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Home My WebLink About612 S Oak St - BuildingPREPARED 3/•2 /11 8 21 04 INSPECTION TICKET CITY OF PORT ANGELES INSPECTOR JAMES LIERLY ADDRESS 612 S OAK ST SUBDIV CONTRACTOR PHONE OWNER HERBERT W KARLA A SWAGERTY PHONE (360) 457 3640 PARCEL 06 30 00 0 1 6405 0000 APPL NUMBER 10 00001296 DEMOLITION PERMIT DEMO 00 DEMOLITION REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL99 01 3/21611 BLDG FINAL March 21 2011 8 18 38 AM 1pangrle HERBERT 457 3640 BUILDING FINAL DEMO D THE HOUSE AT OAK ST THE ALLEY COMMENTS AND NOTES PAGE 4 DATE 3/21/ 1 (2/1/2011) Linda Pangrle GIS update needed at 208 W 6th St Swagerty Page 11 From To Date Subject: Attachments: Hi Billy Linda Pangrle Billy McCurdy 2/1/2011 2.20 PM GIS update needed at 208 W 6th St Swagerty 208 W 6th St Swagerty.pdf Please see the attached zoning lot covenant and e -mails between Starla and me and make the needed GIS updates The new PNUM is 0630 0001 641 1 0000 Thanks Linda When recorded return to /Frz R 7 )1? V /l3, t A ja, ips ;)J1 98 L2 (Owner Signature) Phone: .4 7- 36 yd ss <y 4 p S Rp A t orA q 0 w -.40 EXP 02.242012 A A V 8 L I C �O i��dF WA S Illl 2011 1261214 Page 1 of 1 Protct Covenant Herbert W Swagerty Clallam County Washington 01/04/2011 01 47 53 PM III hPIRI,P1Ph4iEIii 11/211Wiliqi*Liiq MAI ®I III g 1 I/WE the undersigned owner(s) of the following described property o 1)- 6 (insert legal description, address if available, and Assessor's Parcel Number) ots 1 BIOCe t ZONING LOT COVENANT do her -eby- co- versant- that-said pr-opP shall. hP r1e i o- ated.as ore zoning lot as defined in Section 17 08.130. "Z" of the Port Angeles Municipal Code. This covenant creates one. inseparable building hot which may only be removed through compliance with Chapter 58 17 RCW (subdivision regulations) and/or the City of Port Angeles short subdivision regulations (Ordinance No. 77), as amended) This covenant shall be binding on the owner(s), heir(s),. assign(s), and successor(s) zn interest and shall be filed with the County Auditor's Office. This covenant is for the mutual benefit of said owner(s), heir(s), assign(s), and successor(s) in interest and is for the further purpose of compliance with state and local land use and building regulations. This covenant may be enforced by injunction or other lawful procedure and covenant by the recovery of any __darnages r esulting from non coinphance- DATED tins day of t Ai11IJ RV 20 f Pint Naive. //f /e6Fg 7 Sail; ER 7 Print Name lr'1!fi Sk/i E/27 V (Owner Signature) Phone 4 /57 Y STATE OF WASHINGTON) COUNTY OF CLALLAM is/ l� r• �P Notary Public in and for the State of Washington, do hereby certify that on this 7 day .of f 2Oj.personally appeared before me n r" 2_A lalown'to me to be the individual(s) described in and who executed the within Instrument and acknowledged that .n sz signed and sealed the same as free and voluntary act and deed for the purposes herein mentioned. GIVEN UNDER M 4 Jy 2FFICIAL SEAL this 7 day of I 20 NOTARY PUBLIC in and for the /State of Washington residing at Port Angeles. (2/1/2011) Linda Pangrle RE. Swagerty PNUM From Jodoin Starla' <sjodoin @co clallam wa.us> To Linda Pangrle Lpangrle @cityofpa.us> Date 2/1/2011 11 44 AM Subject: RE. Swagerty PNUM Linda The new pnum is 063000 -01 -6411 Please remember it will not show up in our system for a couple of months. Thanks. Starla Jodoin GIS Coordinator Clallam County Assessor's Office 223 East Fourth Street, Suite 2 Port Angeles WA 98362 (360) 417 2206 Original Message From. Linda Pangrle [mailto Lpangrle @cityofpa.us] Sent: Tuesday February 01 2011 10 AM To Jodoin Starla Subject: Swagerty PNUM Hi- Starla; Per our discussion please see the attached information PNUM 0630 00016405 had two homes on it (202 W 6th St 612 S Oak St) The 612 S Oak St home was demolished (see the permit below) The zoning for Lots 1 2 (0630 0001 6405 0630 0001 6410) is RHD which allows two homes per 7 000 sf lot. So it is ok to combine these lots and have two homes on the 14 000 sf parcel. Thanks for your help in these complicated matters Linda Page 11 (2/1/2011) Linda Pangrle RE. What is the new PNUM for 208 W 6thl St? Page 1 I located this lot covenant in the stack and I have a concern that each lot has a house on it. If you put them together you will have 2 houses on one lot. I would not think this would be acceptable Please clarify and let me know what the city policy is on this The city planning department has the jurisdiction in this matter so please email me the decision whether or not to process this document. Thank you Starla Jodoin GIS Coordinator Clallam County Assessor's Office 223 East Fourth