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BLD2006-00963 Final SFR - BLD Permit / Conditions - 4/24/2007
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O D -0 Cl 0) 0 CL U S (D N O p (D S 3 CD N (CD CD (3D 0 `G fa X X n' N cn y 8 a) O (D 0 '0 0) O O O `OG � 0 C T1 j 7 CD CD O a O j cr cCD I 00 cn n (D 3 cn O N y (D _ N m $ ccDD3 3 � ni0 8' o � � 3 CD o CONCRETE MECHANICAL MANUFACTURED HOME rn Setbacks Footings/ bate By Ribbons Gas Piping C) ntenor Date By Interior-Date <L �'�6 Bye- Date By w i xterw Date By Exterior-Date B INS ULA11ON Set-up Point Load!Isolated Footings pate By BG i SLAB INSULATION - Date By Data By FIRE DEPARTMENT Foundation Walls Floors Date By r DateBy bald By NECKS r FRAMING _ Watts Date By Date I I- / oG By ` Data I •cam By A PROPANE TANKS PLUMBING Vault ) i date By Date �r!i By Groundwork Attic C3TNER. Date a mate By Type- DRYWALL Data ay O.W.v DR'r'4AIALl. Type: Date/ �7-0�6 B Int Brace Wall Date B y y77? D$ta By FINAL INSPECTION � w Water Une Fire SSopsration [r IN Date By Data By Data - L-7�� By C oPass or Request inspect. c Type of Insp. Fail Date Date Done By Comments SO 0 a ,TG/'`r z- _7oG fi'2, F -� irr s� FW i.�f►cL. ��Scr� 0 h FORM MUST BE COMPLETED IN INK l PLEASE PRESS HARD 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 C (� APPLICANT INFORMATION On the web www.co.mason.wa.us Owner I I CONTRACTOR INF MATION Mailing Address Z E Company Name - city=at�LTI�N � Mailin Address , State � Zip Code S p M g' Phone I -Sf Other Ph a �7-S1�' Phone �-Al2 State.�_ Zip Code 'Z Lien/Title Holder A2 , -L =4i (� Other P ` _ 2-'— I -26 E mail address Contractor Re_@�.►F,p,IRKL����L 9 -L�LG'�' 136�#S Exp. Drivers Lic.# E Mail Address DOB Drivers Lic. # SEPTIC /WATER SYSTEM INFORMATION-----N -ame of Water System Connect to New Septic DOB ---_ Connect to Water System p — Existing Septic Well --- _ Sewer SystenL_ Name of Sewer Syste PARCEL INFORMATIONDigit Parcel .No Legal Description_{ //�y� 1 Cyp E ll Site Address (Please include street name, street number and city) ya�ir�istrict Directions tositefDLJ.LW ►h� W 12 Will timber be cut and sold in parcel preparation?Yes/ LAV F L Q V _ D Is property within 200'of Saltwater Wetland___Seasonal Runoff Lake _River/Creek ___Stream__Slopes or Bluffs— � 55o�Pond Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action? TYPE OF JOB - New Add Alt Ye /No Use of Building Ipp-"(-= Re air PRIMARY_RESIDENCE describe Work Othe�r�_ SEASONAL No. of Bedrooms--A No. of Bathrooms �7 - �t 3rd Floor=__Basement Square Footage 1 st Floor 149 I > — Deck _Covered Deck 2nd Floor Garage_ Attached —2C ----Other Sq ft. Detached _ Carport___ Attached MANUFACTURED HOM RMATION - Make Detached Length W, Serial No. Model Type of H No. of Bedrooms Year Purchase Price $ Replacement Unit? s/No Bathrooms Instal r Name OWNER/BUILDER Acknowledges submission of inaccurate information may result in aCertification s oplwork 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 furt 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 the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or her declare proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The ow e from all agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access io the theabo work described property and structure for review and inspection. This permit/application becomes null & void if work or authorized o the construction not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF d i CONTINUATION OF WORK IS BY MEAN OFA RESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS ILL INVALIDATE on is X ALIDATETHEAPPLICATION. Owner/Owners Representative/Contractor Date: dS (indicate which one) FO OFFICIAL USE BEYOND THIS POINT DEPARTMENTAL REVIEW Accepted by: A Date APPROVED DENIED Buildin Department NOTES Plannin De artment 110 Environmental Health Department S � Fire Marshal J � f Buildin Permit Fee FEES Plan Review Fee Site Ins ection Plumbin & Base Fee EH Review Fee Mechanical & Base fee Plannin Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee State Fee Valuation $ Pre-Paid at Submittal 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 I On the web www.Co.mason.wa.us APPLICANT INFORMATION TMai NTRACTOR INFORMATION Owner , u _: '` ,. mpany Name Mailing Address i lin ACity T9 ddress _State : ' Zip Code y State Phones ` rx , °t,� Other Ph. Phone ,. Zip Code Lien/Title Ha der- J rt y Other Ph..�' E mail address : , Contractor Reg. # Exp. ffLe rs Lic. # E Mail Address DOB Drivers Lic. # DOB TIC /WATER SYSTEM INFORMATION - Connect to New Septic_ 4` Existing Septic ect to Water System Name of Water System _ Sewer Systeru— Name of Sewer Systemzj EL INFORMATION - 12 Digit Parcel No. — Description I ~ �~ r: Fire District ddress (Please include street name, street number and city) , ions to site s�_ber be cut and sold in parcel preparation?Yes/Nqerty within 200'of SaltwaterLake_d Seasonal Runoff =—River/Creek PondStreamSlopes or Bluffs15%is permit submittal ttoe result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New _Add Alt Repair Other Use of Buildings I_.a- :- — _ PRIMARY RESIDENCE SEASONAL [] escribe Work No. of Bedroom •` f ' ' �' `i�� � � •s---L_No. of Bathrooms Square Footage- 1st ioor { ! 2nd Floor - ~= 7 3rd Floor -- Basement Deck ` ; Covered Deck..• Other _— Garage :i" Attached _ _Detached f Sq. ft. Carport_�_ Attached Detached MANUFACTURED HOME INFORMATION - Make Length Width Serial No. —Model Year Type of Heat Purchase Price $ No. r.f Bedrooms No. of Bathrooms Instalter Name Replacement Unit? Yes/No Cer,... d � ��cation No. OWNER/BUILDER Acknowledges submission of inaccurate information may resuh in _a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners iegai representative, or the contractor. I further declare w that I am entitled to receive this permit and to do the ork as proposed in the applicF,,,On. 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 erriployees 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 v✓ork is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OFA PRO?RESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE CONTINUATION THE OAPPLICATION. I X f,_ Owner/Owners Representative/Contractor (indicate which o Date one) • FOR OFFICIAL USE BEYOND THIS POINT DEPARTMENTAL REVIEW APPROVED DENIED Accepted by: Date Buildin Department NOTES Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee Site Ins ection Plan Review Fee 7 EH Review Fee Plumbing & Base Fee Mechanical & Base fee Plannin Review Fee Other Wood/Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES FORM MUST BE COMPLETED IN INK PLEASE PRESS HARD PERMIT NO. MASON COUNTY PLUMBING/MECHANICAL 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 INF;pRMATION Owner�I1 I F Rnf3f I�r,41,1'1� CONTRACTOR 1 F RN�ATION Mailing Address 52 E 1: iai moo, ACC Company Name E I N C 1CitYLJAEL7-VAL--stateoMailing AddressPhone D-S W� Zip Coded �}- City I - -�7�_Other Ph36�-Z�'�-SI Z tate�1� Zip Code Lien/Title Holder I 2 b Phone �D-Z"15_4�� Other Ph - E mail addresskjAE 7NE311Q1,t.ANlx_�p�✓VI Contractor Reg.4AAft�.IGC' t3�, K Exp. Drivers Lic.# E Mail Address DOB Drivers Lic.# SEPTIC INFORMATION - Connect to New Se tic DOB Name of Sewer System p -�-- Existing Septic Connect to Sewer System PARCEL INFORMATION- 12 Digit Parcel No. �Z Legal Description �U )h O Fire District Site Address (Please include street name, street number and city) Directions to site I U D t l p W R K�w t SAC r L Dw p Is property within 200'of Saltwater 1 T Wetland Seasonal Runoff Lake River Creek `Pond —_Stream _Slopes or Bluffs > 15% TYPE OF JOB - e Add Alt Repair Other Location of Fixtures/Units - 1st Floor ---Use of Building -A— 2nd Floors Basement PLUMBING FIXTURES (Show Number of each �-- Garage Closet Type of Fixture No. of Fixtures ) Fr' ICAL UNITS Toilets Fees Electric— LPCz� Natural Ga it s-- Heat Pump_Bathroom Sink No. of UnitsFeesBath Tubs IFwftaee '� �Showers �— s Water Heater 1 FanClothes Washer I nk _jKithen Sinks I asutlets 3— Dishwasher i _ Wood a Pellet Stove Hosebibs _ Kitchen Exhaust Hood 1 Other Dryer Vent 1 Other ADiA A-'T Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL 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. PROOF O CO UATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X � Date:_ O� f7 b Cc Ow er/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted b Funning Pd Ck# Date Bld PdReceipt No.__DEPARTMENTAL REVIEW APPROVED DENIED Building Department NOTES Occ Grou T e Constr. Planning Department Environmental Health Department Plumbing & Base Fee FEES Mechanical & Base fee Site Ins ection Wood/Gas/Pellet Stove Fee UFC Plan Review Fee Violation Fee Other TOTAL FEES MASON COUNTY PERMIT NO. PLUMBING/MECHANICAL PERMIT APPLICATION 426 W. Cedar-P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670- Belfair(360) 275-4467- Elma (360) 482-5269 APPLICANT INFORMATION On the web www.co.mason.wa.us Owner E l� tt31�1 t> 1 t CONTRACTOR INFORMATION L i Company Name Malin Address -k- P, �'�`�Zi Code y 9 `�' h h t Mailing Address (ZCN � 9lcity'!��� � State t<� , p Phone34..U-_. - Jet City -----State _ r Other Ph.> , ° i .ti Zip Co Lien/Title Holder �'L�/4'L. ° ' ' Phone t r'; other r ' � E mail address A NI l f-+1-4P I t t �,, , r Contractor Reg. '` ' t ' y�her Ph % > E Mail Address Exp. Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic_ X___ Existin Se tin g P Connect to Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. = Legal Description .I k"E!-) I>, 7VR ;, Fire District Site Address (Please include street name, street number and city) �" f Directtiions to site �� ��i H4tj > ; R Y) / �r � 4 y 1-tr�,,.lrt..'l r1 t'1 I'-` f ?7t.a Is property within 200'of Saltwater Wetland Seasonal Runoff Lake River Creek Pond Stream Slopes or Bluffs > 15% TYPE OF JOB - e,�Add Alt Repair Other Location of Fixtures%Units - 1 st Floor --Use of Building '- 't.>i a: t —� 2nd Floor-- - Basement -• I-t Garage PLUMBING FIXTURES (Show Number of each g Closet Type of Fixture No. of Fixtures ) MECHANICAL UNITS t Toile Fees Fuel Type:Electri�_ LPt Natural Gas Heat Pump_ Bathroom Sink Tvpe of Unit No. of Units Fees Bath Tubs 1 Fusee Showers Heatpumps Water Heater Spot Vent Fan — — Clothes Washer 6 Propane Tank Kithen Sinks I Gas Outlets -_ Dishwasher I Wood(G��a "Pellet Stove-- Hosebibs �� Kitchen Exhaust Hood I Other Dryer Vent I Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OVVNER/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. PROOF Of CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X 1 Date:_Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: E+�. P• ..Planning I'd FOR Date Bld Pd__Receipt No.__ DEPARTMENTAL REVIEW APPROVED DENIED Building Department NOTES Occ Grou T e Constr. Planning Department Environmental Health Department Plumbing & Base Fee FEES Mechanical & Base fee Site Ins ection Wood/Gas/Pellet Stove Fee UFC Plan Review Fee Violation Fee Other TOTAL FEES r .. MASON COUNTY PERMIT NO. PLUMBING/MECHANICAL PERMIT APPLICATION Shelton (360) 427-670• Belffairr(360) 275 4467• Ema (3 0) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION �11 `,� 111;Owner � Company Name Mailing Address lcity��HEOLL) Mailing AddressI ' IState tot � Zip Code i Phone ( -cam.=;'7 /� > r - City Mates'.:,, ZipCode' ` —Other Ph. P Phone ode _ Lien/Title Holder ' 5� z Other Ph�` lll E mail address k'i 1;%a E 4 Hil Cis I ra. ., - Contractor Reg. :E '` 1IL ? � 4.