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CD a � 0 & 0) CD� \ � CLM § c E Ekk — @ ] ko -5 m A$ i :_ k ] 0 C: � CD D f m 2 $ % kk ox £ ME CDk� , 2 K 7 » C o § C 2 CD % A cn A 8 C2 f £ / CD -0 n Ie §_ ] i ao \ 0 � CD am2 _ m � k k K ƒ ) k R E � � = e o � � L E n CL g2 BEJ km � eCD q E gad E Ek ka CL: CD £ 2 _ . I 23 \ ± � 'a @ 3GD o m — CD n k E -00 0� # § k k j 0 21 n a @ X 0 kk w 0 a � — 0 00 / � � § \ m w } 7 n k e o 77 ] ESE ) MASON COUNTY PERMIT NO. U NkZvU 1 X a� 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 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner_A1r%QatcAr4 MAQ%*iG % ."W. CEBpjT UN%oa Company Name f w=e c��.r�rtoa►�. c� ..-r...L-r�..�y� Mailing Address 149 'W%olso-ow wMy E4s-r Mailing Address $o% W es- MCEKyR s-T. City S 61"Aftroc.F ioa-State w A Zip Code 99110 City KE�c-v State W A Zip Code 9105y Phone Other Ph. Phone 2s3-8g3-3ioo Other Ph. Lien/Title Holder Contractor Reg. # -Lrrt= c.c.e5i0c.e Exp. 2-0c. -es E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION-12 Digit Parcel No, %2.37_4 ti 1 oflo 1 o Fire District Legal Description_-rtZ 't OF rNB SE PCL- 3 of IS LA3k- qE-58 tk (.'71%193 Site Address(Please include street name, street number and city) 23161 WE s-rk,E Rov-r _ 3 gEL-7^12, Wb 4SS?S Directions to site Will timber be cut and sold in parcel preparation?Yes s property within 200'of Saltwater 00 Lake ao River/Creek mO Pond "10 Wetland nsJ Seasonal Runoff Ov Stream No Slopes or Bluffs > 15%_ ao Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Ye o TYPE OF JOB - New Add x Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL Use of Building SwashweKC-r Describe Work TALC Cab.1T VM%*61 114 SAWS-tsmh No. of Bedrooms NAt_No. of Bathrooms * 0- Square Footage- 1 st Floor 302 2nd Floor 3rd Floor_Basement WA Deck n 16- _Covered Deck A/A _Other_1410, Sq.ft. 3 Garage W & Attached N/A Detached � k Carport a ''4 Attached n1/!�!: _ Detached N 14MANUFACTURED HOME INFORMATION - Make Model Year k Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price$ 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. vVled went of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare I 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 n �f is required from any easemen Idler or any other party in interest regarding this application or the work proposed in the appr I h �bta permission from the for this permit and conduct the work proposed. The owner or agent on owners behalf,represe�t th64n nn `provided is ccurat g is employees of Mason County access to the above described property and structure for review an� PROOF CO A N OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X zsa-sa;2--' 1��30/0`1 Date: Owner/Owners resentative indicate which one FO OFFICIAL USE BEYOND THIS POINT Accepted by: Date I R bE!PARTMENTAL REVIEW I RO-VE9 DENIED NOTES Building Department 1'21 �j Planning Department Environmental Health Department Public Works Department Fire Marshal ta\-. FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Plannina Review Fee Mechanical& Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation$ TOTAL FEES MASON COUNTY PERMIT NO. ZU(J BUILDING PERMIT APPLICATION 0()cD Z� 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 _AF+4R%cA.4 M^ms"r. &.mw. c&4p+T urj%as4 Company Name FL+-r1E Lr.w+Q.�ar►i. io...TsAL-T+.a�_ Mailing Address ty9 w+-+scew Wwti EAtiY Mailing Address $014 We-6- my-g-van sz City t3i►WAR+041 _'(-.State WA Zip Code 94►10 City KE-c-T State H1A Zip Code 91030 Phone Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. # F-Lt-M cc j6iVc.n Exp. .2-n(, -Os E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic !C Connect to Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION-12 Digit Parcel No, t't32_4 ti 1 00o I o Fire District Legal Description -rR of Ne SE P6L- 3 of ISLA�- qa-SS tk (,-7►14g3 Site Address(Please include street name, street number and city) 23961 NE s-r..,c Rc.,T 3 SE,,rr+.