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HomeMy Public PortalAbout08-0152 City of Tybee B8Em CITY OF TYBEE ISLAND BUILDING PERMIT DATE ISSUED: 04-18-2008 PERMIT#: 080152 WORK DESCRIPTION REMOVAL OF ASBESTOS WORK LOCATION 403 BUTLER AVENUE OWNER NAME CITY OF TYBEE ADDRESS PO BOX 2749 CITY,ST,ZIP TYBEE ISLAND GA 31328-2749 PHONE NUMBER CONTRACTOR NAME SUPERIOR ENVIRONMENTAL FORCE rx i G l ADDRESS PO BOX 1447 `t`17 CITY STATE ZIP GRAY GA 31032 FLOOD ZONE BUILDING VALUATION SQUARE FOOTAGE OCCUPANCY TYPE U TOTAL FEES CHARGED $ 0.00 PROPERTY IDENTIFICATION# PROJECT VALUATION $9,365.00 TOTAL BALANCE DUE: $ 0.00 It is understood that if this permit is granted the builder will at all times comply with the zoning,subdivision,flood control,building,fire, soil and sedimentation,wetlands,marshlands protection and shore protection ordinances and codes whether local,state or federal,including all environmental laws and regulations when applicable,subsequent owners should be informed that any alterations to the property must be approved by the issuance of another building permit. Permit holder agrees to hold the City of Tybee Island harmless on any construction covered by this permit. This permit must be posted in a conspicuous location in the front of building and protected from the weather. If this permit is not posted work will be stopped. The building contractor will replace curb paving and gutter broken during construction. This permit will be voided unless work has begun within six months of the date of issuance. Signature of Building Inspector or Authorized Agent: A P.O.Box 2749-403 Butler Avenue,Tybee Island,Georgia 31328 (912)786-4573-FAX(912)786-5737 www.cityoftybee.org i MAYOR �. _+ ;:, CITY MANAGER Jason Buelterman r` - Diane Schleicher CITY COUNCIL ,475" `` ; r�; CITY CLERK Wanda Doyle, Mayor Pro Tern 1 21 Vivian Woods Charlie R. Brewer 1 �4 ..;:z. ,` Barry Brown '\ \'$ + `r CITY ATTORNEY Eddie Crone `tia- 4/ Edward M. Hughes Dick Smith ., Yfax Ec1Yc.-ti='' Paul Wolff ._- CITY OF TYBEE ISLAND r\-- , RECEIVED CITY HALL MEMO To: All City Hall Employees From: Diane D. Schleicher City Manager Date: April 28, 2008 Re: Air Quality Testing Results on April 27, 2008 This memo is to bring you up to date with the asbestos abatement under the city hall building. The abatement of the old steam pipes with the asbestos material and the surrounding soil was completed this weekend. I have attached the report form the company that did the asbestos air quality sampling test on Sunday, April 27, 2008. You will see in the attached report that the air quality sample results were 0.0016f/cc. I appreciate you patience with the process and if you have any questions fell free to contact me. IIou. ,M- Q - 5:4. P.O. Box 2749-403 Butler Avenue,Tybee Island, Georgia 31328-2749 (866) 786-4573-FAX(866) 786-5737 www.cityoftybee.org F ,,, ,_ ENGINEERING,ENVIRONMENTAL ________//1 ISTEN e RESPOND o '_'CFORM D as\ &CONSTRUCT ION SERVICES April 28,2008 Mr.Joe Wilson Public Works Manager City of Tybee Island P.O.Box 2749 Tybee Island,Georgia 31328 Re-occupation Results Tybee Island City Hall 403 Butler Avenue Tybee Island,Chatham County, Georgia WPC Project#WPC3408.00064 Dear Mr. Wilson: WPC has completed the re-occupancy asbestos air sampling at the above-referenced project site. The following report describes the scope of work provided, and our findings. INTRODUCTION The project site, located on 403 Butler Avenue Tybee Island, Georgia, consists of a two story building that recently had asbestos abatement work in the building's crawl space. WPC conducted five(2)re-occupancy air samples of the first floor area. ASBESTOS CAS AW SAMPLING RESULTS The asbestos air sampling was conducted on April 27, 2008, by Jim Mahnke of WPC, using high volume pumps at a rate of 10 liter per minute for over five (5) hours in accordance with standard