Street, Suite 2 Port Angeles WA 98362 (360) 417 2206 Original Message From Linda Pangrle [mailto Lpangrle @cityofpa.us] Sent: Monday January 31 2011 9 AM To Jodoin Starla Subject: What is the new PNUM for 208 W 6th St? Hi, From Jodoin Starla' <sjodoin @co clallam wa us> To Linda Pangrle Lpangrle @cityofpa us> Date 2/1/2011 10:23 AM Subject: RE What is the new PNUM for 208 W 6th St? Linda My computer died before Christmas and I am just now back in business I have 2 month's worth of docs to process It usually takes 3 -4 weeks to process a document when we are caught up I am 2 months behind Please see the attached Zoning Lot Covenant. What is the new PNUM for the new 2 -lot parcel? Recorded doc: 2011 1261214 Dated 01 -04 -11 For Herbert W Swagerty 208 W 6th St Please e-mail me the new PNUM asap Thanks Linda Pangrle Permit Technician City of Port Angeles 321 E. 5th St. Port Angeles WA 98362 360 -417 -4815 360- 417 -4711 FAX (2/1/2011) Linda Pang! le RE. What is the new PNUM for 208 VI8'th '81? Page 2 I Ipangrle@cityofpa us Clallam County Assessor Treasurer Property Details 57232 HERBERT W AND KA. Page 1 of 6 Clallam County Assessor Treasurer Property Search Results 57232 HERBERT W AND KARLA A SWAGERTY for Year 2011 2012 Property Account Property ID' Geographic ID' Type Tax Area: Open Space Historic Property N Multi Family Redevelopment: N Township Range Location 57232 0630000164050000 Real Address. 202 W SIXTH ST PORT ANGELES WA 98362 Neighborhood Cycle 5 Res Neighborhood CD Owner Name Mailing Address. 10955130 Taxes and Assessment Details Property Tax Information as of 12/17/2010 Amount Due if Paid on. Legal Description: Agent Code* 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11 N DFL N Remodel Property N Section Mapsco Map ID HERBERT W AND KARLA A SWAGERTY Owner ID 208 WEST 6TH ST Ownership PORT ANGELES WA 98362 Exemptions: LT 1 BL 164 2 111435 100 0000000000% NOTE If you plan to submit payment on a future date make sure you enter the click RECALCULATE to obtain the correct total amount due. First Second Half i Half i Base Base i Year Statement ID Taxing Jurisdiction Amt. Amt. Penalty Interest Base Paid Ar '2010 40236 ST SCH STATE SCHOOL $12.42 $109 34 $0 00 $0 00 $121 76 2010 40236 CC -GEN COUNTY CLALLAM $6 60 $58 19 $0 00 $0 00 $64 79 2010 40236 PORT PORT OF PORT ANGELES $0 93 $8 18 $0 00 $0 00 $9 11 2010 40236 PORT ANG CITY OF PORT ANGELES $13 31 $134 60 $0 00 $0 00 $147 91 2010 40236 SD #121 SCHOOL DISTRICT #121 $0 00 $140 53 _$0 00 $0 00 $140 53 2010 40236 NTH OLY LIB NORTH OLYMPIC LIBRARY $1 92 $16 91 $0 00 $0 00 $18 83 1 2010 40236 HOSP #2 HOSPITAL #2 $2.71 $23 87 $0 00 $0 00 $26 58 2010 40236 WSMET PK DIST WILLIAM SHORE MET PARK DIST $0 86 $7 60 $0 00 $0 00 $8 46 2010 40236 CITY_STORMWATER CITY STORMWATER $36 00 $36 00 $0 00 $0 00 $72.00 '_2010 40236 WEED CONTROL WEED CONTROL $0 82 $0 81 $0 00 $0 00 $1 63 2010 40236 TOTAL. $75.57 $536.03 $0.00 $0.00 $611 60 2009 572322008 ST SCH STATE SCHOOL $12.32 $12.32 $0 00 $0 00 $24 64 i 2009 572322008 CC-GEN COUNTY CLALLAM $6.25 $6.21 $0 00 $0 00 $12.46 1:2 0097_572322008 00_9 PORT RT PORT OF PORT ANGELES $0 89 $0 88 $0 00 $0 00 $1 77 2009_ 572322008 PORT ANG CITY OF PORT ANGELES $1169 $1 0 00 $0 00 $23 38 2009 572322008 SD #121 SCHOOL DISTRICT #121 $0 00 $0 00 $0 00 $0 00 $0 00 1 572322008 NTH OLY LIB NORTH OLYMPIC LIBRARY $1 81 $1 81 $0 00 $0 00 $3 62 http. /vpn.clallam. net: 8084 propertyaccess /Property.aspx ?cid =0 &year =2011 &prop_id =5 12/17/2010 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 10 00001296 Application pin number 026992 Property Address 612 S OAK ST ASSESSOR PARCEL NUMBER 06 30 00 0 1 6405 0000 Application type description DEMOLITION Subdivision Name Property Use Property Zoning RESIDENTIAL HIGH DENSITY Application valuation 0 Application desc DEMOLISH THE HOME Owner HERBERT W KARLA A SWAGERTY 208 W 6TH ST PORT ANGELES WA 98362 (360) 457 3640 Structure Information 000 000 Permit Additional Permit pin Permit Fee Issue Date Expiration Date desc number Qty Unit Charge Per ,'2 -42 „„x- T Forms /Building Division /Building Permit DEMOLITION DEMOLISH THE HOUSE 176883 50 00 12/17/10 6/15/11 Contractor OWNER DEMOLISH THE HOUSE BASE FEE Plan Check Fee Valuation Special Notes and Comments It is the responsibility of the building owner and /or demolition contractor to contact ORCAA (Olympic Region Air Agency)for demolition permit needs regarding abatement Olympic Region Clean Air Agency 116 W 8th St Suite 113 Port Angeles WA 98362 (360) 417 1466 or 1 800 422 5623 www ORCAA org PROVIDE EROSION CONTROL NO SOIL MUD OR DEBRIS SHALL BE ALLOWED TO LEAVE THE PROPERTY BY MEANS OF TRACKING /TURBIDITY /WIND ETC The Fire