DEMOLITION PERMIT APPLICATION - City of Vernon · Section 8.1.1.3 (1) of Bylaw #4900 states that measures shall be taken during demolition to protect the public in conformance with

CORPORATION OF THE CITY OF VERNON 3001 – 32 Ave, Vernon, B.C., V1T 2L8 Phone: 250-550-3634 Fax: 250-545-5309 [email protected] www.vernon.ca

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Section 8.1.1.3 (1) of Bylaw #4900 states that measures shall be taken during demolition to protect the public in conformance with SCA S350-m, “Code of Practice for safety in demolition of structures” and Subsection 8.2.2. (Fire Safety at Demolition sites). Subsection 8.1.2.2. (1) states precautions shall be taken to ensure that no person is exposed to undue risk.

PROPERTY TO BE DEMOLISHED ADDRESS: ZONING DESC:

RE: DCC CREDIT FOR FUTURE DEVELOPMENT

NUMBER OF SINGLE FAMILY UNITS DEMOLISHED:

SQ. FT AREA AND UNITS FOR MULTI FAMILY DEMOLISHED: ______________________________________________________________________________ SQ. FT AREA OF COMMERCIAL/INSTITUTIONAL SPACE DEMOLISHED:

PROPOSED DATE OF DEMOLITION

REASON FOR DEMOLITION

TITLE SEARCH (<30 Days old) including COV Charges

COMPLETED

OTHER PERMITS REQUIRED TREE REMOVAL: NEW BUILDING:

DAMAGE TO MUNICIPAL WORKS

OWNER OR AGENT SIGNATURE REQUIRED ON ATTACHED DOCUMENT

CSR SITE PROFILE

PROPERTY HAS PRIOR USE OF INDUSTRIAL OR COMMERCIAL ACTIVITY IN ACCORDANCE TO SCHEDULE 2 OF THE ENVIRONMENTAL MANAGEMENT ACT: YES NO

IF YES, SITE PROFILE IS REQUIRED HERITAGE HERITAGE REGISTRY / HERITAGE BUILDING?

YES NO IF YES, A HERITAGE ASSESSMENT AND HERITAGE PERMIT FEE MAY BE REQUIRED

RIPARIAN PROPERTY IS WITHIN 30 METRES OF A WATERCOURSE (LAKE OR STREAM) YES NO

IF YES, RIPARIAN AREA REGULATION MAY APPLY

APPLICANT MUST CONFIRM WITH THE FOLLOWING AGENCIES THAT THEIR RESPECTIVE SERVICES ARE DISCONNECTED AND RENDERED SAFE:

Fortis Gas 1-888-224-2710 Confirmation #: or Signature: Date: BC Hydro 1-877-520-1355 Confirmation #: or Signature: Date:

APPLICANT MUST HAVE A DEMOLITION WASTE MANAGEMENT PLAN APPROVED BY REGIONAL DISTRICT OF NORTH OKANAGAN RDNO Waste Management 250-550-3785 [email protected] Approved by: Signature: Date:

**Upon permit approval/issuance, prior to demolition, the applicant must contact the Operations Utilities Coordinator, 250-550-3620 for Water shut off and Meter Removal.

(For staff completion: Turn off date:_________________ARB#__________________Final Read___________________)

**When the demolition is complete the applicant must have a final inspection approved before any changes are reflected in the Utility billing.

Applicant Name: ____________________________ Applicant Signature: _________________________

Phone:____________________________________ Email: ______________________________________

*If the applicant is not the property owner, Owner Authorization must be attached

Rev:Dec2019

Personal information contained on this form is collected under the Freedom of Information and Protection of Privacy Act and will be used only for the purposes of responding to your request.

DEMOLITION PERMIT APPLICATION

DATE OF APPLICATION: ________________________

PERMIT NUMBER: BP _____________________

PERMIT FEE $150.00 OR HERITAGE $250.00

SUBJECT PROPERTY ADDRESS:

LOT# PLAN# FOLIO:

REGISTERED PROPERTY OWNER

NAME:

MAILING ADDRESS:

PHONE: E-MAIL:

This undertaking is given by the undersigned, as the owner of the property described above, with the intention that it be binding on the owner and that the Corporation of the City of Vernon will rely on same.

I confirm that I have applied for a building permit pursuant to the City of Vernon Building/Plumbing Bylaw No. 4900, and that I have carefully reviewed and fully understand all of the provisions of the Bylaw and in particular, understand, acknowledge and accept the provisions describing the purpose of the Bylaw, the conditions under which permits are issued, the disclaimer of warranty or representation and the limited extent of the scope of the Bylaw and inspections thereunder.

Without in any way limiting the foregoing, I acknowledge fully that it is my responsibility, whether or not any work to be performed pursuant to the permit applied for is done by me, a contractor or a registered professional, to ensure compliance with the Building Code and the Bylaw.

I am not in any way relying on the City or the Building Officials of the City, as defined under the Bylaw, to protect the owner or any other persons as set out in Section 1.2 of the bylaw and I will not make any claim alleging any such responsibility or liability on the part of the City or its Building Officials.

I acknowledge that as a condition of approval of a building permit I will be responsible for any infrastructure improvements directly attributable to my development as outlined in Sections 6 and 7 of the Subdivision and Development Servicing Bylaw #3843.

I acknowledge that billing of utilities (water, sewer, garbage & recycling) will commence 2 months following the date of the plumbing approval date, or immediately after installation of the ARB, unless an application to discontinue services has been received by the City of Vernon Finance Department.

DATE: _______________ PRINT NAME:___________________ OWNER’S SIGNATURE_____________________

Rev: FEB2015

SCHEDULE “2”OWNERS UNDERTAKING CORPORATION OF THE CITY OF VERNON

3001 – 32 Ave, Vernon, B.C., V1T 2L8 Phone: 250-550-3634 Fax: 250-545-5309 [email protected] www.vernon.ca

Personal information on this form is collected under the Freedom of Information and Protection of Privacy Act and will be used only for the purposes of responding to your request.

SUBJECT PROPERTY ADDRESS:

LOT# PLAN# FOLIO:

REGISTERED PROPERTY OWNER

NAME: PHONE:

ADDRESS: FAX:

POSTAL CODE: E-MAIL: CELL:

OWNER’S AGENT

NAME: PHONE:

ADDRESS: FAX:

POSTAL CODE: E-MAIL: CELL:

I, the registered owner of the property identified above, hereby appoint the person identified above as my agent with authority to endorse on my behalf, applications, documents and permits and to represent me in all discussions with the City of Vernon staff in this regard.

As the registered property owner, please initial beside applicable permit (s): APPLICATION TYPE INITIAL APPLICATION TYPE INITIAL

Building ALR

Plumbing Rezoning

Demolition OCP Amendment

Development Sign

Development Variance Access

Subdivision Tree Pruning / Removal

Strata Conversion Soil Removal/Deposition

Site Profile

DATE: _______________ PRINT NAME:___________________ OWNER’S SIGNATURE_____________________

Rev: JAN2015

SCHEDULE “3”APPOINTMENT OF AN AGENT CORPORATION OF THE CITY OF VERNON

3001 – 32 Ave, Vernon, B.C., V1T 2L8 Phone: 250-550-3634 Fax: 250-545-5309 [email protected] www.vernon.ca

OTHER

Personal information contained on this form is collected under the Freedom of Information and Protection of Privacy Act and will be used only for the purposes of responding to your request.

BUILDING PERMIT NUMBER:

ADDRESS: Lot: Plan:

Section 14.2 of Building Bylaw No. 4900 states every owner to whom a permit is issued shall be responsible for the cost of repair of any damage to municipal works that occurs in the course of work authorized by the permit. As part of the permit application the applicant must inspect and declare any existing damage to municipal works. This information can be in the form of drawings, digital images, or photographs.

Upon completion of the work and prior to occupancy, the City will inspect the municipal works and assign value to damage resulting from the work. This cost must be paid before an occupancy permit will be issued and will be used at some time in the future to repair the damage.

DECLARED DAMAGE:

I hereby acknowledge that I personally inspected the Municipal works immediately adjacent to the above noted property and have accurately stated the damage to Municipal works.

Dated in Vernon, BC this _________________day of _________________, 20 ___.

________________________________ _____________________________ Signature of Owner or Authorized Agent Print Name

OFFICE USE ONLY:

_____ sections of sidewalk damage ____________meters X unit cost / meter $ ___________= $___________

_____ sections of curb damage ____________meters X unit cost / meter $ ___________= $___________

Other damage_________________________________________________________________ = $___________

TOTAL: $___________

CORPORATION OF THE CITY OF VERNON 3001 – 32 Ave, Vernon, B.C., V1T 2L8 Phone: 250-550-3634 Fax: 250-545-5309 [email protected] www.vernon.ca

DAMAGE TO PUBLIC WORKSNOTICE TO CONTRACTORS/OWNERS

April2015 Personal information contained on this form is collected under the Freedom of Information and Protection of Privacy Act and will be used only

for the purposes of responding to your request.

CORPORATION OF THE CITY OF VERNON 3001 – 32 Ave, Vernon, B.C., V1T 2L8 Phone: 250-550-3634 Fax: 250-545-5309 [email protected] www.vernon.ca

Hazardous Materials Summary Form

BUILDING PERMIT #: _______________

DATE: __________________

This form is to be completed and submitted in association with an application for a Building Permit where the proposed works include alterations or renovations within an existing structure.

The information provided here is intended to assist the Building Official in determining if a Hazardous Material Survey report, in compliance with WorkSafeBC Guidelines Part 20, has been completed. If a Hazardous Materials Survey report has not been completed, the Building Official will request further information regarding the scope of the project, and the presence of any potentially hazardous- containing materials, prior to the entry of the structure. If deemed necessary, a Building Official may ask that a report be produced. If a report prepared by a qualified person (as per WorkSafeBC Guidelines Part 20) cannot be produced, the Building Official may stop the inspection to ensure his/her safety.