� 'r f� � ' E Mail Address Exp. � Drivers Lic.# DOB Drivers Lic.# SEPTIC INFORMATION - Connect to New Se tic :� DOB Name of Sewer System P Existing Septic. Connect to Sewer System PARCEL INFORMATION- 12 Digit Parcel No ?7 - tee- ' P sc` 1 _, Legal Description k,eU�-1, t �1 ' }= ;;> `,, I 1 Fire District Site Address (Please include street name, street number and city) tale '"I f , ;1 <r1 � ;:y ; , t�i t Directions to site > rEtland-Seasonal I :- _ `•. Ci-1 "•+ r �+9 �H 4,!1 ty within 200'of Saltwater Lake River Creek Pond Runoff_ Stream Slopes or Bluffs > 15% F JOB - KIe ' t yf y! Add Alt Repair Other Use of Building ' 1?Location of Fixtures/Units - 1 st Floor -A-- 2nd Floor t , Basement Garage Closet PLUMBLNGFIXTURES (Show Number of each Type of Fixture No. of Fixtures ) MECHANICAL UNITS Toilets Fees Fuel Type:Electri�_ LP '_'` Natural Gas_ Heat Pump_ Bathroom Sink Type of Unit No. of Units Fees Bath Tubs Fufneee"` I' — Showers — Heatpumps Water Heater 1 1 Spot Vent Fan Clothes Washer : Propane Tank 6 Kithen Sinks -- Gas Outlets > Dishwasher Woodi!!QIPellet Stove_ Di Di sebibs } Kitchen`Exhaust Hood Other Dryer Vent 1 Other T 1PP-% Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL 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. PROOF OF COW0,JUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. e 6 i; Date: Owner/Owners Representative/Contractor (indicate which one) " } , FOR OFFICIAL USE BEYOND THIS POINT Accepted by• '(;1 ?-Planning Pd Ck# Date Bld I'd Receipt No.__ DEPARTMENTAL REVIEW APPROVED DENIED Building Department NOTES Occ Grou T e Constr. Planning Department rEnvironmental Health Department FEES mbin & Base Fee Site Ins ection chanical& Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES MASON COUNTY PERMIT NO. PLUMBING/MECHANICAL 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.cc.mason.wa.us APPLICANT INFORMATION Owner i;, i i ,i s �; ,� ; ; y CONTRACTOR INFORMATION Mailing Address Company Name City, r'Y f r _ state I ,-� Zip Code Mailing Address City —State Phone Other Ph.. Zip Code Lien/Title Holder t r '* Phone Other Ph - - E mail address Contractor Reg. A A ----j- Drivers Lic.# E Mail Address Exp. DOB Drivers Lic.# SEPTIC INFORMATION - Connect to New Se tic-�. DOB Name of Sewer System p Existing Septic. Connect to Sewer System PARCEL INFORMATION- 12 Digit Parcel No " s Legal Description ' ` Fire District Site Address (Please include street name street number and city)+• Y;; Directions to site •'' > .i I rWetlancl�Seasonal perty within 200'of Saltwater Runoff LakeRiver/CreekStream.____,_Slopes or Bluffs � 15% Pond OF JOB - Ne"w Add Alt Re air Location of Fixtures/Units - 1 st Floor-IL, Other of Building 2nd Floor Basement_ Garage-.Cl PLUMBING FIXTURES (Show Number of each oset Type of Fixture No. of Fixtures ) MECHANICAL UNITS Toilets Fees Fuel Type:Electric - LPG�; Natural Gam Heat Pump_ Tvpi-t Bathroom Sink ��' No. of Units Fees Bath Tubs Ftrrnaoe i, t Showers Heatpumps Water Heater i Spot Vent Fan Clothes Washer S Propane Tank Kithen Sinks i Gas Outlets �— Dishwasher k Wood/GagPellet Stove Hosebibs f Kitchen Exhaust Hood i Other Dryer Vent Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL 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 required from any easement holder or any other party in interest regarding this application or the work proposed in the appliction,I haveeobtainion ed is 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. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. Date: Owner/Owners Representative/Contractor (indicate which one) Acce ted b : FOR OFFICIAL USE BEYOND THIS POINT p y Planning Pd______Ck# Date DEPARTMENTAL REVIEW APPROVED DENIED Bld PdReceipt No.. Building Department NOTES Occ Group T e Constr. Planning Department Environmental Health Department Plumbing & Base Fee FEES Mechanical& Base fee Site Inspection Wood/Gas/Pellet Stove Fee UFC Plan Review Fee Violation Fee Other TOTAL FEES FORM MUST BE COMPLETED IN INK PLEASE PRESS HARD 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 (� J On the web www.co.mason.wa.us APPLICANT INFORMATION Owner I l CONTRACTOR INF MATION Mailing Address Z- E Company Name -PGAGE City ll✓LT t�l�I Mailing Address Phone -5'C3d 7tat4_Ujjff-Zip Code City 12 Other Ph ����`�_ Phone State Zip Code Lien/Title Holder_�L `Z er P 6 2 E mail address JSd1L5 @ Contractor Reg. - y �I� E Mail Address________ Exp. Drivers Lic.# __ DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New i Septic vers ic # O Connect to Water System Name of Water System ` -- Existing Se is Well___X___ Sewer Systern— Name of Sewer System. PARCEL INFORMATION - 12 Digit Parcel No. Legal Description (� 1 Site Address (Please include street name street number d city) �_�`- Fire Distri Directions to site 12 R � � ._. 0, � K I T y. Will timber be cut and sold in parcel preparation?Yes/Is property within 200'of Saltwater Wetland�_Seasonal Runoff tre LakeRiver/Creek Pond Sam Slopes or Bluffs�15%Is this per submittal the result of a Stop Work Notice, Correction Notice or other enforcement action?Ye /No TYPE OF JOB - Newer Add Alt Repair Use of Building RID�ov� p Other PRIMARY RESIDENCE No. of Bedroom escribe Work R �tvra SEASONAL s-- J—No. of Bathrooms__�__Square Footage 1st Floor I99 I t � ` 3rd Floor ~---_Basement Deck 3 2nd Floor :2 Garage- Attached k `� --Covered Deck-_.________Other ________ ----- Detached ..._. Carport_. -.Sq. ft. MANUFACTURED HOM p Attached ______ Detached Length W. Detached - Make Serial No. Model Year Type of H Purchase Price $ No. of Bedrooms No. of Bathrooms Instal r Name Replacement Unit? Yes/No OWNER/BUILDER Acknowledges submission of inaccurate information may result i ai sbpiwork 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 al 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 MEAN OFA RESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS ILL INVALIDATE THE APPLICATION. X Date: d5 Owner/Owners Representative/Contractor (indicate which one) FO OFFICIAL USE BEYOND THIS POINT DEPARTMENTAL REVIEW APPROVED DENIED Accepted by: Date Buildin De artment 'r� NOTES V Plannin De artment O Environmental Health Department Fire Marshal r Buildinq Permit Fee FEES Plan Review Fee Site Ins ection Plumbinq & Base Fee EH Review Fee Mechanical P. Base fee Plannin Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee State Fee Pre-Paid at Submittal TOTQi i:r:cc d o Q NI Ll k7jF-- f ,g �f IvLet TV C f L�- ��� TOPOGRAPHY PROFILE: I LO-f— Building Permit number. Direction: _ Scale: q1. Approval:for office use i Ovmer/Applicant-�� (?Th�►A) A i!J�l i n. Building:_ i Parcel Number: Date of Planning: '— I U-3 �o14-i] TT "" --- I application. Env. Health: I i 60163 ACCESS`&�RADE WORKSHEET DATE: dG ADDRESS 44' INSPECTOR DRIVEWAY ACCESS /�'e ,1 � Len the Width: ? Surface: Size of turn-around.- Condition of shoulders: Vertical clearance: need ost at end of drivewa with refle dive address numbers. GRADE,OF DRIVEWAY % OF ROAD ROAD ACCESS Len the Width: Surtace: Condition: Vertical clearance: BURN PERMIT REQUIRED FOR LAND CLEARING FIRE. Tz)(L)—LOT INSIDE SMZ, 4X4 FIRES ONLY. ) LOT INSIDE UGA, NO OUTDOOR BURNING LOT TOO SMALL FOR: PERMITTED. BURN PERMITS —_____4X4 FIRES. REMARKS Z continue remarks on back Apr 20 07 08:04a TNT Excavating (360) 275-1230 p,1 TNT Excavating, LLC P.O.Box 1119 Proposal Belfair,WA 98528 Phone(360)275-1234 Fax(360)275-1230 Date Proposal# 4/19/200? 