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Home My WebLink AboutBLD94-1039 Cancelled SFR - BLD Permit / Conditions - 4/20/1995 /`�■/�-. ■/�_ �pp�� Permit No. �e �UL i BUILDING PERMIT IAPPL IO ON NA, o� 426 W.Cedar/P.O. Box 186,Sh"n,WA 98584 427-9670/1.-800 562 5628 ,O PLEASE PRINT KAMM i. Phone# -S/00 Address 6 -7 l O 2 Gr2&6Vi Fw LMP RD Fire Di$ti�ict tN ity A . IJ St wA- gip. Directions to Job Site TO A sde� Ry- &x) CrAW9 tf") c-fg - Ltox Age &cA)A�y W/fif Aw Shy- S*K srrd.,il . Owner Mailing Address BLS City 56kL.Vin St_WArp IUSW i Uen/Title Holder Address City St Zip j #2 Contractor Name �' �t 11 LI" R Contractor R@g# SKE0t wm o"f Address ��- ( cox `2// Expiration Date / / city Phone# &/Z:z-5700 #3 If septic is located on project site, include records. Connect to Septic? � Public Water Supply . Well C� Connect to Sewer System? Name of System (If residential, proof of potable water is required) ce1 No.1?,?.Z'7 - - + rr Ioi-5 Legal Description �."' .--- -�-�`_ £. Te► #5 Building Square F tage: (existing/prpposed) 1st FI / 2 2nd FI / 1<1-6 3rd FI / Loft / (� Basement / Deck / ZeQ #bedrooms /q_#bathrooms / Garage / Carport / (Circle:Attached or Detached?) Other sq. #6 Use of building r- Describe work #7 Type of Job:New Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year Make Model Length Width Serial No. #Bedrooms #Bathrooms Type of Heat Purchase Price$ #9 Indicate by circling the applicable source if any water is oFk@&vQacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater asonal Runoff Other Show fog owing on the site plan Lot Dimensions Flo,pd ZDeaes Existing Structures Fences ff�' f JUL Stnicture Setbacks Driveways - Water Lanes Shorelines ; Drainage Plan• Topography r ~ Septic Systems Wells Proposed Improv aments Easements Name of Flanking Street Indicate Directional by (N, S, E, W) "y . NmFronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW APPLICANT TO DRAW-YOPC &-RAPHY P110FILt BELOW y t Plumbing Fixtures(S3 eachl Eft f ($6 each) r No. 5,Toilets I� CIRCLE FUEL TYPE: Gas I O� cow Bath Basins Heatpump, Other "1 Bath Tubs j_ �y Showers 3 Furn BTU � 0✓+(`�` J—Hot Water Htr 3 v Heatpumps6dr Laundry Washer 3 _ Vent Systems Sinks 21 Spot Vent Fans _Floor Drains Ng, Boilers/Comwessors _Laundry Basins HP J_Dishwasher 3 NgL Air Handling Units _Disposal _ cfm# _Urinals Ng. File Protection Systems _Other _ Auto. Fire Alarm Sys - 50.00 Fixed Fire Supp. Sys 50.00 Permit Basic Fee 15.00 _ Auto Fire Sprink Sys 25•00 ' TOTAL PLUMBING $- Ng.. Other Gas Outlets. Wood,Gas, Pellet Stove i NOTICE: THIS PERIAIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AVYWRIZED IS NOT COM- MENCED WRIIN V DAYS OR IF CONSTRUCTION OR Permit Basic Fee 15.00 WORK IS SUSPENDED OR ABAND F&A P18AM OF 180 DAYS AT ANY TIMt AFTER WORK-IS COM- TOTAL MECHANICAL- $ MENCED.PROOF OF CM NWATIION OF WORK IS BY MEANS OF A PROGRESS 1f 'SPEG`TiON OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT J AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED 'f MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I I RCW 18.27,AND AM AWARE OF THE MASON CQUNTY AMAWAREOFTHEORDINANCEREQUIREMENTSREGU- k ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICI+THE'PERMIT IS ISSUED MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE-IN CONFORMANCE CONFORMANCE THEREWITH.NO CHANGES SHALL BE THEREWITH.NO CHANGES SHALL-BE MADE WITHOUT MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAININ APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMEN . X OWNER X BY DATE DATE/7— DEPARTMENTAL REVIEW 06R`6FFICE USE ONLY Approved Cond. Hold Approval Planning: - `f ZL 4 Environmental Health: Building Plan Review u Occupancy Group: Type of ConsffZF�:l_ Fire Marshal: Other: Special Conditions: FEES Building Permit , Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee i s Other Other Building Valuation: TOTAL FEE MASON COUNTY DEPARTMENT OF HEALTH SERVICES D POST OFFICE BOX 1666 ° SHELTON, WA 98584 JUL 2 0 (206) 427-9670 FAX 427-8425 APPLICATION FOR DETERMINATION OF ADEQUACY ERVICES Revised 09/01/92 Li ONS 1. Complete Part 1. No determination can be made until Part 1 is fully completed. 2. Complete only the portion of Part 2 applying to the type of water system utilized. 3. Submit completed application, with attachments to the health department for review. PART 1: APPLICANT/PARCEL IDENTIFICATION NAME OF APPLICANT `��( �- )L,'� DATE -7—U g�f MAILING ADDRESS l"Q Z!*C TELEPHONE (2;,a, ) 47�7_670 S jmm 6 k City B£at� Sip � ASSESSOR'S PARCEL NUMBER SUBDIVISION (If Applicable) ze;�ff- (:0 LOT �� TYPE OF WATER SYSTEM (Check O ) REASON FOR APPLICATION (Check One) Public/Community Water System Building Permit, Single Family Res Individual System, Drilled Well -Building Permit, Commercial Individual System, Dug Well Building Permit, Replace/Remodel PIndividual System, Spring Land Use Application El Name Individual System, Surface Water Type Individual System, Other . Other 1 PART 2-A: PUBLIC WATER SYSTEM i NAME OF. WATER SYSTEM WFI ID i I The water purveyor for this system has previously filed a certificate of water adequacy with the health district. I am manager.of the above referenced water system. The water system has DOH approval for service connections, with connections presently in use. The applicant has approval to connect to this water system. Service of water to the applicant for domestic purposes is consistent with both the water system j plan and the water right permit presently in effect. Water lines are available to the applicant's property line, or the applicant has made satisfactory arrangements to extend the lines. i SIGNATURE OF SYSTEM MANAGER DATE j w-7 i ART 2-B: INDIVIDUAL WELL WELL DEPTH Ft WELL CAPACITY t Gallons/Minute Gallo s.Day El Well log is attached to this application Well capacity test results are attached to this application NOTES: well capacity tests are often performed by the well driller at the time the well is con- structed. Teat results from these tests are noted on the well log. Results from these tests will be accepted by-the health department. if a well log cannot be located by the applicant, a well capacity test must be performed by a licensed contractor. Baler or pump tests are acceptable, provided stabilization of draw-down has been measured and recorded. Satisfactory total coliform test is attached to this application. PART 2-C: INDIVIDUAL SPRING OR SURFACE WATER WDOE permit is attached to this application I have reason to believe the spring proposed as the water source will supply adequate water its intended purpose. This belief is based on the following observations: AUTHOR OF STATEMENT °" DATE RELATIONSHIP TO APPLICANT NOTE: In addition to providing the above statement, the applicant will need to arrange an on-site inspection by the health district prior to determination of adequacy. PART 3: HEALTH DISTRICT EVALUATION (Health District Use Only) ❑ SATISFACTORY DETERMINATION: Applicant's water supply appears adequate to meet needs of its intended use. Note: This determination does not address adequacy of the distribution system, guarantee an adequate supply of water indefinitely into the future, or guarantee compliance with all applicable WDOE water resource regu- lations. UNSATISFACTORY DETERMINATION: Applicant's water supply does not appear ade- quate to meet needs of its intended use for the following reason(s): HEALTH INSPECTOR DATE Rev` "aJ01/92 T"HIS P#RCEL iNcLur�s P-,--L,-A, NS, BLUERR 'S OR. OVERSIZE IMAGES LARGE FORMAT IMAGES HAVE BEEN STORED IN FILE CABINETS) UNDER PARCEL NUMBER PARCEL # iaaa9 z.4 - O600o CASE # 8LD Rik- I Daq 4D 41, 4b In ba CA 0 C;l ISO z 3> -G - sr _ O zw ut vv 3 Mm— CL . b JA S .7, s s CcNc MECHANICAL MOBILE HOME Fee490--Setback date by Ribbons deW by Gas Piping date by Foundation Walls date by Set tip dam by INSULATION date by SG/SLAB Insulation Floors Final date by date by date by FRANNG Walls 5. W6016 o FIRE DEPT. dale by date by date by PLUMBING Attie OTHER Groundwork date by date by WALLBOARD NAILING D.W.V. date by date by FINAL INSPECTION Water Line date by dat -� date by 7 � T. 1 il: �, .': 3 .$` MR Ao - - -�j R�..Ln+ t9 .i.k"i t� - a1.5 ,.S��iyf�►�'y'a`,, f`. '�' C 'p tl,r. yeJ.� "'t „� O i5i .M :. 31 """+'" ..'` ..�. �:`{�'`9% 3^r,.ra1 t�� t-+;f'C�>--.t, :s �•` i�'.i'v 'Y�S 'S � .G.a Z.ri �`�'Z O O t�� u,s ;� r , �K�'� �.'`ry �s. •s �r �.`% -� � <.oz, z #r wi".+.. Ae ..y}J� j ♦.-y5'S"ski ►�".':^ .r, � wr'S J !' 3 2 m z" y rw 3 .� 3✓ J '„�"y♦Y T.� �- `�� V9 sY 2 m:tZ's�� y--} ✓• � � � � J { •. J� yirn +i � .�p fn' � N! t e+lT�f.�y Itir v ~"� ..�`yr s ��fe•V w � a+M +�� iw +q1k� w S �. ��.ice♦ i�a W fet� 'r' � V� J � I r Z�c3 Z 1 Z � � I T,, ✓ ± 1s P 3> ram, -t +g .. { u .s- - -! O Y' _ _ CD CZ i� ..s S +� A A 7 �n }w'i L V> y..$3 � T T ei _ T = z Z - £ I I ,�wf r�+��M,r 'r W ae.wrr •f{ .. � r.�' 'N a�" .r. �� O `Y z Z, tr v J _ t �� •;«° �- r�i a.y+�e �' , �. �� rTt :h rr tw ... ,r +r i e/ Building Permit # MASON COUNTY I SUILDING 111 426 VU, dA SW LION, WASHINGTON 98584 (360) 427-9670 ic CORR T1 Job Location ,/ r 7�oZ -�-rp-13 c ur-cuj LP�d _ .,... 9-ov- /0-3 / This structure has been inspected by Mason County Building De IL and the following VIOLATION of County Laws and Ordinances has been found: (� /�C2d -to �r� `/ FyeS G1�Y Porfs ? 'huf►n�CQ Items listed below must be corrected to gain code compliance Hsf Arne be 4rc ,i+4.l o mn i�O i �` eh C_i•%i f Z " owe oaf Y a -t- wt rrtd R hQ L� W= Lz le i�ef sJ ,rt ,-v) y !M foA f y-•. Gvi v� ow G 0 t14 b L+a11 b W t+xd i vy L4 1G c r I p _fO .o i Sf b a i^ j�',e, � w, e fA e�,�. c✓ wry ere..-t_ ,�r,.t, � �� Y.e.i-°r T11O i O rc70^ !Ras Lojt ✓ regil,%3, rat; s ►' icJ ofl You are hereby notified that the above contions shall be rnade BEFORE PROCEEDING WITH ANY FUSER WORK 0 Call for re-inspection when corrections are made before continuing Make corrections, items will be checked on next inspection ❑OK to Department /mile, Date 5`14` f t Inspector VETH ' 11 MO I TAG Building Permit # MASON,COUNTY BUILDING N1' 426 W. CE0Ai SHELTON, WASHINGTON 98684 (360) 427-9670 CO' ON REC, Job Location Hct'A,ilk 1.1 9y -�d3g S r 1k This structure has been inspewted icy Mason County 8ulding DepaIent and the following VIOLATION of County Laws and Ordinances has been found: Items listed below must be corrected to gain code compliance xi ty ;or- " ek f proof prl*j,%+. dtu .Cts flPI cx11 fxfrcrar' ,/ayr- h#12S r — (�`i'P��/L�a�.d t/�'S'9►c.�.c e`.. ii+ L'1'a+.�/ 5 •mac G�c t e st '�'�ra�x L !r(,'fcL,�v.. Y�wfrY I You are hereby notified that the above corrections shall be made BEFORE PROCEEDING VWTH ANY FURTHER WORK 0 Call for re-inspection when corrections are made before continuing Make corrections, items will be checked on next inspection ❑OK to Department 8411011312- Date -6-16-11 Inspector �xf L M0 TAG VE I K-7il -411 • e • • I / / -+ �PAI / ibWIN IWIP—M- 1.PM r Op / V 1 / . / �•) - L �. u/ �. . Rx,-, R IM-m Mo � �• i ems. t JJ WPI or • ,. A JAI a i lip . _ • - .•.ter � .��_ .11►�.�► r 4� Building Permit# MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 gum FT 2.. E; Job Location This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: S . 1E,&, Items listed below must be corrected to gain code compliance a NIJ (TA2 4 You are hereby notified that the alcove corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑Call for re-inspection when corrections are made before continuing ❑Make corrections, items will be checked on next inspection ❑OK to Department Date Inspector HIM ow- r ,