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COM2001-00095 Final Reinforce Structure L2 - COM Permit / Conditions - 6/17/2005
0 ' o CONCRETE MECHANICAL MANUFACTURED HOME N ' o Footings f Setbacks Date B y Ribbons o Date By Gas Piping Date By 0 Foundation Walls Date B y Set-up "' Date By INSULATION Date By B G 1 Slab Insulation Floors Final Date By Date By Date By FRAMING Walls FIRE DEPT Date By Date By Date By PLUMBING Attic OTHER Groundwork Date By Date By WALLBOARD NAILING D.W.V. Date By Date By FINAL INSPECTION Water Line Date By Date By Date By 2 t Ok ' 02 1810 t�E D�c�� L DrScussEO tv l�AT N4 a X-A WOO EEO Ctl�4/V�iGs � X(c�/�E foil RM�� bu►cd�j 2-Z ? ESS © 2 a 0 l- x d _ l 1 A ' .v' P t'ir f (.-. 'ire t-� t,.lG, i -U: ,k �: t:. "k O 0 T1 o / o y 0 n 0 m X N cn (n n G1 b O CD (aD N O W (D Z O N . N C AD -0m 0 :'! 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R ? k / * MCOC 2 $ m § /� eE ;u 2 CD mggac 22 / gQkk 8 � O -0 0 M 2 > / \ / \ q K7 \ &\ \ 0mm xgz -0 k mD ® -n 20- > oxzo § r > m r • : Cl) O � q w0ES � . _ ca 0 c) R7 Tmq � e oO mO E q@M>z . 7J > > 2Q 7 � 0m ® r- q fF m - m ¥ R $ $ ee. f8 0cn m / e 2vnnr CD I /0M oA mor- 0 fi X > mmc 2 / 02O » m � � q ® > $ § a ® = = I m -n ± om5q / S. X — X ¥ m mow � \ � -4 T � / k — r- 0 \ j / ZOOM k \ 0 O2Q2o Cg 2« 2 CD 0- 002$ cE w. � � k/< / I (n �k �0 \ mq 0m � . CD m % 3k C. * mmm § § co � -j %/ � ,M. mkq/ $of @D $ q > 00 k � C/) mn0 « m - 6m a 0 cn CZ CA) q � vzz o . 0 � « # / ® 6 0 \ 2 > k & E FORM MUST BE COMPLETED IN INK J PLEASE PRESS HARD PERMIT NO.: BLD MASON COUNTY BUILDING PERMIT APPLICATION u'�"'I zUbi.�Ob95 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..uv�u o� .�P � T A! � Contractor Name 0JLNerz Mailing Address h08or 521-1 Mailing Address CitytZocuesi*i State wp Zip Code Rom_ Zip Code City State Phone(%&p ) 93L(ZLJp Other Ph.(3W )SjjLSL56 Ph.( Other Ph.( Zip Lien/Title Holder W'17w o Contractor Reg. # Address Expiration SEPTICIWATER 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 Parcel No. .vzz1 / 72, / (00000 Legal Description_Pora'tt nl4 OF NW I/b 1 erg_ �� w Fire District S Site Address(Please include street name, street number and cIY)T t —' I Directions to site 230 Goo1.l IL,v � H Will timber be cut and sold in parcel preparation? (Yes/No) Ne Is your property within 200' of the following: Body of Water(Name) COON Saltwater No Lake_River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑ TYPE OF JOB New Add Alt Repair Other Use f Buildin Describe Work_ YLEIr r-dzr FXI-5Ttua t _Uy4VR49-e, — ,0 No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st loor 437, 2nd Floor No4s 3rd Floor Loft Basement Deck Other Garage Attached Detached _Carport sq. ft. Attached Detached BILE HOME INFORMATION-Make Model BILE Year Leng Width Serial No. No. of Bedrooms No. of Bathrooms Type of at Purchase Price $ Replacement Unit ?(Yes/No) Installer Na a 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 and grants employees of Mason County access to the above described property and structures for review and I inspection of this project. Acknowledgment of such is by signature below: j 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 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 t erewit . o ch nges shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approv first obtaining approval i X Date g 0 X- =& Date i'. ARUtK 4J, FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. <:... P BuilDepartment C .. .: ....R..MT ding Department . >; a <>;<><::>:« ii Occ Grou T e Co str. Planning Department Environmental Health Department i Public Works Department Fire Marshal i Valuation $ Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee Other E Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal ( ) TOTAL FEES FQRM MUST BE COMPLETED IN INK J PLEASE PRESS HARD PERMIT NO.: BLD MASON COUNTY BUILDING PERMIT APPLICATION 60r4200"Mg5' 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-4467.Elma 360 482- 269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owne Mailing Address of 0307 uP r a I-kr Contractor Name_A7J&Nerr_ I w Mailing Address Citylzc,L testatz State wA Zip Code LWil q City State Zip Code—_ PhoneCn*i )Z13-(rt10 Other Ph.