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E � + EAr ) /k } 2i Cr CD \ CR. � � G2 \ / � ooa # d § \kCL < CA E \ ® # o — § o 0f @ g 2 A JJg E n m � :3 E E -++.+rllYnl� ��rYr.�r® �rrtl�rmrlli 0 N 4� r i _... . r j i { lr y i F _..,y.,,e �a� ..,._. ... ..._ .....� .1> _. fy }- V� 5 L i�IN r r`'py ? 'r,i i.^�#`: v�'o ..eL..� E ..,.,. E\ Vic 1 f SS t a K y G 3 i TOPOGRAPHY PFI v e r f 1 a.f rou ni peox fq 1.0fe Direction: Scale: Approval:forofBoe use BuildingPermit number: ao H 3 _rVA" i/ _ Buildin : _ 9 n SaQI��-'� Planning: RECEIVM� _ Owner/Applicant: M Ge r 2n RA1 r1 S 1�;S 4,;kPS, Date of fj 014on l r application: Env. Health: r:Parcel Number: 3 rn, fir.!Ii 321 � 31 �oo� I ,� p , at JW�rz LINES. MASON COUNTY PERMIT NO.QQi Dt o ' �l�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 1,o N R IAI$ Company Name Mailin ddress a o t�5 a ►+ Mailing Address City . n State Zip Code q 8 $ City Stat Zip Code Phone 60` .27-S'7 Other Ph.310 --) 64-c3Z3 Phone Other Ph. Lien/Title Holder. Contractor Reg.# Exp. E mail address - /YI FR AJI N S 60 m i'y Co M E Mail Address Drivers Lic.#R141A/5,P !j90 cF DOB 2-1- 1 Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septi Existing Septic Connect to Water System 61/4 Name of Water System Well Water Syste Name of Water System PARCEL INFORMATION-12 Digit Parcel No 00 Fire District_ Legal Description - rW - cLa Site Address(Please include ptreet name,street numbs a city) nA 49AI e.j � FI<A Dire ions to site +- oS Will timber be cufamb sold in parcel preparation?Yes/&W (440 Is property within 200'of Saltwater Lake --- River/Creek — Pond �— Wetland I Seasonal Runoff Stream '� Slopes or Bluffs ] 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Y TYPE OF JOB-New Add Alt Repair Other -r� PRIMARY REST ENCE SEASONAL E]Use of Building_EQ rg ge Describe Work gaga. r,oc cie tr C No.of Bedrooms No.of Bathrooms Square F ge-1st Floor 2n�loor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage q4v .Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION- ake Model --' Year Length Width Serial N ./ No.of Bedrooms �/N�o f Bathrooms Type of Heat rchase Price$ Repla nit? Ye Installer Name ertification No. CMAVER/BULDER Admowledges submission of inaccurate information may result in a stop work order or permit revocation. ent of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that 1 a m entitled this permit and to do the work as proposed in the application.I declare that 1 have obtained the permission from all the r n is required from any easement holder or any other party in interest regarding this application or the work permission from them to apply for this permit and conduct the work proposed. The owner or Proper in the provided is accurate and grants augertt on owners behalf, g employees of Mason Courtly auocess to the above described property cold structure for reviewinspection. PROOF OF CONTINUA OF WORK IS 1�Y MEANS OF A PROGRESS MISPECTION. O5 X Date: /l—l�l' — D �' Owne Owners Re Presentative/Contractor indicate which one M N T FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department 5tz b 1 Public Works Department Fire Marshal 2 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 N09Lb Dc� 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 MAIZ40N P //✓S Company Name Mailina Address v kS a Lane Mailing Address City State Zip Code_ 8 8 City Stat Zip Code Phone 360-�t 2?-S 261 Other Ph. 310 -.;2 64-c323 Phone_ Other Ph. Lien/Title Holder Contractor Reg.# Exp. E mail address -- ft1 F R A)N 0 M E Mail Address Drivers Lic.#R/+lN5Fn)! 