Department has reviewed the project application and has no comments November 16 2010 4 32 15 PM sroberds The proposal will result in demo of a sfr in the RHD No land use issues anticipated November 9 2010 2 35 38 PM Brian 417 4708 Electrical service conductor has been removed ok for demo Sewer lateral shall be exposed to the property line an inspection by Public Works Engineering is required The sewer lateral will be capped A 2 X4 X36 pressure treated Clean asbestos 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 provisions of any state or local law regulating construction or the performance of construction Date 12/17/10 Extension 50 00 00 0 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 4815 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 IT IS UNLAWFUL TO COVER INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date FOUNDATION Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING Under Floor Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow Water AIR SEAL. Walls Ceiling FRAMING Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION Slab Wall Floor Ceiling MECHANICAL. Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping I SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Electrical 417 -4735 Construction R W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 T:Forms /Building Division /Building Permit Accepted By Comments 'FINAL Date Accepted by FINAL Date Accepted by Date Accepted By Application Number Application pin number Special Notes and Comments post painted green and marked S S Stub indicate depth to service to the nearest foot Attach a 12 gauge galv wire to cap and stake An approved Public Works Waste Disposal Application is required prior to taking material to transfer station Other Fees Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand Total T'Forms /Building Division /Building Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES WA 98362 Charged 50 00 00 4 50 54 50 10 00001296 026992 STATE SURCHARGE 4 50 Paid Credited Due 50 00 00 4 50 54 50 00 00 00 00 Page 2 Date 12/17/10 00 00 00 00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) 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 provisions of any state or local law regulating construction or the performance of construction Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 -4815 Electrical Inspections 417 -4735 Public Works Utilities 417 -4831 Backflow Prevention Inspections 417 -4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs PLUMBING Under Floor Slab Rough -in Water Line (Meter to Bldg) Gas Line Back Flow Water AIR SEAL. Walls Ceiling FRAMING Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION Slab Wall Floor Ceiling MECHANICAL. Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting 1 PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping I SHORELINE. T.Forms /Building Division /Building Permit Inspection Type Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 FINAL Date Accepted by FINAL Date Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Date Accepted By W A S H I N G T O N U S A Public Works Utilities Department December 17 2010 Wayne Swagerty 208 West 6 Street Port Angeles, WA 98362 RE. Port Angeles Landfill Transfer Waste Disposal Application, WDA 10 -28 for 612 South Oak Port Angeles, WA 98362 We have received your application for disposal of building demolition debns from the referenced site and reviewed the testing results. Based on the testing results the debns 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 matenals and quantities listed in the application. Matenals not listed or in excess of the quantities noted may require separate applications and approval. Please call 417 -4812 if you have questions f oR Michae Puntenney City Engineer Encl. WDA 10 -28 Copy Transfer Station Waste Connections N.PWKS/ENGINEER/Waste Disposal Application/2010 Applications /10 -28 61 South Oak.wpd Phone 360- 417 -4800 Fax 360 -417 -4542 Website www cityofpa.us Email publicworks @cityofpa.us 321 East Fifth Street P 0 Box 1150 Port Angeles WA 98362 -0217 4vDA t/O )S3 To City .of Port Angeles Attn Engineering Projects 321 E. Fifth Street P O Box 1150 Port Angeles, Washington NOTE All questions must be answered for waste .to -be- approved. 1 Generator Information Company Name na)A tR Mailing Address 2 D 8 ILJES� �j AR7 i*EIES, &,9. 