HomeMy WebLinkAbout1225 W Ediz Hook Rd - Building
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DrVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
07-00001505 Date
118510
1225 W EDIZ HOOK RD
06-31-00-0-0-0000-0000-
CITY OF PORT ANGELES
DEMOLITION
1/11/08
UNKNOWN
1000
Owner
Contractor
CITY OF PORT ANGELES
PO BOX 1150
PORT ANGELES WA 983620217
HORIZON EXCAVATING
PO BOX 3248
PORT ANGELES
(360) 452-9976
1,065 SQ. FT. BLDG.
WA 98362
Structure Information 000 000 DEMO
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
DEMOLITION
DEMO 1065 SQ. BLDG
117887
50.00 Plan Check Fee
1/11/08 Valuation
7/09/08
.00
1000
Qty
Unit Charge Per
BASE FEE
Extension
50.00
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
January 8, 2008 11:34:55 AM sroberds.
Demolition is okay in the shoreline w/o a shoreline permit.
Best management practices must be observed with debris
stacked and appropriately removed. No land use issues
anticipated.
Public works electrical engineering has no requirements for
this plan review.
Public Works Utility Engineering has no requirements for
this plan review.
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 50.00 50.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 50.00 50.00 .00 .00
h'rt<ttee/
02()
I-OJ
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 has 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 specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the rov' Ions 0 a ate or local law regulating construction or the performance of
construction.
Signature of Owner (if owner is builder)
T:Forms/BlIilding Iiliyisiol~~il~ing Pe~,:,it (10/01/07).wpd
BUILDING PERMIT INSPECTION RECORD
G
-.J
,
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVfDE 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.
\Sl
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IJI
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
SHEAR WALLS / WALLS
FOUNDATION DRAINAGE / DOWN SPOUTS
PIERS
POST HOLES (POLE BLOGS.)
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERIOR BRACED PANEL ONi Y)
T-BAR
INSULATION
SLAB
WALL I FLOOR / CEILING
MECHANICAL
HEA T PUMP / FURNACE / DUCTS
GAS LINE
WOOD STOVE / PELLET / CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD I DUCTS
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
. .
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE
RESIlH:NTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION RW. / PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT. I j ~.
BUILDING 417-4815 BUILDING -..1/ / / t. If-~
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T.Forms/Building Division/Building Permit (1010 1/07).wpd
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BUILDING PERMIT APPLICA TION Print in ink
CITY OF PORT ANGELES
Attn: Building Permit Technician
321 E. Fifth St., Port Angeles, WA 98362
(360) 417-4815 fax (360) 417-4711
Ph
Ph
For City Use Only:
Date Received [2."1 SS-cJl
Permit# Or- ~
te Approved t~ -?
t&"'~ ~ Itl] - Lf Be> "1
bt'J 417 - 48Q'l
Phone
ele~
Expires \ 2-4 O~
PROJECT ADDRESS. 12.2
Parcel Number D G, :31 0000000 0
lc:..1?d .
Loc~:Hon It> i~2.056
Lot Zoning :r. H-
Proiect Tvpe & Brief Description:
Check all that apply
o New Construction
o Addition
o Remodel
o Repair
oRe-roof
. ~~molition
, 0 Sign
o Heat System
o Other
pt...,Commercial
o Multi-family 0 Industrial
.:~ (i" \
~ 3 a;n .2CCl
o other
Floor Areas Existing (Sq. ft.) Proposed (Sq. ft.)
Basement @$ per sq. ft. = $
1 st Floor I ofcS ..fl-Z ()
2nd Floor .,
3rd Floor
Garage
Carport ;/
Covered Porch
Deck
Shed
Other
TOTAL VALUA TlON $ 1000. 00
sq. ft. . Lot size
sq. ft. = Lot coverage
# of bedrooms
# of full baths
# of half baths
%
Total footprint of structures
Max. height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
Occupancy group
Occupant load
Construction type
ft.
. I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are required, and t .
projects. I J 1\ H
Date 12.11 to7 Print Name fWYI.A.Mtt.. 1<0 ~1s Signature
T:Forms/Building Division/Bldg Permit Appl.-2006 Code.doc
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Th. 711;s m .
IS map/draw; . ap,s not intend d
An ng IS produced beta be used a
cv other use oj this mapl:trthe City oj Pori A:;:egfial desr.'ription
awmg shall nol be Ih es or ils own us~ and
e responsibility oifth p'''rposes.
_ eCay.
Vertical Datum -
Honzontal D - NA VD 88
7i",D~'
N
90
Feet
Legend
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W 'A S H I N G TON, U. S. A.
Public Works & Utilities Department
November 6,2007 2007
City of Port Angeles
321 East 5th Street
P.O. Box 1150
Port Angeles, W A 98362
RE: Port Angeles Landfill / Transfer Waste Disposal Application, WDA 07-53; Building
demolition at 1225 Ediz Hook Road, Port Angeles
We have received your application for disposal of building demolition debris from the referenced .
site and reviewed the testing results for lead and asbestos content. Based on the testing results
the debris appears to be acceptable for disposal at the transfer station. A copy of your approved
application is attached. This approved application must be shown to the transfer station 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/VAU~~~r
Stephen Sperr, P.E.
City Engineer
End: WDA 07-53
.Copy: Claudia Stromski
Bldg
City Atomey
N:\PWKS\ENGINEERIWDAPPLIC 07-53
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, WA 98362-0217
, )
W,DA- 07-53
PORT ANGELES LANDFILL
WASTE DISPOSAL APPLICATION
To:
City of Port Angeles, City Engineer
321 E Fifth Street
P.O. Box 1150
Port Angeles, Washington 98362
Phone: (360) 417-4803
FAX: (360) 417-4709
NOTE: All questions must be answered for waste to be approved.
1. Generator Information:
Company Name:
Mailing Address:
CI'-~'I rJ/ P c:;:a..,-t A/f./Q4u<,s
32-1 ~ff" r~ 57i..z<r
1t:A--1' ~4'~""-( t.tJA 9&062
L..f I, - '1809 . (A ~Aw~4 PO~-i-t7"S )
gt..J/uOlvJ6 .{)~""",OLJ7t"1
,.2..2-$'" tZi)lS, &0 lc. e J &'f' 4...; /i-lu!s
Phone:
Project Name:
Project Location:
2. Other Contacts (if applicable):
Consulting Firm: 2-vvocl'C. I- kSlIc, 7"''-
Contact: -t:1'9?7' ~v'<l6"':'-'
Phone: 4('" - 0jC) 1
Contractor Name: ()Ai~c.V.-J
Contact:
Phone:
Laboratory:
Contact:
Phone:
-
NVL LA~4~t)R..I?S. Lr\/C-
~1I~.(.a.. ku..<l,,-..J ,
~tJ~- ~l.{") -c>I{)o
City of Port Angeles - Landfill Waste Disposal Application
Page - 1
Wed, 10/4/20060:4 PM
, ,
3. 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). .
CERCLA/MTCA Remediation
Independent Remedial Action
Unused Chemical Product Spill
Agency Contact:
UST Removal
~ Other Source: 6~() ~<6.eIC;
4. Waste Material Composition: (check all that apply and include percent of total)
- Soil - % _ Foundry Slag - %
- Concrete/Asphalt - % _ Dredge Sediments - %
- Preserved Wood - % ---X::- Debris .lQQ.. %
Coal Ash - % _ Other (list)
Wood Ash - % - %
- %
NOTE: Total must equa/100%.
5. Waste Material Contaminants: (check all that apply)
)()
Gasoline Metals
Solvents _ Heating Oil
Unused Motor Oil Used Motor Oil/Waste Oil
Other ~*~ A-t. "1t:U? ~ Other Petroleum Product
A5~~.s SV'l..,l('( -4lSo ~4.lW1_~
f A##tA.0
Unknown
Supply any MSDS information with application, if available.