200759 Name I Address Mike Birkland 52 East Rainbow Place Shelton,WA 98584 Project Birkland,Mike Description Mobilizations aly Rate Total 12yd Truck w/3 Axle Trailer Sub-Total 3.5 95.00 332.50T Move Shed 332.50 41 OG Backhoe Labor 5 90.00 Sub-Total 5 450.00T 40.00 200.00T SHED RELOCATION IS ESTIMATED-ACTUAL TIME AND MATERIALS 650.00 UTILIZED WILL BE INVOICED Fine Grading 450JD Dozer-Scarify and grade hardpan 41 OG Backhoe 20 90.00 12yd Solo Truck 2 1,800.00T 3/8"Pea Gravel 90'00 180.00T 2 95.00 Sub-Total 15 190.00T 14.40 216.00T Grade and Rock Driveway 2,386.00 450JD Dozer 12yd Solo Truck 4 90.00 314"Clean Crushed Rock 4 360.00T 95.00 380.00T Sub-Total 32 14.40 460.80T 1,200.80 Subtotal S4,569.30 Will Langemack Ltd. 1115 Wing Point Way NE Bainbridge Island, WA 98110 Field Clarification John Van Dijk 4-6-2007 A A$ E Inc. General Contractors PO Box 730 Belfair WA 98528 Re: Birkland Home Job.No2005-158 Enclosure None CommentsF244 up on inspection questions: be substituted for 145 reinforcing. g of short dowels into footing for short fnd. stem 6"is allowed. I do not regard it as prime as it does not need to develop any reinforcing nd aids in elevating horizontal reinforcement.. Wet sticking would not be approved for structural retaining greater than 48". Action For your files and records Please contact my office if you have any questions; thank you. 4966 Will Langemack, Architect From: REGISTERED Pres./ Will Langemack Ltd ARCHITECT "06.780.4145 WILLIAM K LAN ACK STATE OF WASHINGTON MASON COUNTY RBSIDEN'TIAL PLANS SUBMITTAL CHECKLIST Owner's Name, Date. � Reviewed By Documents: 1 Bt11dmg Permit Application Completed Planning Intake Checklist Completed, L`l 416 plan includes:Allowable building 1..=Fite- �� f "hangs,decks,etc. APParatus Access Road info required Yes/k,, Energy Code Application Form•O Blectri heater O Electric central furnace O O Heat pump with electric furnace O Heat LPG Furnace O-Other:Specify: T'�with LPG furnace ©Boiler(heat echanicaUPlumbingApplication•WA TYPB Engiiioem'8 .Ya�(Need 2 sets of cal WATER FUEL Snow load: `- mom)No _ . ? , Seismic Zone(circle one): D 1 r2 �o r assessment? Yes No Construction plans:`3 COMPLETB SETS I.cgiblc _PSn' Fe(Gadation Plan �toof F 1Z0d Scale Elevation views '�Cross Section L riming Plan Hoerr Framing Plan-all floor levelsLotFloor Plan—Use of rooms noted(all floor levels) nP�nted? era deck Framing P1a4 including coyrr.porch framin e'etc. plan Details: ,— - ( b C all Framing:D y truss or WCk fcampd? `�c wall exceed 10'?(Erigtnee8+ y be requdred)N 8� Floor joists: S CD headers marked ott Floor beams: / �( Plans: Typical header: 0 on:f s' _ rte,ranforamcnt i Y N Walls•Does Cmcrcta Wan x eWA-1.� at all exits? Exceed 91?(Englneertng be requlraed) C, Less 11uaa 30"above grade? Y / N Bated By Furnace-Location ofFwxace Fir p— lacelStove Information Shown-,7tl .aL w Sizes Marked on Plus n(s)� -�IRced wall Pals(shear w114)marked on lateral e = Garage? (Engtaeertng„may be r Pleas or ng�a=ing? (per uray not be approved if not pr ovided) equ&r4 R602.10.1,1 story of a two-story D145Y.,D2-55% CCMMMM: ENGII&WING REQVMt D: Braocd wall PaWlSlbraced wadi lines are not Amotiaf and location of b marked oII P�"2.10) UMEGULAR BUIIAINGS(Irregular R3p1.2.2.2 requir m Table R602.10.1 e8�r portions of shall be Considered to be Of when hae or more a thigned efollowingaccordance conditions with acc'cpted g practice. A portion of a bidding shall l OMW 1)Exterior braced wall line or BWP caa�cver or of by more than 4 — 2)Roof or floor is not laterally supported on all 2A)Portion of roof or floor extend more 3)End of BWp extends more than 1 thaw GfL yn the braced wall line. ft.over an Opening re 9M 8 ft in width below. 