+S�, Wg 9SSzS Directions to site Will timber be cut and sold in parcel preparation?Yes s property within 200'of Saltwater uo Lake fjo River/Creek No wo Wetland a Seasonal Runoff Nc, Stream mo Slopes or Bluffs > 15°/Pond40 Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?YOZNo TYPE OF JOB - New Add k Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL Use of Building Swc:nwcKcz Describe Work 'rAll. "%T W41011 -rCF4^Mr S No. of Bedrooms 4Ar No. of Bathrooms j 06 _Square Footage- 1 st Floor 300 2nd Floor 3rd Floor._Basement WA Deck AlAr Covered Deck M/A Other_'41 a- Sq.ft. 3 00 Garage @L/n Attached N/A Detached 41AI Carport 14)Ar Attached AV-!!!: — Detached N 114 r1IMANUFACTURED HOME INFORMATION - Make Model Year k Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price$ Replacement Unit? Yes/No Installer Name Certification No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revoca�=n, wledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare ed to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all ece f,ppeermission is required from any Basemen older or any other party in interest regarding this application or the work proposed app 14a(r�obtained permission from the for this permit and conduct the work proposed. The owner or agent on owners beh �g re t tIA) ation Provided is ccurat g is employees of Mason County access to the above described property and structure for'reww an%eclol. `PROOF CO A N OF WORK IS BY MEANS OF A PROGRESS INSPECTION. S -�Q� X J.�s�-�a rV^A3 zs3-ORS-- Date_ Owner/Owners resentative indicate which one #16J61FFICIAL USE BEYOND THIS POINT Accepted by: Date I ARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department O e� Public Works Department Fire Marshal FEES Building Permit Fee Site Ins ection Plan Review Fee EH Review Fee 7 .O Plumbing& Base Fee PlanningReview Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation$ TOTAL FEES �j I MASON COUNTY PERMIT NO. U NkZUU 1 BUILDING PERMIT APPLICATION 0CJ, 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_At%41RIcA4 '%.kmK p%T Vnt%o&1 Company NameE-L-cm c..s %a Mailing Address c4i w%asL-ow EAs,r Mailing Address_ $Osi W ES-r MeeQmi[ s-T. City 361"GRID46 =t&--State WA Zip Code 941110 City Ke-&-T State MIA Zip Code 1105u Phone Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. # F-LtTp c.c-9526(c.e Exp. I-Oco -os Email address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic �1( Connect to Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION -12 Digit Parcel No, t232_4ti% o0o10 Fire District Legal Description -rot 4 of NE SE Pay-- 3 of 311-A*- 9S- 58 tk. G-711443 Site Address(Please include street name, street number and city)339V1 WE s-U&M Raw ra 3 BC.- A.,jt, w►g 4SSzS Directions to site Will timber be cut and sold in parcel preparation?Yes s property within 200'of Saltwater N, Lake 40 River/Creek a° Pond Wetland a0 Seasonal Runoff N° Stream wo Slopes or Bluffs > 15% mo Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Ye o TYPE OF JOB- New Add K Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL Use of Building Swae%ACKc-r Describe Work T^Lf- eogv vm.4 os -r AIM No. of Bedrooms WAr—No. of Bathrooms W06 _Square Footage- 1 st Floor 300 2nd Floor 3rd Floor—Basement *1 A Deck TA/A- _Covered Deck 1�1 'A Other 1411a, Sq. ft. 3 C50 Garage OL Attached -ALA- Detached 't �'°' Carport N k Attached a/ Detached N t1lMANUFACTURED HOME INFORMATION - Make Model Year ic Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price$ Replacement Unit? Yes/No Installer Name Certification No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocati gement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further ded, that n receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the neceary es.If ission is required from any easemen older or any other party in interest regarding this application or the work proposed in the app lion ve ed permission from th for this permit and conduct the work proposed. The owner or agent on owners behalf,rep r epis in on M`rovided is ccurat g is employees of Mason County access to the above described property and structure for revievil�.�nad in n. ROOF CO A N OF WORK IS BY MEANS OF A PROGRESS INSPECTION. �O X_ 5VA,43 zS3-9%5- �! s12M Date: t%/30/oy J� Owner/Owners resentative indicate which one FO OFFICIAL USE BEYOND THIS POINT Accepted by: Date I b2PARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department �2 a i Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Pumbing & 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 �J MASON COUNTY PERMIT NO. BUILDING PERMIT APPLICATION 0CQQa 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 XK44%cs+,4 MArt+rle- $AKK c"P%T uN+oa Company Name Ew-mLar-sr- iLwoL Mailing Address 144 W+-46"Wi won 6^%-r Mailing Address tom W es-r Meade s-T. City zsa.State del A Zip Code 91110 City Krz A-r State W A Zip Code 91 o3u Phone Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. # F-LjjE cc.020c.o Exp. Z-05,-Os E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic �1( Connect to Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION- 12 Digit Parcel No. %7L324 ti 1 0001 o Fire District Legal Description -rR 4 of 0Z Sc Pe.c- 3 of iJSLA*k- 9S- 58 At l0-1%L443 Site Address(Please include street name,street number and city) 23%1 M8 s-rkcic Ro.,TE 3 B�.vx*+St, Wa 9Ss2S Directions to site Will timber be cut and sold in parcel preparation?Yes s property within 200'of Saltwater 00 Lake ay River/Creek ac Pond "0 Wetland 0 J Seasonal Runoff Na Stream mo Slopes or Bluffs > 15% Ko Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?YeRpo TYPE OF JOB - New Add X Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL Use of Building Sweit NAtKt-r Describe Work TALL 6DYr vai as -r 71 I No. of Bedrooms y WO-No. of Bathrooms O- Square Footage- 1 st Floor 3CXR 2nd Floor 3rd FloorlA_Basement iv A Deck WA Covered Deck 10A Other sJ1 '� Sq. ft. 3 C50 Garage-@Lt— Attached N/A Detached 9 1 Carport '41 A, Attached V t Detached N rlJMANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price$ Replacement Unit? Yes/No p Installer Name Certification No. 1 T OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocati��c, know) of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare thaMi yqdffte this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the net ry parti p ppl�y ion is required from any easemen older or any other party in interest regarding this application or the work proposed in the a lic�ion I hav�b ;ned permission from the p for this permit and conduct the work proposed. The owner or agent on owners behalf,representsl�e information "provided is rat gr is employees of Mason County access to the above described property and structure for review and in PROOF CO A N OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X JuS-r,.A VVA,.tS 253-S4i,7.-► Date: 11/30/011 Owner/Owners resentative indicate which one FO OFFICIAL USE BEYOND THIS POINT Accepted by: Date k2PARTMENTAL REVIEW APPROVED 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 Planning Review Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation$ TOTAL FEES �f ^ �IIIr�Y� I1�11� ��Yilir l/ CONCRETE MECHANICAL MANUFACTURED HOME oFootings I Setbacks Date Ribbons o Date By Gas Piping Date By NFoundation Walls Date B y Set-up Date By INSULATION Date By B G / Slab Insulation Floors Final Date By Date By Date By FRAMING Walls FIRE DEPT D ate I-0 C-= By 7�1� Date By Date By PLUMBING Attic OTHER Groundwork Date By Date By WALLBOARD NAILING D.W.V. Date / C0—By /—�;? Date By FINAL I SP CTION Water Line Date 611,810 By D ate By Date By � �,� -vs— _ �Y —cis— ��f'�+7ir✓� �,v.�rr Cy ✓c� �'c� ��.L Z E�— Q L- Pq, N O O � O O N 7 N a N 0