HomeMy WebLinkAboutBLD2016-00303 DEMO - BLD Permit / Conditions - 4/12/2016 Inspection Line(360)427-7262
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MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County
615 W Alder St
Shelton, WA 98584
RESIDENTIAL BUILDING PERMIT
BLD2016-00303
OWNER: DALE CROWE RECEIVED: 4/12/2016
CONTRACTOR: LICENSE: EXP: ISSUED: 4/12/2016
SITE ADDRESS: 18101 ESTATE ROUTE 3 ALLYN EXPIRES: 10/12/2016
PARCEL NUMBER: 122204300110
LEGAL DESCRIPTION: TR 11 OF G.L. 4 & S 1/2 SW BLA MC#92-2-00274-8 S 19/152
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
DEMO PERMIT FOR SFR (STICK BUILT) FOLLOW ST RT 3 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.: 5 No. of Stories: Occ. Load: Building:
Valuation: Building Height: Occ. Status: Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
:
y
Make: Length: Ft. Front: Ft. Shoreline: Ft. Water Body:
Model: Width: Ft. Rear: Ft. Slope: Ft. Shoreline Desi
Side 1: Ft. g..
Year: Serial No.: Side 2: Ft. I Comp. Plan Desig.:
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Building State Fee GMM 4/12/2016 $4.50 S1201600000001
Demolition Fee GMM 4/12/2016 $ 117.50 S1201600000001
Total $ 122.00
BLD2016-00303 Please refer to the following pages for conditions of this permit. Page 1 of 3
CASE NOTES FOR
BLD2016-00303
CONDITIONS FOR
BLD2016-00303
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
1-800-647-0982�The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
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2) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
permit revocation.
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3) 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
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4) 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
Mason County ordinances apo building regulations.
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5) 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
holder have prevented action flom being taken. No more than one extension may be granted.
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BLD2016-00303 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
PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
Signature Date
/ . -c OWNER - REPRESENTATI - CONTRACTO
Print Name (Circle one to indica
BLD2016-00303 Please refer to the following pages for conditions of this permit. Page 3 of 3
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?� MASON COUNTY t ► PERMIT NO.'�Ld aDl(a-WU 0?j
y DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING•PLANNING• FIRE NARSHAL
WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352
Mason County Bldg. 8 (360)275-4467 Belfair ext. 352
1854 615 W.Alder Street (360)482-5269 Elma ext.352
Shelton, WA 98584
DEMOLITION PERMIT APPLICATION
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 'lf_a)l, )E NAME: j
MAILING ADDRESS: MAILING ADDRESS: /p t c&pc. -j cT-
CITY: STATE: ZIP: CITY:_�4eCrEAJ STATE: i,J A, ZIP:asS-sv
PHONE: CELL: PHONE: CELL:
EMAIL: EMAIL :
L&I REG# EXP.
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER) I AAA 0 `��J ' n FIRE DISTRICT
LEGAL DESCRIPTION(ABBREVIATED) :
SITE ADDRESS /9flOe'
DIRECTIONS TO SITE ADDRESS: 4/aT,y 6=4 a�7'; 36 -ZZZ 4,"�a�J
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 DEMOLISHE sIDENC GE ETC.)
HOW WILL THE DEBRIS BE DISPOSED OF?
PROVIDE A PLOT PLAN INDICATING LOCATION OF STRUCTURE TO BE DEMOLISHED
STot.�1'u�
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OWNER no edges submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledge n o 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
INSPECTIGN. INACTIVI OFT S PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
r Signature of Applicant Date
x_ / „» /] L.24te OWNER/REPRESENTA V lCONTRACTO
Print Name (CIRCLE TO IN
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT