HomeMy WebLinkAboutBLD2015-01058 Cancelled Demo Cabin - BLD Permit / Conditions - 4/16/2020 r 4
060N CO Inspection Line (360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. III
426 W. Cedar
Shelton, WA 98584
RESIDENTIAL BUILDING PER IT
BLD2015-01058
OWNER: GARY HANSON RECEIVED: 12/23/2015
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CONTRACTOR: LICENSE: EXP.- RECEIVED:ISSUED: 12/23/2015
SITE ADDRESS: 4101 E STATE ROUTE 106 UNION C) EXPIRES: 6/23/2016
PARCEL NUMBER: 322314300090
LEGAL DESCRIPTION: TR 9 OF S 13.14 AC G.L. 3 & TAX 281-13-1
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
DEMO 481 SQ FT CABIN BROCKDALE RD, MCREAVY RD, R ON DALBY RD, FOLLOW TO ST RT 106
TO SITE ADDRESS
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: Type of Constr.:
Type of Use: SF Insp.Area: No. of Bathrooms: Occ. Group: Lot Size: Deck:
Type of Work: DEM Fire Dist.: 6 No. of Stories: Occ. Load: Building:
Valuation: Building Height: Occ. Status: Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front: Ft. Shoreline: Ft. Water Body:
Rear: Ft. Slope: Ft. S E PA?:
Model: Width: Ft. Side 1: Ft. Shoreline Desi g"
Year: Serial No.: Side 2: Ft. Comp. Plan Desig.:
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Building State Fee GMM 12/23/201 $4.50 31201500000001
Demolition Fee GMM 12/23/201 $ 117.50 S1201500000001
Total $ 122.00
BLD2015-01058 Please refer to the following pages for conditions of this permit. Page 1 of 3
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Date By Data By DECKS
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DRYWALL Date By
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S"N CoU�'�-
MASON COUNTY PERMIT N035 IC12GI7- D 100 g
y DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING•PLANNING•FIRE MARSHAL
WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352
_ r Mason County Bldg. III,426 West Cedar Street (360)275-4467 Belfair ext. 352
1854 PO Box 279, Shelton,WA 98584 (360)482-5269 Elrrta ext. 352,1 -' jVi`
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DEMOLITION PERMIT APPLICATION DEC 2 3 2015
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: LT aI � Y im -� Y150 NAME:
MAILING ADD SS: -0 -.$0 (o MAILING ADDRESS:
CITY: STATE: LQ ('f ZIP: a- CITY: STATE: ZIP:
PHONE: :?2 I n Q-VIW 02VELL: - 4,10--700(n PHONE: CELL:
EMAIL: LQ EMAIL :
L&I REG# EXP.
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER) 3 -Z 1 I 9 0 FIRE DISTRICT
LEGAL DESCRIPTION(ABBREVIATED): r qv
SITE ADDRESS L{0 51 e. 54 Qe IDS 1p CITY n WA
DIRECTIONS TO/ SITE ADDRESS:
91/a rnt
IS PROPERTY WITHIN 200 FT:
SALTWATER® LAKE[] RIVER/CREEK❑ POND[] WETLAND[] SEASONAL RUNOFF[] STREAM ❑
DOES PROPERTY HAVE SLOPE(S) WITHIN 300 FT OF THE PROJECT- GREATER THAN 14% YES[] NO ❑
IF YOUR PROJECT IS LOCATED ADJACENT TO OR WITHINANAREA THAT IS LISTED ABOVE, PLEASE
CONTACT THE PLANNING DIVISION OF COMMUNITY DEVELOPMENT PRIOR TO DEMOLITION TO
ENSURE REDEVELOPMENT.
USE OF STRUCTURE BEING DEMOLISHED(RESIDENCE,GARAGE ETC.) (.: n
HOW WILL THE DEBRIS E DISPOSED OF ?
PROVIDE A PLOT PLAN INDICATING LOCATION OF STRUCTURE TO BE DEMOLISHED
OWNER/CONTRACTOR acknowledges submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative, or contractor. I further
declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary
parties, including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the
information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for
review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180
days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF
INS P N. INAC IVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
X ON I7 • a3 15
*nature o Applicant Date
X 5101\ QVV—N�R/ REPRESENTATIVE/CONTRACTOR
Print Name (CIRCLE TO INDICATE)
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT