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HomeMy WebLinkAboutCOM2000-00014 Final Break Area and Deck - COM Permit / Conditions - 11/15/2000 PERMIT NO.: BLD MASON COUNTY BUILDING PERMIT APPLICATION 426 W.Cedar/P.O.Box 106,Shelton,WA 99684 Shelton 360 427-9670 Belfair 360 276-4467JEIrna 360 482-5269 Seattle 206 64-6968 APPLICANT INFORMATION �iiONTRACTOR INFORMATION' Owner KbO4 S-GfR5VA1 ontractor Name Mailing Address 7j2 C, (,-PCevww4ii iling Address City ( �yfeF+✓ State WA Zip Code ""?d�01 ty State Zip Code �--- Phone(3ic 0 ), ";burg Other Ph. h. Other Ph.( Lien/Title Holder Ez rr Contractor,Reg. Address iJ 17 Expiration SI PTIrw/VIFATER SYSTtM INFORMATlON-Connect to New Septic Existing Septic t onnect to:Sewer, System Nafne of Sewer System Well. Water System Name of Water System ' PARCEL INFORMATION-12 digit Tax Parcel No. tt X.2 ft #ire District { Legal Description- 4.F- ". c r= Vo4 :3 i J 4,04�1FFN5S ¢ er Site Address(Please include street name, street nurnber and city) Directions to site Mr. dF / 4�N�_�lel? f3tlr+ ►�Ir+:�, ,t l' • { Will timber be cut and sold in parcel preparation?(Yes/No) AKW Is your,property.within 200' of the following: Body of.Water(Name) Saltwater Lake River/Greek Pond Wetland Seasonal Runoff Stream $lopes or BI ff�. 1 TYPE OF JO$New Add Alt Repair Other a of Building oorns No. of Bathro6ixts` SO BAIkB F60T'AOE-1st'Floor Znd Floor 1 Floor ^Loft $ase;ment Deck 3 Other ` sq. ft._7+dD a)'age Attached"—Detached Carport Attached Detached, i BILE W4•ME•INFORMATION�.Make Model 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. NOTICE: THIS PERMIT BECOMES NUL &VOID IF WORK OR'CONSTRUCTION AWTFfORtXEd IS NOT COMMENCED W11TH1N 180 DAYS"OR IF CONSTRUCTION WORK IS SUSPENDED OR;ABANDONED FOR A PERIOD,OFA?.O DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. . ;PROOF OF CONTINUATION OF WORK IS BYMEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents.that the information►provided is accurate and`grants employees of Mason County access to the above described property and structures for review and inspection of this project. AcknoMedgrt►ent;of such is by:signature below: OWNER AFFFIDAVIT-1:certify that I am exempt from the requirements of the CONTRACTORS AFFIDAVIT-1 certify that I am currently registered as a Opotr ctor.Registration Law R W.18.27,and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements,€fer which this permit is issued and that all work will be done in requirements regulating the work for which this permit is;issued and all work c ,nforrgance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without aproval. first obtaining approval ll Date. �+ X Date FOR OFFICIAL U E`BEYOND THIS FONT H: Accepted by - Dated_ Submittal Amount•,Oue Receipt No. OWN 1122UR MO." B tflg• ispartfiRnt Oct Cf u' T e Constr. m Plannifig,Department ri EI-E'ntal Health Department s Department l • ?r Val,�atiorr$ .. a ,ao- ;�. s.h,,h< ^^fE .r sL'ti L r3 > r< a 'h��rt J a• tt?.t. `' •? •.c€ t} ,: . > .::.,-:.,-:,:,•.::a s> h.. hs:•.$: ,r,.»;r '.. .:.•:..::::::.,. ... :,$x.., f+..`2 :?.:•..y.•.::a.,ah:,,c,.n.,.y:.::..:.,•:::::•.'fi.<v:.,v.,:.:.�...,.vr3' :..::y..t:: 5;. ,.::f,. r....•�:,r><.a.:. Building Permit Fee Site'lnspection Plat' Review Fee, UFC Plan Review Pee Pluirtbing;& Base Fee Public Works Review Fee Met hanieal&Base Fee Other Wood/Ges/PelletStove Fee Other ' ,Violation Fee Pre-Paid at Submittal` _T4TAL`F�BS ; PERMIT NO.: BLD `I ly MASON COUNTY BUILDING PtRMO APPLICATION �l ° 426 W.Qoor/P.O,-Box 1 ;Shelton,WA 985" Shelton 360 27-9670 Belfair 360 76-4467., ,ma. 390482-6269 Seattle 206 64-6968 APPLICANT INFORMATION 0 TRACTOR INFORMATION' Owner ontractor Name Mailing Address " X6 F. C- ls� ar t�� ailing Address City�,triffs#�J zState WA Zip Code t j ty State Zip Code Phone . ,� -� Other Ph.