9'I33.2 Contact: SWA -i Phone 36 y57 Project Name .DEM o l fid/U Project Location 12 South OAK 2 Other Contacts (if applicable) Consulting Firm Contact: Phone Contractor Name Contact: Phone Laboratory Contact: Phone WASTE DISPOSAL APPLICATION PORT ANGELES SOLID WASTE TRANSFER STATION Supervisor 98362 WDP 0 Phone (360).417-4700 FAX. (360) 417 -4709 DEC 0 6 2010 City_of, Port' Angeles Public Works and Utilities Dept. Engineering Services Division City of Port Angeles Waste Disposal Application (last updated September 2010) Page 1 of 4 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) 4 Waste Material Composition (check all that apply and include percent of total) Soil Concrete /Asphalt Preserved Wood Coal Ash Wood Ash NOTE Total must equal 100% Other WASTE DISPOSAL APPLICATION PORT ANGELES SOLID WASTE TRANSFER STATION CERCLA/MTCA Remediation Agency Contact: Independent Remedial Action UST Removal Unused Chemical Product Spill Other Source Cubic yards Drums OA 5 Waste Material Contaminants (check all that apply) Foundry Slag Dredge Sediments X Debris Other (list) Gasoline Metals Diesel Solvents Heating Oil PCBs Unused Motor Oil Used Motor Oil/Waste Oil Other L am. (3 Other Petroleum Product Unknown NOTE Supply any MSDS information with application if available 6 Estimated Quantity of Waste for Disposal 5 Tons (estimate both) Tons (estimate both) OA OA OA 1)0 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 Other City of Port Angeles Waste Disposal Application (last updated September 2010) Page 2 of 4 WASTE DISPOSAL APPLICATION PORT ANGELES SOLID WASTE TRANSFER STATION 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 13 Number of DISCRETE samples e40 fe,y l D h in /rim/. a nol eiC tcri 1"-4 7 /OcTf 9, 4) IAA/ L fs hey, 0 I- Z01. NOTE 1 Unless prior approval has been granted by Port Angeles the following sampling frequency will be used 0 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 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 QA/QC 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 NOTE Additional sheets attached YES NO City of Port Angeles Waste Disposal Application (last updated September 2010) Page 3 of 4 Pr' WASTE DISPOSAL APPLICATION PORT ANGELES SOLID WASTE TRANSFER STATION 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 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) X Neither Dangerous Waste (DW> nor Extremely Waste'(EHW) Dangerous Waste (DW) and Waste Code Extremely Hazardous Waste (EHW) and Waste Code 12 Special Notes for Asbestos Disposal AU asbestos containing materials (with the exception of roofing material in good condition that is not peeling cracking or crumbling with petroleum binder that still exhibits plasticity to prevent release of asbestos fibers) must: be tightly wrapped or bagged in 6 mil plastic with no excess air in the packaging not exceed 50 pounds per bundle be labeled as asbestos with required information regarding its origin be transported with a manifest in the vehicle arrive at the transfer station only by appointment with Brian Tate of Waste Connections so that the material can be deposited in a lock box (his cell number is 360- 912 -7080) Certification We THE UNDERSIGNED certify that this application is true to the best of our knowledge AU information provided is correct and the enclosed analytical results represent proposed waste material to the best o our abilities Waste Generator's Signature ic -14 Printed Name l A A tJ Sithq c,'e R Company ()W N Eli Date 7-/e' City of Port Angeles Appr q+�� City Engineer's Signature Date Approval Expiration Date i o Class 3 Class 4 City of Port Angeles Landfill Waste Disposal Application (last updated September 2010) Page 4 of 4 C. NUM Po December 17, 2010 Clallam County Department of Health and Human Services Environmental Health Services 223 East 4` Street, Suite #14 Port Angeles, WA 98362 -3015 Telephone. 360 -417 2258 FAX. 360 417 -2313 Jeremy Pozernick City of Port Angeles 321 E. 5 St PO Box 1150 Port Angeles, WA 98362 RE. PALF Waste Disposal Application WDA 10 -28 Dear Mr Pozernick: Based on the information and the chemical test results submitted by Mr Wayne Swagerty Clallam County Environmental Health Services (CCEHS) concurs with the disposal of 35tons of home demolition from the 612 South Oak to the Port Angeles Regional Transfer Station. If you have any questions, please contact me at 360 -417 2347 or jgarcelon@co clallam.wa.us. Sincerely 21 9 &``cdo'r% H/7 Jennifer Garcelon, MPH, RS Environmental Health Specialist III Andy Brastad, Director of Environmental Health PALF File Correspondence File 17 GENERAL PICTURES OF BUILDING SITE Olympic Peninsula Asbestos Consultants, LLC PO Box 758 Port Angeles WA 98362 Phone: 360-452 9995 Fax. 360-457 9720 www OlyPenAsbesros corn Page 26 of 33 Olympic Peninsula Asbestos Consultants, LLC PO Box 758 Port Angeles WA 98362 Phone: 360 -452 999.5 Fax. 360 -457 9720 www OlvPenAsbestos.com LATEST Renewal Certifications Certificate of Completion fIjir‘ ig to certifp that James W Ciaciuch ia0 riati4factoriip compieteb 24 ijourg of training aft an Asbestos Building Inspector to camplp tnitb tl)e training requirements of C O M M Z<Gitia 131 404E131 763 (Sji,C3ft513) Certificate Number. 