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BLD2008-00900 Final Garage - BLD Permit / Conditions - 12/4/2008
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B O � Date By Date By Date /' �7 y p t70 Pass or Request Inspect. CD Type of insp. Fail Date Date Done By Comments co CD Q in 0 8 a 0 D C o � rn' m � I 0 FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO. I'� Jo�JCX PLEASE PRESS HARD BUILDING PERMIT APPLICATION 6o 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 IL Owner Company Name '' 'AX ti& 424nx Mailing dress Mailing Address City State Zip Code 12Z- City State _ Zip Code Phone Other Ph. �— Phone_ 'ilo� `►�O-IQDS Other Ph. Lien/Title Holder Contractor Reg. # "C Z�tv�6�L�L4��t7xt7 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 Sewer System Name of Sewer System PARCEL INFORMATION - 12 Di it Parcel No. 1;1 O Fire District _ Legal Description 1�410_v\ Site Address (Please include street name, street number and city) Directions to site Will timber be cut and sold in parcel preparation?Yes/ Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs Is this permit submittal the esult of a Stop Work Notice,Correction Notice or other enforcement action?Ye o TYPE OF JOB - ew Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL JZ Use of Building C_ escribe Work No. of Bedrooms No. of athrooms Square Footage- 1 st Floor 2nd Floor /y(� 3rd Floor Basement Deck— Covered Deck Other Sq. ft. r,� Garage�Attached Detached Carport Attached Detached MAN FACT RED HOME IN ORMATION -Wke Model Year Lengt idt Seri I No. No. of Bedrooms No. o�8athrooms Type f H t P rchase Price$ Replacement Unit? Yes/ No Installe ar 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 permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the informaticn provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection.This permit/application becomes null & void if work or authorized construction is not commenced within 180 days or if construction work issuspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY I F 180 DAYS WILL INVALIDATE THEAPPLICATION. MEANS FJPR V X Date: 1 0 r/MnersWpresentative/ ntracto (indicate h one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: L' Date Q DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department 1 �" Planning Department Environmental Health 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 MASON COUNTY PERMIT NO. �.DC BUILDING PERMIT APPLICATION p d 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 INFORM AT ON CONTRACTOR INFORMtATIQN Owner Company Name flo' 4bind-A`^1a x-- Mailin dress .•- Mailing Address 7. City State Zip Code— - City u State >Zj Zip Code Phone Other Ph. Phone, o 'Alb-lt115 Other Ph. Lien/Title Holder Contractor Reg.# IN SaMf3EL,�1- i . E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic NIL Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Di it Parcel No. t Fire District 12 Legal Description "V\ 1., rt*� V%q Site Address (Please include street name, street number and city) �- '�• s-�"'� Directions to site Will timber be cut and sold in parcel preparation?Yes/10 Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs- 5% Is this permit submittal th result of a Stop Work Notice,Correction Notice or other enforcement action?Ye"_0-11 TYPE OF JOB - ew Ad Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL Use of Building 11 escribe Work No. of Bedroom No. o athrooms Square Footage- 1 st Floor 2nd Floor 3rd Floo�r `--Basement Deck Covered Deck Other Sq. ft. Garage�7' Attached Detached Carport Attached Detached MAN FACT RED HOME ORMATION ke MO Year. Lengt — I idt Seri I No. -- No. f Bedroo No. of.�at ooms Type f H t P Chas rice$ R ement Unit? s/ o Installe ame 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 permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the informaticn provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection.This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if construction work' uspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS I PR GRESS INSPEC ON. TIVITY0 IS PE PPLICATION OF 180 DAYSWILLINVALIDATETHEAPPLICATION. Date: Ol06/a$ j X r! ners presentative/ ntract (indicate Wch one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Fire Marshal FEES BuildingPermit Fee ZZ , 2f Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee PlanningReview Fee Mechanical & Base fee Other Wood/Gas/ Pellet Stove Fee State Fee Violation Fee D Pre-Paid at Submittal Valuation $ Z� TOTAL FEES MASON COUNTY PERMIT NO. 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 LZ On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner 'j1 Company Name '"C�1.yM er A;n& Jae y&�: d5 Mailing Address '`f _ "" Mailing Address Oy ILA 225 City tc�! �-��State�Zip Code— CItY 4� `''.a State _ Zip Code Phone Other Ph. Phone `1101115 Other Ph. Lien/Title Holder Contractor Reg. # L L` f i �tp., l " 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 Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. 