Diesel
PCBs
NOTE:
City of Port Angeles - Landfill Waste Disposal Application
Page - 2
Wed, 1 0/4/2006 0:4 PM
6. Estimated Quantity of Waste for Disposal:
25
Cubic yards /
Drums /
lfO
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:
,k-
One time
_ Monthly
Annual
Other
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 --L & number of discrete samples per composite 4.f
Number of DISCRETE samples Lf
~~IA-~~", r
' } tC JIS 114'"11 I 'k
6/ 1Z-~4 t<..........,.} 4. 7i -If $"",.4 <1s!..w
IN*-'t.Ia>? 7-t..,..... (k)#lt'!)
NOTE 1: Unless prior approval has been granted by Port Angeles, the following sampling
frequency will be used:
0-25
25 - 100
101 - 500
501 - 1000
1001 - 2000
>2000
cubic yards
cubic yards
cubic yards
cubic yards
cubic yards
cubic yards
=
1 composite sample
3 composite samples
5 composite samples
7 composite samples
10 composite samples
10 plus one sample for each additional 500
cubic yards
contain a minimum of three/maximum of five
=
=
=
=
=
NOTE 2: One composite sample shall
discrete samples.
City of Port Angeles - Landfill Waste Disposal Application
Page - 3
Wed, 10/4/20060:4 PM
9. Waste Analysis:.
The "Dangerous Waste Regulations" (WAC 173-303) shall be utilized to determine the
appropriate analytical requirements for waste characterization. Ecology Publication #91-30
(Revised April 1994) "Guidance for Remediation of Petroleum Contaminated Soils" shall
also be used to characterize petroleum contaminated soils from UST releases. Submit all
laboratory analytical results, QAlQC data, and Chain of Custody sheets along with this
application. .
(NOTE: The laboratory must be accredited. by the Washington State Department of
Ecology. )
a) List all ani'ytical test methods used:
fi.J>A f)l f ~ aB
b) Pr~vide a narrative as to why the above analytical methods were selected:
l.Ju~ '10 46! cY ~",,'UJ':rJ/l.l.. r'4fA"l tAJ4S f?,$t4'u~Y lJ~
~~ A,,,,-t ON ,5-?'-1dC",(u/t(.
)
~~-ro> ~-t.t)"y f~q;VI-'l~ ~€;JA. 16 ~C::U"1'&e"'"
L-r-'!J
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 waste is classified as: (check one)
)c Neither Dangerous Waste (OW) nor Extremely Hazardous Waste (EHW)
Dangerous Waste (OW) and Waste Code:
Extremely Hazardous Waste (EHW) and Waste Code:
City of Port Angeles - Landfill Waste Disposal Application
Page - 4
Wed, 1 0/4/2006 0:4 PM
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 materA the est of our abilijies.
Was enerator igna
-;;;;~ y 6' ~6"'^-
Printed Name
2"1rvt) J, c. I
Company
/1 (s/~')
Date
ASsOCI 7~
.
City of Port Angeles Approval:
,,1/tY/H'--IC0 ~ ~~ k__ ~--V/--. ~ I?~,
City Engineer f)
j/-Ob'-07
Date
2 --OiL? -08
Approval Expiration Date
City of Port Angeles - Landfill Waste Disposal Application
Page - 5
Wed.10/4/2006 0:4 PM
nrr l' ?nn7 R ~n6
rW Y ': '... 4V V/- v: """,,M---NVL LA80R~,TnR T ~~ I NC
\ NVL Laboratoiies, !nc. ""... NO. 3m-~p , i i
I 4700 ^"""" Ave. 1'1., _e, WA 98100 I . , ~ ;- I I
l T 01; 206.547.0100, Fox; 206.6...1035 _..... ^IHA .IH # 101661 ~=,.,.;,;! ,
. www.nvIlabs.com AnalYsIS "aport W.A - DOE # 01765 .....oIliiORiJJ
Toxieit'1 Characterisiic Leaching Procedure .. Lead (Pb)
Client: Zeno"ic & Associates, Inc.
