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Home My WebLink AboutMIS99-0422 Demolition #205 - MIS Permit / Conditions - 7/20/1999 MASON COUNTY Mason County Bldg, III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 M I SCE L_ L— A N E O U S PERM I T FOR INSPECTIONS CALL 427-9670 MIS99-0422 PARCEL :42OO133OOO40 PLAT : DIV : BLK : LOT : JOB ADDRESS : 80 E BLEVINS RD SHELTON APPLICANT : SHAWN LAGASA 426-2015 OWNER : SHAWN LAGASA 426-2015 LEGAL : S 543.65' Of E112 SI SM PROJECT DESCRIPTION : MOBILE HOME TO BE DEMOLISHED AND TAKEN TO SHELTON AUTO PARTS TO BE DEMOLISHED . PROJECT LOCATION : E 80 BLEVINS ROAD # 205 PROJECT NOTES : TYPE AMOUNT BY DATE RECEIPT STFE $ 4 .50 TW 07/20/99 50967 DEMO $ 42 .00 TW 07/20/99 50967 AA� jj-AJ� 7 -,2a - � 7- TOTAL : 46 .50 VOWNER OR A ENT DATE MIS_PRMT, rev: 04/01/92 COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 PERM I T C a N ID I T I (DNS Case No . : MIS99-0422 For : SHAWN LAGASA Page : 1 1 ) PURSUANT TO 1997 UNIFORM BUILDING CODE , ALL SITE MUST BE MARKED WITH APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A REINSPECTION FEE , BASED ON RATES ADOPTED FEE SCHEDULES AND THE 1997 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNER/C NTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS . X 2 ) THE DEMOLITION AND DISPOSAL OF DEMOLITION DEBRIS MUST MEET REQUIREMENTS AS PER MASON COUNTY EGULATIONS . X 3 ) CONSTRUCTION PROCESS TO BE FIELD CORRECTED EQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND UNIFORM BUILDING CODE . x FORM MUST BE COMPLETED IN INK �" 99 PLEASE PRESS HARD PERMIT NO.: MASON COUNTY DEMOLITION 9ERMIT 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 APPLIC T INFORMATION CONTRACTOR INFORMS IONp Owner ` Contractor Name ``�1 X Mailing Address �. Mailing Address City sh�)f State Zip Code City State Zip Code Phone( Other h.0 Ph. Other Ph.( Lien/Title Holder Al ( Contractor Reg. # Address Expiration PARCEL INFORMATION-12 digit Tax Parcel No. c�(90 J / / Fire District Legal Description Site Address(include street name and city f 7 .F- — Directions to site: Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs /f 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? c ^ " What is the use of the building being demolished? 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 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 requirements regulating the work for which this permit is issued will be done in conforman ther with. No changes shall be made without and all work shall be done in conformance therewith. No changes shall first ob 'Wing approval. be made without first obtaining approval. X Date 7-J0.-�1 X Date Provide a plot plan indi fcating location of improvements and structure to be demolished. FOR OF�FJCIAL gUSE BEYOND THIS POINT C Accepted by�� Date SIi bmittal Amount Due Receipt No�G64� DEPARTMENTAL REVIEW APPROVED DENIED CONDITION CODES Building Department D Occ Grp Type of Const. Planning Department Fire Marshal FEES Building Permit Fee Other Violation Fee Other Site Inspection Pre-Paid at Submittal ( ) ��:..,•, .`:..�>: :' .: r..�:•i•'^' {�+:!g:�r.,:c.,:. . :>:.�:�'i.•:•. TOTAL FEES