HomeMy WebLinkAboutBLD2007-00700 SFR - BLD Permit / Conditions - 5/17/2007 M
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>f x MASON COUNTY PERMIT NC:D
BUILDING PERMIT APPLICATION v�lL
426 W. Cedar* P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670• Belfair(360) 275-4467• Elma (360) 482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Allan&Linda Anderson Company Name HiLine Homes
Mailing Address 14244 NW Dolly Varden Ln Mailing Address 11306 62ND AVE E
City Bremerton State_WA Zip Code 99312. City Puyallup State WA—Zip Code 98373
Phone 360 830-2292 Other Ph360 981-5568/908-3911 Phone 360 907-1 449 Other Ph.
Lien/Title Holder National City Mortgage Contractor Reg.# 1411.IN14*9R 1 RT Exp. 2/100009
E mail address Buffalo97na,msn.com E Mail Address
Drivers Lic.# Anderaw4171m DOB 6/14/1959 Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic yes Existing Septic
Connect to Water System Name of Water System
Well yes Water System Name of Water System Anderson Family Well
PARCEL INFORMATION-12 Digit Parcel No.__223027590034 Fire District
Legal Description TR 3 of Survey Vol 1 PLY 200 i ot:7 D of Sn#269.
Site Address (Please include street name,street number and city) 37 NE Trudeau Mountain Rd Belfair. WA 98528
Directions to site From Bear Creek Dewatto Rd travel weft toy=lards Dewatto Rd east Effend hl Pass &Toonerville
take the next left onto Trudeau Mtn Rd,make first eft past Shafer's Place and follow easement road to end
Will timber be cut and sold in parcel preparation?Yes/lU
Is property within 200' of Saltwater Lake , liver Creek Pond
Wetland Seasonal Runoff Stream. Slopes or Bluffs ] 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?YesMo
TYPE OF JOB Newer_Add Alt Repair Other PRIMARY RESIDENCE ® SEASONAL ❑
Use of Building home Describe Work New Construction of primary residence
No. of Bedrooms —No.of Bathrooms 2.5 Square Footage- 1st Floor 1484 2nd Floor 1292
3rd Floor Basement Deck Covered Deck 228 Other Sq.ft.
Garage 624 Attached yes Detached TR1) Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make 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.
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
permissio from them t apply for this rmit and conduct the work proposed: The owner or agent on owners behalf,represents that the information
provided s a rate d grants e s of Mason County access to.the above described property and structure for review and inspection.
P F N A N O BY MEANS OF A PROGRESS INSPECTION.
Date: ` IW3�0 7
wner/Owners Fier entative/Contractor indicate which one
FOR OFFICIAL USf BEYOND THIS POINT Accepted by Date
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Planning Department
Environmental Health Department
Public Works Department �J
Fire Marshal no
FEES
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbing& Base Fee Planninq Review Fee
Mechanical & Base fee Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation $ TOTAL FEES
t x MASON COUNTY PERMIT NOQv 0—
BUILDING PERMIT APPLICATION 01_ L
426 W. Cedar- P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670 - Belfair (360) 275-4467- Elma (360) 482-5269
On the
web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Allan & Linda Anderson Company Name HiLine Homes
Mailing Address 14244 NW Dollv Varden Ln Mailing Address 11306 62ND AVE E
City Bremerton State-)Y.A_Zip Code 99112. City Puyallup State WA—Zip Code 98373
Phone 360 830-2292 Other Ph 360 981-5568/908-3911 Phone 360 907-1949 Other Ph.
