HomeMy WebLinkAboutCOM2000-00553 Cancelled Demo - COM Permit / Conditions - 5/11/2000 Inspection Line (360)427-7262
MASON COUNTY PERMIT ASSISTANCE CENTER Phone: (360)427-9670, ext. 352
Mason County Bldg. 3 426 W. Cedar P.O. Box 186
Shelton, WA 98584
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RESIDENTIAL BUILDING PERMIT BLD2000-00553
OWNER: ROBERT CONTENO 360-830-0345 pe*0,V.� �T•a4S �4`a RECEIVED: 05/11/2000
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CONTRACTOR: q .;ISSUED: 05/11/2000
SITE ADDRESS: 3381 NE OLD BELFAIR HWY BELFAIR EXPIRES: 11/11/2000
PARCEL NUMBER: 123094200030 ��Ll- �?j c:
LEGAL DESCRIPTION: TR 3 OF NW SE "
PROJECT DESCRIPTION: DIRECTIONS TMW:
DEMOLTION OLD BELFAIR HWY TO BEAR CREEK DEWATO RD. LOCATED 1/8 MILE
TO BEAR STORE . TO ADDRESS.
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.: 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. Comp. Plan Desi .:
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Building State Fee KS 05/11/200 $4.50 53422
Demolition Fee KS 05/11/200 $42.00 53422
Total $46.50
BLD2000-00553 Please refer to the following pages for conditions of this permit. 1 of 2
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 ^ r CONTRACTOR INFORMATION
Owner L._ ^L-/Vo Contractor Name ,X/40
Mailin Address . Gi, OCI 2 Mailing Address
City .Ice.4 a C StatC&ff Zip Code`j S7--. City State Zip Code
Phone(,-'Z-(J O 3-/SOther Ph.0 Other Ph.(�
Lien/Title Holder �ldlf tGillw<< Ct= Z Contractor Reg. #
Address 21<-16/vim c.9-i v � � 4 5<< ; Expiration l I
PARCEL INFORMATION-12 digit Tax Parcel No. �1,23 U 1 / /O6<93 0 Fire District
Legal Description /U L nE
Site Address(include street name and city C r'L ,q Z l,,
Directions to site: 41d M. y, ,- ('�� s c c- e ?
Is your property within 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 prior to demolition; since removal of an existing structure could
affect future building locations.
How will the debris be disposed of? /i2?"1X3a
What is the use of the building being demolished? A_,cl.✓
NOTICE: THIS PERMIT BECOMES NULL R 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-1 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 conformance therewi No cha s shall be made without and all work shall be done in conformance therewith. No changes shall
first obtaining app val. be made without first obtaining approval.
�( y Date //'G/Ls X Date
Provide a plot plan indicating location of improvements and structure to be demolished.
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 ( )
F»: TOTAL EES