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BLD2001-00418 Final Replace MFG Home - BLD Permit / Conditions - 11/30/2001
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CD - (n m o ai m o cn3 a3 Z a3 a In o m CD o m .► �, 0 < 0-a , 0 � CD y X W "a O CD 71 0) C m 0 o m cr P. -S• O �. < •• O m O CD `< .�+ 7 < N m m S = Co 0 is CDm O- O 0 3 w 7 CD m m m 'a O = Tl a< -o m S y fn o O (n 0O � - m -° -� O < m 3 .-• h m m cu 0 0 O \ 2 ?_ $ 7Em C) O '10 , § � 0 mil \/_ ] 2 9 7 �\f m / % \ / � E9 & 0 \ \ / ` R 2 \ '0 CD \ g 9 mP- « � � � -0 CD C & / \ j \ E 3f / E N \ / / to 2 / / C / 0 3 cn 0q 0 D / k \ 2 ƒ 0 \ ? h a / '0f ® § f CDE ¥ N. s K § _ _ 5. 0 \ \ / § 00 f \ 2f g. @ � e 22 # \ k o §' E # Do aa) k2 0 7. .i _ PERMIT NO.: BLD MASON COUNTY BUILDING PERMIT APPLICATION 426 W.Cedair/P.O.Box 186,Shelton,WA,904M S � lton 360 27.9670 Belfair 3 75.4467:Elma 360 82ai 69 Soattls 206 4eell APPLICANT INFORMATION CONTRACTOR INFORMATION turner E - f= Contractor Name V_ I r Ala)4tt 4�'S _y .,_L► Moiling Address Mailing Address City aQC Q &-/ State wil Zip Code 9 1_ City#22z 020 t 1 A•Z6 State�k_ � Zip Code Phone() A .9•y2,80ther Ph.( ) lPh.( f1�-Q271 Other Ph.(_, Llen/Title Holder Contractor Reg. #tat L1Qy&,4icn,S4n A Address Expiration _/ SEPTICNMATER 8Y%TEM INFORMATION-Connect to New Septic xisting Septic Connect to Sewer System Name of Sewer System ater System Name of Water System. S '2 PAR L"INFORMATION-129digit Tax Parcel No. I " � :, �` / 6. Fire District Le Description ,,. .: ,r t Rea F ite/Address(Please include street name, street number and cit irections to site-Alt747iR"4 �1 G r A,,, S 14, toy � F I3z,e9Aiie ° i tuA +/ „ rQ 20 9 2 !''v a iZ ,4s 5 8ife—rA ite tl Cie+4 4C orr)t'rCt � Will timber be cut and sold In parcel preparation? (Yes/No)_ L Is your property within 200' of the following: Body of Water.(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs PER A ANENT`-Rli«SIDENCE O SEAWNAL RESIDENCE❑ TYPE OF JOB New_Add Alt Repair Other U Se,of Buildi Describe Work No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1 st Floor te-J!3 2nd Floor 3rd Floor Loft Basement Deck p• Other sq. ft. Garage__Attached Detached` Carpml Attached Detached +ARMATION=Make " t r,: Model 4403 ztl Modit.:Y r Length 4C Width A, Serial No. t No. of Bedrooms "' Mien s Z, Type of Heat rz e r >f it Purchase Price $ 4 }_zot..y Replacemgiit Utt Installer Name �. - Certification No.dct>1 aw a IN NOTICE: THIS PERMIT BECOMES NULL A 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 the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a .Contractor Registration tawRCW 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 be done in conformance therewith. No changes shall be made without approval. first obtaining approval X X �` Dat FOR OFFICIAL USE BEYOND THIS PO T Accepted by Date-'Submittal Amount Due 1.5 Receipt No. 5 10 Building Department > Occ Group Type Constr. Planning Department 5/ 01 Environmental Health Department Public Works Department Fire Marshal Valuation $f -�� : � <� o# M1°�ky.t} �iv {^}, kY•�: } r> ''. � r s. i r {,� r r s i, �t rf ',• s,,,' { t f`''., ,`.. •:..'x...F ;:3::;k r,,;,{;.