HomeMy WebLinkAbout9412-13C I T Y O F P O R T T O W N S E N D
DEb10LITION PERbIIT APPLICATION
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- FOR DEPARTMENT USE ONLY: ; L
Plan Review fee of ~ ~~ •rU Paid: on 12 -2? ~~`"~
Receipt: No_ ~ For Clerk-Treasurer ~ ~ - ~ ' '• _.___
A demolition permit is required to ensure that your structure is removed from the Assessor's tax rolls and that the site is ]eft in a
safe, sanitary condition. IInderSection 1409 of the L`aiform Building Code the Buildine Official may require submittal of plans and
a schedule for demolition. When such plans are required, no work shall be done until the plans or schedule, or both, are approved
by the Building Official. When plans or othez data are required to be submitted. a plan review tee shall be paid at the time of
submitting plans and specifications for review.
Property Owner(s) Namur Phone ~ -
Mailing Address - ~ -
Contractor's Name `r-..~„j,__~_`~ ~ ~ , -- ' Phone ~ 1 - 'f~-.
Mailing Address ~ ' _
Property Street Address C • ~~ t ~~~~`__.,
roperty Legal Description ~ ddi[ion, Block Lot(s)
Work to begin • o(~ ~ ~ ~ and be completed 6v . ~~ ~ ~ ~('
The use of all existing and proposed buildings and structures on sits is: f-P_1tC_~ c~.~c7- ri
Materials from [he demolished site will be transported to ~ ' ---~~ _G~ -
and used for ._
Is the site in the Historic District? _ YES ~NO (If yes, please refer to Attachment regarding design review)
SITE PI.,A~i REQliIItEMENTS: To help ensure timely review of your application, plea. - submit two copies of an
accurate site plan drawn to scale which include the following information:
1. Scale used and a marker showing the direction of North;
2. Location and dimensions of all property lines;
3. Location and dimensions of all existing and proposed buildings and structures on the site, showing distances from
property lines;
4. Location and name or number of all streets and alleys adjacent to the site;
5. Existing buildings scheduled fot demolition or removal must be indicated.
_ach plan shall be dated, shall clearly indicate the nature; extent and purpose of the work and shall list the location-of the
.work, the name of the owner and the name of the person who prepared the plan.
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Do you wish to abandon any existing utility services? _ YES ~ NO If yes, please indicate disconnect date:
Note: Monthly utility charges will remain in effect unless service is abandoned. If either water or sewer, or
bout, are to be abandoned, you must submit a written request, prior to demolition, for City approval. Yoi
will continue to be charged your current smrmwater rate unless you notify the Utilities office of a change.
After you have obtained your permit, you must meet the fallowing requirements:
o Whenever demolition interferes with pedestrian travel, demolition work may not begin until the required
pedestrian protection structures are in place;
o Remove all floors, foundations, footings and basement and retaining walls down to 18 inches below grade.
Basement sections below this must be broken into pieces not more than 8 inches in any dimension;
o Fill ezcavatioos and other cavities with noncombustible, inorganic material smaller than 8 inches and cover
with dirt or gravel so that broken concrete is no[ exposed;
o Grade site so that surface is smooth and water will run off. Be sure grading conforms to existing
neighboring grades of all sides of lor,
o During demolition, use water to control and reduce dust and its impact on neighboring properties;
o Leave the site clean and in a safe condition.
I certify that all information given above and on accompanying plans is complete and accurate to the best of my
knowledge; that all information given above and on accompanying plans will be relied upon in granting permits and
that if such information is later found to be inaccurate any permits may be withdrawn.
The undersigned hereby saves and holds the City of Port Townsend harmless from any and all causes of action,
judgments, cl ' or demands, or from any liability of any nature arising from any non-compliance with
1t@striptions wlu have been established by parties other than the City of Port Townsend.
Signature of Appli o Au rued Representative Date
pass FOR OFFICE USE ONLY ssss
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