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HomeMy WebLinkAboutBLD2004-00509 Final Dock - BLD Permit / Conditions - 7/13/2004 W 0 -0 CL n o m m C o A r b m o m o �, c � o m O � m O 3 Q- D c/) .o to r m z CD c 0 � � o � o „ v m 3 o z � � � � � co :3 W W m -+ z c o a co y z .mX. 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Date By Date By FINAL INSPECTION Water Line Date By Date By Date By CD 0 0 bd x � d C) c 0 0 " o x � o ErJ a �x MASON COUNTY PERMIT NO. BUILDING PERMIT APPLICATION ooso0 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 k�N �OgSo1Q Company Name L>AK�rSHoR.�� �c.•Rcv�..� Mailin Ad res ! Mailing Address City P1 State I+V Zip Code 9 City State Zip Code— City Phone HIS -q(,r5• "0 Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg.# Exp. ' E E Mail Address 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. of Q 3,30 -SO a=3 Fire District Legal Description eN T Site Address (Please include street name, street number and city) 00 Nt HA1JQv �- Directions to site 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% i 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 RIMARY RESIDENCE ❑ SEASONAL Use of Building Describe Work L4 No.of Bedrooms No.of Bathrooms Square Footage - 1 st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. 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 permis- sion from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this applica- tion or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. X Date: j Owner/Owners Representative/Contractor (indicate which one) I FOR OF FI A USE BEYO T7 IS OINT .ot I.IU-4 tX3,i3 Accepted b Planning Pd _Ck Date Bld Pd Receipt No DEPARTME L 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 PlanningReview 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. BUILDING PERMIT APPLICATION oos()CA 426 W. Cedar • FO. 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 w Owner KaN) 90Eksor.) Company Name LIAk .SHp tpn7�r�•X tliC Mailin Ad res Mailing Address City +n State lid Zip Code 9 © City State Zip Code Phone MZ4 -QL5—C_Q 0 Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg.# Exp. 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. at Q,330 -5 0—(,1no.Y3 Fire District 614.1 Legal Description j4AQe6J - Site Address (Please include street name, street number and city) 20 NW H 60-a 40L Directions to site Will timber be cut and sold in parcel preparation?Yes/No Is property within 200'of Saltwater LakeXRiver/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs 1 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 RIMARY RESIDENCE ❑ SEASONAL Use of Building Describe Wo No.of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. 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 irlaccurate 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 permis- sion from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this applica- tion or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. X Date: Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIA USE BEYO T IS OINT .vt',. 4 e ,`O. Accepted b Planning Pd '"" Ckf _Date'� . Bld Pd _ Receipt No DEPARTME L REVIEW APPROVED DENIED NOTES Building Department prmcFIVE Planning Department Environmental Health Department R Public Works Department Fire Marshal FEES Building Permit Fee Site Ins ection Plan Review Fee EH Review Fee Plumbing & Base Fee PlaaE!a Review Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation$ TOTAL FEES 1 cn Az� C -p to U3 rri v oo © ® vCO CD -v m oz z v' Z rm S Z r 1 � O l N i ` N n b' r i I E I, P i 1 c� �y y L s� n � ' + i a �r n s"� 1 �o CHANGE, on, y 1�ttt Ai'1'itAY111 ` ri r1HESE PLANS ' v ON THE 8E OR INSA <w 1 w + ze 3Er#d 1SNM 3UQHS3Wl SZ94SLZ99E K:11 99GUET/11 r ' M ` S a r = o 1 r 4p s ll 0 lot dw lk do doom Afo N 37 t i t t t Lb-&^ I'trt44M.1 ��- 20'd 10/02/2000 MON 12:46 (TI/RX NO 64501 R$01 MAY-21-2004 08:32 From:The Funk Law FirmFax 425 746 4236 To:3604278425 P.2/2 2 -PROPOSAL PNQPOSAI'Mo n n LAKESHOR CONSTRUCTION SHEET NO. P.O. BOX 1058 BELFAIR WA. 98528 DATE 3-17-04 PROPOSAL SUBMITTED TO: 360/275-5029WORK.TO BE PERFORMED AT: NAME 1 S G yyju��� 9t e ADDRESS 159 3 SE 177th tv: . RENTON WA. 9805.1 DATEQE,PLANS PHONE NO. ARCHITECT 425/254-1685 We hereby propose to fumish. ry o1b x f pa iIR. VE r S.EJAPE M > 1�T C 1 1C 'v: 4 104.00 TAX 340. 3 $:4',444.63 ... . . .. ALL PRESSURN `��nnmob 1E3' b 2 X 6 OUT WO -000: Fog'���1KIL•i. PTIQN, IF YOU WA.t T D >t 1�1C Set .1 E1 DOfrylN Ai 3D 3'9'S.QO TAX 32.79 $ 427.79 All material is guaranteed to be as specified, and the above work. to be performed in accordance with the drawings and specifi- cations submitted for above work and completed in a substantial workmanlike manner for the sum of FOUlt THOUSAND, FQ:QJR YURDRED FORTY FOUR - —63/10611ars ($ 4 ,4.44 .63 with payments to be made as follows. T5iii0 THOUSAND. :2WO .ji.UNDj$ED TWENTY ,TWO.,,DOWN TOt ORDER. 'MA ERIAL AND $2, 222.63 DUE UPON COMPLETION. Respectfully submitted TIN ZECH Any alteration or deviation Irom above specifications involving extra coals LAKESHORLP""COATRUCTION will be executed only upotl written order, and will become an extra charge Per over and above the esbmale. All agreements contingent upon strikes, ac- cidents,or delays beyond our conlrol. Note—This proposal may be withdrawn by us if not accepted within 30 days. ACCEI TANt I=°..OF PROP AL The above prices, specifications sldnd.i>i0n5:ale eati, (4ctory''al1d are hereby accepted,• You are authorized to do the work as specified.Payments will be made as outlined above. J Signatu fe Date C Signature Mmd— NC:3818-50 MADEIN PROPOSAL MADE IN USA i