HomeMy WebLinkAboutBLD2012-00512 Demo - BLD Permit / Conditions - 7/20/2012 C
Inspectun Line; 427-TM
MASONCOUNTY DEP7, OF COMMUNITY DEVELOPME4TI" Phone.(160)427-9M.eA 352 m
Mason Couity Bldg, 111426 W. Cedar P.O. Box 186
Shelton,Wh 98584 N
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1ESIDENTIAL BUILDING PERMIT BLD2 100 12 m
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DWNER: MIA VANS RECEIVED: 7/20/2012
COCRACTOR: ACTIVE UNDERGROURD (;60)426-9277 LICEI-&E:ACTIVULSMRL E)P.- 12J1=013 ISSUED: 7=2012
SITE DRESS. 331 E��HNAVE UNION
EXPIRES: 1"Z0/'Zfl13 3
PARCEL UMBER: 3223 51.009
LEGAL DEi IPTION: UNION HOOD CANAL LAID &IMP CO BLK: 51 LOT9-10 &VAC KLIHN ET AW
PROJECT DESCAPTON: _ — — S J — DIRTION TO SITE. C EC
DEMO OF EXIS-0G DERELICT SFR EIRCCKDALE RD, NCREA Y RD, L ON KUHN AVE TO SiTE.ADDRESS Q
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Gen ,nfonnation Gmsbuctlon&Occupancy Information Square Footage Infcrmatior
o.cf Bedrows: Type of Corstr.:
Type of Use: S 1nsp.A•aa: No.6 Flahrowm: Occ.Gaup: Lot Size: Deck
Type of Work: D M Fire GK: 6 Na,o Starim: Ooc. Lead: Wilding:
Valuation: Buldinf Hdght Ooc. St-tus: Basement
Manufaetumd lome Infumaticn Setback Information Shor9ell;ne&Planning!r omtatim
Make: Length: =t. Fr3ft Ft. Shorene: Ff ater Bo p:
Rae Ft. Slope: Ft SEPA?:
Model: Width: =t. Silo Ft. I Shoreline Desi
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Year: Ski No.: Sidi 2: Ft. Comp. Plan Desig.:
Plumo4ra Fixtures Machanloal Fixtures FEES 'a
Type sty. Type thy. Type By Date Amount Rctaipt
Bukig Stye Fee GMM 7l20QD12 $45D S1=20000000r
Dem�Etion leg GWA 7120RV12 $117.50 SIZ120000000r
TOW $122.00 UI
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ELD2012-00512 please refer to the following page:for cordilJons of Ibis p:rmlt. :1 bt 3
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CASE NOTES FOR
BLD2012-Ot1512 m
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CONDITIONS FOR N
BLD2012-00612 a
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1) All construction and demolition debris must be removed from the beach after project completion. Prope disposal C7tru Qon debris must be on land 3
In such a manner that debris cannot enter or cause water quality degredation of State waters. �%/j
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2) Contractor registration laws are governed under RCW 1 a27 and enforced by the WA State Dept of tabor and Industries,Contractor Compliance Division Q
There are potential risks and monetary liabilities to the homeowner for using an unregistered conttador. Further information can be obtained at
1-800-647-0 82. h e n signing this condition is either the homeowner,agent for the owner or a registered contractor according to WA state law. N
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3) Own t is responsible to post the assigned address arid/or purchase and post private road signs in accordance with Mason County Title 14.28.
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4) The demolition and disposal of debris must meet the regulations of Mason County and Olympic Region Clean Air Agency(ORCAA).
It is unlawful fnr any person to cause or allow the demolition (or major renovation)of any structure unless a[I asbestos containing materials have been
id ified and removed from the area to be demolished.Work shall not commence on an asbestos project or demolition project unless the owner or
obtained written approval from ORCCA.24.90 B Limited Lane NW,Olympia WA 98502, 360.58GA 044/800.422.5613 www-orcaa.org
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5) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration.The failure �D
to A
est al inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
un nances and building regulations. w
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6) 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 ca
action for a period not exceeding 180 days, upon the receipt of a written extension request[ridicafing that circumstances beyond the control of the pemtiit l OD
h e vented action from being taken. No more than one extension may be granted.
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BLD2012-00512 Please refer to the following pages for conditions of this permit. Page 2 of 3
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This permit becomes null and void if work or construction authorized is not commenced vAlhin 180 days,or if corMniction or work is suspended for a period of 180 days at any
lime after work is commenced_ Evidence of continuation of work is a progress inspection within ttte 180 day period. Final inspection must be approved before buriding can be N
occupied.Proof of contI'tionof work is by means of a progress inspection.The owner or the agent on►he owners bel�f,represents that the information provided is as oratero ert and structure for rediew and inspection.n access to the above described p p y and grartta emptnye tYOWNER OR AGEN . f DATE: m
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BL02012-00512 Please refer to the following pages for conditions of this permit. Page �
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o CONCRETE MECHANICAL MANUFACTURED HOME
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N Footings!Setbacks Date By Ribbons Z
Gas Piping N
0 Intenor Date By Interior-Date By Date By
N Exterior Date By Exterior-Date By-- Sot- D
INSULATION
Point Load I Isolated Footings Date By
BG/SLAB INSULATION ---
Date By Data By FIRE DEPARTMENT
Foundation Wails Floors Date By
Date By Data By DECKS
FRAMING Walls Date By
Date By Data By PROPANE TANKS
PLUMBING vault Date By
Date By OTHER
Groundwork Attic
Date By Date By Type.
Oats By
D.W.v DRYWALL Type.
v Date By
Int Brace Wall Date By W
y Date By FINAL INSPECTION p
Water Line Fire Seperation N
Date By Dale By Date By _x
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Pass or Request Inspect. c
s Type of Insp. Fail Date Date Dane By Comments CA
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FORM MUST BE COMPLETED IN INK
PLEASE PRESS HARD 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 Contractor Name UAJ,0tz:
Mailin Address s G� /A-z LC Mailing Address AC /,Sj Z
City�/,) CJ,&feA[70tate CA Zip Code. Z-(c-"7Z _ City NE Al State WA Zip Code �_ Y
Phone( 711q) ifyy /YZ��ther Ph.( - )— Ph.( .3(,o) �(2_& 1271 Other Ph. 3( 6,0 )1�79 777 9
Lien/Title HolderALA Ek;+AJ,' 7P_/1.(r Contractor Reg. # /} -7-1✓ L/L_ 9sy RL--
Address Expiration
PARCEL INFORMATION-12 digit Tax Parcel No. 3ZZ 3 Z / / 5-7009 s D// Fire District
Legal Description = - &Mjdlr If
Site Address(include street name and city - nj AV - U O g Z
Directions to site:
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Is your property with n 200' of the 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 drior to demolition; since removal of an existing structure could
affect future building locations.
How will the debris be disposed of? �tCa ,' — 3f- L—
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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
ordina ce re rements for which this permit is issued and that all work ordinance requirements regulating the work for which this permit is issued
vill be in c formance therewith. No changes shall be made without and all work shall be done in conformance therewith. No changes shall
USt [Wingaoval. be made without first obtaining approval.
Date 7,11I� X Date
Pr bride a plot plan indicating location of improvements and structure to be demolished.
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FOR OFFICIAL USE BEYOND THIS POINT
Accepted byc�L(il �L( . Date � bmittal Amount Due 1,:u, C� Receipt No.
DEP TM NTAL REVIEW APPROVED DENIED CONDITION CODES
Building Deparklent
Occ Gr e of Const.
Planning Department
Fire Marshal
FEES
Building Permit Fee Other
Violation Fee Other
Site Inspection Pre-Paid at Submittal ( )
F TOTAL EES
AUG-01-2012 04 :03 PM evans 949 369 5689 P. 05
949 369 56B9
JUL-24-2012 09 :26 AM •vans►
P. 01
►i \ Clymplc Raagion C1tan Air Ag%cy
2940-B Urruted Lane NW
OlympLs.WA 96502
(360)SS5.7610-FAX(360 491-6306 Demolition Pernut
poxr Ar,gnler office(360)417.1466
QRCAA R'Ymo"Office(360)942,2137
WOO www.ORC.t1A,or j
hvnei occuPled resideudal dwelling.—Permit fee; $33.00—Prior Notice-Nonrefundable �CP4dkt Calrl� �
1�.KQrther Struetnres—Permit foe. S60.00—10 workLog day welt period-Nonrefundable
1�nt� rY o�wNe m v7: ,a,vflllrark.,t�
lama: Phanc: s'
ILIA Al S Fr�X: PNIobIr. 8
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DEMOLITION CONTRACTORI 'I Check iI same as ro erty Owner inforr u ion
iluti art Name: Phone; FirnNl:
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naitr ontact Phone: hiol»Ie: ( �}p�?
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lvirul d d9: Ci Staff: Zip.
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fk of�Otuccuref ring demolip xd: Darn Cr Gate: �4
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Mbcatae prctent et survey t[nctttd e o I�rs eu idcptt$ed'Wabeatoa bo
51t f2tS removed Yea
GD 1►OLMON PRO CT CATEGORY
Ctwuplete Demolition
Trz ru S Fire—Fire Agency:
( )Ronovjjdor4 Ajmmdon,Aen+odaling,Maintenance,or other Gonttmc"n
Eraser en —Addittot+sl Fee of$50.00 must be aceoY0 01%194 by G"Ornmout Ordan:d Declaration-Commeraialron
1'have read and mW abide br the cungidafnt set forth io this patmir alrrd vAY oddendttrxt rhereso, X da 6erdbv cerQI
that w1I ideffrrCed Jeeboarar bees beta removed pad the Arfvt-wo au io this 01Pp6'c400u and Str 111cmeab d dAU
dcucdbed.hei- in A, ra the best&1'mpknvw1c ,accurate ynd eompltre. i4C.11 lt. wN AT 7WI S 7YH9
Applicant Neuno Signature Date
Datc A'l'ili6ati P9yrnatnt info, [L4,Approved 'label rot $omit
( ]Cash [ ) Disapproved perrrtiit# __—ASB00_
Ghcdc # Dcmohpo crrmt
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