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Fail Date Date Dorte By Comments � e, -t7_ s':1's /F/) sue' 11-77-7 0 9 lO! CONCRETE MECHANICAL MANUFACTURED HOME N no Footings 1 Setbacks Date B y Ribbons o Date By Gas Piping Date B y N Foundation Walls Date B y Set-up °' Date By INSULATION Date By B G f Slab Insulation Floors Final Date By Date By Date By FRAMING Walls FIRE DEPT Date By Date By Date By PLUMBING Attic OTHER Groundwork Date By Date By WALLBOARD NAILING D.W.V. Date By Date By FINAL INSPECTION Water Line Date B y Date By Date By OWN- Ka ,rms o1L- &— ►PA 'o O � N O � O O O d N � V� 0 y 0 FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO( br)ft?!10)4�� PLEASE PRESS HARD BUILDING PERMIT" APPLICATION 426 W. Cedar • P.O. Box 186, Shelton,WA 98584 Shelton (360) 427-9670 • Belfair (360) 275-4467 a Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRICTOR INFORMATION Owner IJIrI/ ME&I76c-5 b Company Name Mailin Address _ �-- �- Mailing Address C.xit _ State W.4 Zip Code City State Zip Code Pfe — � 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 Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION- 12 Digit Parcel No. — OO OD Fire District Legal Description pQ Site Andress (Please include street na e, treet um r d pity) I D! S orL Directions to site v Will timber be cut and sold in parcel pre aration?Yes N 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 eMorceft"t aiE>64?l/ TYPE OF JOB - New Add AltV Repair t r IM RY RESI EK ❑E SEASONAL Use of Building Describe Work No.of Bedrooms N . of Bathrooms�_Square Footage- 1 st Flo o 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Yeja Length Width Serial No. No.of Bedrooms No.of Bathrooms Type of Heat Purchase Price$ Replacement Ud' ?�Y N Certification Noi"l;- E Installer Name q� per l f9A OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stopwork or tractor.I fu Acknowledgement of such is by signature below.I declare that I am the owner,owners Iega repres , declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare ttiaf I'ham obtainedhapOlibAsign from the necessary parties.If permission is required from any easement holder or any otlt�(aI�/ir><ii$�`�'�ad gion oork oposed in the application, I have obtaned permission from them to p y for this permit and coriduct the work propos . Date: Owner Owners Representative/Contractor (indicate which one) F R OFFICIAL U BlEyOn T POSIT S Z(�17 4- Accepted by: Planning P k# Date Bld Pd 43 Receipt No. DEPARTMEN . `L R0� NOM APPROVED RbVEO DENIED $wilding Department a UOa- UC7Igo i canning Department O J nvironmental Health Department ublic Works.Department dire Marshal Eris ildin Permit Fee Site Ins ection elan Review Fee EH Review Fea. lumbin .&Base Fee Plannin Review Fee ilFechanical & Base fee Other 1Nood/Gas-/Pellet Stove Fee State Fee Violation Fee Pre-Paid at $ybnjtt l TOTAL FEES F ,.Valuation $ " MASON COUNTY PERMIT NO. BUILDING PERMIT APPLICATION 426 W. Cedar • PO. 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 INFORMATION Owner 4�AI C� t k- Company Name Mailin Addres 2-1 Mailing Address Cit State �""" Zip Code City State Zip Code e ?.a�i Other Ph. � Phone Other Ph. Lien/Title Holder �w'' 1h�l�i' Contractor Reg.# Exp. E Mail Address E mail address Drivers Lic.# pOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION - 12 Digit Parcel No. -A'1476b— — 00100 Fire District Legal Description Site Address (Please includqtreet na�e,lstreet num r� d�city) �f Directions to site ## Will timber be cut and sold in parcel pre aration?Yes N 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?Ye TYPE OF JOB - New Add Alt RepairtFter PRIMARY RESI E ❑ SEASONAL ❑ Use of Building Describe Work ��11 No.of Bedrooms N .of Bathrooms Square Footage - 1st Floor2nd 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 Nod 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 representativ ,k e1ajnt I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare hart"I��have o ained the aermcisa_ sion fro II the necessary parties.If permission is required from any easement holder or any other parhrjp,i e ro posed. tion or ork o osed in the application,I have obtained permission from them to p y for this per L�15►i P I� pYf Date: Owner Owner Representative/Contractor (indicate which one) F,SJR OFFICIAL USE BEYO D.TkiIS POINT - - I 1 --- Accepted by: - Planning Pd" ?--. k# Date Bld Pd Receipt No. DEPARTMEN L REVIEW APPROVED DENIED NOTES Building Department Planning Department G Wit'' '' M Environmental Health Department Public Works Department "4n Fire Marshal FEES Building Permit Fee Site Inspection EH Review Fee Plan 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 PERMIT NO., MASON COUNTY 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 .5 uM M� �L > t-5 -- Company Name Mailin Address��`��' —� y ,"'f-� 5 w Mailing Address City _ State wA Zip Code ')d 1 6 City State Zip Code e Z.. Other Ph. Phone Other Ph. Lien/Title Holder fd o �' Contractor Reg.# Exp. E mail address _T— 0 E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB - SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION - 12 Digit Parcel No. --' 00,100 Fire District Legal Description Site Address (Please include street na e, treet num r a d Gity) O'�m Directions to site l� Will timber be cut and sold in parcel pre aration?