Lien/Title Holder National City Mortgage _ Contractor Reg.# 1411.TN14 991 RT Exp. 2/10/9009
E mail address Buffalo97na.rnsn.com E Mail Address
Drivers Lic.# Anderaw417lm DOB 6/14/1959 Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic yes Existing Septic
Connect to Water System Name of Water System
Well Yes Water System Name of Water System Anderson Familv Well
PARCEL INFORMATION- 12 Digit Parcel No 223027590034 Fire District
Legal Description TR 3 of Sur-yev Vol 1 Pn Inn Tot• D of Sn#2698
Site Address(Please include street name,street number and city) 37 NE Trudeau Mountain Rd Belfair.WA 98528
Directions to site From Bear Creek Dewatto Rd travel west toWards Dewattn Rd past F_.ff.ndahl Pass &Toonerville
take the next left onto Trudeau Mtn Rd.make first eft past Shafer's Place and follow easement road to end
Will timber be cut and sold in parcel preparation?Yes/(No)
Is property within 200' of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream. Slopes or Bluffs > 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - NewX Add Alt Repair Other PRIMARY RESIDENCE ® SEASONAL ❑
Use of Building home Describe Work New Construction of nrimary residence
No. of Bedrooms 3 No. of Bathrooms 2•5 Square Footage- 1 st Floor 1484 2nd Floor 1292
3rd Floor Basement Deck Covered Deck 228 Other Sq.ft.
Garage 624 Attached ves Detached T 3D Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make 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.
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
permissio from them t apply for this rmit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
provided s a rate d grants e o es of Mason County access to the above described property and structure for review and inspection.
P F NT A N O BY MEANS OF A PROGRESS INSPECTION.
Date• a-3�D7
caner/Owners Re r entative/Contractor indicate which one
FOR OFFICIAL USf BEYOND THIS POINT Accepted by j9jo4 Date
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Planning Department _
Environmental Health Department
Public Works Department
Fire Marshal
j FEES
j 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
Valuation $ TOTAL FEES
I x MASON COUNTY PERMIT NOa0 0-2-b U?L
con BUILDING PERMIT APPLICATION rX
426 W. Cedar• P.O. Box 186, Shelton, WA 98584 _5
Shelton (360) 427-9670• Belfair(360) 275-4467• Elma (360) 482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Allan&Linda Anderson Company Name HiLine Homes
Mailing Address 14244 NW Dolly Varden Ln Mailing Address 11306 62ND AVE E
City Bremerton State WA Zip Code 99112. City Puyallup State WA_Zip Code 98373
Phone 360 830-2292 Other Ph 360 981-5568/908-391 Phone 360 907-1 R49 Other Ph.
Lien/Title Holder National City Mortgage Contractor Reg.# 141T.TN14*991 RT Exp. 9/10/9009
E mail address _Buffalo97na.msn.com E Mail Address
Drivers Lic.# Anderaw4171m DOB 6/14/1959 Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic yeS Existing Septic
Connect to Water System Name of Water System
Well Yes Water System Name of Water System Anderson Familv Well
PARCEL INFORMATION- 12 Digit Parcel No, 223027590034 Fire District
Legal Description TR 3 of Survey Vol 1 Pg 200 Lot- Q of Sn#2698
Site Address (Please include street name,street number and city) 37 NE Trudeau Mountain Rd Belfair. WA 98528
Directions to site From Bear Creek Dewatto Rd travel
take the next left onto Trudeau Mtn Rd,make first eft bast hafer's Place and follow easement road to end
Will timber be cut and sold in parcel preparation?Yes/ o > .
Is property within 200' of Saltwater - Lake River/Creek Pond
Wetland Seasonal Runoff Stream. Slopes or Bluffs > 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - New_X_Add Alt Repair Other PRIMARY RESIDENCE M SEASONAL ❑
Use of Building home Describe Work New Construction of primary residence
No. of Bedrooms-_No. of Bathrooms 2.5 Square Footage- 1st Floor 1484 2nd Floor 1292
3rd Floor Basement Deck Covered Deck 228 Other Sq.ft.
Garage 624 Attached yes Detached -TBD—Carport Attached Detached
MANUFACTURED HOME INFORMATION -Make 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.
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
required.from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
IMPA
ply for this rmit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
ants e o s of Mason County access to.the above described property and structure for review and inspection.
