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By INSULATION Date ByW H G flab Insulation Floors Final Date By Date By Date J fs 6x By 9LV FRAMING Walls FIRE EpT Date B y Date B y Date B PLUMBING Attic OTHER Groundwork Date By j3LO 2mq -b 1�D 45 Date B WALLBOARD NAILING D.W.V. Date By F&Z OIL Date By FINAL INSPECTION Water Line Date B Date By Date By 8 1?151oy L9 s 6Ai a C0 4 L z &�7 8 N r 7/ i f M � O '` R � � • � nn•�1. � F �� 8 oy t� zcs � f�tS � oo-7/34 c� bus AT:Xj 1, S$�`= P - _ .� [S E Goy �iE-r�szs �► b sad, t9k& N rri F y j V r CONCRETE MECHANICAL MANUFACTURED HOME Fee l etbacks Date By Ribbons Date q10 By S Gas Piping Date �� d� By Foundation Walls Date By se >zp Date By INSULATION Date I OS7p, B B G / Slab Insulation Floors Final Date By Date By Date By FRAMING Walls FIRE DEPT D ate B y Date H y Date B PLUMBING Attic OTHER Groundwork Date B Date By WALLBOARD NAILING D.W.V. Date By Date By AL INSPECTION Water Line Date B /?- D ate By Date By it I 'Q o _ 1t I g O — rKA50 — S4ejeS Fr s 73/ R�sc o' AWN , 116ME S4.gg ©mot &Wdo-el' 'T6 w C � N 846 O � o � c, a 0 0 V 0 i \ MASON COUNTY PERMIT NO.gcrococf— PUILDING PERMIT APPLICATION _ 426 W.Cedar- P.O. 136x'186, Shelton, WA 98584 , helton (360) 427-9670 • Belfair (360) 275-4467• Elma (360) 482-5269 On the web www.Co.mason.wa.us APPLICAN INFORMATION CONTRACTOR INF RT OWN A Owner L PIJ Company Name 1,"L C'��S 1r�U. �prJa�?/tYC I k MailingAd re L urxr �� Mailin Address City State WA Zip Code City -� G�-c-� State Zip Code Phone 27 -'5'S4 1 Other Ph. Phone 36 Z Z' l Other Ph. 'Lien/Title Holder Contractor Reg.#6ct f(4--'T 99 j/c fj• 7112, E mail address E Mail Address Drivers Lic.# DOB Drivers Lic # 1,0plo?4 sr LD 5 3C. b(hB 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 c j PARCEL INFORMATION - 12 Digit Parcel No. Fire District z j Legal Description L A& C, Pe,-t 9 Site Address(Please i clude street name, street number and pity) fm u)� / n 75 Directions to site A -0 v ko 0 p � N C L r „ l r, LC JJ t Vw _... 'i - T 4 .e i I limber be cut and sold in parcel preparation?Yes/ o //vi t'4.�' CD /2/y 647— Is property within 200'of Saltwater River/Creek Pond.. Wetland Seasonal Runoff Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement,action? o TYPE OF JOB - New Add Alt Repair Other PRIM RY R SIDENCE ® SEASONAL ❑ Use of Building I q .p A(65 Describe Work Na of Bedrooms No.of Bathrooms_Square Footage- 1st Floor—L''-- 2nd Floor 3rd Floor Basement Deck-----4._1✓ove rd ` -ther< Sq.ft. �� S tiara e - Attached Detached dar o f Attacked-" Detached MANUFACTURED HOME INFORMATION - Make f ok, mA"A" Length_L de 53 Width Serial No. -(�� `� Z� � No,of Bedrooms �hrooms D �._ Type of Heat �� A Purchase Prce$ .. SZ, 'ZZ ). trO Replacement Unit? Yes/. l Installer Name 4�z��,4 Certification No. 110c4//V S Z Z _ 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 permis- ionfrom all the necessary parties.If permission is required from any easement holder or arty other party in interest regarding this applica- tion or the work prQDQsed in the application,I have obtained permission from them to apply for this rmitand conduct the work proposed. X— Date: ;ell Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS,POINT Accepted by: Planning Pd Ck# Date Bid Pd Receipt No. FDEPAPTMENTAL REVIEW APPROVED ' DENIED NOTES Department .3 V.,Ivv T S a1Gg Department nvnmental Health Department Public Works Department Fire Marshal FEES Buildinq Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Plannin Review Fee Mechanical& Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation$ TOTAL FEES SON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Planning Division P O Box 279,Shoi m WA 98584 (360)427-W70 NOTIFICATION OF INCOMPLETE APPLICATION June 01, 2004 JERRY WHALEN 2582 SE LUND AVE PORT ORCHARD WA 98368 Parcel No.: 122297890014 Project Description: NEW MANUFACTURED HOME Dear Applicant: You have submitted a permit application (case no. BLD2004-00735)for proposed construction or development in the county. Upon review of your application, I have determined that the contents of the application are irfcomplete or do not provide enough detail for review. Therefore, review of your application will not proceed until the necessary information is provided (see the comment section of this letter for details.) Once the information is submitted and the application is complete, I will continue to process your application accordingly. If the additional information is not provided to the County within 180 days of this request, the application shall expire and no further action on the proposed development shall take place. Please contact me at(360)427-9670, ext. 577 if you have questions. M Rick Mraz Land Use Planner Mason County Pla nt 6/1/2004 1 of 2 BLD2004-00735 NOTIFICATION OF INCOMPLETE APPLICATION 6/1/2004 Can No.: BLD2004-00735 c0mmer s: A field