4)Opening in a floor or roof exceed the-lesser of 1 &r5 the leastoor or roof dimensio 5)Portions of floor 1eve1 are offset vertically n. — 6)Shear wall lines do not occur in two perpendicular directions. . ---- 7)When a story above grade is includes maso demos'or concrete construction(exc..fireplaces,chimneys,and veneer). Witt this applies the entire story shall be - DESIGN wed.In accordance with accepted engineering practice. CRITERIA:Wind 85 mph exp B(unless proven otherwise), Seismic Zone: Snow: psf .2003 IItC Plans submittal ehecUists4lified(Vf Mason County Permit Assistance Center Planning Intake Checklist Owners Name: Project: —i�� Date: ` Commercial Development- ES Reviewed By: f Planner: GB M TSC CMM O Comments: ('- K1M PBC RDH Site an: orth Arrow ,-U�erty Dimensions:.. -�361 _X ? I S-� Street and Driveways Shown. Road name: 5-" It Existing Structures shown with setbacks a ' 11 Location, Septic and Drain-field Shown with setbacks / Identify all surface water(strqams,ponds, shoreline, wetlands, etc.) --a___ opography(slopes) -s--Proposed Structure Setbacks (Direction/Setback): F: !� / Lp ;:v-- tility and Dr—a e 8 n R:�/ L S 1:-L-/ S S2: g Easements: Yes ,(if yes enter condition#5022) -a""�er Easements /�(..� -Er-Accessory Appurtenances Q-`"County Access Permit Needed(add rdndition#0010) q D State Access Permit Needed(add condition#0020) NJ, Standard Conditions to be added to all Building permits that planning reviews: #5019 and#0700 B Are there any impediments that may restrict access to your site? (dogs/gates) Shoreline and Planning Info Setbacks: Shoreline: _ Slope: v Shoreline Designation:Designation: Comprehensive Plan: ❑ N Applicable Rural Zonin ❑ Agricultural '�RR 2.5 10 20 Urban ❑ In-holding ❑ Rural ❑ RMF ❑ LTCFL ❑ RC 1 2 3 ❑ Conservancy ❑ Rural ❑ Natural ❑ RI ❑ Unknown ❑ RCC-Hamlet ❑ RAC ❑ RNR ❑ RT ❑ Urban Growth Area ❑ MPR Water Bodyt ❑ Unkno ❑ Unknown (typeJwar if unnamed): ,.�y� � f SEPA: Yes NoFlood Plain: YESCho Map# Aquifer Recharge: YES NO �Ynkno 1 Map# Tags/Cases: RL e PI Nest Tag:Case: Eagle Nest - 6-Year Dev. Moratorium: YES YE NOS,; Other YES O � '. `. Addressing: Check box if needed Pre -t it 1 �C vL C(S l� Reviewed by: L;' R vise : 1 01- 5 l 9n.�1� r � �� 1APLANNINGTACTLANNING INTAKE 4. MASON COUNTY DEPARTMENT OF HEALTH SERVICES Environmental Health Personal Health PO BOX 1666 SHELTON, WA 9858 LOCAL(360) 427-967 Application for Determination of Adequacy BELFAIR FAX((360 360)427_�g Instructions x iS PART 1: Applicant/Parcel Identification Name of Applicant Al I 61 RVV LANn Date-aC,vZbS Mailing Address + LTryJ AAA Telephone-AC- F3C-37�'4 Assessor's Parcel Number. ZZ ©S" T e of Water S stem Check One : Reason.forA lication Check One ❑ Public/Community Water System t2 or more connections)" Building permit Individual water source tone connection), Land use application, if so.. if so.. Division of land: Well #of Parcels? Spring/surface water SPL ❑ Other(explain. v Boundary line adjustment ff you have more than one residence Other(explain) connected to this well,check the Public box. Replacement(please indicate name of water system below if applicable—no signature required) PART 2: Water System Information Complete the section appropriate for the type of water system being evaluated: Public Water system FName Water System cility Inventory(WFI) Number: ne"for two party) 17 I am the manager of this water system.The water m has been approved for. services. There are presently connections)in use.r will be the — connection-1 am the manager of this system.This connection will be to up a or change the use of an existing connection on this system(ie:recreational to full-time Please indicate on the following line the nature of this change: This water system is able and willing to provide water to this(these)connection(s)without exceeding the limits of the water system or any limits set by state and local regulation. Signature of Water System Manager Date K'IWELLIWEBPAGEIWEB SITEIWATERAD4.DOC Update:April 2006