000 cubic yards = 10 composite samples >2000 cubic yards = 10 plus one sample for each additional 500 cubic yards NOTE 2: One composite sample shall contain a minimum of three/maximum of five discrete samples, City of Port Angeles - Landfill Waste Disposal Application Page - 3 J. " ~."Jl. ----.--. -.--.-.-- 9. Waste Analysis: The "Dangerous Waste Regulations" (WAC 173-303) shall be utilized to determine the appropriate analytical requirements for waste characterization. Ecology Publication #91-30 (Revised April 1994 ) "Guidance for Remediation of Petroleum Contaminated Soils" shall also be used to characterize petroleum contaminated soils from UST releases. Submit all laboratory analytical results, QAlQC data, and Chain of Custody sheets along with this application. (NOTE: The laboratory must be accredited by the Washington State Department of Ecology.) a) List all analytical test methods used: b) Provide a narrative as to why the above analytical methods were selected: ~-tD~ Jk.& ~ _~ ~ ~ tJD __ ~~ NOTE: Additional sheets attached: YES NO 10. Soil Classification: (**FOR PETROLEUM CONTAMINATED SOILS ONLY**) Based on the analytical data and Ecology Publication #91-30, the soil classification is: (check one) Class 1 Class 2 Class 3 Class 4 Calculated Hazard Index 11. Dangerous Waste Affidavit: Based on a review of the analytical test results, site history, and the applicable regulations, this ~s)e is classified as: (check one) + Neither Dangerous Waste (OW) nor Extremely Hazardous Waste (EHW) Dangerous Waste (DW) and Waste Code: Extremely Hazardous Waste (EHW) and Waste Code: City of Port Angeles - Landfill Waste Disposal Application Page - 4 I " t ,; ,., . 12. Certification: We, THE UNDERSIGNED, certify that this application is true to the best of our knowledge. All information provided is correct and the enclosed analytical results represent the proposed waste material to the best of our abilities. ddwnlL i7/fe~ Waste Generator Signature SflIJD~i.. IYl {:: f: .{-{-Ii fl) Printed Name Si &tttrryJe$ wA cJ (40 u.)' tf~ C('f3# ~ ~~/- ;){;e5S- Dat City of Port Angeles Approval: j;~ityEnr~ y ,11(05 Date 1 (JOlo5 Approval Expiration Date C:\DA T A\WP\FORMS\WDAaPP.wpd Page - 5 City of Port Angeles - Landfill Waste Disposal Application CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT ISSUED: 8/14/2002 PERMIT NO: 13634 OWNER/APPLICANT PROPERTY LOCATION 1203 CAMPBELL AVE BEN BOWMAN 1203 CAMPBELL Lot: 17 - 22 Port Angeles, WA 98362 Block: 3 [] Long Legal 360/000-0000 Subdivision: BEACON HILLADDNT. T: S: Parcel No: 063014530340000 CONTRACTOR ARCHITECT LINDQUiST CONSTRUCTION N/A 1509W 7TH ST Port Angeles, WA 99360 , 98360-0000 206/452-4820 360/000-0000 PROJECT INFO Project Value: $2,200.00 SFD Units: 0 Commercial: 0 Project Type: RE-ROOF SFD SQ FT: 0 Industrial: 0 Occupancy Type: RESIDENTIAL Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: PROJECT NOTES TEAR OFF, FELT, COMP RECEIPT#9559 FEES ASSESSMENT Building Permit: $83.25 Misc Fee 1: $0.00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $4.50 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 Sign: $0.00 TOTAL FEE: $87.75 Plumbing: $0.00 AMOUNT PAID: $87.75 Mechanical: $0.00 BALANCE DUE: $0.00 Radon: $0.00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is net commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last I hereby certify that I have mad and examined this application and know the same to be true and correct. All provisions of inances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not provisions of any state or local law regulating construction or the performance of ~gent Date Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\ 1102.15 [4/20021 BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSUL4TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE I DATE I YEsACCEPTEDt NO COMMENTS FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LiNE BACK FLOW / WATER AIR SEAL WALLS CEILiNG FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD/ DUCTS PWUTILITIES/ SITEWORK (EngincefingDivlslon) SEPARATEPERMIT#'$: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'$ SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERING 4l 7-4807 PW / ENGiNE EKING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 ~/[//D ~ PLANNING DEPT. BUILDING 417-4815~ [ [~'1~ [~ I~( BUILDING T:\PLANN lNG\FORMS\ I 102.15 [4/2002 ] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ............ REQU/~ T: Date ~- '/'/~ ~ ~:~'~i=~. Time Received by / (phone, person) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Sewer Foundation Framing Chimney Plumbing Final ~ewerExcav. Other INSPECTION N0/~ES: Inspected: Date '!- //" ':;~ ~ Time By ~':__ Remarks: RESTORATION REQUIRED ...... YES NO ;URFACE RESTORATION: SURFACE TYPE: [] Unimproved [~]Gravel [~Asphalt I--IPCC [~Other FI Repaired by City Work Order # El Repaired by Permittee [-~ COMPLETE []No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)