1031115 �U...... AllGliS lun 3 5.2009 Instruct? Date(6) of Training EPA Provider Cert. Number 1085 Q Exam Score: SCJ to Expiratio Date Ju 5, 2010 Argus Pacific, Inc. 1900W. Nickerson Su e 31 Seattle Washings 98119 (206) 2153373 fax (206) 2853927 Certif state of Completion VCljigs io to certifp that James W Ciaciuch (jags oatisfactoriIp cotnpleteb 4 Ijouro of refresljer training aO an Asbestos Building Inspector to rotnptp tuity the training requirentento of 216QM tTtitic 33 40 (CIA 703 (ZIAPER'n) Certificate Numbe 1066749 rgu Pa 11c, b 9001 Nichersn 31 de, chmgt May 12. 2010 Date(6) of Trm ng Exam S yr NA Expr ado Date May 12, 201 6) 21153373 Ix (206) 2853927 Page 27 of 33 Olympic Peninsula Asbestos Consultants, LLC PO Box 758, Port Angeles WA 98362 Phone: 360 -452 9995 Fax. 360 -457 9720 www OlyPenAsbestos.com Asbestos Fibrous Components: No Asbestos Detected Layer 1 White paint on olrrhlte paper with brown powder (Sample restIls continued on next aarie:l 215 SW 153rd Street Borten, WA 98106 OFFICE. (206) 988 -174ri FAXL {2O6) 9881978 NVLAP Lab Code: 284)511 -0 Bulk Asbestos Analysis Report Olympic Peninsula Asbestos a Env.Oonsunnanin, LLC RN Batch Number. 10-00907 P.O. Box 755 Client JobNmber 1i-N12 Poet Angelee, WA 30262- r1115 lima 7)Ine: 2,1 Hour Project Location: b12 a Da Siree[, Pot Angeles, WA samples Analyzed: 9 Lan Sample t Wrrttter. 1C-07.A001 Client ale Number AS-1 Client Sample Desorption: Light-Brown Vinyl Flouring Client Sample t acanon: Parch Entry Floor Sample coerenents: Materieta dtelel9Isehe lie but tneapnrable Cm-ehlte w with track Mums avert batldng and restdltrbrosvn coating Aebsetos Maue Components: Non Asbestos Fibrous CampnneniE NanFarous €comp Lents: No Asbestos Detected 23% Cellulose 40% Asphalt Fier and Blotter 7% Synthetic 10% Filler and Binder 20% Vn l Filler and Binder Checked If =We NIX Anal Fed Client Sanpte Nuntrer. AS -2 Lan Sample Number. 10-00907.0002 Client Sample DescalptbrE Waipaper.Material Client sample Lac3llon: Lung Rooeie Wan Sample Comments: Checked IT =see NO Malyzed Non Asbestos. Fibrous Corrrprxrent& lion- Pmeaus C ranenr: B5% Cellulose 15% Filler and Binder 20% Paint Coferrientr Materla•,ta rtletingtuebabte but Inn operable Layer 2 Orono powder on ligrd brown paper Aabeetox moue components Non- Aetwets Fbrran Conrltonwds: Non- Ferrous Carrpcxre ts: No Asbestos Detected 135% Cellulose 15% Filler and Binder Comments: Matertaie dtet9kgueshabla. Inseparable Layer 3 Tan woven tlbers [cloth matertaa Aabsretos Fibrous Co :wants: Non- Asbestos FIRMS Cot ponetds: elan- Ferous canponenis: No Asbestos Detected 100% Cellulose client Sarrr le Number AS-3 LW: p r to NUrruIer 70- 00s07.0000 Client SarrpleOesalptbrt Gray vinyl Flooring Client Sarple location: t.MOg 50050 Floor Sample Comments: Materiels diSibigutelmillo but Inniepareible Checked IT Sample NotAnatyzed Sampled by: Jellies W. amnion 11151 :010 Received by Fermin Urine i 1110x2010 _c Reviewed CT Rachellaelgaza i1f11J 110 Rachel Melgout, Analyst Aare 1 Page 28 of 33 Bulk Asbestos Analysis Report Olympic Peninsula Asbestos Env Consultants, LLC Nil Batch Number 10 -00907 P.O. Box 758 Client Job Number 10 -0612 Port Angeles, WA 98362- Turn Around Time: 24 Hour Project Location: 612 S. Oak Street, Port Angeles, WA Samples Analyzed: 9 Client Sample Number Client Sample Description: Client Sample Location: Sample Comments: c. Pale -green vinyl with black fibrous asphalt backing and reddish -brown coating Asbestos Fibrous Components: Non Asbestos Fibrous Components: No Asbestos Detected Client Sample Number AS-4 Client Sample Description: Three Layers Vinyl Flooring (Red, Green, Tan) Client Sample Location: Eating Area Floor Sample Comments: Layer 1 Reddish -brown paint on gray /blue vinyl with black fibrous asphalt backing reddish coating Asbestos Fibrous Components: Non Asbestos Fibrous Components: Non Fibrous Components: No Asbestos Detected Comments: Materials distinguishable but inseparable Layer 2 Green vinyl with black fibrous asphalt backing and reddish -brown coating Asbestos Fibrous Components: Non Asbestos Fibrous Components: Non Fibrous Components: No Asbestos Detected Comments: Materials distinguishable but inseparable Layer 3 Brown /tan vinyl with light -brown woven fibrous backing and brown brittle material Asbestos Fibrous Components: Non Asbestos Fibrous Components. No Asbestos Detected 15% Cellulose 3% Synthetic 20% Cellulose 5% Synthetic 20% Cellulose 