20 cF DOB 2_L- Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic- Existing Septic Connect to Water System ��-Name of Water System Well Water Systenht &_ Name of Water System PARCEL INFORMATION-12 Digit Parcel No, :3.2,1 - =7-044 ire District Legal Description - rcr �#6/OS/ c_L Site Address(Please include ptreet nam street numb apdcity) an/ e f ,, t 419 O - p Di ns to site + oS in 001A < < t )Mc. Will timber be cufanfi sold in parcel preparation?Yes/ Is property within 200'of Saltwater Lake -- River/Creek — Pond "—th Wetland Seasonal Runoff �- Stream "--- Slopes or Bluffs > 15% 1 (140 Is this permit submittal#*result of a Stop Work Notice,Correction Notice or other enforcement action?Y esjW TYPE OF JOB-New Add Alt Repair Other PRIMARY REST ENCE SEASONAL ❑ Use of Building s r�r Describe Work 2,2 r/%r a „a c„e No.of Bedrooms No. Bathrooms Square Fo tage-1st Floor 2nhtr ofloor and Floor Basement Deck--�-Covered Deck Other Sq.ft. Garage0 Attached Detached ML Carport Attached Detached MANUFACTURED HOME INFORMATION- ake Model / Year Length Width Serial No No.of�Bedroomso. f Bathrooms Type of Heat rchase Price$ RepInstaller Name Ce OWNER/BOLDER Admowledges subrr>ission of t wcurate k ffnation may nm*in a stop work order or perm t revocation.AGvrowtedgement of such is by sigrrahie below.I declare that I am the owner,owners legal represeniative,or the contractor.I further declare that I am erMed to receive this permit and to do the work as proposed in the application.I declare Itrat I have obtained the pem*;§on from all the neces arlies ff errriission is mend from any easement holder or any other party in interest regarrfxtg this application or the work P perrrNs m from Item to apply for this permit and conduct the work P in the provided is accurate and grartis employees of Mason proposed. The owner a agent on owners behalf, access to the above described property and shurfire for review and inspection. PROOF OF CONTINUA OF WORK IS BY SANS OF A PROGRESS*jSPECTION. NOV 4 2005 X Date -/ - y COM841 Owners Re five/Contractor indcate which one I FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date [Building EPARTMENTAL REVIEW APPROVED DENIED NOTES Department anning Departments f Environmental Health Department cJ 1 x Public Works Department Fire Marshal FEES Building Permit Fee Site Ins tion 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.�c_U 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 M A R 1,o N n A f/d$ Company Name Mailing ddress v r' a n Mailing Address City State JdA Zip Code J 8S�- City Zip Code Phone 360- r-2?- �6 Other Ph._3)0 -�64-y323 Phone Stat Other Ph. Lien/Title Holder 9 Contractor Reg.# Exp. E mail address - M FR A)NS& 19 gM C©A4 E Mail Address Drivers Lic.#B/+/N SPIT)44o cF DOB 1 Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION-Connect to New Sept' Existing Septic Connect to Water System Adfi—Name of Water System . 10ft Well Water SysterrAt — Name of Water System PARCEL INFORMATION-12 Digit Parcel No ;-FT1 Fire District Legal Description - ruc cLa �,I1 �6/0.? et- Site Address(Please include-street name street numbe city) aN T e.J ,, CAL A # _ c Di ons to site r oS e AWCJ4 WfG. Will timber be cufamb sold in parcel preparation?Yes/ Is property within 200'of Saltwater Lake River/Creek — Pond _._.. (u0 _h A 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?Yeso TYPE OF JOB-New Add Aft Repair Other PRIMARY RESI ENCE P SEASONAL ❑ Use of Building Describe Work —✓- ---IV%A C o�e G ✓ ' No.of Bedrooms No.of Bathrooms Square Footage- 1 st Floor 2nti'Floor t 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage D Attached Detached ILL Carport Attached Detached MANUFA&TURED HOME INFORMATION ake Model / Year Length Width Serial N _- No.of Bedrooms o.of Bathrooms Type of Heat rchase Price$ Repla nit? Yes/No Installer Name rtification No. GM*R/RXDER