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HomeMy WebLinkAboutA_Demolition_Permit_Application_B17006124_180711_v2DEMOLITION PERMIT APPLICATION FOR OFFICE USE ONLY: PERMIT NUMBER:_______________________PROJECT NUMBER:______________________LAND USE NUMBER:______________ This application must be fill out completely in order to be submitted for review. We will not accept incomplete applications. We require one (1) Demolition permit application per structure. This application is good for one (1) year from the submittal date A one –time extension of one (1) year can be requested at a cost determined by the Building Official. Please follow our Electronic File Standard when you are ready to apply. 1. LOCATION AND VALUATION INFORMATION JOB ADDRESS:________________________________________________________________________________LOT #____________________ VALUE OF WORK: (Fair market Value for Time + Materials) $______________________ BOEING JOB #(If applicable) 2. DEMOLITION TYPE (CHOOSE FROM BELOW): Fees (Public Works disconnection/capping fees are separate) : Single Family: $122.95 Commercial/Multi-Family: $262.00 Square Footage of structure being demolished?__________________________ Each structure needs its own application. Will the demolition involve a building greater than 4,000 square feet? YES / NO Circle One Is any tree removal proposed for this demolition? YES / NO Circle One RESIDENTIAL MULTI-FAMILY ACCESSORY STRUCTURE POOL COMMERCIAL GARAGE/CARPORT INTERIOR (NON-STRUCTURAL) OTHER 3. BUILDING INFORMATION WATER SUPPLY CONTACTS NUMBERS_ METER TO REMOVED, OR REMAIN IN PLACE? _________________________ DEVELOPMENT ENGINEERING (425) 430-7266 SANITYAR SEWER/ SEPTIC SEWER TO BE CAPPED OR REMAIN IN PLACE? _________________________ SEPTIC SYSTEM? Y/N________ TO BE FILLED? Y/N_________ KING COUNTY PUBLIC HEALTH (206) 477-8050 ELECTRICITY Electricity to be shut‐off and meter removed? Y/N_______ PUGET SOUND ENERGY (888) 225-5773 GAS Gas to be shut‐off and meter removed ? Y/N________ PUGET SOUND ENERGY (888) 225-5773 Remove fuel or oil tanks? (Complete a RFA Tank Removal Permit Application) RENTON FIRE AUTHORITY 425-430-7000 FOUNDATION Foundations destroyed and removed? ______________ All debris to be removed from site is to be restored to original condition. CITY OF RENTON DEVELOPMENT SERVICES Building Division | 1055 South Grady Way, 6th Floor | Renton, WA 98057 | 425-430-7200 | Website: rentonwa.gov 2801 NE Sunset Blvd 54,000 X 1200 SF REMAIN REMAIN NA N N YES DEMO OF USTS AND FUELING CANOPY 4. CONTACT INFORMATION CONTACT NAME:_______________________________________________________PHONE:______________________________ EMAIL:_____________________________________________________________FAX:___________________________________ 5. OWNER INFORMATION PROPERTY OWNER NAME:__________________________________________________________PHONE:___________________________ ADDRESS:_________________________________________________________________CITY:____________STATE:____________________ 7. SUBMITTAL REQUIREMENTS  A copy of the an Asbestos Abatement Report performed by an approved asbestos remediation company.  A Site Plan showing structure being demolished, tree protection and erosion control measures taken to control any erosion or debris that may leave the property during demolition. This application does not give permission to remove any trees on the property. Trees are to be protected during demolition. I certify that the information on this application furnished by me is true and correct and that the applicable requirements of the City of Ren‐ ton will be met. I understand that this application is valid for one (1) year from the application date. If a permit is not issued during this time period, the application will become void. This application does not constitute a permit to work. Work is not to commence until the building permit is posted on premises where work is to be performed. Certification is hereby rendered that no work is to be done except as described, and that all work shall conform to applicable codes. Work in public rights-of-way and/or utility easements are not authorized under this ap‐ plication. Any work done without the benefit of having a building permit issued is subject double the permit fee as well as an investigation fee. Fees to be paid at permit intake. APPLICANT SIGNATURE______________________________________________________DATE__________________________ APPLICANT NAME PRINTED_________________________________________________________________________________ OTHER THINGS TO CONSIDER Check to see if Puget Sound Clean Air Agency need notification prior to proceeding with demolition. If structure to be demolished is over 4,000 sq. ft. - Environmental Checklist is required. Construction debris is to be taken to an approved disposal facility. See King County Solid Waste for information. If you have ques‐ tions about disposing of asbestos, check with Puget Sound Clean Air Agency PCCCA regarding requirements. The Lot is to be restored to original condition. 6. CONTRACTOR INFORMATION I AM DOING THE WORK AS THE HOMEOWNER. If yes, please fill out the Owner Affidavit and include it with this document I AM HIRING A LICENSE CONTRACTOR. Fill out the portion below: NAME:_________________________________________________________PHONE:_____________________________________ STATE OF WASHINGTON CONTACTORS LICENSE:___________________________________________________________________ CITY OF RENTON BUSINESS LICENSE:_____________________________________________________________________________ CLEARCREEK CONTRACTORS, INC. - MARK MCCULLOUGH 206-423-8120 MARKM@CLEARCREEKCON.COM 360-659-9346 x CLEARCREEK CONTRACTORS, INC.206-423-8120 CLEARCI997K1 BL.025209 CLEARCREEK CONTRACTORS, INC. - MARK MCCULLOUGH, PRESIDENT Chule Hyoun Kim 2801-A NE Sunset Blvd Renton WA 425-227-9340 12/26/17