Project Address:_____________________________________________________

Applicant:__________________________________________________________

Was the existing building constructed prior to 1990?

Yes No

If building has been constructed prior to 1990, a Hazardous Material Survey Report is required.

Has a Hazardous Material Survey report as per WorkSafeBC Guidelines Part 20 been completed for this structure?

Yes No

Please note, if a Hazardous Materials Survey report has been completed, documentation, including the report and evidence that the material was removed and disposed of properly, must be available and produced upon request for inspection purposes. Once the hazardous materials are removed, an “All Clear” letter must be posted, signifying the building is safe to enter.

Applicant Signature______________________________________ Date:_________________

Office Use Only: Date of Original Building Permit: Building Permit Number: Copy to Applicant

Revised: DEC2019 Page 1 of 1

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WorkSafe Bulletin

Asbestos is extremely hazardous to people’s health. Demolishing or renovating houses containing asbestos products can release asbestos fibres, which are extremely fine and can stay in the air for hours.

Unprotected workers exposed to asbestos-contaminated air can breathe in the fibres. This may cause serious health problems, such as lung disease and cancer.

What is asbestos?Asbestos is a strong, fire-resistant mineral fibre. In the past, asbestos was used as insulation against heat or noise, and for fire protection. It was also added to materials such as cement and plaster to give them more structural strength.

Where was asbestos used in older homes?Until the late 1980s, more than 3,000 products containing asbestos were used in house construction. The drawing on the back of this page shows potential sources of asbestos once commonly used in residential construction. When demolishing or renovating older houses, there is a high probability of encountering asbestos-containing materials, which may release asbestos fibres and put unprotected workers at risk.

What are my responsibilities as an employer or owner/builder?You are responsible for ensuring the health and safety of all workers present at your workplace. You are also responsible for protecting the public from any asbestos-contaminated air.

When doing any demolition, renovation, or salvage work, you must follow WorkSafeBC OHS regulations, specifically Part 20: Demolition and Part 6: Asbestos.

What do I have to do before demolishing, renovating, or salvaging buildings or structures?1. You must have a qualified person inspect the site to

identify any asbestos that may be handled, disturbed, or removed. OHS Guideline G6.6-3 outlines the acceptable qualifications for persons conducting asbestos hazard assessments.

WS 2003-03Rev. March 2014

WorkSafeBC Prevention Information Line: 604.276.3100 or toll-free 1.888.621.SAFE (7233) page 1 of 2

2. You must submit to WorkSafeBC a Notice of Project form for asbestos at least 24 hours before any asbestos removal or other work begins.

3. You must have trained and qualified asbestos-removal workers properly remove and dispose of all material containing asbestos.

You should receive written confirmation that the asbestos specified for removal on the Notice of Project form has been properly removed.

For more information, refer to OHS Guideline G20.112, which explains the hazards associated with the uncontrolled release of asbestos. It also provides information on the following topics:• What constitutes a compliant asbestos inspection.• Arranging for and confirming the safe removal of asbestos.• What to do if you encounter more materials suspected

to contain asbestos during demolition or salvage work.

What should I do if I find more asbestos-containing material once work has started?Stop work immediately. Have trained and qualified asbestos-removal workers properly remove these materials before resuming work.

Where can I find additional information about asbestos and Notice of Project forms?You can submit a Notice of Project form online at worksafebc.com. Asbestos survey and removal companies can be found in the Yellow Pages under Asbestos Abatement & Removal, Health & Safety Consultants, or Environmental Consultants.

For more information about asbestos and what your responsibilities are, check out hiddenkiller.ca or go to worksafebc.com for the following resources:• Safe Work Practices for Handling Asbestos booklet• Safety at Work Construction webpage• OHS Guideline G6.8: Procedures for abatement of

asbestos-containing material during house and building demolition/renovation

Asbestos hazards in demolition, renovation, and salvageAsbestos causes more worker deaths than any other workplace disease — what can you do?

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Roof felt and shingles

Loose, blown-in insulation, such as vermiculite

Incandescent light fixture backing

Roof gutters can be made of asbestos cement

Artificial fireplace logs and ashes

Acoustic tiles

Deck under-sheeting

Asbestos pad under the fireplace hearth

Pipe insulation

Main panel and fuse box; each fuse wire has an individual asbestos flash guard

Door and gasket covers

Backing behind recessed lighting

Boiler and furnace insulation

Asbestos can be found in stucco

Soffit boards can be made of asbestos cement or asbestos insulating board

Textured or stipple-coated walls and ceilings

Asbestos cement (transite) board siding and undersheeting

Outlets and switches

Gypsum board filling compound, and patching and joint compound for walls and ceilings

Window putty

Flooring: vinyl tiles and linoleum sheet flooring; flooring adhesive

Downpipes can be made of asbestos cement

Insulation on electrical wires

Heat reflector for wood stove

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Potential sources of asbestos in the home.

Please note: This floor plan depicts a typical older home. Asbestos use has declined significantly; homes built before 1990 are more likely to contain asbestos products.

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