Acknowledges submission of Kraoouraw irdorrnation may result in a stop work a ler or permit revocation.AclaxWedgernent of such is by skjnalum 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 porn ssion is required from any easement holder or any other party in interest regarding this appicabon or the work proposed in the application,I have obtained permission from them to apply for this pwTd and conduct the work proposed. The owner or agent on owners behaff,represents that the information provided is accurma and grants ernpbyees of Mason County access to the above deswbed property and stnx t re far and' PROOF OF CONTINUA of WORK IS k1Y MEANS OF A PROGRESS INSPECTION. 1\\ C EUVIR X Date: /L - Dj' Owrre Owners Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date [Building EPARTMENTAL REVIEW APPROVED DENIED NOTE LINTY Departmentanning Department Environmental Health Department `j b Public Works Department �? Fire Marshal FEES f Building Permit Fee of 2S Site Inspection f Plan Review Fee EH Review Fee Plumbing&Base Fee Plannino Review Fee Mechanical&Base fee Other Wood/Gas/Pellet Stove Fee State Fee _S� Violation Fee Q - /b' G$— Pre-Paid at Submittal i Valuation$ TOTAL FEES MASON COUNTY PERMIT N04�1 46 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 M4RI.Qtj RAW$ Company Name Mallin Address 00 e 14'sn Mailing Address City State Zip Code q B S 8 City State Zip Code Phone 3b10`4 a 7-S 76 I Other Ph. 3)o --- 64-c323 Phone_ Other Ph. Lien/Title Holder at Contractor Reg.# 4010011111111f Exp. E mail address— /yl FR A)N 6i-> mg j co m E Mail Address Drivers Lic.#X fjiAl5Fln tt2 cF DOB -6- 1 Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION-Connect to New Sep" Existing Septic Connect to Water System f/4 Name of Water System Well Water Systerr Name of Water System PARCEL INFORMATION-12 Digit Parcel No 00 Fire District Legal Description - S rcr - cL c_L. Site Address(Please include treat nam street numbs city) il/ J ,� COLA _ o Dir ons to site + . o S PWC.4 AirrS. Will timber be cutlanfi sold in parcel preparation?Yes/4150 Is property within 200'of Saltwater ^' Lake River/Creek -- Pond- Wetland t'� Seasonal Runoff �-- Stream '­ Slopes or Bluffs ) 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Y TYPE OF JOB-New Add Alt Repair Other PRIMARY REST ENCE SEASONAL ❑ Use of Building Describe Work_ r" — e��2s c p S �¢C No.of Bedrooms No.of Bathrooms Square Fo&age- 1 st Floor 2ntYFloor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage . D Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION- ake Model_ Year Length Width Serial No No.of Bedrooms o.of Bathrooms Type of Heat Grchase Price$ Repla nit? Yes/No Installer Name rtification No. WER/BOLDER ACIMMedges submission of inaoaxate k*rrnation may result in a stop work order or ment of such is by sW al re below.I declare that I am the owner,owners legal rep weed*e,or the conl actor.i entitled this pemMt and to do the work as proposed in the applicalon.I declare that I have obtained the permission from an/the is requred from any holder or any other party in interest regarding this application cation or the work proposed in permission from tFlern to apply for this permit and conduct the work proposed. The owner or agent on owners , provided is accurate and grants employees of Mason County access b the above described prvpeity and wuckn for I ' PROOF OF CONTINUA OF WORK IS IPY MEANS OF A PROGRESS INSPECTION. J�U� X Date: —/ — D N Owns Owners R talive/Contractor 4e which one COUNTY I FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Lz�j Public Works Department Fire Marshal FEES Building Permit Fee Site Ins ion 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