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HomeMy WebLinkAboutBLD2002-00416 Cancelled Demo - BLD Permit / Conditions - 4/10/2002 C ' o H j- , q q CD CD S % \ / & > m c $ § g R CD 8 . } o § CL \ .� o / ) _ / � f (D@ - � OL £ oCD m £� � � § ® C2 CD � ' E 0 kk n 0 / \CL t V0 rk 2 , CD _ 2 E / $ -n 22 / m m �O co � - � -n \ Nj \ � M � 2 0 \ § Q § a \ � \ 2 ER ; - CA � �'a i /k E & G ® 2 � G2 � k E 0 � § Q kCL , ,< k � J o / � m / k 1 FORM MUST BE gqOMPLETED IN INK PLEASE PRESS HI D PERMIT NO.: i MASON COUNTY DEMOLITION PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 276-4467 Elma 360 482-6269 Seattle 206 464-6968 APPLICANAINFO M TION� CONTRACTOR INFORMATION Owner f4RD w Contractor Name f,1,C)i1i 1L Mallina Add ess R. Mailing Address I,I City State_WA Zip Code S-74 City State Zip Code PhoneQGo �g2Io• �f Other Ph. 3( 60 ) - Other Ph.(� Lien/Title Holder • Contractor Reg. # Address Expiration oa PARCEL INFORMATION-12 digit Tax Parcel No. l L S 3 / District Legal Description 13 — t �t LA to �t= Itt" Site Address(include street nam and city v — Directions to site: S`"2 Is your property within 200' of the following: Body of Water(Na e) N 0 13 M& Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs if your projec /s 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. i i How will the debris be disposed of? k/L cAvc� What is the use of the building being demolished? G 9 s NOTICE: THIS PERMIT BECOMES NULL d.VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF J 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: 1 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 j ordinance requirements for which this permit is issued and that all work ordinance requirements regulating the work for which this permit is issued 1 will be done in conformance therewith. No changes shall be made without and all work shall be done in conformance therewith. No changes shall first obtaining approval. be made without first obtaining approval. X Date Ai Date r fi Provide a plot plan indicating location of impro nd@cture to be dem(�olished. vements 1b In, �v 1 2002 PI 4.41T ASSISTANC! CH TT� 1 FOR OFFICIAL USE BEYOND THIS POINT�� Accepted by Date 4 ubmittal Amount Due Receipt No. r DEPARTMENTAL REVIEW APPROVED DENIED CONDITION CODES Building Department Occ Grp Type of Const. Planning Department Fire Marshal FEES Building Permit Fee Other Violation Fee Other Site Inspection Pre-Paid at Submittal ( ) TOTALFEES PERMIT NO.: ' MASON COUNTY DEMOLITION PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98684 / Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFOgM TION CONTRACTOR INFORMMrA Owner a rt..D la Contractor Name TIO 1C_ MailingAdd ess S(4 R.E Mailing Address City Se_ State W A Zip Code $S. ` City State Zip Code Phone L ('f Other Ph. 360 l T�� �� l 3 Ph.(_) Other Ph.(_ � Lien/Title Holder Contractor Reg. # Address Expiration a� f. PARCEL INFORMATION-12 digit Tax Parcel No. I o� / Jc 3 / - ® District Legal Description 136 - 1 +1 LAKE Lt ILL Otrt t o.J 4 LoT I n 2Tptp2.t Site Address(include street namq and city S © 0 kTM 0 ofS In, o [A ILE Directions to site: W M LA k-e (Z.UA KE IM C fZlcfe, - AST ce_ R R-c m -S Is your property within 200' of the following: Body of Water(Na e) tv 0 13 Mlk Y 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 will the debris be disposed of? n(A SAv6_r2) What is the use of the building being demolished?_ P-i S 1 D6--N`h AL GA MA GE 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 information provided is accurate and grants employees of Mason County access to thebbove 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 qm-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 work shall be dpnek in conformance therewith. No changes shall first obtaining approval. be made without first obtaining approval. 4. X Date X- Date Provide a plot plan indicating location of improvements and structure to be demolished. SZ 3 v l l FOR OFFICIAL USE BEYOND THIS POINT _ Accepted by LU 7C&4 Date ubmittal Amount Due Receipt No. tJ,6 DEPARTMENTAL REVIEW APPROVED DENIED CONDITION CODES I Building Department Occ Grp Type of Const. 0 4 Planning Department Fire Marshal FEES Building Permit Fee Other Violation Fee Other Site Inspection Pre-Paid at Submittal ( ) TOTALFEES f i i r 20,70 PERMIT NO.: ' •, MASON COUNTY DEMOLITION PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner N tc. ,Ael tz Contractor Name OWn F(F Mailing Add ess ^1 R C. Mailing Address City State I., JL Zip Code ; 1 ;?' 1 City State Zip Code Phone C 6o )V26, Other Ph. 3( 6U )7t-1f , 3 t? 7 Ph.( Other Ph.( ) Lien/Title Holder , Contractor Reg.# Address Expiration PARCEL INFORMATION-12 digit Tax Parcel No. f '? / _/ -� C9 District Legal Description L e. 1 3 6 - 14 1 LAIct L i Lv /�f • 2 k Site Address(include street namq and city Directions to site: % AA L k C n # G / S"? Is your property within 200' of the following: Body of Water(N e) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs if your proje ►s 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 will the debris be disposed of? nUM.P - JC vG r-1 What is the use of the building being demolished? IC - 1 D t-Al-VIAL G fi RA GE 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 information provided is accurate and grants employees of Mason County access to theabove 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 requirements regulating the work for which this permit is issued will be done in conformance therewith. No changes shall be made without and all work shall be done in conformance therewith. No changes shall first obtaining approval. be made without first obtaining approval. X Qk� Date X Date Provide a plot plan indicating location of improvements and structure to be demolished. 5-2 3 v FOR OFFICIAL USE BEYOND THIS POINT Accepted by r _ Date Submittal Amount Due 96 Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED CONDITION CODES Building Department Occ Grp Type of Const. Planning Department ®/A, Fire Marshal FEES Building Permit Fee Other Violation Fee Other Site Inspection Pre-Paid at Submittal ( ) TOTAL FEES i 10 � pn �A n . a kq ce �-till, , to R a AO l � J L �� y1 ,66'SE� 00.09 0o vie uv uy 46 • v\\ N p o O O • • 901 ' .r, �'0 •28 p•1 \\ o£I •�1 �� w Vol • • £ol zol �_ N N 10 •ss �� ,6F �i'e � .No W fl1 RI �. fL po aSd A. 2i 6� �E'� •�L'Ele n+ ZS'8 •Ob C� .9f• S 64 Z ,00'OS ,00.09 00.09 100.05 .00• I£I �O oy • s . :: �• �2''`. � .>ss•102£0.62,y� �ti•''�05• o .6�'as• �•- 80Z s �..9s.tq.'[ v Q 19 IE1 iZLL 00'SL 00' LL • ��b�`qd9 s vir y4 Z£I o J �y,rS.1< tip•► yy s .�6.�6 w 6Z1 � o 0 801 Z u 221 g ' .00•oS l rn 901 Lo l 8 .: i .o � $ t:r'•t>•Z N A M"•tS,01 .LBN � N — _ V£1 S 8Zl o ��+ w y�� N�Wsr�s9vSrtPA _ Wo K C. — -- O 00' M..ZS,Oi �Q Si. .j C vcpz 9£1 J �E•Z4{ .3 43 it`£I LZI p 10 d ,00•S2Z S .E2 LIZ 921 c of .Ls N N . a T w 9Z I 8 z b i 911 P.•P-�. 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