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?Ye o TYPE OF JOB - New Add Alt Repair Der PRIMA Y RESI ENE] Use of Building ❑ SEASONAL E]ng Describe Work dd �- `` No.of Bedrooms! -N .of Bathrooms_ _Square Footage - 1st Floo 2nd Floor's 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. ``II CC OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order orWe( ydc�lti6c� further Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,,orontb ctor.Ithe ermis- declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare tlia-Hi ; Q i'� I P sion from II the necessary parties.If permission is required from any easement holder or any other party inirs a this applica- k*5E;:; tion,I have obtained permission from them to p y for this permit and Gconduct W. EDAhe RrWroposed. Date:Contractor (indicate which one) F_PR OFFICIAL USE BEYOND T IS POINT Accepted by: Planning P k# Date ( Bld Pd -� Receipt No. DEPARTMENTAL REVIEW PR V D DENIED NOTES Building Department 0 c2 U0;- Uv I`/ Planning Department (?C l5 Environmental Health Department Public Works Department 1r 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 THIS PARCEL INCLUDES PLANS, BLUEPRINTS OR OVERSIZE IMAGES: - - LARGE IMAGES HAVE BEEN STORED IN FILE CABINETS) UNDER PARCEL NUMBER PARCEL # zi - cr� ic3o CASE # ('Cnkzooq--o0oz� Ind � L�►� � fLcez,;<— 1 -ems AGE Ma �oNG �o �N.STA, MASON COUNTY �p5 M 0 °4 DEPARTMENT OF COMMUNITY DEVELOPMENT o A°u �= Planning Division y o T i P O Box 279,Shelton,WA 98584 �oJ N Y �Oti (360)427-9670 1864 NOTIFICATION OF INCOMPLETE APPLICATION February 13, 2004 SUMMERTIDE RESORT AND MARINA 15781 NE NORTHSHORE RD TAHUYA WA 98588 Parcel No.: 322282100100 Project Description: add deck and replace stairs Dear Applicant: You have submitted a permit application (case no. COM2004-00026) for proposed construction or development in the county. Upon review of your application, I have determined that the contents of the application are incomplete or do not provide enough detail for review. I Therefore, review of your application will not proceed until the necessary information is provided (see the comment section of this letter for details.) Once the information is submitted and the application is complete, I will continue to process your application accordingly. If the additional information is not provided to the County within 180 days of this request, the application shall expire and no further action on the proposed development shall take place. i Please contact me at (360) 427-9670, ext. 577 if you have questions. Si Y Rick Mraz Land Use Plann Mason County Tanning+Department I 2/13/2004 1 of 2 COM2004-00026 NOTIFICATION OF INCOMPLETE APPLICATION 2/13/2004 Case No.: COM2004-00026 Comments: A field inspection of the subject property was conducted on 2/13/04 pursuant to a request for a building permit to enlarge an existing deck. Per the Fish and Wildlife Habitat Conservation Areas chapter of the Mason County Resource Ordinance, the minimum shoreline setback for commercial construction is 100' as measured from the ordinary high water mark (OHWM). Existing construction is grandfathered. The proposed addition would be approximately 30' from the OHWM of Hood Canal. Per the Resource Ordinance, expansion of existing construction may occur within the setback but is limited to 10% of the existing footprint that is under roof. Your proposed construction appears to exceed the 10% limit and is, thus, only approvable by variance. A variance from the Fish and Wildlife Habitat Conservation Areas chapter may be necessary to pursue this project. A Habitat Management Plan (HMP), prepared by a qualified biologist, would be required to support the variance request. The HMP addresses impacts to the buffer and offers measures to preserve and protect the buffer or mitigate impacts. A copy of the Fish and Wildlife Habitat Conservation Areas chapter is enclosed. It includes details on the contents of an HMP. Application for a variance does not guarantee approval. The proposal must meet specific criteria listed in the Resource Ordinance. Please contact me to further discuss this proposal. 5 2113/2004 2 of 2 COM2004-00026 'I Request To Revise An Approved Plan m � 0(33a(o Permit Number: - Parcel Number RL 1 —�0— Phone Number daytime (__) Project Address Mailing Address Please provide a complete,detailed escription of the proposed revisions to a approved plans: Are two sets of the revised plans or addendum indicating the changes included? ❑ Yes ❑ No Are the approved site plans included? ❑ Yes ❑ No Are the revisions clearly and accurately identified on the plans or addendum? ❑ Yes ❑ No Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes ❑ No If Yes,Has the engineer or architect approved this revision? ❑ Yes ❑ No Is a stamped and signed approval included with this request? ❑ Yes ❑ No (Note No structural changes to a"designed"plan will be approved without the written consent of the engineer and/or architect of record.) Does the proposed revision modify the footprint or location of the structure? ❑ Yes ❑ No If Yes, Is a revised site plan,with all new setback dimensions included with this request? ❑ Yes ❑ No Additional Information: Applicant's signature: Date: Office Use Only Received by: Date Sent Assigned To B D to Original Valuation: $ ❑ B. lr m 0 Additional Valuation: $ Sq.Ft. x$ $- XQ Sq.Ft. x$ $ ❑ E.H. Total New Valuation $ Additional Fees: ❑ P.W. Additional Planning Dept. $ Additional Plan Review $ New Setbacks: Front / Rear / Additional Building Permit $ Side1 / Side2 / Additional Plumbing $ I Additional Mechanical $ Additional Conditions/Comments: Additional E.H.Dept. $ Other $ Total Amount Due: $ Amount To Be Paid Up-Front$ Tech mitiY { Revised SRG 9122 2M 3