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Home My WebLink AboutBLD2016-00170 Demo Mobile Home - BLD Permit / Conditions - 3/9/2016 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County 615 W Alder St Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD2016-00170 OWNER: DAVID RICHMOND RECEIVED: 3/9/2016 CONTRACTOR: COUGAR TRAIL, INC/TRAIL EX. 239-8229 LICENSE: TRAILE"970JP EXP: 4/17/2017 ISSUED: 3/9/2016 SITE ADDRESS: 7601 W SHELTON MATLOCK RD SHELTON EXPIRES: 9/9/2016 PARCEL NUMBER: 420181390041 LEGAL DESCRIPTION: LOT 1 OF SP#2993 PTN W1/2 E1/2 SW NE PROJECT DESCRIPTION: DIRECTIONS TO SITE: DEMOLITION PERMIT FOR MOBILE HOME 1972 TAMARAC FOLLOW SHELTON MATLOCK RD TO SITE ADDRESS ON THE LEFT SIDE 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.: 13 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. SEPA?: Model: Width: Ft. Side 1: Ft. Shoreline Desig.: Year: Serial No.: Side 2: Ft. IComp. Plan Desig.: Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Demolition Fee GMM 3/9/2016 $ 117.50 S1201600000001 Building State Fee GMM 3/9/2016 $4.50 S12016000000D Total $ 122.00 BLD2016-00170 Please refer to the following pages for conditions of this permit. Page 1 of 3 CASE NOTES FOR BLD2016-00170 CONDITIONS FOR BLD2016-00170 1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-80 647- n signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. 2) The demolition and disposal of debris must meet the regulations of Mason County and Olympic Region Clean Air Agency (ORCAA). It is unlawful for any person to cause or allow the demolition (or major renovation) of any structure unless all asbestos containing materials have been identified and removed from the area to be demolished. Work shall not commence on an asbestos project or demolition project unless the owner or operator has obtained written approval from ORCCA.2490 B Limited Lane NW, Olympia WA 98502, 360.586.1044/800.422.5623 www.orcaa.org 3) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mas ounty mances uilding regulations. 4) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holde ave r m being taken. No more than one extension may be granted. X b i BLD2016-00170 Please refer to the following pages for conditions of this permit. Page 2 of 3 OWNER/BUILDER 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 INSPECTION. INACTIVITY OF THIS PERM APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. Signature Date 'i cl� ,l�/vi Dir (`� OWNER - REPRESENTATIVE - CONTRACTOR Print Name (Circle one to indicate) BLD2016-00170 Please refer to the following pages for conditions of this permit. Page 3 of 3 I Pso CoUN� . - 1 a a.00 MASON COUNTY s PERMIT NO. I CIA 01(p w DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING• PLANNING•FIRE MARSHAL 00110 WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 Mason County Bldg.8 (360) 275-4467 Belfair ext. 352 1851 615 W.Alder Street (360)482-5269 Elma ext. 352 Shelton,WA 98584 DEMOLITION PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: v /T NAME: ("ay 9/9/c, �/t•q� r1r�-,q v/��i��y MAIL ADDRESS: L o MAILING ADDRESS: CITY: STA E: PtiA. ZIP: ? CITY: STATE: ZIP: PHO ..Q�77�-�7 5 CELL:ae PHONE: CELL: EMAIL: A EMAIL7",c�t; _ e�r�9✓�14'e� ,��ioy, Cvt"� L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) FIRE DISTRICT LEGAL DESCRIPTION(ABBREVIATED) : SITE ADDRESS ' CITY O/J� DIRECTIONS T SITE ADDRESS:_ UZe f o< IS PROPERTY WITHIN 200 FT: 5� C 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 9 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.) HOW WILL THE DEBRIS BE DI_VOSED OF ? / ; `2 /1,n 50, /,-d r/1i/ e PROVIDE A PLOT PLAN INDICATING LOCATION OF STRUCTURE TO BE DEMOLISHED iN. I/�/lam 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 INSP CTION I CT I OFT MIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. 3�L1 0/4 Signature of ppli — D�to X � 4 �tib �✓ OWNER/ REPRESENTATIVE/CONTRACTOR Print Name (CIRCLE TO INDICATE) DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT