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Home My WebLink AboutBLD2012-00313 Final Demo of SFR - BLD Permit / Conditions - 6/20/2012 Inspection Line(360)427-7262 toMASON 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 o RESIDENTIAL BUILDING PERMIT BLD2012-00313 OWNER: FIRST OLYMPIC HOLDINGS RECEIVED: 5/9/2012 CONTRACTOR: LICENSE: EXP: ISSUED: 5/9/2012 SITE ADDRESS: 50 NE BELFAIR ST BELFAIR EXPIRES: 11/9/2012 PARCEL NUMBER: 123294200220 LEGAL DESCRIPTION: PCL 2 OF BLA#01-21 PTN OF NW SE SURVEY 26/167& 168 PROJECT DESCRIPTION: DIRECTIONS TO SITE: DEMO OF SFR ST RT 3 TO BELFAIR, L ON ST RT 300, L ON BELFAIR ST TO SITE ADDRESS ON THE RIGHT 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.: 2 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?: Rear: Ft. Slope: Ft. Model. Width. Ft. Side 1: Ft. Shoreline Desig.: 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 GMM 5/9/2012 $4.50 S1201200000001 Demolition Fee GMM 5/9/2012 $ 117.50 S1201200000001 Total $122.00 BLD2012-00313 Please refer to the following pages for conditions of this permit. Page 1 of 2 ' CASE NOTES FOR BLD2012-00313 CONDITIONS FOR BLD2012-00313 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 pening this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 2) 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 X 3) 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 ordinanc building regulations. X 4) 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 hve�ented action fr eing taken. No more than one extension may be granted. X l c� This permit becomes 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. Evidence 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 means 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 property and structure for review and inspection. OWNER OR AGENT: � DATE: 7l BLD2012-00313 Please refer to the following pages for conditions of this permit. Page 2 of 2 L. Olympic Region Clean Air Agency 2940-B Limited Lane NW w 1 Olympia,WA 98502 Commercial (360)539-7610•FAX(360)491-6308 0 -CdA Port Angeles Office(360)417-1,166 Asbestos Pei'iYllt :arse„. • Raymond Office(360)942-2137 www.ORCA&org ,�Commerew Structure [ j Owner Occupied Residential Dwelling 10 Working Day wait period Prior Notice PROPERTY OWNER Name: Phone: 003 ' - Emas7: FAX -3 (9-bD-7-2 Mobile: Address: CEL a qq /,� stint/ Site Contact Person: Ph e: Easar7: n' !2r : FAX: (a;bb" - gobjL- - Yq5F Site Address: City. State Zip- .o Ne firm ASBESTOS CONTRACTOR Contractor/Business Name: Phone Z Bmat. ,[ 1 r1� �'.r'rrol.t art .L� FAX: l-rf r Mobile:. NIailing Qtr.1�.2 Address s� 1S f- G s PRO CT INFORMATION Start D te: Compkdon DRAM Work Shift Days: Work Shift Hours: .� J,�� M!fig 9V✓fh vFzi'Sa_Su . �,yl 3�m #Staktaeb to be abated: Total Quantity to be Square Feet Linear Feet removed Dis osal..Site: Win this-structure be demolished after asbestos Will aIl identified asbestos be iemoved from removal Yes.� No,— structure Yes jg�-`1110 Circle Material being temobed: Boiler/Furnace .,_Duct Insulation _Pipe Insulation Fireproofing Paints Plaster _Cement Board Cement Pipe Flooring -jejMfing . -L,,Tn tired Coating —met ASBESTOS PROJECT CATEGORY NONREFUNDABLE FEE 1 ill-ZS911inear or i1-15'9. uare feet $L50 2- DQ 2606999 linear or 160-4 999 squaw feet $325 3- 000-9i999 linear or 5,000-49,999 eq feet $650 4- 10 000+linear or 50,000 square feet $1,300 Erne $50 Annual-limit of 260 linear feet or 160 square feet $500 I have read and sdR abide by the conditions rat forth in this pnmit and pa addendum tbsreto. I•do hereby saW that the i>iforips¢tfos:'itt this appCsca#on and supplemental data described btrels it,to the best of my knonkdje, arearate and soVIete. Applicant Name Signature Date QP Date A Papment Info. [ ] Approved Asbestos [ ]Cash ] Disapproved Pc=3k#j-cz"BO� APR 0 5 2012 [ ]check # Demolition Permit [+rj'Csedit Card'tn3�-op Review date:1/k - S: # EA100� Receive date:��'- Reviewed by: ✓J ' ' $utrey: 5�es [ ]No AA Use On Use On Use 0 Use On 10/21/08 OVER Y �ggGiON C[, Olympic Region Clean Air Agency otig /1,�'YCPy 2940-B Limited Lane NW �•�/ c Olympia,WA 98502 (360)539-7610•FAX(360)491-6308 i Port Angeles office(360)417-1466 Demolition Permit N ORCAA . Raymond Office(360) 942-2137 0e•�sol•wese". www.ORCAA.org [ ] Owner occupied residential dwelling-Permit fee:$35.00-Prior Notice-Nonrefundable Other Structures-Permit fee: $60.00-10 worldng day wait period-Nonrefundable PROPERTY OWNER Name: Phone: Sr]- Ft53D Email: tA IL . bl k n FAX: a-glf7 Z Mobile: Jilin A�ddr sty � Stu zis Site Address: /� �'f"LQ-ply State, Zi�� DEMOLITION CONTRACTOR I Check if same as propertv owner information Business Name: //.l / Phon 7 - Email: l `f� 1..J.}- FAX Sq l v. Rite Contact.n Phone: Mobile: FAX-- Mailinp,Addres DEMOLITION INFORMATION #of Structures being demolished Start Date: ,2 Completion Date: 2 5" 3( 1 Asbestos present No Survey attached — es _No Has all identified asbestos been removed Yes DEMOLITION PROJECT CATEGORY omplete Demolition ]Training Fire-Fire Agency: [ ]Renovation,Alteration,Remodeling,Maintenance,or other Construction Emergency-Additional Fee of$50.00(must be accompanied by Govemment Ordered Declaration-Commercial only I have read and will abide by the conditions set forth m this permit and any addendum thereto. I do hereby certify that all identified asbestos has been removed and the information in this application and supplemental data descrybed herein is, to the best ofmyAnowledge,accurate and complete. Applicant Name Signature Date Date Application Received Payment Info. [ ] Approved Asbestos Permit [ ] Cash [ ] Disapproved Permit# ASB00 [ ] Check: # Demolition Permit ( ] Credit Card Review date:_/_/_ Permit# DEMoq Receive date:_/_/_ Reviewed by: A en Use On1 A en •Use Only A en Use Orrl A en Use On 08/11/11 OVER i W o CONCRETE MECHANICAL MANUFACTURED HOME 0Date N Footings ISetbacks Gas Piping By Ribbons 0) o Interior Date By Interior-Date By Data By 0 wExterior Date By Exterior-Date B� Set-up Point Load I Isolated Footings. INSULATION Date By BG 1 SLAB INSULATION LATION Date By Data By FIRE DEPARTMENT = Foundation!Mails Floors Date By 0 Date By. Data ay DECKS p FRAMING Walls Date By Z Date By bate By PROPANE TANKS N PLUMBING vault Date toy Date sy OTHER Groundvrork Attic Data By Date [3y Type: Date By D.W.V DRYWALL Type: Date 8y Int Brace Wall Date By W w Date By FINAL INSPECTION w Water Line Fire Seporation CD Date By Date By Date By I _a CD N o Pass or Request Inspect. c Type of Insp. Fail Date Date Done By Comments w CD o w cc cc CD en 0 1 0 0 n. o' 0 to CD 3 T N c0 (D 0 tii ti FORM MUST BE COMPLETED IN INK PLEASE PRESS HARD PERMIT NO.: 'Old gol.� )031 j MASON COUNTY DEMOLITION PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98684 Shelton 360 427-9670.Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968 APPLIqANOwner T I . MATION' d l j 1 ContracCONTtor Name NFOR Mail Add[ ss IC) Mailing Address Cit V tate Zip Code City State Zip Code Phone Oth r Ph:C Ph.( Other Ph.( Lien/TitI&WIder Contractor Reg.# Address G Expiration / / PARCEL INFORMATION-12 digit Tax Parcel No. O t Fire District Legal Description Site Address(include street name and city c- Directions to site: 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. h How will the debris be disposed of? ir1 What is the use of the building being demolished? t' 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-1 certify that I am exempt from the requirements of CONTRACTOR'S AFFIDAVIT4 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.l 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. be made without first obtaining approval. X Date 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 ( ) TOTAL FEES