practices. The samples were read using the Phase Contrast Microscopy(PCM) analysis(NIOSH 7400). The sample locations and results are summarized in Table 1. The analytical results are included in Appendix I. Table 1. Summary of Asbestos Air Sam'ling and Results Sample# Air Volume mp Sale Location Sa^ p e Results I 1 3000 Liters 1 Auditorium 0.0016 f/cc 2 3000 Liters j Front Entrance Hallway 1 0.0016 flcc I 2201 Rowland Avenue,Savannah,GA 31404 tel 9-12.629.4000 fax 912.629.4001 www.wpceng.com Re-occupancy Asbestos Air Sample Tests WPC Project#WPC3408.00064 Tybee Island City Hall April 28,2008 CONCLUSIONS AND R.ECOM EN 1 ATIONS The results of the asbestos air samples completed by WPC indicate that the levels on both samples are below the <0.01 fibers/cc of air limit for a sample to be considered clear_ The working area of the building's air is clear of asbestos and is inhabitable for normal (non-protected)workers. CLOSING WPC appreciates the opportunity to provide these asbestos related services. If you have any questions concerning the information presented, or if we can be of further assistance, please call us at(912)629-4000. Respectfully submitted, WPC :p t % Elise Zador William.S. Anderson, HI. P.E. Staff Professional Senior Pnvironmental Engineer Asbestos License No.B1-01673 Attachments: PCM Results � � Page2of2 ( -- Wr. v; ENGINEERING,ENVIRONMENTAL r 11 / &CONSTRUCTION SERVICES ---.7- i L -.. – Name: / ,‘" 0.e-t... C it 71/ )71 4 I( , —• c- Project.Number. kei)f- „.% y 0 el , CPO ea (4 y__ Data: i-i..47, . el Y Site: '----.„/,,/ - ', .; leL/L___L e,'ly )j v 1/ Rolomeier No.: l' 5/3 „/11,_ Microscope No.:—4-1 :-.). Analytical Method:NIOSH 7400,A Counting Rules,Walton Beckett GrOcula Gra'..iele Fielci Amt.(OFA): 0 t 0 o 2 ,i'_) mm2 Note:II fibers counted(FCS)are lass irt,FCS) .ii PCB Nil r..-.E than 10 In 100 fields then assume No. 1 No.2 1-ormula: i (0385 =f/cc --- --- \FL.S. \FLB) (GFAXFRXT)1000 and report fiber conosntration Fibers Counted in SianL(FCB) * as less than(<)in the comptaed value. Fields Counted in Slane,(FLB) 100 100 FLOW RATE TOTAL — - - START STOP TIME, SAMPLE SAMPLE (tFFCIF.,b)ar Cirrini ' IN LPM(FR) SAMPLE LOCATIMCOMMENTS pump Precalibration TIME TIME MIN. TYPE LOCATION and :f Fields NUMF.;;EI. NO (2j CODE CODE Posi calibration IPA HR CLOCK) (FLS) ii cc* ....._...... 32 - 27 4 1„....„,,,,,..„-- i --- 1 -/ fl-- ' r 1-1.--4-- re- r _- S> ...) .----- /f 1 e, / I i - / 6),.0, 7/ 7 /d/l (0 -,„ - I o 0 V -- -1----------A---'” 4,, , . c — ...,- 7/ 7 . '''' / c"e• e,,-7''..)— ____. _ — .,/— ..- --- i '' / /..3 . '.5.) 1 6,, 1,..,.- ...-- A :::.. ,...........,'" ___c_j ___,- _±.1±22_ ___A Collected By: — z■ze.... 6..- ,, Analyzed By: / ----- (.--- --- Reviewed By: I Sample Type Code: G=General A=Ambient P=Personal rClearance S.-Background F.Field Sianlc S=Sealed Rank I Sample Location Code: 0S----0ulalde Building ID-Inside Suildine OWA-Oulairls Work Ares AA/A.-Inside Work Area , I Vinm2/1/cc fiestili9 Ot:ci-,: ;:01....Filter 0,ayloodsfi mr..r.:,I k.,‘P.I1 r.,L 1.7rf cc--.:' 7:':-P3,T=)1,7..":"-iiii''-:: WPC( ENGINEERING ENVIRONIAMT ------1----- I.'''';,i &CONSTRUCTION SERVICE'S AL H I : r i ' '''C / ' Pro joci Herne: \2iLI--1/4'. ` ,.. art I v., j,.4% // Project i'Ailaber: 1179 c-- ,g Y'-f-n 8: 4 f-5;'' t) Ce r Dale: Y— 2- r," _ _7_ _____.______— sito; -... 'L.) --r-e-4e-- ...7-.3str,4,.,v d t'-..!/ i 404_, e i uz ....1....5 Flotorneter i\io.: --' 7 ...,'.-- i Microscope No.: Analytical Method:NIOSH 7400,A Counting Rules,Walton Beckett Graticule Oracle Field Area PEA): ._________O . 0 e-) - 7 t111112 Note:R Hem counted(FOB)are kea than 10 in.100 fiskla then assume Formula: (_.L1 -(FcBV .r iE)305 =lice E,L FLS f ,FLB,1 I (GFAXPR)(1)1000 and report fiber concentration Fibers Countet:in as less than(<)In the computed value. Fields Counled in Blank(ELS) 100 100 FLOW RATE TOTAL 0 Fibers i l i/rnm2' IN LPM(FR) STAFIT STOP TIME, SAMPLE SAMPLE (FCS) SAMPLE LOCATIONiCflivIMENTS PUMP Precalibration TIME TIME MIN. TYPE LOCATION NUMBER NQ. and , CODE CODE .Holds Post calibration (24 HR CO CLOCK) (FLs.) i tice i L „4„/" 4.