Loading...
HomeMy WebLinkAboutBLD2002-00841 Final SFR - BLD Permit / Conditions - 7/18/2003 co r K X -0 O Cl) r- m n 0) --A (mA 0 sv (D m y l< C- C) 0mvmm m CD'T =7 0 <m 0 � r O O' cr * CD D 0 - 3 N O CD Z -j m cn CD m o o � m -n 3 =� � c0 � 0 m x v CD o o Z m m � z am z o co nyy> D y O 5 EF M d .O. X U) � X ;; O m o c 0 = n Co Cn0 '� N N X Z < C Z Q T m 7 0 (D N N m m � D .:3 v 0 .< .� C� W — — 1 N (n W '� .-. O (o X C) n 00 Co 0 W G) " ozo P' n. 0 � oZ (Q Z fJ Co � C Z N 0m < m0mm � o z � � � °' 0 (n (n co o —I O CC C�D "0 � 0 7 ? O (a�. (aD• (xD � s. z O � N � z T� p a N V N < O 7 0 Cn IV (fl 0 co r w GL (D (D C W TT N o o rn aOD 0 Ti o w_ s cD � rn "17 Q m CD 7 OOOA W Fr y ti O 0D � v ` O O O O D PO N CA) coCNn rn p O (D -n r- r- M T1 n O W Z � (D Zi Qo 00 rn C (D 3 0 0 � oN r Z_ (n m o o o n Z7 (o cI C m =- = o 0 -"`< m = 0 D r w CD 0 (� � � r � o n * 56 o mN r o o o y o ;u m � -n z OwcD v n-a B -q Cn � Z a 0) — z po co w Z ' n' m /) cl) r Xo o o� m I0l1 Cl) 0 O S i m CD c c 9. S. a C 00 r � CAn � � 3 3 a a c 3 - o < m N (D n n (Q (a D CC) CO CAm Z ((D ZJ -D Cn -n N C) m (D co T (D (D 3c fm1l m (D m m ai m m o (0 -n V=i (D (D T -rl CD O CD CD CD W :D 'p � CD CD (D w, y CO r o (\a N fD (D T CD C O �O N o `° `° 0 3 (A = N � o =r Y cp m o CD S CD N CD 0 m :3 CD rn r_ o Z I 23 mCCoXXM � X ;o;u m „ m � mmCD om zzzzZzz � g m Cl) yDoo2D T � Z CA -J`G CL O 0 cco oD oD R w aD oD aD R 1 Q q C OZ 0 (D m (0 j W OD OD OD OD CO OD 1 N p 7 _ O OOOOOOD v co to DO N O O O N : —I �. o 0 0 0 0 0 0 0 0 0 0 p O •< o `y N O N N N N N N N N O = •� m _ m T _ N N O Z x (/� 0 W _ 0 c m rn iv to EA to FA o (A 0) 3 -G y C Z7 C < r o r N V V N A N CD V fA En (a G .� 0 O m m m Q 7 (n (n O w W O CT N A W to W O rn o o (n in o o u am o " > 0 -{ Cn .. .. CDJ m o O o O (n O o cn o o (o X O (A) .0 0) rn rn rn rn rn rn rn rn rn rn o p � N - o O O O O O O o 0 00 (o - -� N o rn rn rn rn rn rn rn rn rn rn -14 -{ 00 00 0`0 O m N N N N N N N N N N N O) W o N N N O O O O co O CA) N N N N W -4 0) CA ? w N - N O 0 N o x0 D x -io D w nn N w -0 xj -io -i , C) CD o = pp S 0 t3 ::t O -n O"d -� CD � 00 � 0 O � 00 _0p (D = o CD -0 = 0 , w O CD CD = W Cn �� om oocD 3 c om ow m � -0 inv 0 o _0 0 '. v ? o aim Win) m CD w < m S CD m o to � CD 0 = m -0 -p CL cO = � w -0 " X m. -O CD 0 C'0 0 CD (0D x o = - o n 0 (7 = coe O CD i�; a w CD(Q a O o 0 (c Q CD y Oc 0 co (D(0 - N � cn CD CS w �' Cn C = 7 N = (n = 0 0 �• (� (D le O Q .. � K = 0 C n -n w =r = (n w a n O 0 n N (0 (D = (D �• = CD 0. O c = C L CD _ �' (n O_ CD 0. _0 � = Q `< r. CD 0 O (D p c• O CD C Cn *00,L CD c -0 y w r2 0 0 = In .O N O �- C 0 = 0 w 0 O =. � cn Cy0 =r �' O 0- = ' 0 Q O CD c 0 � w 0 cD CD 0 ? " , � o 0 CD Cp 0 0 w -0 -0 0 O CO p 5 0 = _ co cD N`< = -0 c CD � � _0 to cr CD u Cn 0 �' a- x 0 CD <O N (D 0 CD N CCDD n O 0 O 3 n) N C0 M CD = c0i O �`� = y a = a' CD =3 `� 7 t2 o' �=', v' a 0 Ana �. Nco O �' ni a r (n = - 0 cr C = w 0 � = CD O cr C 3 CT -,. CD = - = 0 0 = w 07O� n = - = Q CD Ev CD O Q 0 C O N CD O 3 a CD- Q. (n CD -p CD _ = O X - 0 � p j o 0 N 7 g .� -O m m (n F. sC) 9 C CD CCD = � w N � C) �. CD O = %C) c c (n CD CD ° O � CD. � y v m o f 0 �' s — CD m 3 0 o' =• 0 CO CD 0 (n K 0 C ? 0 CO .O CD s = CD iv o 0) 0 ma) = m CD 3 iv EP o : � � o 0) z CD w M. C) --i Cn3 3 imp m -0 CD 0 � cD o (D Op CD C O cr x o � Q 0 -u � oo 0 vW CD mo o UTwnm maim 0) cc CL � c0 CD CD 5O C, w = to CD (n p w C = CD 5' a ;:v0 0 � o CD 5 o. 0) NZ Nm CD (° (a a D = a Co $ to $ Cn o � CDcn CQ � � a) on`< 5 � 07 (n � cn � m � m0 (D -C (D c CC7 w 0) = C CD _ O 8 a �. m CD Cl,Co mQ � _ � m a � CC � C fl O 0 CD < N CD (n Q O CD o CD C _ cQ D -o w LD. _ _ Ca D a = vi (n o. w m g g (n =r (n' fA m cn O CD CD w :t) w CD c CD CD W � v 0 CD m o m �m v v0i o m m 0 CD CS = mCDo 0c =CD _o o ; mo f x o �9 n = w w = 3aC]. 0 O w n 0CD CD n cr c r- CD w O c w = - 0 0 =rO Co * p 0 Q CD c (Q (n CD C w n y n) a °' 3 o CD c w a CD CD a C—D n 0 w O CD N a CD 0. CD CD 0 .-. ` CD 0. M a ' _ °) C) 0 -. O 0 a a) 0 o 0 _ n _ = 0 3 CS CD = 0 — w = = 0 , c (D 0 O = O (n3 CD o p o 0 (n 0 0 c < 3 w .0-. a) w 0— = (n c CD - 0 - = O vcn T w O ( 0 CD ( CDQ =wCD n CD 0 0 0 (D C) CCD CD � 0 n 0 _ O 0 0 O � C_ � O 3 i n 0 O. CSC) = 0 w n -0 a O. CS0 CD CD O = "' C C C 7 CD O CD (D CO 0 , CD a) <C) CD � �' Z �, (0 0 � l< CDc OC N O n < 0 3 O O OC N O N = CCD -0 x- 7 `< - = CL CCD •O CD w D C1 cn O < c- D 0 0 -n 0 CD CD 0 w O � y Cy w _ QO fD CCP CDD c0'. n c� _0 CD CD O CD .�. CD `G 0 CD < 3 w 0. 0 .+ 0 - O. co r s cm 00 O O N o Xo D XCD X0 � � � Xv XW� = X� s0 Xe y � ° CD ° c 0 c 0 0 sv •0 `< 00 cfl - ° 0 3 cD ° � CD a n O __ CD c � v - 0 _ m cn — v Q0 C� 0) aN BCD CD0 vo0C c=3 <i0 .n 00 �_v coi �. m0 ��CD N Q Cn ° 0 � � Cu p - a CO 0 � � � o o n 0 v ° aim ai oa n ° o z CD 0 3 ? o =3 3 o. ° cn � s � 0 _ C p 0 0 < _ 0 3 - n O C v' cn O =O Q D O• ° CD' — C��D (D -� », 0 0 •a -i sv c0 ac 0 3 -, ° CC .-. 3 a 0 00 C O n d CD gCD 0 0 0 11 CD _ (D p O Q C' CD rn S CD 0 ? (3D n M D 0 "0 =r 0 -< c O C77 — � CD Q �0 � o m ° ° v cn 0' ° v 0 - 0 0 ° 03 0 o ° O CD 0 0 CO CD n O C. m 0 n C- O N ' a 3 "' 7 O v (D p O O 0 CL �. Q Q Q J. CD ° 0 cn 7 0 7 7 7 -C , Q 7 (D cD 3 to c (q c� 7 (0 n CD n N '< CD 0 cci CD `C -4 ^ C. cD = � �. � 0 cn 0' � C: Q-0 O' CD C (D �d D -� n O C C Q C D (D C = CD O 0) _. 0 CL00 0 ° a CD ' p O r o o,< Cl) Q(C "0 cn X n = W-0 O O U 0 0 Cr W CD' Cll O0 0' (D O S cC o C O Q 0 �. Q 0 y' C11 C m e C cn O C O n CD a - °> < CD°� CD Cr CD' ° CL CD - r -n0 0 0 ° °' 0 m `< m CD o mQ 0 =BCD sp0a 0 CD m -cC ° v � u' °' v0 CD CL -0 0) yCDo vino p 03' � �. D In 4q � ° ° � a � � 0 � � mom O o � � = � CL 6 -�« 7 3 ° 3 CD CD CD 0 Q C CD �' 0 to Z 0 ° O p O 0 c� 0 � �c° 0) Q yiiy cl z 333 50 ° � O O �. - 0 'a CD Cj `< -0 -0 CD -0 C N j cC Q _ CD pCD cy 0-0 CL - CD C-. N CA O CD CD (D' n p CD 0 !!1 Cll co CD cOn `� C N Q n� cD cn p' -^-0 -I 7 C C CC a 0 < o .a �• CD o _ cCD tiN � 3 � c C a m << CDm� CD O' C C co N 0 N co =r 0. O '0 W = 0 O0 -'C' W� o � � QCCD c � 0 ° gym rn CDCm � a�icnQo C � O sC=. � � �n � 3O � ° < cc o m s0co yv0 0 CD Z O 0*=3 Q 0 361 0 °� cn -0 0 � 0 -DI n� vcnCD ° oc o c 3 3 r, 3 00 a � 0 0 << a) CD 0 o ' � -0 3 8 ^. 0 co CD CD �' QC VT cn �' m v =r o Q � � n 0o v 0c 0 �. a0 CD CQ �O cn '0 00i � g30 O Q QCD CD Q .n� Cn CD Q n 0 CD CD O _0 y CD CD Cl) 0 N N O ° CD O O O cn C c r O CD CD C- 7 O _ (D < Q (D 0 0 0 0 CD 0 CD CD CD 0 CT0 � 0 � � o cn CDX 0CL- o-0 Q v 3 v Q 0 ° 0 0 - 00 3 Fn' o 0 3:� c• a in CD C O CD 5' C ti d N 3 � 0. 0 C Q CD CD 3 CD CDD Q 0 3 D-0 CD Q 0 c - c 0 0 w w �• � ccn Q cu. ° �� cn Q - ::r 30 ° cn0 ° av v 3 a CD -o c '(p CD ! � 0 3 o v Q N cC 2. a j. O m o 0 3 00 * o v 0 0cr ny2. m C Q7 v y Q C CD Q CD W N CD Q CD c=n CD Q CD °Q I ° o i °° ��,' Via, CD CD moo CD c-� � mm gom CD sy - - 3 c Q _0 mQ ° ojm m0 30vm 07 � o v Ci0 � 0 � `< m 00 vo � � 000 C) N N C) 0 7 7" O- C N O v CD -0 N fD n 7 N Ca O �. N -^ 0 Q o `< 7 j Cl : O CD 3 co CD O C CD Zr CD O Q CC 7 ' Q 0 Q CD CD CD C1 ° — CD cn c Sll ? 0 Q 3 0 0. 0. CD Q 7 C Q C C 0 D O tv -0 CD 7 O O O O D In I � CD 7 0 C 0 �_0 C. O O 0 c3 Q CD a) ocn0 Qa c30o =^ 0Cn 00 3 = cn a 0 Q < tv sU - o o n 3. CD v � am_ ya CD 00- ° o CD ° cv0 cD ca ° c0i cr c CD �� � Cflv 0 3 0 c m -• v v w 0 CD ol< a - '-` o o a-aX =3 0 ° 0 c a c � v in -h 00 Oa ON 0) > cn 0 `p�' 0 o v �• 7 c 0 n cOn Q p Q Q y T. Q 0 `G 7 CD fl. cC 7 - CD CD -0 Cn - - 3 O� (D 0 C7 Q 5• 5' Q CD C d CD � O O _ (a CD CCD n 6 C n. N N. CD 0 C C O CCD `< (D O O� 7 CD Q CD (0 W aD C� 0 N C 0 W N N N N N N N O O N _ - o X :' m D X 6D D � -I X � � X3D X < =1 - > X -» Cp 5' y. D X:-§ --I O O 0 = N - _ CD CD N O O 3 C CD = m X N = N cn - cn S 00 d O."O cn (D O" -0 C 7 m CD CD �. C-n'o .O y �. m -p m -It m O m : o C- O CCDD O O 0 CD O '0 Coy O C CD , O CD 3 p CD 5 0 Q _0 C1 O _ O ni ° nvoi — m 3ycocoi ccn � � °� � m `nco -a ° cn m � CD Cp 7' - n N N O a Cv O y CD Oc cn << O � m a0cQ CD om Nm C Cop c o - Cvoc < o O T 3 cn m CD y 0 = o' N cp CD - 7c v o D CL cn 3 -h � � CD-0 (n y CD O O Cv O w CO com c? 3 , CD 5. ' C V, c CD y -0 C $CD S n :3 CD n :� � a> my o_ 3 x a ° �y�PCDw CD CD C° --cc -0 m 3 ° ° � ocw3. Q � y y 7 0 `� c 0 7 0 O O O CD N n 7 m cn CD � D m 3 °C o� y a < y' a < 3 o' 3 0- a) v Cy v o m _. � cn � c v � 3 Boa a- oo� a CD im Xcn cn � 3 a av � m -W CD a m_0 m o3 �' sv c c � y 3 �. � y ° Q5' v o ' c o-o 5sz - o5co c� ° y w = m 3Cv 3 `< mv a- w � - cCDn � 0 y 3 c° MU) CDw -0 Q - 5 c � c � 30 mmvo � � a � cn y csa -0 m m CD CD CD 3 0 c m o < a � o co W (n c c a - Rv � CD m y Qo. � � ° 3CL j -cp n Ill O o' S C O o o m w CD Cn 3 v n o j E. d o C on < o cpv a ° � � C � 03 �•< o a� a3 v � m � °' � y00 CD 0 non �03 ° CD Z - y CD CD � - y o CD to CD N �. Cp ° CD O: n o. CD o m 4a) yov � � ° � �_. n' cyn ° � cacmy �. �� o omoo m3 0 =` ,� mn?i0 cn CD ET33 � � � �. � m CD (D CD -, 3cn fl- ° cn - 3 c � 3= v0wm � ymy. m. Q. 0o C� O C -� p cn m y O m co �' O y m y 0 7 < 0 M O CT � O�. CD C 3 C CD Cn a O CD 0 CD m j O cam» Q COD n N-0 �' Q D Cy O -0 � O " j = o o o' n o' ov °��' mCv -- � o - cn � o v°'i ,� o 03vmo � o � c m -, CD 0 CD CD 0 << F- m o Qo m o c ° xCDCD � < y 0 CD mo3 � � ca CD g CD o m _0 c a -, -o y m > > m Qco c CD m Dm y x y � °- CD -0 Cyp 3 < o m 0 0 o - C� Q y n `� K y (D o � 7• CD 7 0 < Vmi w m CD O m0-co m ((D 0 cn 00 (n cc CDO CD O CD X cn � d 7 a y m Q 3 C-aD cn A. Q O n Oa a ' oCD CD 5.5. O ai '0 O Q CD v 3 v cn o• N m c 0 co N o CD 0 y0 CD cn m C C m _0 0 CD -0 m ^?cn C o0 0 ' n' 07 n c o y 0• CD C (p c `< 7 m y 7 7 3 Q. O '' 0 O - m CT C 0) y N c CD N C1 y - (v CQ t1 cn � y. O .< Cy o o c. 6 = m � � c� CT � W =' m a N =. CAD N Q CO (n Q y v m 07 M m fl. 5- O m cn C C0 n o C o a a CO °D3 cony, 3 � cn � � �. v °' -0 �. 7 -a CD 0 0 O O O 0 0 N 0 CD Cu m 3 m CO Cp w y Cv - C1 o m cn o y ~, Cl) m °' v D o n� n 0Cp x 0 � 3 (� d �• m C 3 0 �` Q O Cy O C O 0' m 0 j• Cp m 0 cn x CD y to = O y CD 7 ton r- c ca cn 0 O�G O 0 + m W 0 � _0 ti CD �' QCD O COD Cn n 3 a C. 0 o Cn CD v Cv �' C1 0 -0 � CD o n o ;l iv 0 o iv o n� a y CD 0 mCD v-0 cn � � o3m : cn cQ o' m CD _, 0 � 0 � cQ o - Q cn 0 � 07 a sv - m � m cn cn m 0 m 0 � o m ° y m _: y m o cn v 0 CD ° vCSN O i 0 m -0 o (7-00 gcn oD oD_ - D_ o 0- N y �- m C 'c (D CD ET y 3 - 3 m M 0m mv, �� yCCDio o0M - o � � 0 mm c0x xn' � c o� x =,.0 CD CDn � ° � v v tD o � v0 �o :3 -0 m �' x � � �� m Om Am ao om � m x o y 9 0 CD I cn m o m �• < In � � n �Q � y � 3 � �' cr mmy =^ ao cn CD m 0• C � cD CD y y c O m m (n ° ,< 5' 3 mCD c. co 3 3 CD C m rn ? 3 ? O Cp v m CCD m y o G � e ' q / a w (D ODc / q m \ / 2 \ \ 0) « D $ nw x �3 $ \ 58 En Rm / 00 \ \ � j + E qE 2 � % e/ \# 3 ) / ® ® nC ¢ / 8 @E _ � R = a ai \ ® r ^ \ / �_ \ d $ ems= ƒ /_ 9 \ � � 2 ƒ \ 0 �E \ - o # E n2R �= m \ E \ � R � � � � � � � _ 993 CD c: c 2 of t/ CL X CD � a) D & \ / \ j »d 7 k ƒ k _ \ / f 2 a q F q m ] a \ m0 � m o \ k q / ^ R $ / � 0 g 90g EC m f q Eon § = 2 & _ � R _ � � \ t . n seCD � / CD CD 0 CD w cn� } / / 0 \ k / § } 0f 0 m / ¥ _ \ & m ; a) ® @ _ CD 7E C8 \ \ $ E � fCL \ e oR ƒ =r0 �2 \ 2 f 25 _0 CD / § < 7 CO m = a : n CD= m o 2 § ClL 7 \ o » r 5 s � m fi 37 X7_ CD a) � � L f CD cn CD cn / CDR ' \ � & 3 k � } ^ k 6 o co = , ° & Gm \ � y 7 ocoCD = & 7 7 \7 ~ }. � 0) g 7 0 - f 8 ` ® k k / \ 0 \ k - E 7 / < 9 | \ 8 ] - c e m m / § A \ % a) / (n - c » / K ca] £ \ 0 / / @ o m < » c n E J � s E ° m kE CD \ / C cn D § » ° 2 / \ 7R F. ƒ ƒ ° s oe E\ / m � ° ®� \ k § CD C. CD \ c /� % a CD A m - ] 5 - \ x CD \ \ ƒ ƒ / \ § / / k § 0 - 0 � n _ _ n o & 7 § ° \ ) § / CD (T � y \_ § f e 7 � u) CL / 0 Cl) -0 7 \ o a ¥ CD 8 m _ Q 0 f ® 0 / C a CD7 E CD CD ƒ / / e q 2 » _ x R ta � FORM MUST BE COMPLETED IN INK PERMIT NO.: BLD�` PLEASE PRESS HARD MASON COUNTY BUILDING 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 !, APPLIC T INFORMATION CONTRACTOR INFORMATION Owner Contractor Name G�i'ZE't'' 6)u.5'C(L 2U1W Mailing Address Mailing Address '1 City State 1A Zip Code City i witW,-Z State WI _ Zip Code Phone( M ) Other Ph: Ph.(2-1;�, ) Vlor.+fi Other Ph.(?A;i ) Lien/Title Hgglder 1 Contractor Reg. #_, �Dti + 1Zl- �C Address A Expiration / 2A74*0 `SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic__X_Existing Septic Connect to Sewer System Name of Sewer System Well-_Water System Name of Water System i PARCEL. INFORMATION-12 digit Tax Parcel No. ?Z 3 2 / J Fire Distric Legal Description -TQ Site Address(Please include street name, street number and city)loo E Directions to site © U iil timber be cut and sold in parcel preparation? (Yes/No) . Is your property within 200' of the following: Body of Water(Name)'86,PT LAIN Saltwater__ Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE Q SEASONAL RESIDENCE In TYPE OF JOB 4NewAdd Alt Repair Other Use of Building Describe Work 4-1No. of Bedroomo. of Bathrooms_SQUARE FOOTAGE-1st Floor If 2nd Floor�'� 3rd Floor 6JA _Loft Basement Deck Other sq. ft. s Attached Carport Attached Detached MOBILE HOME INFORMATION-Make Model Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price $ Replacement Unit ?(Yes/No) Installer Name Certification No. i 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. x 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 the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance 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 will be done in requir nts regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall done in conformance therewith. No changes shall be made without approval. first ining appro X Date X ! Date FOR OFFICI L USE BEYOND IS POINT Accepted � ,� D 02�ftbmittal Amount Du � Receipt No,S b k ���f :K::;:i � :'.SAS:••. �y Building CIO rt nt Gr Occ Groin - Type Constr.v Planning Department Environmental Health Department Public Works Department i Fire Marshal I r, Valuation $ am Building Permit Fee Site Inspection Plan Review Fee EH Review Fee 7S Y Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Me Pre-Paid at Submittal ( ) TOTAL FEES ' PERMIT NO.: BLD� �tKJb7! MASON COUNTY BUILDING" PERMIT APPLICATION 426 W.Cedar/P.O.Sox 196,Shelton,WA 986" -Shelton 360 27-9670 Belfair 360 275 Elma 360 2-5269'Seattle 206 464.6968 ' AP T INFO MA .IO.N CONTRACTOR INI` RMATION Owner Contractor Name Mailin Address Mailing Address City State Zip Code' City�„�► _State Zip Code Phone Other Ph. Ph.(? ) r Other Ph: j Lien/Title H Ider Contractor Re .# i j Addres$ .; Expiration/ / { j SEPTICI>IlIATER SYSTEM INFORMATION-Connect to New Septic_X _Existing Septic Connect to Sewer System__�Name.of Sewer System Well—,X—Water System Name of Water Syster6 I I l PARCEL INFORMATIO -12 digit Tax Pa cel No. �► f� / / 42 JZ W Fire Distric Legal Descdp#ion Site Address(Ptease include street na e, street number and city) h Directions tq site { Wilt tirnber be cut'and sold in parcel preparation? (Yes/No) 92. { Is your property within 200'of the following: Body of Water( ame) T Saltwater _ f Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs -= PERMANENT' . ❑ SEASONAL FlESIDENCE TYPE OI~-JOB N Add_ Alt Repair Other Use of Buildin Describe Work. s ° No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Floor E 3rd Floor. Loft Basement Deck Other sq.4t. Attached Carport Attached Detached MOBILE HOME INFORMATION-Make Model Model Year I,pIngtfi L Width Serial No. No. of Bedrooms No. of'Bathrooms 'Fype of Heat Purchase Price $ Replacement Unit ?(Yes/No) ' ltlstallerNeme Certification No. NOTICE: THIS PE #gCOMX NULL B VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF �ONS'TRUCTIONWORK'IS Sl*PfNDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. ROOF OF Cb0V 1411UAV15N OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the i rormotion provided is accurate and grants employees of Mason County access to the above described property and structures for review and r nspectio f this project Acknowledgment of such is by signature below: OWNER AFFIDAVIT-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a P Contractor Registration Law RCW 18.27 and am aware of the ordinance 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 will be done in requir ents regulating the work for which this permit is issued and all work } conformance therewith. No changes shall be made without first obtaining shal done in conformance therewith. No changes shall be made without 3 approval. first ining appro L X Date X Date FOR OFFICI L USIE BEYONDRAIS M POINT Accepted y D 0 bmittol Amount>Du6(� l3 w Receipt l�;7k > •.. L Buildin Oe nt .A c a . . 1 ti N Occ Grou Type Constr. Q S E S L n. -OZ Planning Department X/fA Environmental Health Department Public Works Department Fire Marshal I _ Valuation $ Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing&Base Fee Planning Aeyiew Fee Mechanical&Base Fee Otper Wood/Gas/Pellet Stove Fee State Fee Violation Fee ll%kN �1'�j, Pre-Paid at Submittal TOTAL FEES ' PERMIT NO.: BLD MASON COUNTY aM,? tb$Y l BUILDING( PERMIT APPLICATION 426 W.Cedar/.P.O.Box 186,Shelton,lNA 98584 Shelton 360)427-.9670 Belfair 366 +75.4467 Elmi 3611482�269.Seattle 206.64-6968 APPLIC T INFORMA. ION CONTRACTOR IN RMATION Owner Contractor,Name Maitin Address Mailing Address w '"1A Sr IV City State;, zip Code City La STale t A Zip Code .._ . Phone Other Ph. Ph:(261 ) -V Other Ph.(1F� ) - Lien/Title H lder +lIU ►� Contractor Re # ty. PC Address Expiration/ 2 3 /-23: I _ SEPTIC/WATER SYSTEM INFORMATION-Connect to New'Septic _Existing Septic Connect to Sewer System Name"of Sewer System Well—Jf—Water System ,, _Name of Water System PARCEL INFORMATION-12 digit Tax Pa cel No. / / 9 Fire District Legal Description . Site Address(Please include street name, street number, and city) DirecUonS to site timber be cut-and soldi in parcel preparation? (Yes/No) via �C� Is yput-property within 200' of the following: Body of Water( ame) r Saltwater i Lake River/Creek Pond Wetiand Seasonal Runoff Stream Slopes or Bluffs t.:. PERMANENT RESIDENCE[) SEASONAL RESIDENCE IS ` TYPE OF JOB Nep Id Add Alt__Repair ' Other Use of Building I Describe Work LMIXT A.1 I No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor,two2nd Floor 13rd Floor JJA _Loft Basement Deck Other sq. ft. Attached Carport Attached Detached ! MOBILE HOME INFORMATION-Make Model Model Year Length Width Serial No. No. of Bedrooms No. of°bathrooms Type of Heat -Purchase Price$ Replacement Unit?(Yes/No) Installer Name Certification No. ` s b� NOTICE: THIS PERMIT BECOMLIt NULL 8 VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED.WITHIN 180 PAYS OR IF "sr CONSTRUCTION WORK IS SUkPf NDED OR ABANDONED FORA PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. µ 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 l am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 certify that 1 am currently registered as a !� Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and`thatI am aware of the ordinance requirements for which this permit is issued and that all work will be done in requir ents regulating the work for which this permit is issued and all work corirfbrmance therewith. No changes shall be made without first obtaining shat b done in conformance therewith. No changes shall be made without approval. first b ining appro I: X Date X Date�'"� • Y FOR OFFICI ��1-^ USE BEYOND iS�,P�OjIN7 /,, Accepted y D tJ bmittal Amount Dube/ r.31 Receipt N � (% `.....:<.,...... ... .. �it?tfX tE1I I X I t Building Del rt nt C� 0 O L(-. I a t ct�►'' Occ Grou - Type Constr. \ -p2 Planning Department Environmental Health Department i Public Works Department f Fire Marshal ValuationG`8 '7 1 ' Building Permit Fee >O --- Site Inspection Plan Review Fee '� `° EH Review Fee Plumbing&Base Fee �oc5 00 , planning Review Fee 77 Mechanical&Base fee Other - Y Wood/Gas/Pellet Stove Fee State FeeU Violation Fee 11 t,O f�* ,y ro Pre-Paid at Submittal :E TOTAL FEES s d i ,: FORM MUST BE COMPLETED IN INK PERMIT NO.: PLEASE PRESS HARD MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Ceder/P.O.Box 186,Shelton,WA 98684 Shelton 360 27-9670 Belfair 276 Elms -62M Seattle 206 668 APPLIC T INF TION CONTRACTOR I RMATION Owner Contractor Name Mal lln Address S Mailing Address City State u&,Zip Code City State Zip Code Phone her Ph.