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BLD2007-00386 Cancelled Demo SFR - BLD Permit / Conditions - 3/27/2007
• Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, WA 98584 i� RESIDENTIAL BUILDING PERMIT BLD2007-00386 OWNER: MICHAEL WITTENBERG RECEIVED: 3/8/2007 CONTRACTOR: LICENSE: EXP: ISSUED: 3/27/2007 SITE ADDRESS: 10232 E STATE ROUTE 106 UNION EXPIRES: 9/27/2007 PARCEL NUMBER: 322365100002 LEGAL DESCRIPTION: PEBBLE BEACH PARK TR 2 & T.L. PROJECT DESCRIPTION: DIRECTIONS TO SITE: DEMO SFR FROM ALDERBROOK RESORT, CONT EASTBOUND ON HWY 106 FOR 3 MILES, TURN RIGHT ON PEBBLE BEACH LN, SFR ON LEFT SIDE OF ROAD. 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: SEPA?: Model: Width: Ft. Rear: Ft. Slope: Ft. Shoreline Desi Side 1: Ft. 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 KS 3/8/2007 $4.50 S12007000 Demolition Fee KS 3/8/2007 $105.00 S12007000 Total $109.50 BLD2007-00386 Please refer to the following pages for conditions of this permit. 1 of 2 Case Activity Listing 12/4/2008 12:35:51PM Case #: BLD2007-00386 4 Assigned Done Activity Description Date 1 Date 2 Date 3 Hold Disp To By Updated Updated By BLDA010 Application Received 3/8/2007 3/8/2007 None DONE KS 3/8/2007 KS BLDB130 Planning Review 3/8/2007 3/26/2007 None DONE KJM 3/26/2007 KJM Structure 110 feet from OHWM. BLDB110 Building Plan Review 3/27/2007 3/27/2007 None DONE CMH 3/27/2007 CMH BLDA100 Approved for Issuance 3/27/2007 None DONE CMH 3/27/2007 CMH LMOR FOR APPLICANT. BLDA500 Issue Building Permit 3/27/2007 None DONE KS 3/27/2007 KS BLDA540 Print Inspection Card 3/27/2007 None DONE KS 3/27/2007 KS BLDA510 Reprint Building Permit 3/27/2007 None DONE KS 3/27/2007 KS BLDA560 Permit Cancelled 10/26/2007 None DONE TFR 10/26/2007 TFR Page 1 of 1 Casenctivity..rpt r t W o CONCRETE MECHANICAL MANUFACTURED HOME CD Date By o Footings I Setbacks Gas Piping Ribbons 1 1 oInter�u Date By interior-Date By Date By Z Co Exter" Date By Exterior-Date B m Point Load I Isolated Footings INSULATION Date By 0 BG t SLAB INSULATION Date By Data By FIRE DEPARTMENT 9 Foundation Walls Floors Date By = Date By By DECKS D FRAMING waft Date By rn r Date By Data By PROPANE TANKS PLUMBING vaun Date By Date By OTHER Groundwork Attic Date By Date By Type_ Date By o.W.v DRYWALL Type: Int.Brace Wall Date By IOU� Date By Date By FINAL INSPECTION 0 w Water Line Fire Separation IV Date By Date By Date: By O 4 Pass or Request Inspect. c Type a#Insp. Fail Date Date Dane By Comments co a a' 0 y O 8 CD o' O CD O A 0 FORM MUST BE COMPLETED IN INK �� PLEASE PRESS HARD PERMIT NO.' MASON COUNTY DEMOLITION PERMIT APPLICATION T� 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 N ;INFORMATION ``II - CONTRACTOR IN RM TIO Owner -S N"&,vvl�' Contractor Name Mailing ress Mailing dress IV City ~ /0 State 64" Zip Code City State Zip Cod Phone ther Ph.(.�kO) � Ph. her Ph.( ���) 7erl (z62/ Lien/Title Holder n►` Contractor Reg. # �Af_ Address Expiration PARCEL INFORMATJPW1,2 digit Tax P eel o. /_ L/ (90�,C—Fire District Legal Description / 2 !� � a V Site Address(include street name and ci Direction to site: �I1 voG GGSGV — CdYh 61C O l o — aLO Is your property withi 200' f the following: Body of Water(Name) Saltwater Lake River/C 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 prior to demolition; since removal of an existing structure could affect future building locations. How will the de is be disposed of? b" d S e Ve ( What is the use of the building being demolished? �S�G � WJe jkil .1Lp� — 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<6 pctures for review and inspection of this project. Acknowledgment of such is by signature below: l OWNER AFFIDAVIT-I certify that I am exempt from the requirements of CONTRACTOR'S AFFIDAVIT-]certifY{Tfat`IIaa entl gistered as a the Contractor Registration Law RCW 18.27 and am aware of the contractor in the State of Washingto that, a f the ordinance requirements for which this permit is issued and that all work ordinance requirements regulating rk f@@�� ich permit is issued will be done in conformance therewith. No changes shall be made without and all work shall be done in con' ce,tt�er`CthL o changes shall first obtaining approv be made without first obtaining ap val. X Date 2/©;) X b Date Provide a plot plan indicating location of improvements and structure to be demolished. GrIlk /vur� FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED CONDITION CODES Building Department Occ Grp Type of Const. Planning Department Fire Marshal FEES Building Permit Fee Other Violation Fee Other Site Inspection Pre-Paid at Submittal ( ) /i• 7-77-5555 :-•%�'•' %h<::•J::F!,W'<:•':{`�::'•:i%':::'Ii% •'f•' ••ii TOTAL FEES J. W.Campbell E 10232 Hwy 106 Union,WA 98592-9738 GlJ1`I A L SH c)P L 1 M L A Dx r 3 NoMe IPCPTIC- TAIV4S O CCU P^wr AkD ti PUMP OC a t Dcuvb WA1C ' l 9MALL tzc�t�v4 v L o cc-pphT 1 r r i f