-es 1.--A 5.-.'a 1'v.. - 71' ---7 , — _,----- i ---7 ci .1-i, ,4 -) i .____. (-.P._q___(....J .5>ii tet . s* le-.0 /-..,,,..) it ./..) - ' 4, :.0*-i 'e., ' -5'.., t"'• c., I-I '—44 ? 7 ---1 /e).'efr 1. 1,- i 51--i -3' ' - ' " se-01 ----Ai-S-67-• 0- fr--7 :-itl— --7 __,....." ----- /41. , e) /5/2 '172-) i3 4,,c,- C- 13 ,----- _jle) i i / 0 1------- i:VI-45f) - 3.'-*-. -i t ------1 _d_ F) __,..,__ _ ei , k [ I/ 7/ ingigerv. ,,, — / ,-- ' -- -k- 0 Oollocied By: ...:, /(Z .t 0( Analyzed By: h ./..„--t... ,„ Reviewed By: Sample Type Code: G=Goneral A=Ambient P45ersosal O=Cleararuce B.--BacItgroursi F=Field Blank Sr-Sealed Slant: Sample Location Code: OFACutside Building IB.Inside 13ullitling OWA=Outaide Work Area 'WA...Inside Work Area *1/mm2/*I/cc Resulie Code: POL=Filter Overloaded FTO.Fillar Tampered With or Dammed PF=Purnp Fallon-, &- 0 5z City of Tybee Island, PO Box 2749, Tybee Island, GA 31328 912-786-4573 I (fax)912-786-5832 What products/services do you provide to the City of Tybee Island: Please provide copy of worker's comp coverage when providing any service ASBES'IOS ABATEMENT involving labor on city property To whom shall we direct the Purchase Order? Sales Contact MAAISON DE ES Email MAT1ISON @SUPERIORIlWIRON(`ZENTAL.US Phone Fax 478-986-1460 478-986-1410 Address -‘s'9(P.O. BOX 1447 GRAY, GEORGIA 31032 To whom shall we direct Payment? h A/R Contact MAn'ISON DEES Payment Terms ` Remittance Address P.O. BOX 1447 GRAY, GEORGIA 31032 ,=oven WINg Request for Taxpayer Give form to the (Rev.October 2004) Identification N umber and Certification requester.Do not oepertmmt of the Treasury send to the IRS. lnternci Revenue Service csi Name(as reported on your income tax return) nBusiness name,if different from above ° SUPERIOR ENVIRONMENTAL FORCE, LLC lndividueV Exempt from backup 'j Check appropriate btat, ❑ Sole proprietor ❑ Corporation ❑ Partnership El Other/ .��"_. ❑withholding Addreee(number,street,end apt.or suite no.) Requester's name end eddreae foptionefr 1411 MONTICELLO HIGHWAY i City,state,and ZIP code a GRAY, GEORGIA 31032 3 List account nunrher(s)here(optional) ase Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on Line 1 to avoid Social security number backup withholding,For Individuals,this is your social security number(SSN).However,for a resident ( ( 4 ( 4 ( ( ( alien,sole proprietor,or disregarded entity,see the Part I instructions on page a For other entities,it Is your employer identification number(EIN).If you do not have a number,see How to get a TJVN on page 3. or Mote.It the account is in more than one name. see the chart on pale 4 for guidelines on whose number Employer identiircation number to enter. 3. I 641(7 (0 (1 (9 I 0( 2 Emil Certification Under penalties of perjury. I certify that: 1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me),and 2. I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that i am no longer subject to backup withholding,and 3. I am a U.S.person(including a U.S.resident alien). Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply. For mortgage interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments ether than interest and dividends,you are not required to sign the Certification,but you must provide your correct TIN.(Sea the i t. ore 4.) Sign Signature of Here U.S.person Or Date R MAYOR CITY MANAGER Jason Buelterman Y Diane Schleicher 4 CITY COUNCIL i °1 CITY CLERK Wanda Doyle, Mayor Pro Tern '� .. ( Vivian Woods Charlie R. Brewer Barry Brown ` /;' CITY ATTORNEY Eddie Crone ' tee N,4„/ Edward M. Hughes Dick Smith Paul Wolff "oct CITY OF TYBEE ISLAND CITY HALL MEMO From: Diane Schleicher, City Manager To: All City Hall Employees Date: April 8, 2008 In order for all to feel comfortable returning to work at City Hall, I have attached the report from the company that did the asbestos air sampling test on Monday, April 7. You will see that the sample results were 0.0016 f/cc throughout City Hall. These results are below the 0.01 f/cc to be considered clear for reentry. Therefore, it was decided that reopening City Hall on Tuesday, April 8 would be safe. The asbestos abatement below the building had to be postponed due to unforeseen complications with the company originally hired. We will be handling this issue as soon as possible and will keep you notified. As always, if you have any questions please feel free to contact me. Thank you. P.O. Box 2749—403 Butler Avenue, Tybee Island, Georgia 31328-2749 (866) 786-4573—FAX(866) 786-5737 www.cityoftybee.org ENGINEERING,ENVIRONMENTAL &CONSTRUCTION SERVICES LISTEN•RESPOND•PERFORM April 7, 2008 Mr.Joe Wilson Public Works Manager City of Tybee Island P.O.Box 2749 Tybee Island,Georgia 31328 Re-occupation Results Tybee Island City Hall 403 Butler Avenue Tybee Island,Chatham County, Georgia WPC Project#WPC3408.00064 Dear Mr. Wilson: WPC has completed the re-occupancy asbestos air sampling at the above-referenced project site. The following report describes the scope of work provided, and our findings. INTRODUCTION The project site, located on 403 Butler Avenue Tybee Island, Georgia, consists of a two story building that recently had asbestos abatement work in the building's crawl space. WPC conducted five (5)re-occupancy air samples of the first floor area. ASBESTOS AIR SAMPLING RESULTS The asbestos air sampling was conducted on April 7, 2008, by Jim Mahnke of WPC, using high volume pumps at a rate of 10 liter per minute for over five (5) hours in accordance with standard practices. The samples were read using the Phase Contrast Microscopy(PCM) analysis (NIOSH 7400). The sample locations and results are summarized in Table 1. The analytical results are included in Appendix I. Table 1. Summary of Asbestos Air Sampling and Results Sample# Air Volume Sample Location Sample Results 1 3150 Liters Offices South Side of Building 0.0016 f/cc 2 3150 Liters Front Entrance Hallway 0.0016 f/cc 3 3150 Liters Hallway North Side Of Building 0.0016 f/cc 4 3150 Liters Southeast Side of Auditorium 0.0016 f/cc 5 3150 Liters Northwest Side of Auditorium 0.0016 f/cc 2201 Rowland Avenue,Savannah,GA 31404 tel 912.629.4000 fax 912.629.4001 www.wpceng.com Re-occupancy Asbestos Air vie Tests WPC Project# WPC3408.00064 Tybee Island City Hall April 7, 2008 CONCLUSIONS AND RECOMMENDATIONS The results of the asbestos air samples completed by WPC indicate that the levels on all five (5) samples are below the <0.01 fibers/cc of air limit for a sample to be considered clear. The working area of the building's air is clear of asbestos and is inhabitable for normal (non-protected) workers. CLOSING WPC appreciates the opportunity to provide these asbestos related services. If you have any questions concerning the information presented, or if we can be of further assistance, please call us at(912) 629-4000. Respectfully submitted, WPC ./(//'; l� L11 . ,,,- --- Elise Zador William S. Anderson, III, P.E. Staff Professional Senior Environmental Engineer Asbestos License No. BI-01673 Attachments: PCM Results FAPage 2 of 2 AIR SAMPLING FIELD FORM _�„ � ENGINEERING,ENVIRONMENTAL &CONSTRUCTION SERVICES Project Name: "r/ h e..