•,••>:'.':••.;• .........,............... .......................:... ............................::.•::::::.::x::::::::::::a...�::.. ......:::::::�.;,}y:w}.:w.:::..fn.w...n:.:.r;•.:c•.?....5• ?::i:sb:: ,. r'k•'tx 4• r.:A„:?:•Cov ...............::..............:...;.:�.::::::::..:::.:.:.:�.::::�.::::.::.;:.:::::::>:•:tat`t}:;•::;,::to:�>.:e:.::::.:,...................:.:..:.::::.,:........'..:.:.....,.t .,o:.,.:.::..:.:�:.�:•:i•:i:'•::•>:•>:•.,•.�::......... Building Permit Fee Site Inspection Plan Review Fee UFC Plan Review'Fee Plumbing &Base Fee Public Works Review Fee Mechanical &Base Fee Other Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal ( ) TOTAL FEES PERMIT NO.: BLD MI-t{ MASON COUNTY BUILDING PERMIT APPLICATION 51 1� 426 W.Cedar�P.O,Box 186,Shelton,-WA 98594 S Iton 360 27-9670 Belfair 3ii�275.4467 Elnm 360 2-4269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Contractor Name i Lys I '" �, €,X- Mailing Address ?/;; µ ,a r Mailing Address r , _ City C 144 � _ State M Zip Code �����_ City ; ,; � ,"� .�, State FL Zip Code Phone , ,, ... ° , Other Ph. .:Other Ph.(_� Lien/Title Holder, Contractor Reg AddressExpiration SEPTIC/WATER SYST15M INFORMATION-Connect to New Septic P Isting Septic Connect to Sewer System Name of Sewer System tlVett V5ter System Name of Water System a PARCEL INFORMATION-12 digit Tax Parcel No. / / _ ,,, tl ' Fire District egel Description �.4 c'. I ,+, ription /_ ; �: .:��K r � Site Address(Please Include street name, street number and city)__ _ 's Directions to site i, .•� .�; � � ' �,�. � .tee Will timber be cut and sold In parcel preparation? (Yes/No) � Is your property within 200' of the following: Body of Water(Name) Saltwater N Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE Q SEASONAL RESIDENCE❑ s Add Alt Repair Other Ue of Bungildi TYPE OF JOB New Describe Work -"a=�I C' , ' ' .F t 5 ; r P>:<P" tL,:a' a.., .,e i" t w t t.. r"rr x ., 1 e No. of Bedrooms—_No. of Bathrooms_SQUARE FOOTAGE-1st Floor .A? 2nd Floor ��� � .l 13rd Floor Loft Basement Deck Other sq. ft. Garago Attached Detached Carport Attached Detached MOBILE HOME INFORMATION-Make iL.9 ct,,4 F.° Model elIxj e, 2 V Model Year }, Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat �z ; ;4:k, Purcliase Price $ ri F _ Replacement Unit ?(Yes/No) installer Name T•, Certification NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF s 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-I 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 be done in conformance therewith. No changes shall be made without approval. first obtaining approval. Date X ` < Date > FOR OFFICIAL USE BEYOND THIS POINT a� Accepted by..&(k Date Submittal Amount Due Receipt No. 0 TME4�F > > .. . . . Building Department,,( r Occ Group_- _Type Constr. Planning Department Environmental Health Department zl Public Works Department Fire Marshal Valuation $ : Building Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing & Base Fee Public Works Review Fee Mechanical &Base Fee 6t#�sl*� sO od Wood/Gas/Pellet Stove Fee Other .