investigation of the subject property was conducted on 5/26/04 to assess critical areas issues relevant to a building pennit application for a single-family residene. During the site visit, staff observed Pileated Woodpecker foraging and nesting habitat. At least one tree onsite and two others nearby contain nest holes common to this species. Other trees were noted to contain forage holes and excavations. The Mason County Resource Ordinance lists Pleated Woodpeckers as a Species of Importance in Mason County. Per the Fish and Wildlife Habitat Conservation Areas (FWHCA)chapter of the Resource Ordinance, a Mason Environmental Permit shall be obtained from the County, using the administrative review process in# Chapter, before undertaking development activities in FWHCAs or their buffers. When a development is proposed within 1/4 mile of a listed species point location (den or nest site), as identified through the WDFW PHS data base, tribal and other local fish and wildlife databases or knowledge, a preliminary review by a qualified fish and wildlife professional shall be provided to the county which shall determine if a FWHCA or its buffer is within the area of the development. If the development occurs in the FWHCA, a Habitat Management Plan (HMP), prepared by a qualified biologist,vwuld be required to support the permit request. The HMP addresses Impacts to the buffer and offers measures to preserve and protect the bra or mitigate impacts. A copy of the Fish and Wildlife Habitat Conservation Areas chapter is enclosed. It includes details on the contents of an HMP. A preliminary review of the area is required for this proposal. As noted above, enclosed is a copy of the FWHCA chapter and a list of consultants. The consultant list is title"wetland consultants", however, several of these businesses may be capable of conducting the review. If you have questions about the review or require clarification of these issues, please contact me. I 6/1/2004 2 of 2 BLD2004.00735 Mason County Permit Assistance Center Planning Intake Checklist Owners Name: ��C 'p (A Date: J� G Project: Reviewed By: Commercial Development: YES O Comments: Planner: SAL GBM RAM DMJ TSC Site Plan: ?' North Arrow pP Property Dimensions: Streets and Driveways Shown. Road name: All Existing Structures shown with setbacks o Well Location, Septic and Drain-field Shown with setbacks Identify all surface water(streams ponds,shoreline,wetlands, et .) ❑ Topography (slopes). /v 4L 25 !� t � Q Or Proposed Structure Setbacks(Direction/Setback): F::_/ 25' R: V4 / I "S 1: /�_S2: r= / � 11,t Utility and Drainage Easements: Yes if yes enter condition#5022) Other Easements Accessory Appurtenances County Access Permit Needed(add condition 00010) State Access Permit Needed(add condition#0020) Standard Conditions to be added to all Building permits that planning reviews:#5019 and#0700 ---ro Pe* Shoreline and Planning Info Setbacks: Shoreline: Slope: Shoreline Designation: Comprehensive Plan: Rural Zoning: ❑ Not Applicable ❑ Agricultural 0 RR 2.5 5 10 20 ❑ Urban ❑ In-holding ❑ RMF ❑ Rural 0 LTCFL 0 RC 1 2 3 ❑ Conservancy ❑ Rural ❑ RI 0 Natural ❑ RAC ❑ RNR ❑ Unknown ❑ RCC-Hamlet ❑ RT ❑ Urban Growth Area ❑. WR ❑ Unknown ❑ Unknown Water Body(type of water if unnamed): SEPA: Yes No Unknown Flood Plain: YES NO Unknown Map# Aquifer Recharge: YES NO Unknown Map# Tags/Cases: RLC/SPI Case: 6-Year Dev. Moratorium: YES NO Eagle Nest Tag: YES NO Other YES NO Addressing: Check box if needed ❑ Reviewed by: Rmbet 13 R t4 SGi4(r,12 OW.& NLcA- 9 XA nl - qo T W� C_..¢ tit I 1$o I BUILDING a a � F�� 1�X I: �erp L L , BEDROOM L L l L L x .L DING arx�,r +axirr LLL LC LLLL50. � f L tom_ + �• Hoine uvm ROOM LL �6wx1N! L L raax�+o Fr I LIBERTY ANNIVERSARY DOUBLE WIDE HOUSE SQ. FT. 1284 QG285263 09L34906XU DECK SQ. FT. 265 TOTAL.1549 Sr. 28x58 BASE PRICE: $ 52020`00 OPTIONS SHOWN: DLX. .EXTERIOR PKG. 40 GAL. HOT WATER TANK EXTERIOR FAUCETS 2EA. FIBERGLASS TUB/SHOWER METAL FAUCET PKG. OPTIONAL FRONT PORCH 16SF. WOOD ENTRY 8' EXTERIOR SIDEWALLS 5.5/12 ROOF PITCH ARCHITECTURAL SHINGLES ADD KITCHEN PANTRY LIGHTED BATH FANS 2 EA. ROCKER SWITCHES REAL OAK -CABINETS TILE BACKSPLASH THRU-OUT TILE SELF-EDGE THRU-OUT TILE BATH COUNTER TOPS ACRYLIC KIT. SINK PORCELIAN LAVS BREAD BOARD ADD 3.653 WINDOW ENLARGE WDO. 6' SLIDING GLASS DOOR GRID WINDOWS ADD 3036 WINDOW ADD 7612 TRANSOM WDO. 3 EA. APPLIANCE PKG. #1 TAPE AND TEXTURE DRY AREAS. TAPE AND TEXTURE KIT. BATHS ROUNDED CORNERS LET THERE BE LIGHT PKG. CHROME BATH PKG. PLANTATION BLINDS LEVER HANDLES 6# 1 /2" CARPET PAD DLX. CARPET UPGRADE LINO LOG SIDING 9LT. EXTERIOR DOOR EXTEND BASE CABINETS PRICE AS SHOWN: $83,6.20..Olt 5-04-;04 .mu Rs , Jun 04 2004 9: 39RM HP LRSERJET 3330 P. 2 66/02/2004 23:06 2536535405_ PAGE 02 86/83/2004 11:38 2535012754 11LAt "W fe. 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