- r J 71/ i-71`l l I Project Number. GI"?C- 3 N o 8 - Co G' is `7/ Date: Y- 7 Site: '7/by. s/9 n cI G-i' 1/ 1111 Rotometer No.: V3 ,941-1 Microscope No.: A t3 Analytical Method:NtOSH 7400,A Counting Rules,Walton Beckett Graticuie Graticle Field Area(GFA): 0 , 0 0 78'-7 mm2 Note:ii fibers counted(FCS)are less than 10 in 100 fields then assume No. 1 NO.2 Formula: [1 FCSI _(FCB\1 =E (E)285 =f/cc E=0.1 L FLS I FLB (GFA)(FR)(1)1000 and report fiber concentration Fibers Counted in Blank(FCB) as less than(<)in the computed value. Fields Counted in Blank(FLB) 100 100 FLOW RATE TOTAL #Fibers f/mm2' IN LPM(FR) START STOP TIME, SAMPLE SAMPLE (FCS) SAMPLE LOCATION/COMMENTS PUMP Precatibration TIME TIME MIN. TYPE LOCATION NO. and ('I) CODE CODE #Fields flcc* NUMBER Post calibration (24 HR.CLOCK) (FLS) _O rPCe 5 .._,.5P44-lj .3. 'J o I fC' / /G • J%r.e.- 7L t' h r 5-, c. I/cy 1/ 4.. a. -r 12 V / S l 1....-A ili'ar f4 s/' /.a IO J �- 13 '/f/,'"� :z-2- 1 0 � -o- . /? . >""+ a 41' CITY OF TYBEE ISLAND BUILDING PERMIT DATE ISSUED: 04-4-2008 PERMIT#: 080152 WORK DESCRIPTION REMOVAL OF ASBESTOS WORK LOCATION 403 BUTLER AVENUE OWNER NAME CITY OF TYBEE ADDRESS PO BOX 2749 CITY,ST,ZIP TYBEE ISLAND GA 31328-2749 PHONE NUMBER CONTRACTOR NAME SAVANNAH ABATEMENT SERVICES ADDRESS 702 E DUFFY ST CITY STATE ZIP SAVANNAH GA FLOOD ZONE BUILDING VALUATION SQUARE FOOTAGE OCCUPANCY TYPE U TOTAL FEES CHARGED $ 0.00 PROPERTY IDENTIFICATION# PROJECT VALUATION $9,365.00 TOTAL BALANCE DUE: $ 0.00 It is understood that if this permit is granted the builder will at all times comply with the zoning,subdivision,flood control,building,fire, soil and sedimentation,wetlands,marshlands protection and shore protection ordinances and codes whether local,state or federal,including all environmental laws and regulations when applicable,subsequent owners should be informed that any alterations to the property must be approved by the issuance of another building permit. Permit holder agrees to hold the City of Tybee Island harmless on any construction covered by this permit. This permit must be posted in a conspicuous location in the front of building and protected from the weather. If this permit is not posted work will be stopped. The building contractor will replace curb paving and gutter broken during construction. This permit will be voided unless work has begun within six months of the date of issuance. Signature of Building Inspector or Authorized Agent: ,Llyzy ieV v P.O.Box 2749-403 Butler Avenue,Tybee Island,Georgia 31328 (912)786-4573-FAX(912)786-5737 www.cityoftybee.org APR-04-2008 09:87 CITY OF TYBEE ISL. 912 786 9539 P.91/04 CITY OF TYBEE ISLAND,GEORGIA APPLICATION FOR BUILDING PERMIT A"(1 Location: Tybee Island City Hall PIN# NAME ADDRESS TELEPHONE Owner i f in 702 East Duffy Street 912-233-9926 Architect e-e- or Engineer Building S4.v'6 Ako4-k-�a^� Contractor c-e S (Check all that apply) Repair ❑ Residential ❑ Footprint Changes Renovation ❑ Single Family ❑ Discovery ❑ Minor Addition ❑ Duplex ❑ Demolition El Substantial Addition ❑ Multi-Family C Other El Commercial Details ofProject: Removal of asbestos Estimated Cost of Construction: $ 9, 365. 0 0 Cons k ction Type (Enter appropriat- umber) (1) Woo. Frame (4) Masonry (6) Other(please specify) (2) Wood Masonry (5) Steel &M. (3) Brick Ven-- Proposed use: Remarks: ATTACH A COPY OF T CE' IFIED El.FVATION SURVEY OF LOT and complete the following information based o e construction drawings and site plan: #Units # : z drowns #Bathrooms Lot Area Livin_ .ace(total sq. ft.) #Off-street parking s.aces Trees located&lis •d on site plan Access: Driveway ($.) With culvert? With swale? Setbacks: Fr'nt Rear Sides (L) (R) #Stories Height Vertical distance measured from the average adjacent grade o'the building to the extreme high point of the building,exclusive of chimneys,heating units, entilation ducts, air conditioning units, elevators, and similar appurtances. APR-04-2008 09:08 CITY OF TYBEE ISL. 912 796 9539 P.02/04 During construction: On-site restroom facilities will be provided through 4-05-08 - 4-30-08 On-site waste and debris containers will be provided by Savannah Abatement • Construction debris will be disposed bysav Abatementby means of Transportat ion . I understand that I