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COM2003-00176 Remove Siding - COM Permit / Conditions - 10/16/2003
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O co D < a3i t ..! -o m = =* n 0 a CD CD m m X () a �. a u, .. .. p mmm O o � m ° o m m m � 73 y in m O [) [) W m J J J 0 o Z A O rn^w O O � O A t N x v ONN (" v 0 0 0 N .P O O re r.e N N n O o o N m O O O w x Q o D m m O 6) 0 8 m n cn mZ) < c a CD 0)� ZI o_ o o. -� n o c v a o o n =3 o 0 o � �c . o n> m � o CD i m (n a � N-O 7 CD o S1 o 3 � I (D a CD �. OZ) 0 a D l< o m -v n CD a) o' chi a _ 0 T = o C CD c 0 _ o o Z; =3 O O Q O N� N O Q N Q d (D r O O (D N U TJ �. (D n o. 9' n ca o n� 00 O CD a o N c � w v •-• rD' m O o c 3 CD n� rn CONCRETE MECHANICAL MANUFACTURED HOME N o Footings 1 Setbacks Date By Ribbons 0 0 Date By Gas Piping Date B y o Foundation Walls Date B y Set-up °' Date By INSULATION Date By E G / Slab Insulation Floors Final D ate By Date B y Date B y FRAMING Walls FIRE DEPT Date // -2 .,c j By Date By Date By PLUMBING � Attic OTHER Groundwork Date By Date By WALLBOARD NAILING D.W.V. Date By Date By FINAL INSPECTION i14Tater Line Date By By Date B D ate B y n d n 70 N V1 O � W O O J O� y 0 A O A iVE joaa> S Wp, CG1'✓1 206:5 - CEO %-i,4, t23 , Z3 FILE Z COPY THESE PLANS MUST BE ON THE JOB SITE FOR INSPECTION CHANGES SUBMIT CHANGES FOR APPROVAL j PRIOR TO PERFORMING WORK I APPROVED I MA BUILDING INSPECTOR ES SUBJECT TO APPRO AL I DATE �Td G S f7 i C Jv 1 I VE® �:1 1 4 2003 CEDAR ST, DCroSs taec��eri I Rew�pi��e+- b�' S��ress Secron.� C- I /1 Flr ; R U I /dX7 I I � E,c�sfiin � I 7--I11 ��• T-ul l /�µ l - = �► T � YE I��� s /�pCow�Eoe� BUILDIlNG OA i i 4 2093 Dridt Tl,nt Crnss 5ectien kel., .-Jet- OP 8h1e(Toss Se,�on.� i d�, T--11I i I" r I � Ij(i'111: +, e P13weoJ, I +/ N MASON COUNTY PERMIT NO. `�`' • BUILDING PERMIT APPLICATION CO"2-0G'3' ` 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 00 1 ) `' Shelton (360)427-9670 • Belfair(360) 275-4467 • Elma (360) 482-5269 1 On the Web www.co.mason.wa.us AP�LQANT INFOnRMATION CONTRACTOR INFR RMATION Owner r1aV\ 13LoCttAjLuP1`Qr , MG ! n IBIS Contractor Name _VAirieft h Maefi.yk Mailing Address IZ35'A arlGPf 0-feet Mailing Address '1p77 (,hI C© uWALI City r`i r h land—State Wot Zip Code 9IT 3 12 City � � n State Zip Code 2, Phone(.- L5 ) r 1 Other Ph. ( )~ Phone (360 ) 7 Z Other Ph. (�) 6-W-07AFi Lien/Title Holder _�Qom + Contractor Reg. # WIASgS &a Exp. 6 / _12 'Em ail Address Email Address SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System Well Water System Name of Water System PARCEL INFORMATION - 12 digit Tax Par el No 12-3-ze9000 ire District Legal Description I Site Address (Please Lnclude street mime, &1treet tyjmber and city) Allp 2.z42nfj SICille ;e Directions to site flu-f,e �"-'� , e+ i r- BS A Will timber be cut and sold in parcel preparation? (Yes/No) Is property located within 200' of saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE ❑ SEASONAL RESIDENCE ❑ TYPE OF JOB - New Add Alt epai Other' -_ Use of Is this permit submittal the result of a Stop Work Notice, Orr ec ign No 'ce or other enf ent tion?(Yes/No) Describe Work / St (,,,,�I.� Gt11 s No. of Bedrooms No. of Bathrooms SQU E FOOTA E- 1st Floor 2nd Floor 3rd Floor Loft Basement Deck Other Garage Attached Detached Carport Attached MANUFACTURED 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. 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 AN73 GRANTS EMPLOYEES OF Mason COUNTY ACCESS TO THE ABOVE DESCRIBED PROPERTY AND STRUCTURES FOR REVIEW AND INSPECTION OF THIS PROJECT. OWNER/BUILDER ACKNOWLEDGES SUBMISSION OF INACCURATE INFORMATION MAY RESULT IN A STOP WORK ORDER OR PERMIT REVOCATION.ACKNOWLEDGEMENT OF SUCH IS BY SIGNATURE BELOW: OWNER AFFIDAVIT- I certify that I am exempt from the require- CONTRACTOR'S AFFIDAVIT- I certify that I am currently regis- ment of the Contractor Registration Law RCW 18.27 and am aware tered as a contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and of the ordinance requirements regulating the work for which this that all work will be done in conformance therewith. No changes permit is issued and all work shall be done in conformance there- shall be made without first obtaining approval. with. changes shall be made without first obtaining approval. X Date X Date I P/3 Q FOR OFFICIAL USE BEYOND THIS POINT RECEIVED Aceeptedbyt----- Planning Pd Ck# Date Bld Pd. Reciept No. OCT 14 20 E' al .. " Building Department �� Occ Grou Type Constr. Planning Department Environmental Health Department Public Works Department Fire Marshal Valuation$ i ` 42 Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee Other f Wood/Gas/Pellet Stove State Fee Violation Fee Pre-Paid at Submittal TOTAL FEES