Address: 301 E. 6th St. Suite 1
Port Angeles. WA 98362
aatch #: 2714653.00
Matrix: Bulk
Mct'1od: EPA 1311/70006
Client prolect #: 07251
Date Ri:esl'Y'sd: 10/1112007
Samples Received: 1
Sampies Alliiilvzeo: 1 .
.. "__.:,.... 1Ul" G d I
"'''w,.......... ...r. . !'acy u ge
project Looation: 1225 E=dis Hook Rd, Port Angeles, WA
Lab 10
ciient SamP;6 #
RL Results Resu!t!! in
m~!L in maiL pprll
0.5 . < 0.5 <: 0.5
2;095935
07251 A
r-- Sampl~ by: Client'" U C A ~....
l Analyzed by: Tanveer K...,," Date Analyzed: 1011212007 I.....,.r I
mgll- =MllliS"'"'. per Iller Rl- ~ Reportill!ll-imft
ppm = l"'ris per million '<' ~ - the reporting Umll
Note: Method QC results are acceptabie unieiS stat:!ld cthe!W!~e.
Ilnless otherwise indicated, the condition of all s~mj:)les was accet'tabie~t time of r~!pt.
Page 1 I
Northwest Asbestos Consultants
406 Reed 8t.
Port Townsend, WA 98368
360-385-0584
northwestasbestosconsultants@cablespeed.com
~
10/8/07
lob Site:
1225 Ediz Hook Rd.
Port Angeles, WA 98362
City of Port Angeles
Port Angeles, WA 98362
Contacts:
Zenovic and Associates
Tracy Gudgel, PE
301 E. 6th St. Suite #1
Port Angeles, WA 98362
Subiect: Demolition
Inspector: Bob Witheridge
AHERA - Building inspector / Management Planner
WAMOA - 0042-10270601
Expires - 10/27/07
Scone of work
1) Building survey and inspection to inspect for asbestos containing building
materials (ACBM).
2) Survey, sample and record suspect materials.
3) Report to Tracy Gudgel, PE of Zenovic and Associates. results of testing from
Northern Industrial Hygiene, Inc.
Insnection Report
Requested by Tracy Gudgel, PE of Zenovic and Associates.
Sampling of suspect asbestos containing building material (ACBM).
Single story building had wood siding, wood shake roof, aluminum clad windows,
electric heat, some sheet rock walls and rock wool insulation.
The following samples were taken and sent to lab.
Sam,ple #1: Homogeneous floor covering with mastic. Black
Sample #2: Attic insulation.
Sample #3: Plaster ceiling material.
See lab attached results.
ASBESTOS BULK SAMPLE DATA
Northwest Asbestos Consultants
406 Reed 8t.
Port Townsend, WA 98368
360-385-0584
northwestasbestosconsultants@cablespeed.com
To Northern Industrial Hygiene, Inc.
~
10/4/07
Tob Site:
1225 Ediz Hook Rd.
Port Angeles, WA 98362
City of Port Angeles
Port Angeles, WA 98362
Contacts:
Zenovic and Associates
Tracy Gudgel, PE
301 E. 6th St. Suite #1
Port Angeles, WA 98362
Samnle #1: Homogeneous floor covering with mastic. Black
Sample #2: Attic insulation.
Sample #3: Plaster ceiling material.
Insnector: Bob Witheridge
AHERA - Building inspector / Management Planner
WAMOA - 0042-10270601
Expires - 10/27/07
Please call with results when completed.
See attachment.
Thank you,
Got W~
Bob Witheridge, E.F.M.