5% Synthetic 25% Cellulose Comments: Materials distinguishable but inseparable AS -5 Red Vinyl Flooring Bedroom 1 Floor Materials distinguishable but inseparable Sampled by James W Ciaciuch 11/5/2010 Received by Fermin Uribe 11/10/2010 Reviewed by Rachel Melgoza 11/11/2010 (Sample results continued on next page.) Rachel Melgoza, Analyst 215 SW 153rd Street Burien, WA 98166 OFFICE: (206) 988 -1746 FAX. (206) 988-1978 NVLAP Lab Code. 200511 -0 Non Fibrous Components: 35% Asphalt Filler and Binder 7% Filler and. Binder 40% Vinyl Filler and Binder Lab Sample Number 10- 00907.0004 Checked If Sample Not Analyzed O 35% Asphalt Filler and Binder 5% Filler and Binder 10% Paint 25% Vinyl Filler and Binder 40% Asphalt Filler and Binder 10% Filler and Binder 25% Vinyl Filler and Binder Non Fibrous Components: 25% Filler and Binder 50% Vinyl Filler and Binder Lab Sample Number 10 -00907.0005 Checked If Sample Not Analyzed Page 2 Client Sample Number Client Sample Description: Client Sample Location: Sample Comments: Client Sample Number Client Sample Description: Client Sample Location: Sample Comments: No Asbestos. Detected No Asbestos Detected Sampled by James W Ciaciuch Received by Fermin Uribe Reviewed by Rachel Melgoza Olympic Peninsula Asbestos Env Consultants, LLC" P.O. Box 758 Port Angeles, WA 98362 Project Location: 612 S. Oak Street, Port Angeles, WA Reddish paint on green /blue vinyl w /light -brown woven fibrous backing brown brittle material Asbestos Fibrous Components: Non- Asbestos Fibrous Components: Non Fibrous Components: 20% Cellulose Comments: Materials distinguishable but inseparable Layer 2 Light -brown paper with silver coating Asbestos Fibrous Components: No Asbestos Detected Comments: Materials distinguishable but inseparable Layer 3 Brown fibrous material Asbestos Fibrous Components: No Asbestos Detected Bulk Asbestos Analysis Report AS -6 Ceiling Paper with Felt Backing Underlayment Eating Area Layer 1 Yellow paint on tan powder and light -brown paper Asbestos Fibrous Components: Non Asbestos Fibrous Components: No Asbestos Detected 60% Cellulose Non Asbestos Fibrous Components. 80% Cellulose Non Asbestos Fibrous Components: 85% Cellulose 10% Synthetic Tan and green vinyl with black fibrous asphalt backing Asbestos Fibrous Components: Non Asbestos Fibrous Components: 20% Cellulose 3% Synthetic NIH Batch Number Client Job Number Turn Around Time: Samples Analyzed: (Sample results continued on next page.) Rachel Melgoza, Analyst 215 SW 153rd Street Burien, WA 98166 OFFICE. (206) 988 -1746 FAX. (206) 988 -1978 NVLAP Lab Code: 200511 -0 10 -00907 10 -0612 24 Hour 9 20% Filler and Binder 10% Paint 50% Vinyl Filler and Binder Lab Sample Number 10-00907.0006 Checked If Sample Not Analyzed Non Fibrous Components: 25% Filler and Binder 15% Paint Non Fibrous Components: 10% Coating 10% Filler and Binder Non Fibrous Components: 5% Filler and Binder AS -7 Lab Sample Number 10- 00907.0007 Vinyl Beige Floor Tile Bathroom Floor Materials distinguishable but inseparable Checked If Sample Not Analyzed Non Fibrous Components: 35% Asphalt Filler and Binder 7% Filler and Binder 35% Vinyl Filler and Binder 11/5/2010 11/10/2010 11/11/2010 Page 3 Q Olympic Peninsula Asbestos Env Consultants, LLC P.O. Box 758 Port Angeles, WA 98362 Project Location: 612 S. Oak Street, Port Angeles, WA Client Sample Number Client Sample Description: Client Sample Location: Sample Comments: Layer 1 Tan vinyl with black fibrous asphalt backing and reddish -brown coating Asbestos Fibrous Components: Non Asbestos Fibrous Components: Non Fibrous Components: No Asbestos Detected Comments: Materials distinguishable but inseparable Layer 2 Pale -green vinyl with black fibrous asphalt backing and brown coating Asbestos Fibrous Components: No Asbestos Detected Comments: Materials distinguishable but inseparable Client Sample Number AS -9 Client Sample Description: Asphalt Roof Material and Underlayment (Numerous Layers) Client Sample Location: Roof Sample Comments: Bulk Asbestos Analysis Report AS -8 Two Layers of Vinyl Flooring Kitchen Storage Room Floor 20% Cellulose 5% Synthetic Non Asbestos Fibrous Components: 23% Cellulose 5% Synthetic Layer 1 Gray gravel on black fibrous asphalt Asbestos Fibrous Components: Non Asbestos Fibrous Components. No Asbestos Detected Comments: Materials distinguishable but inseparable Layer 2 Green gravel on black fibrous asphalt Asbestos Fibrous Components: Non Asbestos Fibrous Components: No Asbestos Detected 15% Fiberglass 15% Cellulose Comments: Materials distinguishable but inseparable Sampled by James W Ciaciuch 11 /5/2010 Received by Fermin Ur lbe 11/10/2010 Reviewed by Rachel Melgoza 