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Date By Date By FINAL INSPECTION Water Line Date B y Date O By Date By CD CD '3 - a ARo4f�tG GLt t 1 w c GL m 0 ML a 0 o yy r., 5 y N CD N ~ O Z W w 0 r �, , ,� Building Permit # MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location �, �l f. &� N 161�kbS_ kl'(d(7('A � This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items Listed below must be corrected to gain code compliance 6. t&Y--"C I r Ak., r)U'f' i ICx� 'C� (,i 1-0 L,'Y 4. L Gi r/ ci0 Gc i�C'�S ►' j�v► ' yY1gnln ctc 1 c.�:' 14, 3 IUD C.'� � S�<=C�► -� = -- �n. �G ec-tr`ic�:ti You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing G-Make corrections, items will be checked on next inspection ❑ OK to ❑ This is not a complete inspection Department 6d Date 7���U Inspector DO NOT REMOVE THIS TAG PERMIT NO. BLD � MASON COUNTY =:y BUILDING PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 $} Shelton(360)427-9670 Belfair(360)275-4467 Elma(360)482-5269 Seattle(206)464 6968 , . On the Web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Contractor Name Mailing Address 1�tt 9- ' '- t aiIingQddress city I?_11c;lf/5 L� State'Zip Code City ; , ty; State f p Phone �-1,'r' tether Ph U .3 '� -- hone, "Other Ph 3 n �. _ �' Contractor Re # t `z Lien�tle Holder r� r � >_�� r ��-� 9 -.L,�• � `' p•--- E-mail Address E-mail Address SEPTIC/WATER SYSTEM INFORMATION-Connect to New ; Existing Septic Connect to Sewer System—Name of Sewer System Well Water System Name of Water System PARCEL INFORMATION- 12 digit Tax Parcel No. _ si` / / ,` Fire District " '3 Legal Description Site Address(Please]include street na e,street number and city) � t-� C>F:-.�___t I�, •- a' �-�' � �,r -'-� -�",� Directions to site '' Ah 1 ca— Will ti ber be cut andsold in parcel preparation? (Yes/No) Lake ­'" � River/Creek - Pond - Wetland Seasonal Runoff Stream -- Slo es or Bluffs PERMANENT RESIDENCEM SEASONAL RESIDENCE❑ TYPE OF JOB-New Add Aft Repair Other se of Building % ''' Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action? (Yes/No) Describe Work ik j r'r %t� a .`a .,j ,. :;• , r . , No.of Bedrooms. No of Bathrooms SQUARE FOOTAGE- 1st Floor 2nd Floor -�-� 3rd Floor=• Loft Basement - Deck Other sq.ft. Garage Attached Detached Carport Attached Detached MOBILE HOME INFORMATION-Make L-' - ' f f o el el Year Length Width Serial N, 1 f �-� r No.of Bedrooms%'") No.of Bathrooms Type of Heat ' "' Purchase Price$ ;� Replacement Unit? (Yes/No) Installer Name -yi C L Certification No. , NOTICE:THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION.The owner or agent on wmer's behalfi mpresents that the information provided is accurate and grants employees of Mason County access to the above described property and structimWor 13eN4w4nd inspection of this project.Owner/Builder acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a the Contractor Registration Law RCW 18.27 and am aware of the ordi- contractor in the State of Washington f)d ittdt I ft;9P�c8 to ordinance nance requirements for which this permit is issued and that all work will be requirements regulating the work for which this permit is issued and all done in conformance therewith. No changes shall be made without first work shall be done in conformance therewith.No changes shall be made obtaining approval. �` ( without first obtaining approval. X ' Y Date ti' X Date POR OF ICIAL USE BEYOND THIS POINT Accepted by Date _' Submittal Amount Due i . ,' `_ Receipt No! J �r�y A ,ItE Building Department i A Occ Group Type Constr. Planning Department Environmental Health Department Public Works Department Fire Marshal Valuation$ ' ... h � i..y 'Si s :�: n s ... ✓�y�s�, :.p ..G .VSt,:, -� �, :, e sr Building Permit Fee Site Inspection Plan Review Fee - EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee --_ Other :+ ,; ;' 4 t Wood/Gas/Pellet Stove Fee State Fee '' ;!ZQ 6 Violation Fee Pre-Paid at Submittal TOTAL FEES oN-STATE MASON COUNTY c ° DEPARTMENT OF COMMUNITY DEVELOPMENT o A°u �= Planning Division y N T P O Box 279,Shelton,WA 98584 ooJ Y ~ (360)427-9670 1864 NOTIFICATION OF INCOMPLETE APPLICATION February 24, 2003 PATRICK MARTIN 1800 NE LINCOLN RD #4 POULSBO WA 98370 Parcel No.: 122297890053 Project Description: MANUFACTURED HOME Dear Applicant: You have submitted a permit application (case no. BLD2003-00136) for proposed construction or development in the county. Upon review of your application, I have determined that the contents of the application are incomplete 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. Please contact me at(360) 427-9670,ext. 295 if you have questions. Sincerely, Y L Pam Bennett-Cumming Land Use Planner Mason County Planning Department 2/24/2003 1 of 2 BLD2003-00136 MASON COUNTY DEPARTMENT OF HEALTH SERVICES f February 14, 2003 PO BOX 1666 SHELTON, WA 98584 SHELTON (360)427-9670 FAX (360)427-7798 ELMA (360)482-5269 PATRICK MARTIN BELFAIR (360) 275-4467 1800 NE LINCOLN RD #4 SEATTLE (206)464-6968 POULSBO WA 98370 Case No.:BLD2003-00136 Parcel No.:122297890053 Dear Applicant: Your building permit cannot be approved by Mason County Environmental Health until the following are completed and turned in: Application for Water Adequacy " m Please see comments at the end of this letter. Please call me at(360)427-9670, ext. 279 if you have any questions. Sincerely, Amanda Reynolds Environmental Health Mason County Health Services Comments: I need a recorded right of entry or a design for a three bedroom septic. 2/14/2003 1 of 1 BLD2003-00136 vow, NOTIFICATION OF INCOMPLETE APPLICATION 2/24/2003 Case No.: BLD2003-00136 Comments: Site review was performed by planning staff on February 21, 2003. Site is a partially cleared lot off Bay Heights Drive. There is a drainage ditch on what appears to be the lot line. This appears to be constructed to move runoff from the road area down the slope which is part of the subject lot. Other than the area cleared for the building site and the drainage ditch, the sloped area of the lot is wooded. At the base of the slope there appears to be wetland vegetation. Without a wetland delineation it is not possible to know for certain, but the wetland likely has either Category III or Category 11 setbacks. As long as the proposed development stays at least 100ft from the wetland edge setbacks will be met. The vegetated slope between the low wet area and the building site is considered slope and vegetation buffer and must remain undisturbed per Mason County Resource Ordinance provisions (Landslide Hazard Area chapter 17.01.100 and Wetland Chapter 17.01.070). Landslide Hazard Area chapter 17.01.100 of the Mason County Resource Ordinance guides in the review of development adjacent to slopes. The proposed residence and garage will be on level ground. Adjacent to the level building area is a steep vegetated slope. Review of the building permits requires completion of a geological assessment by either a licensed engineering geologist, or a licensed engineer. The geological assessment should address the site during and post-construction. If you have any questions please do not hesitate to call me. I can be reached at (360)427-9670 extension 295. Both the wetlands chapter and the landslide hazard area chapter are enclosed. 2/24/2003 2 of 2 BLD2003-00136 UU CABINET � o U BED ROOM BATH#2 ----FAMILY ROOM TTi ---_ U l BEDROOM#2 OFFICE �•, _l ' DINING ROOM u h 0 �/ `\ LIVING ROOM KITCHEN PANTRY / CLOSET TER BEDROOM �UILA L:lU U =UWH I SHOWER U _J / MASTER BATH J JAN- 27-03 01 :57 Pi-t RLAC:KHAWK LAND CO 253 R51 2764 P. 02 MASON COUNTY � ` DEPARTMENT OF HEALTH SERVICES •-.1°rtvlr metilal Heahh Parsonalll�ealrh , .; PO BOX 1666 SHELTON, WA 98584 c LOCAL(3(50)427-9670 13ELFAIR(360)2754467&4468 r.. Application for Determination of Adequacy Instructions '. z'; :t R. A. tlti t St Ott , ' � �• t. too �� =a 'l;'�ts=fat . :�.' :�; � G .S W j PART I.- Applicant/Parcel Identification j Name of Applicant Date Mailing Address Telephone Assessor's Parcel Number �(r(r Type o Yi'aterS sle�n: Check One): RPt?St77n orA ficattionr Check One): Ef>. F�. ❑ Public/Community Water system(2 or more Building permit ,.: wnneutotss} o Land use application,If SO-- < Individual water source tone eonneetton),if so.. o Divisiort of land o well it of Parcels?_. o Springlsw face water SPH9 �..., << ❑ Ocher expla' ) a Boundary line adjustment ❑ Other(oxplain) 7 !PART 2: Water System Information ` �. ::Complete the section appropriate for the type of water system being evaluated for adequacy: Public Water!&slem _— ` Name of Water System ,. Water Facility Inventory (WFI)Number; s;•, ; 04. ';1 .0 The water purveyor has filed a letter granting blanket hookups to this water system. 1 am the man f this water system. The water system ben approved for services. There are resentl connections to use, nis will be the - connection. water stern is able.and williisg to de water to this(these)connections wt out exceeding the limps of the water system oruny limits set by state and local regulation. r ,. r ignatare of water System Manager Date y N.-IIVDATAWRCHIV l0,4TV)UDJ.HT update:March 21,1999 3�n V?, 39Vd •`INdSZ:Z SO-91•-8dV `99V0 5LZ 095 I `3lV1S3 IV38 013U :h9 1N3S