215 SW 153rd Street Burien, WA 98166
OFFICE: (2M) 988-1746 ~AX: (206) 988-1978
EMAIL: nihin.scheIoR.com
NVLAPI 200511-0
B~lk ~bestos Analy~i~ R~p~~
~_... iWDestM ecnsua.nts
.all R8d StnIet
Poft l'owmIand., WA ....
Prq<<t ltleaIhlfr 1225 Edls HcaIl RJ1. PrlrI AnJ:lII*l WA
NIH Batch Number.: G7.o09lS3
ClInt Job Number.
Tum Amund Tirn9: 5 Day C
S&mpIss Analyzed: a
Ctient Sample Number: 1
San1IiB c--..ilAiOR: Flour CoftriItg wiltt ttiastk
Sample Looatfon: HemopOf lNW
commentS:
lAyer 1 Sliver eodng
~ fiJWGUS Compoiaems:;
No As&Je:Itos ~
l..8b Sample Numher: 01.Q0963.0001
Chedted If Sample Not Analyzed 0
Non-Asbestos Fitwus CoInpomlnts;
3'It ce&dOse
Non-FibIous Componeflts:
mrr CoatIng
..... 2 BlKk n.xibI8 tll~ dldMiaf
Au.......1lua ~ c..~ Non-Asbestos FibRnl5 Components;
No ~ DeI.eded
Non-RbfOus Components:
101Yl1l flier and Blr.der
Client Semple Number: 2
~ Desc:riptiofl: JnauIaUcn
Sample LocaUon: AUk
Comments:
Lab Sample Number: 07.ootA.OOU
Chsdced If Sample Not Analyzed 0
Tan fiiimus mlletiid
~ Abrous CCHDpOI1IHIIB:
No AsbeBtoB 0etectBd
l\IoIw\sbesms Fibrous~:
7ft CeflulD5e
Non-Fi>>ruus COmpon&nIs:
3a FillBr and BInder
Client Sampfe Number. 3
~~; Ptatw
Sample Loc:atfon: Ceiling
Ccmm8nIs:
lab SamplE! Numbet: D7..ooD$1.OfJ03
Checked If Sample Not Analyzed 0
WhItIa fibofus (;O!l1'fk--4 po'" with _ fiImMIs ~ue
AsbaIDs FiIWaus Compansnts: Non-Asbeslos FiIImus COlll8>>o~
No Asbastos D8b!ldad _ c..~
Non-Abrous ~:
82% Filler and 8lnd9r
10Y1 Pelfile
~ By: BOb .'ilmiatidge
~Iiy: JUfJa~
ft.....Jit.......d by: Jude Cummi1ig:a
1Cf41Z1lO1
1~
1~
~i--
C.L-....
---yo
.... Cummings. Labarat.oly Manager
Paga 1
'.
Summary of Inspection
Lab reports as follows:
Sample #1: Homogeneous floor covering with mastic. Black
No asbestos detected.
Sample #2: Attic insl;llation.
No asbestos detected.
Sam.,ple #3: Plaster ceiling material.
No asbestos detected.
See lab attached results:
All asbestos containing building materials with a reading of greater than 1% is
considered a hazardous material if disturbed. Removal of any hazardous materials must
be abated by a certified abatement contractor which follows the rules of the EPA and
governed by Olympic Region Clean Air Agency.
During building demolition, it is possible that additional suspect asbestos
containing building material (ACBM) may be found with in a wall, floor, ceiling
or other areas not accessible at the time of the survey. 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 Consultants is not responsible for identification of hidden
materials that are not identifiable with reasonable diligence.
After the facility is completely cleaned out a walk through and re inspection is
required by the original AHERA building inspector (NW Asbestos) after abatement,
then a copy of the letter certifying that abatement has been completed needs to be
received by the City of Port Angeles Permit Center and Olympic Region Clean Air
Agency.
Thank you,
\3 CYG~
Bob Witheridge, E.F.M.
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