11/11/2010 (Sample results continued on next page.) 215 SW 153rd Street Burien, WA 98166 OFFICE. (206) 988 -1746 FAX. (206) 988 -1978 NVLAP Lab Code. 200511 -0 NIH Batch Number' 10 -00907 Client Job Number 10 -0612 Turn Around Time. 24 Hour Samples Analyzed: 9 Rachel Melgoza, Analyst Lab Sample Number 10-00907.0008 Checked If Sample Not Analyzed 40% Asphalt Filler and Binder 5% Filler and Binder 30% Vinyl Filler and Binder Non Fibrous Components: 40% Asphalt Filler and Binder 7% Filler and Binder 25% Vinyl Filler and Binder Lab Sample Number 10 -00907.0009 Checked If Sample Not Analyzed 0 Non Fibrous Components: 35% Aggregate 50% Asphalt Filler and Binder Non Fibrous Components: 30% Aggregate 55% Asphalt Filler and Binder Page 4 Bulk Asbestos Analysis Report Olympic Peninsula Asbestos Env Consultants, LLC NIH Batch Number 10 -00907 P.O. Box 758 Client Job Number 10 -0612 Port Angeles, WA 98362 Turn Around Time: 24 Hour Project Location: 612 S. Oak Street, Port Angeles, WA Samples Analyzed 9 Layer 3 Black fibrous asphalt Asbestos Fibrous Components: No Asbestos Detected Layer 4 Gray gravel on black fibrous asphalt Asbestos Fibrous Components: Non Asbestos Fibrous Components: No Asbestos Detected Comments: Materials distinguishable but inseparable Layer 5 Black fibrous asphalt Asbestos Fibrous Components: Non Asbestos Fibrous Components: No Asbestos Detected Layer 6 Black fibrous asphalt Asbestos Fibrous Components: No Asbestos Detected Non Asbestos Fibrous Components. 30% Cellulose 5% Synthetic 15% Fiberglass 30% Cellulose Sampled by James W Ciacluch 11/5/2010 Received by' Fermin Uribe 11/10/2010 Reviewed by' Rachel Melgoza 11/11/2010 C» Non Asbestos Fibrous Components: 30% Cellulose Rachel Melgoza, Analyst 215 SW 153rd Street Burien, WA 98166 i OFFICE. (206) 988 -1746 FAX. (206) 988 -1978 NVLAP Lab Code: 200511 -0 Non Fibrous Components: 3% Aggregate 60% Asphalt Filler and Binder 2% Mica Non Fibrous Components: 35% Aggregate 50% Asphalt Filler and Binder Non Fibrous Components: 65% Asphalt Filler and Binder 5% Mica Non Fibrous Components: 65% Asphalt Filler and Binder 5% Mica Page 5 r.' 11/1112010 Dear James W Ciaciuch Sincerely Rachel 'i telgoza Analyst Olympic Peninsula Asbestos Consultants, LLC PO Box 758 Por€ Angeles WA 98.362 Phone: 360 -452 9995 Fax. 360 -457 9720 www OlyPcnAsbcstos.corn N azit-e mAzy Enclosure: Bulk Sample Resufts James W Ciaciuch Olympic Peninsula Asbestos Env. Consultant P 0. Box 758 Port Angeles, WA 08362 RE Bulk Asbestos Fiber Analysis; Batch 10 -00007 Project Location 612 S. Oak Street Port' Angefes, WA 215 SW 153rd Street Darien, WA 9B166 OFFICE: (206) 98B -1746 FAX: (2 06) SB8 -1975; EMAIL. jcurnrningst bridgeband.com NVLAP Lab Code: 200511-0 Thank you for choosing Northern industrial Hygiene, Inc. as your laboratory Enclosed you will find analytical results for the bulk samples submitted to the laboratory Northern Industrial Hygiene is accredited by hi L&P Lab Code: 2Y. )0511- 0..Aocreditatian by NVLAP does not indicate endorsement by NVLAP or any other government agency All bulk samples are analyzed in accordance with U.S EPA. Method 0001M4- 82 -020, December 1E182 and EPA Method 000.11143-1 15, July 1003. "Method for Determination of Asbestos in Bulk Building Materiais"(NESHAP 40 OFR -Part 01) protocol. Analysis is cross checked through our inter or antra laboratory quality assurance program for verification,. The percent values reported are based on calibrated visual estimates by volume unless verification by Point Count is indicated. Test results reported relate only to the samples submitted by the customer to Northern Industrial Hygiene, Inc. Trace amounts of asbestos are below the limit of detection and asbestos fibers with .diameters below approximately 025 m: „,eters are not detectable with the Polarized Light Microscopy {PLM) analytical procedure. A trace amount of asbestos is defined as one to five fibers in three slide mounts. Asbestos found in this amount will be reported as 111W by PLM analysis. I firs report is highly confidential and shall not De reproduced without your written approval and the written approval of Northern Industrial Hygiene, Inc. Samples are archived for thirty (30) days following analysis Please contact us iif samples need to be archived longer than thne standard holding time. Thank you for using Northern Industrial Hygiene, Inc. If you have any questions or axsr, please contact us. Page 33 of 33 1 Commercial Structure Permit fee. $60.00 -10 working day wait period Owner occupied residential dwelling Permit fee $35.00 Prior Notice PROPERTY OWNER ame ,Jh Yii-e S& 9 RPy Mailing' Address: t 2 O' &A Si, Site Address: 672 SSa111 (ARK