'L 2>7 C)r ` Fire District Legal Description A I�,.0 v'� 1 a k 2L V.; ,t Site Address(Please include street name, street number and city) ` '� t—lV, L 4- V,f ` cs, Directions to sitb Will timber be cut and sold in parcel preparation?Yes Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluff 5% �. Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/.No. TYPE OF JOB - New Add . Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL Use of Building , ` .Describe Work No. of Bedrooms No. of Bathrooms Square Footage- 1 st Floor 2nd Floor 3rd Floor Basement Deck— Covered Deck Other Sq. ft. ` WO Garage ��' Attached Detached 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 permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 180 days or if construction work is.suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS 71PRGRESS INSPECTION.INAG,TIVITY OF TITS PE fiAPPLICATION OF 180 DAYS WILL INVALIDATE THEAPPLICATION. w_- ' Jt` o$ X �. . Date. r! ners presentative/,Contractor (indicate h one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date I DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department i Planning Department Environmental Health 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 MASON COUNTY PERMIT NO. �.►,t .fit -vt' 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 INFOR TION Owner Company Name ''"(`% r'A Mailin dress -- Mailing Address '� City State Zip Code `e City �� State Wlk_ Zip Code Phone Other Ph. Phone C1-t7t1 OLer h. Lien/Title Holder Contractor Reg. � f. IE mail address E Mail Address i ,�, 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 Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. K-1 O Fire District Legal Description +*' . ' • \21 Site Address (Please include street name, street number and city) - V�• e-V``-^ Directions to site Will timber be cut and sold in parcel preparation?Yes/40 Is property within 200'of Saltwater Lake River/Creek—T/o Pond Wetland Seasonal Runoff Stream Slopes or Bluff Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Ye TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL Use of Building /`R ` - escribe Work No. of Bedrooms No. oftathrooms Square Footage- 1 st Floor 2nd Floor 3rd Floor Basement Deck— Covered Deck Other Sq. ft. 44gO Garage Attached Detached Carport Attached Detached MANFACTURED HOME IN.FORMATION,� M ke Mo¢e� Year Lengthh idth Seri I No. No%pl f edroom5f No. of Satl'kooms y-- Type of Heat Ptchase Brice$ lacement Unit es/ 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 permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the informaticn provided is accurate and grants employee$of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 180 days or if construction work' uspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS F PR GRESS INSPEC N. TIVITY O IS PE APPLICATION OF 180 DAYS WILL INVALIDATE THEAPPLICATION. I . p X - Date: . r/ Hers presentative/ ntract (indicate ch one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date t✓ DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Pqt: tJv, Environmental Health Department I-�_y. r .60 Fire Marshal FEES f Building Permit Fee Site Ins ection Plan Review Fee EH Review Fee 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 LZok Up a Contractor, Electrician, Plumber or Elevator Professional License Detail Page 1 of 2 Information in Spanish I Topic Index I Contact Info Home Safety Claims&Insurance Workplace Rights Trades Ft Licensing Find a Law(RCW)or Rule(WAC) Get a form or publication Close this Page > General/Specialty Contractor A business registered as a construction contractor with I-Ed to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. TIMBERLAND GARAGES LLC Business and Licensing Information Verify Workers' Comp E9 Printer friendly Premium Status Name TIMBERLAND GARAGES UBI No. 602505796 LLC Phone No. (360) 264-2674 Status ACTIVE Address PO BOX 275 License No. TIMBEGL957RZ License Type i CONSTRUCTION Suite/Apt. CONTRACTOR City TENINO Effective Date 12/9/2005 State WA Expiration Date 1/2/2010 Zip 98589 Suspend Date lb County THURSTON Separation Date Business Type INDIVIDUAL Previous License Parent Next License Company Associated License Specialty 1 , FRAMING AND ROUGH CARPENTRY Specialty 2 UNUSED 8 Business Owner Information 9 Hide All Name Role Effective Date Expiration Date https:Hfortress.wa.gov/lni/bbip/Detail.aspx?License=TIMBEGL957RZ 8/8/2008 Leak Up a Contractor, Electrician, Plumber or Elevator Professional License Detail Page 2 of 2 1BAUMLEY, KATIE M JOWNER 112/09/2005 e Bond Information ij Bond Bond Effective Expiration Cancel Impaired Bond Receivt Bond Company Account Date Date Date Date Amount Date Name Number GREAT 2 AMERICAN FS776321211/02/2006 Until $6,000.0011/03/21 INS. CO. Cancelled ACCREDITED Until 1 SURETY Et 10042981 12/06/2005 Cancelled 