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Home My WebLink AboutBLD2000-00133 Cancelled DEMO - BLD Permit / Conditions - 1/23/2003 i33 PERMIT NO.: 0 MASON COUNTY DEMOLITION PERMIT APPLICATION 2� iy 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 276-4467 Elma 360 482-6269 Seattle 206 64-6968 APPLIOANT INFORMATIIpN (SON CONTRACTOR INF�QRMATION Owner C` I/ �-'h 3P-' is ` `��``� Contractor Name �` C.�'�'�-r:��- �LS e J Maili Aq ress C Mailing Address > City 4 St ,e, Zip Code City Sly-t--1 State Zip CodeIX Phone Z brother Ph.( Ph. 3( Uo ) 2 b -OtfZDther Ph.(,300 ) 5 Lien/Title Holder Contractor Rey..# Ir O Address Expiration/ 3 / Z.S� PARCEL INFORMATI N-12 digit Tax parcel No. / / Fire District Legal Description ��Y\-v` 4 Site Address(includg stre t name and city A- Dire tions to si D-,' � S Is your property within 200' oft a following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs If your project is located adjacent to or within an area that is listed above, it is advisable to contact the Dept. of Community Development regarding future development prior to demolition;since removal of an existing structure could affect future building locations. How vyilt the debris be disposed of? What is the use of the building being demolished? i Svv`r�SC-. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF 4 CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the Information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a the Contractor Registration Law RCW 18.27 and am aware of the contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work ordinance require ents regulating the work for which this permit is issued will be done in conformance therewith. No changes shall be made without and all sh b done in conform Ace therewith. No changes shall first obtaining approval. be ade 'ho firs obtai ing ap o a1. s I�X Date X Date�� -� u Provide a plot plan indicating location of improvements arty trru tureC to be A-molished. i E I FOR OFFICIAL USE BEYON T IS POINT Accepted by I21`.Jl - Dat Submittal Amount Due XCW Receipt No. oC l DEPARTMENTAL REVIEW APPROVED DENIED CONDITION CODES i Building Department //1 Occ Grp Type of Const. (J Planning Department f Fire Marshal c k FEES k Building Permit Fee '7 UV Other Violation Fee Q' Other Site Inspection Pre-Paid at Submittal ( ) TOTAL FEES i f. FORM MUST BE COMPLETED IN INK PLEASE PRESS HARD r' PERMIT NO.: " MASON COUNTY DEMOLITION PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 27"67 Elma 360 482-5269 Seattle 206 464-6968 APPLIQANT INFORMATION / CONTRACTOR INFORMATION f Ownerl:-� i<_Oc.t, F- 4 r.)o~-' l �a r.J Contractor Name Mailing Apess c z Mailing Address City'. t ' St to Zip Code` }. ,` City` t+ tt State Zip Code Phone G)r��`� Dther Ph.( iPh.(.,t^d )y 2 o -02.17-0ther Ph.( Lb ik, Lien/Title Holder i Contractor Re-g. # Address Expiration PARCEL INFORMATION-12 digit Tax Parcel No.,... Fire District 11 Leg Description vY� 4 Ttx- Sit Address(include street name and city r ctions to s' e: 7sf, TFLB13luffs_lf ^your property within 200'of he following: Body of Water(Name) 14 Saltwater ake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or your project is located adjacent to or within an area that is listed above, it is advisable to contact the Dept. of Community Development regarding future development prior to demolition; since removal of an existing structure could affect future building locations. How wil the debris be disposed of? �. 70 - S What is the use of the building being demolished? `C.- NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the i# information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: ;$ OVWNER AFFIDAVIT-I certify that 1 am exempt from the requirements of CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a the Contractor Registration Law RCW 18.27 and am aware of the contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work ordinance requirements regulating the work for which this permit is issued will be done in conformance therewith. No changes shall be made without and all w rk sh 1 b done in confor nce therewith. No changes shall first obtaining approval. be ade 'itho t firsf obtai ing ap r al. Date X '"�" , Date -� Provide a plot plan indicating location.of improvements and structure to be demolished. `• Lam' t, s fir. C T_..__,. _ _...... 1 FOR OFFICIAL USE BEYONR7HIS POINT Accepted by ) 611, Date Submittal Amount Due Receipt No.• DEPARTMENTAL REVIEW APPROVED DENIED CONDITION CODES Building Department. PC77i J} fir- L'/t- 1-2 V1 Occ Grp Type of Const. Planning Department � d Fire Marshal FEES Building Permit Fee 13 OU Other ? 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R2 . 0 0 D � k CL m k ƒ . / (0) co co o J . J 1 CO) m 2 / q :3 "; E f0 _ :3 / \ k0 . ƒ ) � � o D 0 � � 2$ c \ a 0 5E CA D / am /2 k ] CONCRETE MECHANICAL MOBILE HOME l Footings-Setback date by Ribbons date by Gas Piping date by Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. to by date by PLUMBING date OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by I� V