(_ :( ) Other Ph:( Lien/Title Holder: *r sr 0A#4Contractor Reg. # Address Ure 4 Expiration 'SEPTIC/WATFR SYSTEM INFORMATION-Connect to New Septic Existing Septic � Connect to Sewer Sis'fbw Name of Sewer System Well ,� Water System Name of Water ystem' PARCEL INFORMATION-12 digit Tax Parcel No. /;L it 3 1 / I'll / `7 ey 10 Fire District _t- : ` Legal Description L tt i re tJ r `A " ` y 06 f,0 : ('Rvew, ( cs a. Site Address(Please include street name, street number and city) Jk)*I t e'. iere. Au rf&*rW;�. Directions to site / r� Hicrtrirrt l9 . Will timber be cut and sold in parcel preparation? (Yes/No) Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluff.: TYPE OF JOB New Add k Alt Repair Other se of Building Describe Work * - r cc,- +iE rs / r e� =gym IVo,,of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Floor , t Floor Loft Basement Deck 336 Other sq. ft. "Garage Attached Detached Carport Attached Detached =.J MOBILE HOME INFORMATION-Make Model 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. 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 owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER Al2FIDAVIT-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a Contrtctor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining approval. X rev.. F Date ; bet of X Date FOIR OFFICIAL U§E BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. ..V}✓nr.^�..... ... .. JNw ...:..:L !:..;:;.v'Y. 1 v'v'w:'S::ii: :i� ?::vYY::' • 8ti#Id .g Department �; L. Occ Group Type Constr. Planning Department Environmental Health Department 3 Gt;a Public Works Department Fire Marshal Valuation $ .............. ........................... Building Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing & Base Fee Public Works Review Fee Mechanical & Base Fee er L�u hAj ZSoU Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal ( ) TOTAL FEES — PERMIT NO.: BLD MASON COUNTY I I r ,BUILDING PERMIT APPLICATION ' 426 W.Cedar/P.O.Box 186,Shelton,WA 98684 Shelton 360 427-9670 Belfair 360 276-467, 'lma 360 48 -5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION I Owner ontractor Name Mailing Address .370 E. G-PtirdWw4tj Mailing Address City C' c►rEb%J State 6dA Zip Code 174fiWk ity State Zip Code Phone(3u o ,�')S--6sx'o Other Ph.__} h. ) Other Ph.( ) Lien/Title Holder (Vesr dawr jfAssc Contractor Reg. # Address Qjej3jW Will ,t7► Expiration / , i i 4 `SEPTIC/WATER SYSTEM INFORMATION-Corinect to New Septic Existing Septic ?C Connect to Sewer System Name of Sewer System Well Water System Name of i Water System PARCEL INFORMATION-12 digit Tax Parcel No. I�L 13 / / /Y / ev 10 Fire District_, { Legal Description GAT " r Val. 3 trim ,I'4avEats 3W E SiteAddress(Please include street name, street number and city) 10.11i / E. X;f4- 4. ieTv, it-om Sl .. { Directions to site f.!r-Mf. S. Ofr /gtt`?f/ l�lt�h NKc�l�btTf9 • Will timber be cut and sold in parcel preparation? (Yes/No) Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or BWfs TYPE OF JOB New Add Alt Repair Other a of Building Describe Work Gt A cN a i �, 4 E o f Bedrooms No.. of Bathrooms SQUARE_FOOTAGE-1st Floor 2nd Floor 3 Floor. Loft Basement Deck 336 Other _ sq. ft.J Garage Attached Detached Carport Attached ` D ached ILE HOME INFORMATION-Make Model Model Year I Length, Width Serial No. No. of Bedrooms No.of Bathrooms Type of Heat Purchase Price $ Replacement Unit ?(Yes/No) Installer Name 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 1S BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the l information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project Acknowledgment of such is by signature below: OWNER AFFIDAVIT-1 certify that I am exempt from the requiftaments of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a i Contractor.Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance _ requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining approval: X Date Z14 of X Date FOR OFFICIAL USE BEYOND THIS OOINT Agcepted by Date- Wbmittal Amount;Due Receipt No. I •-; ,y.�{S ;j �y��,,.ii�5 J" .y.