� Violation Fee Pre-Paid at Submittal ( ) TOTAL:FEES 1 PERMIT NO.: BLD VZOM MASON COUNTY BUILDING PERMIT APPLICATION ��3 426 W.Cedar/P.O.Box 186,Shelton,WA-98584 elton 360 27-9670 Belfair 360 75.4467 Elms 360. . 2-5269 Seattle 206 64.6968 lAPPLICANT INFORMATION CONTRACTOR INFORMATION Owner Ky lC/ 91Ajo i 50,UAjI C Contractor Namely_ ,' -170- MRCS Z^•C Mailing Addres 11 2 R T',4l AVE- E. c T Mailing Address..3-T U_3 S T/#w►/ / (. Cityaug-KLgy Statet,.,A Zip Code 83rt/ City 07.0P+ Q_i> Statew �4- Zip Cod�8367 PhoneQ(o )829•11218 Other Ph.( -___) Ph.(36D )479-d39S Other Ph.(_) Lien/Title Holder Contractor Reg.. #jo CO 3vylZt d if oRln Address' Expiration SEPTIC/WATER SYSTEM%INFORMATION-Connect to New Septic xisting Septic Connect to Sewer System Name of Sewer System ater System Name of Water System i ! PARCEL INFORMATION-12 digit Tax Parce 90C>4 COD Fire District { Legal Description L—t2-r 7 o f ghbq.T P4_6 7 74 S' 7,aco9pra F6:13 zT 19�a A 4Z�[ 7364 4 E Site Address(Please include street name, street number and city) 241)61 may, 3 U—A i Z I Directions to site /10,Z7' f.95T ©iv ST Ah, ty F2©�t r 13 /(t 2-1 v 0Etj A V 4N L EF7- Fie14r fStr;:oR-fit �R e v i qSS 80CFAlR sro(LA"6C reAeiL/ 7V. Will timber be cut and sold in parcel preparation? (Yes/No) _ Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE 0 SEASONAL RESIDENCE❑ TYPE OF JOB New Add Alt Repair Other Use of Buildi oF, ,c E Fo¢ M i4wA.C� Describe`Work ?2I- P4 4C.i>I`�11 ST f"d 14w f Lu r TN C I' No. of Bedrooms_I_No. of Bathrooms__SQUARE FOOTAGE-1st Floor/n_!T3 2nd Floor i 3rd Floor Loft Basement Deck - Other - sq. ft. Garage Attached Detached Carport- Attached Detached MOBILE HOME_ INFORMATION-MakeFri 0 it Model 44 03 ZV " Model Year_A0/ p Length 40 Width Serial No. No. of Bedrooms-_,j_No. of Bathrooms 2 Type of Heat c� >✓A it Purchase Price $ 4 2Ota Replacement Unit ?(Yes/No) Installer Name u - t vN Certification Not ca v H C.� NOTICE: THIS PERMIT BECOMES OLL&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-I 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 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 be done in conformance therewith. No changes shall be made without approval: first obtaining approval X �� ivy-r2+y�'rkaNrtS DateXLLA"d-9c1le z Da FOR OFFICIAL USE BEYOND THIS P 1NT v Accepted by Date Submittal Amount Due Receipt No; l'1� Building Departme D/ Occ Group_. T e Constr. Planning Department oi,,, Environmental Health Department Public Works Department Fire Marshal Valuation ;( S r .......................,... .:.......... ....:....... ..:.. .......' .......:.� . .......n.r., ........,•::.:.....::::::::..:. ..:Y%iiis^}:•ii:;3:rr.:L::•:iiv ,.,.. w:::::::.r.........:.:::{w:.vv... .. ........r.......... Building permit Fee ' Site Inspection Plan Review Fee - UFC Plan Review Fee Plumbing & Base Fee Public Works Review Fee Mechanical &Base Fee Other " Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal ( ) TOTAL FEES N m wi In N0 i m i \ E ! ' r uj Xf cc CL i rCalOQ� N 1 -e4 �y ` a Q _ a CL C00[n SHWCiH H.T.TN xllA nenTa 1 s,nnn v ..