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HomeMy WebLinkAboutBLD2006-00176 Foundation Repair - BLD Permit / Conditions - 2/8/2006 W r TOE rn (D m m C m v m r C) 3 w o (� -D_I G) c c o C 0 Cif o o C Z N r ZJ cn 0 r O 3 �O' X � mmm0 S Ci -n � d m � nrD � co x O v c � � � Z m CD o cW yo cv � 0 n'i o � z � coom � zcn o E. `Q d m z ;o(n ; 7 �, = X w 0 m o r o CEO O o vD � m W zg Z v Z 0 E: n W Z FD `° Z N Z Z ;U O v Cl) v) m W ° o Z v x � 171 (D CD CD CD n o t ° o m � 0 T a (o n 3 3 p +� T N O -co cr m Wp r ic °1 „ „ „ � 0 �° T. Z x M a Y 1D (D d N Z v y Cl) �' 000 ° Q Wd zv O C N o o A .-. = o m O o � �n, rG) ° :3 m w r ° oyo m « n C 0 d a 3 ~` CA W � Z 8 °► � Cr`� O m G) CD -,, z x co,"�7 C1 C PL -1 5?0 0 �a3 o tb r C CD < tTl Co m IM CD 1 N p j x { �1 Qo N N W r CD C O C1 �. 3 0. cn n cn CD7 N `� ^' cn C S 3 (0 CD cn � 0 c v n rr ° N S0 m CD o D n 0 m � `< w r- 0 M m CA O ft� N `� m m `° C5 D •`CL °o o ff (A cn3 o d 3 to cn a ((D — CO 7 ° y, crm m j 3 m p -a � mm W o � h O 0 CD 0 Cll CD Cn O D v cWa CD 00NN N N n Cl OD OD OD O O 1° CD O O O O X v ' N O O O i r y CL O N N co o -1 b q < cr 2 (D i > A § m 2 / f � -0 CD k � o / § 2L mffJ § ECL r 0 0- � � § ¢ 2 � � § L � m0 © 7 � 77 7 � Rf � $ / £ \ \ § _ 8 / § � 2 > Qk 0 \ $ '< � @ m 32g B � 2 Bkk % -nE % � @ $ 770 � X � M K _ ¢ \ fA k \ � k / 7Eq \ �k � � Ea + � / / \ � C, mEE & Ee @ D � � { -00 \ s ° ° Or- go E ) a % 0 ƒ� ) ° / o3 � J } % R E m � ?5- 3 / E E MASON COUNTY PERMIT NO. 5a 0 (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 ? t% APPLI INFORM ON CONTRACTOR INFORMATION Owner �I SRO ! Company Name Mani Address 3 S Mailing Address City d 6 4 State W Zip Code City State Zip Code Phone Other Ph. O6 015Y R Phone Other Ph. Lien/Title Holder L- Contractor Reg.# Exp. E mail address Ms,e-cm E Mail Address Drivers Lic.# DOB� O Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic Existing Septic Conneclic Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION-12 Digit Parcel No o- Fire Distri Legal Description 5 '. —16 G fr F 9LA t t — Site Address(Please include street name,street number and city) Ste;' O/(. t Directions to site Will timber be cut and sold in parcel pre tion?Yes/No Is property within 2W of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% Is this=ft submittal the result of a Stop Work Notice Correctlon Notice or other enforcement actionWeadto TYPE OF JOB-New Add Alt Repair Other PRIMARY RESIDENCE SEASONAL Use of Building Describe Work j* WROD CePT14cr `/LL 19 JJAC No.of Bed s No.of Ba ms Square Footage- 1st Floor 2nd Floor 3rd Floor r Basement Deck Covered Deck V-011 Other Sq.ft. Garage Attached Detach Ca rt Attached a Detached MANUFACTURED HOME I ATION -Make Model ear Length Width erial No. No.of Bedrooms No.o rooms Type of Heat Purchase Price$ Replacement Unit? Ye o Installer N ` Certification No. OIM&FI/BULDER Admowledges submission of inaccurate infomration may result in a slop work order or pemrt revocation.Advawledgement of such is by signature below.I declare that I am the owner,owners legal representalive,or the contractor.I further declare that I am entitled to receive this perm[and l o do the work as proposed in the application.I declare that I have obtained the permission from at the necessary parties.ff permission is required from any easement hokler or any other party in interest regarding this application or the work proposed in the application,I have obtained penrission from them to for this permit and conduct the work proposed. The owner or agent on ownprs behalf,represenlsihat the information provided is rate employees of Mason County actress to the above described rty structure for review and inspection. PROOF TION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. -27a LCi- ers Representative/ or indicate which one FOR OFFICIAL USE BEYO HIS POINT A pted by: Date DEPARTMENTAL REVIE A ROVED _DENI NOTES Building Department Planning Department — Q Environmental Health Depa ment Public Works Department Fire Marshal FEES Buildina Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing&Base Fee PlanningReview Fee Mechanical&Base fee Other Wood/Gas/Pellet Stove Fee I State Fee Violation Fee Pre-Paid at Submittal Valuation$ TOTAL FEES