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HomeMy WebLinkAboutBLD99-0555 - BLD Application gq�s55 i PERMIT NO.. BLD 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 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner a- fl �L/J'?AIV Contractor Name NN_A� o k'� DF l� Mailing Address E 8Y0 Qe4 144V < Mailing Address 1yiA9 A& fL City &-e- t/ State_LA Zip Code _9fS- a' S City G�kolcva State W,41 Zip Codeq(f, 6 Phone(_?W Z7S-9W40ther Ph.( Ph.( ) -V2�&-s'767 Other Ph.( Lien/Title Holder -f,Ot 6!- Contractor Reg. # &NA1y/,//i9Z-T7 Address Expiration el Z Z- / 00 SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System Well Water System Name of Water System PARCEL INFORMATION-12 digit Tax Parcel No. /2 Z/"7 / 67> / Wgoo Fire District Legal Description 6465�t"O UItG/aoee 'p' // -,OT /.39 7 4e,F e aWJ5 T /77Z Site Address(Please include street name, street number and city) E8VO OLfJ A4-AA1 y RZ Directions to site [O4W Ld N© 1//G4146 - -7Z)P UG HL`lC oeI&Ir C .& Will timber be cut and sold in parcel preparation? (Yes/No) AJ Is your property within 200' of the following: Body of Water(Name) N Q Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair Other Use of Building Describe Work AF/W.N' AR7j17,V(, &cA dfAW t /Z0/Ct,,!6 -xe/� ce, No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Floor 3rd Floor Loft Basement Deck .522. Other sq. ft. Garage Attached Detached Carport Attached Detached MOBILE HOME INFORMATION-Make Model 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. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining approval. X Date Dat IJ FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. CEPRTMENI k� VW AAPRQVEf� QfVIEp. CID;IIITIC?pl� Building Department WLx j15r OtCtKt►JG i ?OIbT Fkw Occ Group Type Constr. 6-2.3-Sg *� NttOtO Planning Department Environmental Health Departmen Public Works Department I Fire Marshal Valuation $ FEIcS. . :::. Building Permit Fee 2 f• 00 Site Inspection Plan Review Fee UFC Plan Review'Fee Plumbing & Base Fee Public Works Review-Fee Mechanical & Base Fee Other lod/Gas/Pellet Stove Fee Other sr_ 3r0 `ion Fee Pre-Paid at Submittal r ' TOTAL FEES S'O �, . �s . �zsTr,xawasv�u. Rvn+r.nanT+eMM�' ws'.a,.ma.M�' •R�9T....wrz�nF+Frsan*nrr'acm., a --_fi — __ MASON COUNTY PERMIT ASSISTANCE CENTER Mason County Bldg.111426 W.Cedar P.O.Box 186 Shelton,WA 98584 (360)427-9670 Belfair(360)275-4467 Elma(360)482-5269 Seattle (206)464-6968 June 23 , 1999 Peter Hoffman E 840 Old Ranch Rd Allyn, WA 98524 RE: Parcel Number: 12217-50-00900 The Mason County Building Department exempts the replacement of decking material (non-structural) and guardrails from the permit process . This exemption is based on non-expansion and all replacement or maintenance must meet current Uniform Building Code Requirements . The replacement decking and rails at the above address has been exempted from the permit process. For further information, Aamiri Griffey at (360) 427-9670 ext 356 . Building Inspector/Code Enforcement CC : Property File 1 MASON COUNTY PERMIT ASSISTANCE CENTER Shelton(360)427-9670 Belfair(360)275-4467 Elmo(360)482-5269 Seattle(206)464-6968 TAMI GRIFFEY Building Inspector/Code Enforcement (360)427.9670 MASON COUNTY BUILDING 111,426 W.CEDAR EXT.356 P.O.BOX 186 SHELTON,WA 98584