11/04/2006 $6,000.0012/09/21 CAS CO c-i Insurance Information Insurance Company Policy Effective Expiration Cancel Impaired Amount Name Number Date Date Date Date 3 ATLANTIC L071002781 11/26/200711/26/2008 $1,000,000.001 CAS INS CO 2 WELLINGTON 4600200479 11/22/200611/22/2007 SPEC INS CO $1,000,000.001 WELLINGTON 1 SPECIALTY 460020013011/22/200511/22/2006 $1,000,000.001 INS CO a Summons / Complaint Information Summons / Cause Tax Warrant Plaintiff County Complaint Complaint Judgment Judgn Complaint Number Id Date Amount Date Amol 1 072010693 LCTONIXTHURSTON 06/04/2007$1,673.30 $0.00 ACt"k'as About L&1 I Find a job at L&I I Site Feedback 1 1-800-547-8367 A"Washingtcrn'* ©Washington State Dept.of Labor and Industries.Use of this site is subject to the laws of the state of W Access_Agreetnent I Priv..acy and.securaty statement I Intend.eG u.S2/.external_content P.oucy I Staff_. i i i i f k kf 1 https:Hfortress.wa.gov/lni/bbip/Detail.aspx?License=TIMBEGL957RZ 8/8/2008 k Mason County Planning Intake Checklist owners Name: Date:_ - n Project: Reviewed By: Proposed use(s)of s) Commercial Development: YES(,_NJOU PLANNER GBM TSW PBC RDH REC ]MS North Arrow. o Survey required In All WA — u AF# o Monuments , " Property Dimensions: S/) X � ( n 'nA 1 Streets and Driveways Shown. Road rWme: n CIJIXC . �C —i-�1 M All Existing Structures shown with setbadcs and use 1�C Well Location,Septic and Drain-field Shown with setbacks 'ls,(Identify all surface water(streams, ponds,shoreline,wetlands, natural or historic drainage,defined drainage ditches) N)C.Topography(slopes) ,.n Minimum re• dcs in aio do . FS . / R: S2: Utility and Drainage. Easements: Yes( �n .other Easements if yes enter condition #5022) C�3 No Accessory Appurtenances: Props Does site plan show landing all exits?� p%M Variance applied for: Yes / - paridng,spaces ai Yes / �CPCounty Access Permit Needed(add condition #0010T � Stage Access Permit Needed'(add condition #0020) I1O �. Standard Conditions to.be added to all Building permits that planning reviews: #5019 and #0700 site Are there any lm (dogs/gates)that my restrict access do your site? Is the site dearly marked? How? -f me Zollingg ❑ Other. ral r 2.5 5 0 20 ❑ RT/RTC © R.1 0 R 5 ❑ HC ❑ BI ❑ RAC ❑ RMF 0 Unknown ❑ R-1P R 10 0 LT ❑ .Allyn UGA. ❑ AC 1 2. 3 0 Agricultural 0 R 1R ❑ ❑ T ❑ Belfair UGA ❑ RI ❑ In-holding 0 R 2 0 PF 11 0 MHP D Shelton UGA ❑ RNR 0 LTCFL -3 0 POS. 0 GC , _BP . ❑ Tribal ❑ GO a Critical AMS: (streams, ponds,shoreline,wetlands,sty slopes) \ Shoreline , llSpaWIl: o N/A ❑ Urba o Rural D Conservancy ❑ Natural 0. Unkown. Water Body of water if unnamed): V SEPA: Yes/ nk"r~ Flood Plain: YE5/NO nkno Map# Aquifer recharge: / Map# ` RLC/SPI Case: 6-Year Dev. Moratorium:. Eagle Nest Tag: YES/ other YES Rom: 02-07-2008 I.V1AMVWACV LANNM INTAKE N jAjku`A., WA %Ott r M � PLANN►I'oIG: t\o ALL SETBACKS ARE MEASURED FROM 0 MT HE FURTHEST ST PROJECTION OF THE BUILDING C,4��N ED APPROVE 0 r! Y MASON COUNTY G%rl) PLANNING SITE PLAN REQ 11:;"Er) TO BE '.')N SITE CHAN ES "U3i "—C i f u A-•,--)t20VAL BY , Date ID oi. �j ss, DRAtu�1 41; ��VOL Name Parcel# BI.D# Mason County Department of Community Development Sm l P #Stornata►ater eft tionMorksbeet 1 of 2 Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development,or redevelopment',with more than 2,000 square feet of impervious surfacez. 'Redeve means,on an already developed site,the creation or addition of impervious surfaces,structural development including construction,installation or expansion of a building or other shueture,and/or replacement of impervious surface that is not part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. =Common Uinervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. EEM Surface T rLength Width = Area *All dimensione ii!'That Buildi s = Measurements for buildings are taken at the X _ perimeter of the farthest projections(example: eaves/gutters) X = X = Length of drive begins at the right of way X = Parking Areas X _ X = Any paved, gravel or packed area per definition above table X = Patios/V1lalks X = X = Any paved, gravel or packed area per definition above table X = Others X = :.w X = X ---------------------- = ?:• H the Total Impervious Surface Are is LESS THAN 2000 Souare Feet,pole a read,acknowledge and sign below. Based Upon the information you have pr�ded a,&oa,mwater S*e Plan IS NOT required for this development activity. Owner/Builder/Agent Acknowledges that 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,owner's legal representative,or the contractor.I further wledge that the information provided' accurate and employees of Mason County are granted access to the above- descri rty for review and ins Lion as m be gUired. X Owner/Agent/Contractor(circle one)Date: 41(/d, If the TAW Impervious Surface Area is GREATER THAN 2000 Sguare Feet.please read,acknowledge and sign the information provided on page 2 of 2. Page I of 2