ge413 4 -I ff10. il), DEMOLITION CONTRACTOR Business Name: ntvAiER Onsite Contact: Mailing Address: DEMOLITION INFORMATION of Structures being demolished: &UL Asbestos present Yes N Data 4 ed VA A NC- S tc��l y c RtY App1iL<ant Name Olympic Region Clean Air Agency 2940 -B Limited Lane NW Olympia, WA 98502 (360) 586 -1044 FAX (360) 491 -6308 Port Angeles office (360) 417 1466 Raymond Office (360) 942 2137 www ORCAA.org Check if same as property owner information Phone: FLAX_ Phone: 4. �f✓gr�FS. Start Date. Survey attached DEMOLITION PROJECT CATEGORY fJ Complete Demolition Training Fire Fire Agency Renovation, Alteration, Remodeling, Maintenance or other Construction Emergency Additional Fee of $50 00 (must be accompanied by Government Ordered Declaration- Commercial only) I have read and will abide by the conditions set forth in this permit and any addendum thereto I do hereby certify that all identified asbestos has been removed and the information in this application and supplemental data described herein is, to the best of my knowledge, accurate and complete. Payment Info Cash xi Check. Credit Card Receive date: //10 lgenq (Tse Only Phone: FAX. t p )ys7,34YO Approved Disapproved Review date: �6 //O Reviewed by PC 'lgeny I I.e Only Demolition Permit Email. Mobile: State: (r3 Sta WA}, Email: Mobile: Completion Date. 1i 1G State: Zi GOP Has all identified a estos be r removed Y No N /I- 46: Date 9836.2, Asbestos Permit Permit \S1300 Demolition Permit Permit DEM0( 1gency: Use Only Applicant hip' 47,6ERt 11 c3.4 s, Property Owner /y,/ S'1Jir cRf.I Property Owner's Address v pg itiE,sfd Contractor ilp„nz- OwirFi2 Contractor's Address -t�- License PROJECT ADDRESS (p 1 2— S O a, K S Parcel Number 0(030 DPI 64465 Project Type Brief Description. Check all that apply New Construction Addition Remodel Repair X Re -roof Heat System Other Floor Areas Total footprint of structur Site Coverage the amo and other impervious su Max. height of proposed struc Will a lawn sprinkler system Will a fire sprinkler system BUILDING PERMIT CITY OF PORT ANGELES Attn Building Permit Technician 321 E Fifth St. Port Angeles WA 98362 (360) 417 -4815 fax (360) 417 -4711 v X Residential Multi- family Commercial /Demolish 4 home- Uft have- h qe v, ofd 4/, /2t/ Sub ad— iAJaG4R., G�tS.pDSCALL It(4- 1 41..✓S House garage other tear off re -roof lay over one layer Heat pump wood burning stove gas fireplace pellet stove other Existing (sq. ft.) Proposed (sq. ft.) Basement 1 Floor 2 Floor 3` Floor Garage Carport N X Covered Porch Deck Shed Other sq ft. T Lo size nt of impe us surface on a parc- includi'. es (s-e PAMC 17 94 135 for ex- pt s) e ins e instal Iled? Date -c13 -10 Print Name/ I,(M/A/ T Forms /Building Division /Building permit application ft Oc pa cy group ccupa load Construc, on type APPLICATION Print in ink sq structures paved r Pho Pho ,qA r ,4WQS S /A)12, Phone' i/,57 3G Expires E -mail Signature �/J: For City Usp n^' Date Received) ?i Permit# l(i-tZ. (o Date Approved ///5 ,//7 g245 ?4 4'6 Lot Zoning R\-kD TOTAL VALUATION per sq ft. of b- •rooms of full the C of half b. the 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 to obtain permits prior to working on projects Lot cove -ge veways idewalks patios it overage Industrial Ir *it Clallam County Assessor Treasurer Property Details 57232 NELS H JOHNSON for Year 2010 2011 Page 1 of 7 Clallam County Assessor Treasurer Property Search Results 57232 NELS H JOHNSON for Year 2010 2011 Property Account Property ID 57232 Geographic ID 0630000164050000 Type: Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11 Open Space: N DFL N Historic Property N Remodel Property N Multi Family Redevelopment: N Township Range Location Address: 202 W SIXTH ST PORT ANGELES WA 98362 Neighborhood: Neighborhood CD Owner Name. Mailing Address. rTaxes and Assessment De Cycle 5 Res 10955130 W ner ID Ownership NELS H JOHNSON 7 202 W 6TH ST Property Tax Information as of 11/03/2010 Amount Due if Paid on. PORT ANGELES, WA 98362 -6009 Year Statement ID Taxing Jurisdiction 2010 40236 ST SCH STATE SCHOOL 2010 40236 CC -GEN COUNTY 2010 40236 PORT PORT Section: Mapsco Exemptions: Legal Description: Agent Code. Map ID 2 LT 1 BL 164 33232 100 0000000000% NOTE. If you plan to submit payment on a future date make sure you enter the date and click RECALCULATE to obtain the correct total amount due. First Second Half Half Base Base Amt. Amt. I Penalty Interest j Base Paid t Amount Due $12.42 $109 34 $0 00 $0 00 $121 76 $0 00 $6 60 $58 19 $0.00 $0 00 $64 79 $0 00 $0 93 $8 18 $0 00 $0 00 $9 11 $0 00 http. /vpn.clallam. net: 8084 propertyaccess /Property.aspx ?cid =0 &year= 2010 &prop_id =57232 11/3/2010