(3W S Ph.(- Other Ph.( Lien/Title Holder W&WS Contractor Reg. # Address Expiration SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System Water System Well Water System Name of PARCEL INFORMATION-12 digit Tax Parcel No. 12Ztq / 2 / (00000 Legal Description_ P,o1LfitbN oc HY411b r IA 122N , :— Fire District 5 Site Address(Please include street name, street number and city) , Z o F G N ��,� � H Directions to site Will timber be cut and sold in parcel preparation? (Yes/No) Is your property within 200' of the following: Body of Water(Name) ir001`4 LA V a Lake_River/Creek Pond Wetland Seasonal Runoff Stream Slopes over No Bluffs PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑ TYPE OF JOB New Add Alt Repair Other Use f Buildin _ L�Describe Work 0,Wr4 xle No. of Bedrooms No of Bathrooms SQUARE FOOTAGE-1st loor 2nd Floor NoNt 3rd Floor Loft Basement Deck Other Garage Attached Detached Carport Attached Detached s4 ft. BILE HOME INFORMATION-Make Model Model Year r g Width Serial No. No. of Bedrooms No. of Bathrooms e of at Purchase Price $ Replacement Unit ?(Yes/No) aller Na a 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 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: E 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 1 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 t erewit . o ch nges shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without appro first obtaining approval. X Date g oat f X Date i Ratty !J, ` Z131'Da1 FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. ::.'T0.0 MIT .,;..R..,.EYII~VHF:;.;:;.:.:;::::::.::::.:APtR. .:..:.;:..:<.:..: :.:. . ..........;:,:.;:::::::.:.::::::::............ Building Department f .:, Occ Group_ Type Constr. Planning Department Environmental Health Department C�v Public Works Department Fire Marshal Valuation $. Building Permit Fee Site Inspection Plan Review Fee EH Review Fee _ems Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal TOTAL FEES FORM MUST BE COMPLETED IN INK J PLEASE PRq,SS HARD PERMIT NO.: BLD MASON COUNTY BUILDING PERMIT APPLICATION 40" "- t b9S 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275.446T.Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owners vi�ui5 !'uprnFJ.dT0i6 Contractor Name 7Wtvelz Mailing Address_h �o 50A -1 Mailing Address CityCLoiAo! n-, � State%6Lk_ Zip Code_ � _ City State Zip Code Phone(%eO )Z13-tr»a Other Ph.(� )mod.�t�c� Ph. Lien/Title Holder h Ws �----) Other Ph.�� Contractor Reg. # Address Expiration 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 ARCEL INFORMATION-12 digit Tax Parcel No. _ 12Z1q / 2 / t'oDOoo Legal Description POiZfiIbN of NWtlb . [.ra '-- — Fire District 5 Site Address(Please include street name, street number and c122 N, IZ�w � w,� Directions to site Will timber be cut and sold in parcel preparation? (Yes/No) Is your property within 200' of the following: Body of Water(Name) GOON L.AV a Saltwater NO Lake_River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑ TYPE OF JOB New Add Alt Repair Other Usq f Buildin �. Describe Work Vu-IW xl N �-1-rig- �M�rr� No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st loor 2nd Floor NoNE 3rd Floor Loft Basement Deck Other Garage Attached Detached Carport - Attached Detached sq. ft. BILE HOME INFORMATION-Make Model Model Year Leng Width Serial No. No. of Bedrooms No. of Bathrooms Type of at Purchase Price $ Replacement Unit?(Yes/No) Installer Na a 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 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 t erewit . o ch nges shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approv first obtaining approval. X Date 12&3 1 X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. Building Department Occ Group_ Type Constr. Planning Department A# Environmental Health Department Public Works Department Fire Marshal Valuation $ Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal ) TOTAL FEES