must comply with zoning, flood damage control,building, fire, shore protections and wetlands ordinances, FEMA regulations and all applicable codes and regulations. I understand that the lot must be staked out and that the stakes will be inspected to ensure that the setback requirements are met. I understand also that a certified plot plan showing elevation must be attached to this application and that an as-built elevation certification is due as soon as the habitable floor level is established.Drainage: I realize that I must ensure the adequacy of drainage of this property so that surrounding property is in no way adversely affected. I accept responsibility for any corrective action that may be necessary to restore drainage impaired by this permitted construction. Date: — Signature of Applicant: Note: A permit normally takes 7 to 10 days to process. The following is to be completed by City personnel: Zoning certification NFIP Flood Zone Approved rezoning/variance? Street address and number: New Existing Is it in compliance with City map? If not,has street name and/or number been reported to MPC? FEMA Certification attached State Energy Code Affidavit attached Utilities and Public Works: Describe any unusual finding(s) Access to building site Distance to water main tap site Distance to sewer stub site Water meter size Storm drainage • Approvals: Signature Date FEES Zoning Administrator Permit Code Enforcement Officer Inspections Water/Sewer Water Tap Storm/Drainage Sewer Stub Inspections Aid to Const. City Manager TOTAL X`' APR-04-2008 09:08 CITY OF TYBEE ISL. 912 786 9539 P.03/04 ooLoF NATURAL [/�•�Y GEORGIA Permit Acknowledgement of Asbestos/Environmental Notification to Georgia EPD for Projects Involving Demolition,Wrecking,or Renovation The undersigned hereby acknowledges that the issuance of this permit does not in any way grant permission to the owner, owner's representative, or permit holder to proceed with demolition, wrecking, or renovation of a structure prior to the filing of any required ten (10) day "Project Notification for Asbestos Renovation Encapsulation or Demolition" form in accordance with the Georgia Asbestos Rules. The Georgia Environmental Protection Division administers the rules. In most cases, the rules require both the owner and the involved contractors to assure the portion of the building involved in the project is thoroughly inspected by an Accredited Asbestos Inspector for materials that contain asbestos; and the removal of the asbestos before renovation, wrecking, or demolition begins almost without exemption. Georgia EPD requires a completed demolition notification from be submitted 10 workings days in advance even if no asbestos is present in the building. Further guidance for regulatory compliance and contact telephone numbers are provided by the brochures entitled Asbestos & Renovation and Asbestos and Demolition. Other environmental issues such as asbestos removal techniques, lead abatement, ground contamination, or unusual site conditions may have EPD regulations that could affect the project. Undersigned � Date Ak> Printed Name Office Use Only: Project Address; Permit Number; CITY OF TYBEE ISLAND, GEORGIA APPLICATION FOR BUILDING PERMIT 5 Location: PIN## NAME ADDRESS TELEPHONE Owner C;-?7 , /ty « Architect or Engineer Building Contractor p c___. 2ze)/ /2,,i...-/.1 I 4 i.,ti G,2 5 V.