N O BY MEANS OF A PROGRESS INSPECTION.Date: ' lo?3�07
e r entative/Contractor indicate which one
FOR OFFICIAL US BEYOND THIS POINT Accepted by 4 Date
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Planning Department
Environmental Health Department r7 , 1� �..--
Public Works Department `�
Fire Marshal no
FEES
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
I
Plumbing& Base Fee Planninq Review Fee
Mechanical & Base fee Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation$ TOTAL FEES
I
i
I' MASON COUNTY PERMIT NCfQ 7-6
Coo D: BUILDING PERMIT APPLICATION vclL
426 W. Cedar• P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670• Belfair(360) 275-4467• Elma (360) 482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Allan&Linda Anderson Company Name HiLine Homes
Mailing Address 14244 NW Dolly Varden Ln Mailing Address 11306 62ND AVE E
City_Bremerton State WA Zip Code 99312 City Puyallup State WA Zip Code 98373
Phone 360 830-2292 Other Ph360 981-5568/908-3911 Phone 360 R07-1 R49 Other Ph.
Lien/Title Holder National City Mortgage Contractor Reg.# 1411.TNT4*9R1 RT Exp. 2/10/2009
E mail address _Buffalo970,msn.com E Mail Address
Drivers Lic.# Anderaw4171m DOB 6/14/1959 Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic yes Existing Septic
Connect to Water System Name of Water System
Well yes Water System Name of Water System Anderson Family Well
PARCEL INFORMATION- 12 Digit Parcel No, 223027.59 0034 Fire District
Legal Description TR 3 of Survey Vol 1 Pe 200 I.ot- n of Sn#2699
Site Address (Please include street name,street number and city) 37 NE Trudeau Mountain Rd Belfair.WA 98528
Directions to site From Bear Creek Dewatto Rd trae 1 west'towarrls 17Pwatto Rd nacr Fffanrlahl n T., tt
lll
�ls L ne V e
take the next left onto Trudeau Mtn Rd,make first eft past Shafer's Place and follow easement road to end
Will timber be cut and sold in parcel preparation?Yes/ o
Is property within 200' of Saltwater'. Lake : River/Creek Pond
Wetland Seasonal Runoff Stream. Slopes or Bluffs ] 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - Newer_Add Alt Repair Other PRIMARY RESIDENCE ® SEASONAL ❑ /
Use of Building home Describe Work New Construction of orimary residence
No. of Bedrooms--No.of Bathrooms 2.5 Square Footage- 1st Floor 1484 2nd Floor 1292
3rd Floor Basement Deck Covered Deck 228 Other Sq.ft.
Garage 624 Attached ves Detached ._BIZ Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make 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.
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
required.from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
permiss
or this rmit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
provided e o s of Mason County access to.the above described property and stricture for review and inspection.
P.
F BY MEANS OF A PROGRESS INSPECTION,.//
Date: 7 XR3�0 7
entative/Contractor indicate which one {
FOR OFFICIAL USf BEYOND THIS POINT Accepted by 104 Date
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Planning Department S•�
Environmental Health Department f 7 �-
Public Works Department �.J
Fire Marshal
FEES
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbing& Base Fee Planninci Review Fee
Mechanical & Base fee Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation$ TOTAL FEES
i
r MASON COUNTY PERMIT N0Q0 0 -6 0?[
C;W�22 _ Cnd � BUILDING PERMIT APPLICATION r
426 W. Cedar• P.O. Box 186, Shelton, WA 98584 f"�, _5
Shelton (360) 427-9670• Belfair(360) 275-4467• Elma (360) 482-5269
On the web www.co.mason.wa.us
V142—
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Allan&Linda Anderson Company Name HiLine Homes
Mailing Address 14244 NW Dolly Varden Ln Mailing Address 11306 62ND AVE E
City Bremerton State WA Zip Code 99312 City Puyallup State_WA Zip Code 98373
Phone 360 830-2292 Other Ph 360 981-5568/908-391 Phone 360 907-1 R49 Other Ph.
Lien/Title Holder National City Mortgage I Contractor Reg.# 141T.TNN*991 RT Exp. 2/100009
E mail address Buffalo97na.msn.com E Mail Address
Drivers Lic.# Anderaw417lm DOB 6/14/1959 Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic. yes Existing Septic
Connect to Water System Name of Water System
Well yes Water System Name of Water System Anderson Family Well
PARCEL INFORMATION- 12 Digit Parcel No, 223027590034 Fire District
Legal Description TR 3 of Survey Vol 1 Pg 200Lot- D of Sn# 69R
Site Address (Please include street name,street number and city) 37 NE Trudeau Mountain Rd Belfair, WA 98528
Directions to site From Bear Creek Dewatto Rd travel wP Axu arch I)ewatto Rd past Effend hl Pass &Toonervill
take the next left onto Trudeau Mtn Rd.make first left east hafer's Place and follow easement road to end
Will timber be cut and sold in parcel preparation?Yes/ o
Is property within 200' of Saltwater - -- Lake Diver/Creek Pond
Wetland Seasonal Runoff Stream_. Slopes or Bluffs > 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - Newer_Add Alt Repair Other PRIMARY RESIDENCE ® SEASONAL ❑
Use of Building home Describe Work New Construction of primary residence
No. of Bedrooms_3 No.of Bathrooms 2.5 Square Footage- 1st Floor 1484 2nd Floor 1292
3rd Floor Basement Deck Covered Deck 228 Other Sq.ft.
Garage 624 Attached VeS Detached TBIL Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make 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.
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
permissio from them t apply for this rmit and conduct the work proposed: The owner or agent on owners behalf,represents that the information
provided s a rate d grants e o es of Mason County access to-the above described property and stricture for review and inspection.
P F A N O IS49 BY MEANS OF A PROGRESS INSPECTION.
Date: W3�07
caner/Owners Re r entative/Contractor indicate which one
FOR OFFICIAL US BEYOND THIS POINT Accepted by 4 Date
DEPARTMENTAL REVIEW APP VED DENIED NOTES
Building Department
Planning Department
Environmental Health Department
Public Works Department
Fire Marshal
FEES
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbing & Base Fee / G0 Planninq Review Fee
Mechanical & Base fee Other
Wood/Gas/ Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation $ Z 2 Z Z Fl. ✓ TOTAL FEES
o FORM MUST BE COMPLETED IN INK PERMIT NO. Z ®7— 007
PLEASE PRESS HARD MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W.Cedar•P.O. Box 186, Shelton,WA 98584
Shelton (360)427-�Vt •Belfair(360)275-4467• Elma(360) 482-5269
n t e webb www.co.mason.wa.us
APPLIC NT INF RMATI N CONTRACTOR INFORMATION
Owner ►` 5 Company Name
Maili Addres K Mailing Address
City taste �q Zi Code a- City State Zip Code
Phone 60 XSn-8'Zr°1 O her Ph Phone Other Ph.
Lien/Title Holder a Contractor Reg.4 Exp.
E mail address E Mail Address
Drivers Lic.# i2 DOB 12,12-Lflk I Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. Fire District
Legal Description
Site Address (Please include street name, street number and city)
Directions to site
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff—Stream—Slopes or Bluffs > 15%
TYPE OF JOB - New Add Alt Repair Other Use of Building
Location of Fixtures/Units - 1st Floor 2nd Floor Basement Garage Closet
PLUMBING FIXTURES(Show Number of each) MECHANICAL UNIT
Type of Fixture No. of Fixtures Fees Fuel Type:Electdr V LPCz_ Natural Gas_ Heat Pump_
Toilets Type of Unit No. o� Fees
Bathroom Sink Furnace
Bath Tubs Heatpumps s—
Showers Spot Vent Fan
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kithen Sinks Wood/Gas/PelletStove �-
Dishwasher Kitchen Exhaust Hood =
Hosebibs Dryer Vent 1
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
CVNNER/BULDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Admowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
permission from them t ply for thi rmit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
prov' a rate a grants a of Mason County access to the above described property and structure for review and inspection.
F N O BY MEANS OF A PROGRESS INSPECTION.
X �— Date: /°�3�Z
caner/Owners Rep sentative/Contractor (indicate which one)
FOR OFFICIAL USE BEYOINDTHIMPOINT
Accepted b . tanning Pd Ck# Date -1 —Bid Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group.Type Constr.
Planning Department
Environmental Health Department
FEES
Plumbing& Base Fee Site Inspection
Mechanical&Base fee UFC Plan Review Fee
Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FEES