HomeMy WebLinkAboutCOM2010-00072 DEMO Final - COM Permit / Conditions - 9/29/2010 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Inspection Line(360)427-7262
Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Phone: (360)427-9670,ext.352
Shelton,WA 98584
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COMMERCIAL BUILDING PERMIT COM2010-00072
OWNER: WA ST DEPT OF CORRECTIONS RECEIVED: 8/3/2010
CONTRACTOR: LICENSE: EXP: ISSUED: 8/3/2010
SITE ADDRESS: 3420 NE SAND HILL RD BELFAIR EXPIRES: 2/3/2011
PARCEL NUMBER: 123180060000
LEGAL DESCRIPTION: ENTIRE SECTION
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
Demo of 1 metal storage tank ST RT 3, L ON ST RT 300/NORTH SHORE RD, R ON SAND HILL RD TO
SITE ADDRESS ON THE RIGHT SIDE
General Information Construction&Occupancy Information
Type of Use: Insp.Area: No. of Units: Type of Constr.:
Type of Work: DEM Fire Dist.: 2 No.of Bathrooms: Occ. Group:
No. of Stories: Exit Design. Load:
Valuation: •
Building Height:
Pre-Manufactured Unit Information Square Footage Information
Make: Length: Lot Size:
Model: Width: Building:
Year: Serial No.: Basement: Parking Spaces:
Setback Information
Shoreline&Planning Information
Front: Ft. Shoreline: Ft.
Rear: Ft. Slope: Ft. Water Body: Shoreline Desig.:
Side 1: Ft. SEPA?: Comp. Plan Desig.:
Side 2: Ft.
Fire Protection System information
Auto Fire Alarm System?: Emergency Key Box?: Standpipe?:
Auto Fire Sprinkler System?: Access Road?: Fire Extinguishers?:
Fixed Fire Suppression System?: Fire Hydrants?: Fire Lanes?:
COM2010-00072 Please refer to the following pages for conditions of this permit. 1 of 3
Plumbing Fixtures Mechanical Fixtures FEES
Type City. Type Qty. Type By Date Amount Receipt
Demolition Fee rnAnA R/'2/gn1n �irp Fn C19ninnn
Building State Fee ('nnnn R/i/gn1n qa Fn C19n1nnn
Total $173.00
CASE NOTES FOR
COM2010-00072
CONDITIONS FOR
COM2010-00072
1) 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 th it holder have prevented action from being taken. No more than one extension may be granted.
Xi
2) A II irig permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The
r o request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being
non - liant with Mason County ordinances and building regulations.
3) T4E'6ItMOLITION AND DISPOSAL OF DEMOLITION DEBRIS MUST MEET REQUIREMENTS AS PER MASON COUNTY REGULATIONS. 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 REMOVED FROM THE AREA TO BE DEMOLISHED. WORK SHALL NOT
CO MENCE ON AN ASBESTOS PROJECT OR DEMOLITION UNLESS THE OWNER OR OPERATOR HAS OBTAINED WRITTEN APPROVAL
F CAA, 2490 B LIMITED LANE NW, OLYMPIA WA 98502, 360-586-1044, 800-422-5623, WWW.ORCAA.ORG
This permitEv'
es null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended for a period of 180 days at any time after work is
commenced. ence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of
work is by ans of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to
the above described pr erty and structure for review and inspection.
Q
OWN ER OR AGENT' DATE:
COM2010-00072 2 of 3
1
0
K CONCRETE MECHANICAL MANUFACTURED HOME D
Date By N
o Footings I Setbacks Gas Piping Ribbons --I
o Interior Date By Interior-Date By Date By rn
N Exterior Date By Exterior-Date _ B
set-up
Point Load/Isolated Footings INSULATION Date By Q
BG I SLAB INSULATION TI
Date By Data By FIRE DEPARTMENT n
Foundation Walls Floors Date By 0
Da By Data By DECKS X
FRAMING walls Date By m
n
Date By Data By PROPANE TANKS �
PLUMBING Vault Date �y Z
Date By OTHER Cl)
Groundwork Attic
Date By Type
Date B y Date By
D.w.v DRYWALL type: O
Int Brace Wall pate By
Date By �
Date By FINAL INSPECTION p
Water Line Fire saperation -7
Date By Date By Date By /
O
Pass or Request Inspect. c
Type of Insp. Fail Date Date Done By Comments I;
w
0
W
FORM MUST BE COMPLETED IN INK
PLEASE PRESS HARD PERMIT NO.:
MASON COUNTY
I�Y11SS516n Cree L 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 Err I�-tcnrt S Contractor Name
Mai�li Addres Mailing Address
City 1 Umi'y'. r' State WA Zip Code City State ( Zip Code
Phone &q?.S- Q)3�ther Ph.L� Ph. (90(� b(o5 they Ph.( 5�� )'"l
Lien/Title Holder Contractor Reg. # 1�
Address ZApixaU1944 ./
PARCEL INFORMATION-12 digit Tax Parcel No. o (Q ocloo Fire District
Legal Description
Site Address(include street name and city 20
Directions to site: F>~
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 wi hi a that is listed above, it is advisable to contact the Dept.
of Community Development regarding future developme p o o demolition; since removal of an existing structure could
affect future building locations.
How will the debris be disposed of? 1
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-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 therewith. No changes shall be made without and all work shall be done in conformance therewith. No changes shall
first obtaining approval. e made without first obtaining approval.
X Date X � Date &3 ,i
Provide a plot plan indicating location of improvements and structure to be demolished.
FOR OFFICIAL USE BEYOND THIS ttPOINT
Accepted b Dat ubmittal Amount Due I q:�.00 Receipt No.
DEP RT NTAL 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 ( )
TOTAL FEE S