= . (Check all that apply) ❑ Repair ❑ Residential ❑ Footprint Changes ❑ Renovation ❑ Single Family ❑ Discovery ❑ Minor Addition ❑ Duplex ❑ Demolition ❑ Substantial Addition ❑ Multi-Family i I Other ❑ Commercial Details of Project: A /',r- _5"' 4 ,-,,y)J,' Estimated Cost of Construction: $ Cons'1 ction Type (Enter ap. .rriate number) (1) Wo.,. Frame (4) Maso (6) Other(please specify) (2) Wool : Masonry (5) Steel : Masonry (3) Brick V=4,eer Proposed use: Remarks: ATTACH A COPY O'THE CE TIFIED ELEVATION SURVEY OF LOT and complete the following information bas<. o he construction drawings and site plan: #Units #Bedrooms #Bathrooms Lot Area ' .,Living space(total sq. ft.) #Off-street parking space s Trees located &listed .n site plan Access: Driveway (ft.) With culi rt? With swale? Setbacks: Front Rear Sides (L) (R) # Stories Height Vertical dist. e measured from the average adjacent grade of th- .uilding to the extreme high point of the b'•;iding, exclusive of chimneys,heating units, ventilation ducts, air conditioning units, elevators, id similar appurtances. During construction: On-site restroom facilities will be provided through On-site waste and debris containers will be provided by Construction debris will be disposed by by means of I understand that I must comply with zoning, flood damage control,building, fire, shore srotections and wetlands ordinances FEMA re. lations and all applicable codes and regulations. I understand that the lot must be staked out and that the stakes will be inspected to ensure that the setback requirements are met. I understand also that a certified plot plan showing elevation must be attached to this application and that an as-built elevation certification is due as soon as the habitable floor level is established. Drainage: I realize that I must ensure the adequacy of drainage of this property so that surrounding property is in no way adversely affected. I accept responsibility for any corrective action that may be necessary to restore drainage impaired by this permitted construction. Date: q- Signature •of Applicant: Note: A permit normally takes 7 to 10 days to process. The following is to be completed by City personnel: Zoning certification NFIP Flood Zone Approved rezoning/variance? Street address and number: New Existing Is it in compliance with City map? If not,has street name and/or number been reported to MPC? FEMA Certification attached State Energy Code Affidavit attached Utilities and Public Works: Describe any unusual finding(s) Access to building site Distance to water main tap site Distance to sewer stub site Water meter size Storm drainage Approvals: Signature Date FEES Zoning Administrator Permit Code Enforcement Officer Inspections Water/Sewer Water Tap Storm/Drainage Sewer Stub Inspections Aid to Const. City Manager TOTAL OEFEOF RESOURCES GEORGIA Permit Acknowledgement of Asbestos/Environmental Notification to Georgia EPD for Projects Involving Demolition,Wrecking, or Renovation The undersigned hereby acknowledges that the issuance of this permit does not in any way grant permission to the owner, owner's representative, or permit holder to proceed with demolition, wrecking, or renovation of a structure prior to the filing of any required ten (10) day "Project Notification for Asbestos Renovation Encapsulation or Demolition" form in accordance with the Georgia Asbestos Rules. The Georgia Environmental Protection Division administers the rules. In most cases, the rules require both the owner and the involved contractors to assure the portion of the building involved in the project is thoroughly inspected by an Accredited Asbestos Inspector for materials that contain asbestos; and the removal of the asbestos before renovation, wrecking, or demolition begins almost without exemption. Georgia EPD requires a completed demolition notification from be submitted 10 workings days in advance even if no asbestos is present in the building. Further guidance for regulatory compliance and contact telephone numbers are provided by the brochures entitled Asbestos & Renovation and Asbestos and Demolition. Other environmental issues such as asbestos removal techniques, lead abatement, ground contamination, or unusual site conditions may have EPD regulations that could affect the project. Date Printed Name Office Use Only: Project Address: Permit Number: