HomeMy WebLinkAboutBLD2006-00238 Final Drive Pile and Dock Addition - BLD Permit / Conditions - 10/2/2006 OW
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o CONCRETE MECHANICAL MANUFACTURED HOME D
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Go Piping N
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Exterior Date By Exterior-Date B
00 INSULATION n
Point Load I Isolated Footings DOW 19y D
BG I SLAB INSULATION
Date By Data By FIRE DEPARTMENT m
Foundation Walls Floors Date By
Date By Data By DECKS
FRAMINA Waft Data By
Date 10 d24CC , Byf56 Date By PROPANE TANKS
PLUMBING vault Date By
Date By OTHER
Groundwork Attic
By Type-,
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Date By Date By
O.W.V DRYWALL Type:
Int Brace Wall Dew By W
Date By Cate By FINAL INSPECTION �
Wat+errUne Fire Separation /q/- j?/��> NO
Cate By Date By Datwo ozla By/ kL CD
Pass or Request Inspect. b
Type of Insp, Fail Date Date Dane By Comments CD
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FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO. 0
PLEASE PRESS HARD 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
APPLIC#qT IN ORM TI IN CONTRACTOR I ORMATI N
Owner Company Name
mte-
Mailin—Addy ss Maili Addr ss OS
City rc�t it�tate p Code City State Zip Cod
Phone Other Ph. Phone Eli — Otnh Ph.
Lien/Title Holder Contractor Reg. 5 J*�Exp.
E mail address E Mail Address
Drivers Lic.# DOB I 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 Di it Parcel No. Q7,4, Fire District
Legal Description
Site Address (Please include str tname, street numiDer and city)
Directions to site ROIM �o i'1 Y4_ Ir Oled
0. LK
Will timber be cut and shIld in parcel preparation?Ye
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?Y
TYPE OF JOB - New Add Alt Repair Other PR ARY R.ESYf NCE
Use of Building Describe Work
No.of Bedrooms - No.of Bathrooms * Square Footage- 1 st Floor 2nd Floo
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 "to receW this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary� is
required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I Have='
permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,rep rese a nformation
provided is accurate and yants emp ees of Mason County access to the above described property and structure for revie i ^r
PROOF OF C NUA OF K IS BY MEANS OF A PROGRESS INSPECTION.
X Date: Z 2 l-O 6
er/O Re resentative/Contractor indicate which one
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Planning Department
Environmental Health Departmen
Public Works Department
Fire Marshal
FEES
Building Permit Fee Site Ins ection
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
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
On the web www.co.mason.wa.us
APPLIC T IN ORM TION CONTRACTOR 1 ORMATI N
Owner Company Name
Maili ddr ss Maili Addr ss S
City r _State p Code City State Zip Code
Phone Other Ph Phone — Other Ph. i
Lien/Title Holder Contractor Reg. xp.
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
j PARCEL INFORMATION-12 Digit Parcel No. Fire District
Legal Description
Site Address (Please include stre t,name, street number and city) --f?5 l
Directions to site Ro Go r1 t R
e 1.
Will timber be cut ands din parcel preparation?Ye
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 Other PR VARY ES D NCE ❑a
Use of Building Describe Work
No.of Bedrooms No.of Bathrooms Square Footage- 1 st Floor 2nd Floo
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 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 app i k Wta,416informagn
permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represent
i provided is accurate and grants employees of Mason County access to the above described property and structure for review ¢ s"n
PROOF OF C INUATI OF K IS BY MEANS OF A PROGRESS INSPECTION. l- �� �
j X - Date: 1? ' 2 1-0 BELFAIR OFRCc
ner/Ow Representative/Contractor indicate which one
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department �o r —iV ,Epos^ 00.0Sy Pry
Planning Department
Environmental Health Department
Public Works Department
IFire Marshal
i FEES
Building Permit Fee 2 _ ILS— Site Inspection
jPlan Review Fee // 1/ EH Review Fee
f Plumbing &Base Fee Planninq Review Fee
i Mechanical& Base fee Other
Wood/Gas/Pellet Stove Fee State Fee S�
Violation Fee Pre-Paid at Submittal
Valuation$ o 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
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner M i a i-i w y' 'k I 1 ( Company Name C a L• ;.,'.z s
Mailing Addr ss w�' E���~ P Mailing Address °j"� '`' 11
City tate k .. Z p Code- - 'a i;"� City :ir' i '`TIC State Zip Code `` y
Phone Other Ph. Phone . 49ci a ► ,_ ) = i— Other Ph.
Lien/Title Holder Contractor Reg.# -► r i ' a i=xp.
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. Fire District
Legal Description
Site Address (Please include stre t.name, street number and city) j2I N[: 1— t ! 1
Directions to site EKom 1 C-,o 1': `'1h t R r r C 0 0, it
..t ,. �, £li L.K r
Will timber be cut and sbid in parcel preparation?Ye `•`
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 Other PRI ARY ES NCE ❑ E ON
Use of Building Describe Work
No.of Bedrooms No.of Bathrooms Square Footage- 1 st Floor 2nd Floo
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 declarb 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 empl ees of Mason County access to the above described property and structure for rea ion. '
PROOF OF CONTINUATIOW OF K IS BY MEANS OF A PROGRESS INSPECTION. /
x i �, //c . Date: 2 / ' 0 6, FEB 2 3 7P;
Q(Vner/Ow Representative/Contractor indicate which one
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: BEi testa i
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Planning Department S 0 A '
Environmental Health Department
Public Works Department
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
� r �
THESE PLAf,,I..) I'vi.-�!ST BE
ON THE j,;L3 -XFE
FOR INSPECTION.
MUST MEET ALL CURRENT u
WASHINGTC~N STATE CORES
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THESE PLAN-, 1MUST BE
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iv1UST MEET ALL CURRENT t-� t
WAS INCTON STATE CODES10
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THESE PLAN., MUST BE
ON THE J ,6 :ATE
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MUST MEET ALL C:URREN-1
WASHINGTON STATE CODES
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THESE PLA MUST BE
ON TH L .JOB SITE
FOR a -�SPECTION.
Documents attached to approved plans.
Plan�rev ew �
ch —�---- Pages UT h�EE-f AL s
Engineering: Y O / Lateral Vertical
Number of pages p
APPROVED
MASON BUILDING INSPECTOR
C—HSUBJECT TO APP OVA
DATE_=3_ /0 06