( Ph. > Other Ph. Lien/Title Holder Contractor Reg.# Address Expiration / / SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System FESR*Add ORMATION-12 digit Tax Parcel No. / b / �Z/Za Fire District (Please Include street name,street number and city)ite Tb Is your property within 200'of the following:Body of Water(Name) M;jdieT -(VI('u" Saltwater�� Lake River/Creek Pond Wetlanb Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair Other Use of Building W1 Location of Fixture nits 1st Floor -9-2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric Tvoe of Fixture Fixtures LPG_ Natural Gas Heatpump Toad Tyne of Unit No.of Units Etter Bathroom Sink Furnace Bath Tubs Heatpumps Showers T Spot Vent Fan Water Heater IF Propane Tank Clothes Washer I Gas Outlets Ititchen Sinks T Wood/Gas/Pellet Stove Dishwasher I Kitchen Exhaust Hood Hosebibs :9 jDryer Vent I Oar IMF _�_ Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT. 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 the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance 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 will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall one in conformance therewith. No changes shall be made without approval. first fining approval. X. Date X WN LE'm Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. ?•:fir,:3• �:.;:;.;;:;:::>:•::•::??::.;:.:::::::•,:>:.;;-.;•?::.. 4.0 M_>::..n;C::z.;:•:.:.:.:..:}::r�:< :::>:<;:>::>::>::>::s Building Department Occ Group Type Constr. Planning Department Other Other 4;•.•,'{•;:4:;••;•:•:%::{?.••:v;:.::.:?;•::•:::4:•i:..:., ....%:...:x .,.. r,.:.v:::•.iv:' w:r.. .;...• f....:Y�.`•:ii:-?%i:'+i',r;;:r•':i' ::''SI:{tit. :i: •::.2::,.:.•:,:::::r.:....,vw::::::.......:a.2.`r.?t?•*.r,.�tr::::.::.f;:,.?•:.t•:,•:r:.:::;E;:,}r.�t•::?rtt.,.,>.;.:,a.::t'#x •::::,;: ::??,9'. ...2+x•:7i ---,{ ,{. ::;;;i.�....:; ,tn;.,:•:•:•,•• ...... 'fir;.:....•.r;iY... r:.v.•:.v::::::•::�•:::.i is;•:: v., x.: .`.. .$f^:S:X�ti:?<Yt<'A+'$:v:�'iM:•v$ti:•r :::iF F.`.� +fie:.': ::'t:::;:'<•;;,.r:• .:raacssa.f..ma:rrt..':... .,w\,•;...;t.!{fc7'::..... :} 't^,:.x•r:..rot•.:?.;:.. :�:•.;r � :S..t�'A'.:.. :.. .... •--.. ;• :�:i •l•.•:•rbx•`•:• .:! •ct. i is'•.rr::o::•:::: •.{.:::.::::::::.r::::.:••.:,:�':.3?•.k.:t::t•:.r::.>::•:'•:::.::??•r:.•;;.•i:S:;•:.::....h...x....:..:..,..,•:•::.w .. :;,.r::t,,::....:.:......... ..:.. '::r`r....:::�: ::•. \':ri::5::•+'t:','•:6a... •:?•:v:::n:nvri.•\A}.:::.,•:.w: :::::ttixk....:•:::.{I,.:.....:.r...r..:............. ............:..................n..... : 'C ::. Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing&Base Fee Other Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( ) Violation Fee TOTAL FEES