�t@ , >`i`t:�`:-`f?rJ Bulldintg.Department ... . g z-t- i Oct Grow Type Cnstr. U �... Planning Department: Environmental Health Department, ; i - , f Public Works Department i Fire Marshal t 1 k, Valuation $ SY Y.......•iii:•:::•:s.:::: ......... ...... ............... :,......}-::{.fin ..... ......................... ... is •i:•..., ...::: S is ...:........... Building,Permit Fee Site Inspection l Plan Review Fee Plumbing& Base Fee 34 Public Works Review Fee 61�ianical &Base Fee Other r Vtlp04/G3 /Pgjlpt Stove Fee Other � Pre-Paid at Submittal: l TOTALFEES i FORM MUST BE COMPLETED IN INK PERMIT NO.: PLEASE PRESS HARD MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar/P.O.Box 186.ShMton WA SON Shelton 0 27J670 Beltair(34011V Elms 2Mfigft fjftft ONW41-04111 APPLIC 1RWTION CONTkACTOR 1WO MATION Owner Contractor Name Mailltlg , t�eais cy+r./1 , Mailing Address C State_M' Zip Code 7&Vg City State Zip Code Ph t Other Ph.( ) Ph.( Other Ph.( Lie Contractor Reg. Adore , A&AAration / $ IIItA, onnect to New Septic Existing Septic_2� _Connect to Sewer System Name of Sewttr PARCE4 12 digit Tax Parcel No. I Z- 31 / ( / `l i0 Fire District Legal Desotipt rt #1 3 ,e, Site Addtsss(F'lease street name,street nu ber and city Directions to site l Nif S', eF c-�tis1 a �}o�tosr' ram , M dafter 1 Is your property within 200'of the following: Body of Water(Name) Saftwater Lake_River/Creek Pond Wetland Seasonal Runoff.Stream Slopes or Bluffs New„,_Add AIL Repair Other Use of Buildi J1f s"T.aeri►hs1 F a Q»da rr...- —u Lotalpn .PbtturiNlnits 1st Floor tarage 2nd Floor Basement Clo PL r; S(Show Number of each) MECHANICAL UN(TS Fuel Type:EIectric Fhdtft No of Futures Fees L.PG Natural k3as Heatpump Tts TvDe of Unit No. of Units Fees WO'Basins Furnace 11341h Tubs Heatpumps Shimors Vent Fans WOW, Heger Propane Tank Lax"'y iNstw Gas Outlets Sinks ( Wood/Gas/Pellet Stove DWroasher Direct Vent? Other Other Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTUREIUNIT. tlCrtiAEB NUM A VOO F WORK OR C0 7TON,AAITHOrtIM is COMMENCED WITM 180 BATS OR IF . aM SUSP&DP.CI OR ARIIDDONED FOR A PE lIOD O<`10 OATS MANY, AFTER THE WORK W COMMENCED. "OF W01mc 1S BY MEANS OF A PROf3 S 94SPSCI IM The owner or on owner's Whalf.'represse is that the p erYtplad is Acwrate and grants s aptoyaa of Mason County access to the above de a properly and structures tar review and nipd.1llis project. Acknowledgment of such Is by signature below: 000 Aipi+I*VITd coaldfy that I am exempt from the reqL*wnents of the CONTRACTOR'S AFFIDA . 4 certify that I am currently registered as a Cant ' �IMon�RCW 18.27 and on aware of the ordnance cantragtor n fire ale of and that I wn aware of the ordinance petrnit Is bond and t st ati work will be done n ragttllelr�Mrlh r gtllatlrtq d,e for wtrich liras pemA is isscu jd and am work etwo a star/be made wtlhout first obtanirlg i � r9 app�• therewith. No dmrpes slits be'rhade wivwut Iapp�• All X Dale , . lG Dde FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. coo. Constr. Plarming DapprOnent 7!7 Other Other se � UFC Plan Review Fee Fee Offer Fee Offer 51oNrFus 131s4'aid at soblaitfal TOTAL FEES FORM MUST BE COMPLETED IN INK PLEASE PRESS HARD MASON COUNTY PROJECT SITE INFQRMATION Case No. Name • Q�N ��C-ge-C41-'/ PARCEL NUMBER 12 Z3/-/'/- 9,ft/6 Date /G, OD_ SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicotiong N, S, E, W in relation to the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography Well Location (including adjacent) Drainage Plan Names of Streets Easements Names of Fronting Streets Septic System DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line. adjacent property line4 , , E-adjacent property line I I I I I 1 I 1 I 1 I 1 1 I � I t t t 1 I 1 1 1 I I I 1 1 I I I I I I I I I I I I t 1 I adjacent property lined E-adjacent property line SAMPLE SITE PLAN adjacent property lined 3�0 E-fidjacent property line �I I D 30' fife=Sarty� �f- �I .gEASC7N AV I afi �6fTIL_�,I ►wnneo- � ,Gaaew I aoPoxn saptla �'-�, l� I• 1 J I 7� VACANT 1 GARA66 I ravie�ca T A"XA& LTUJLALso SC' I � � I ' /DO I r c...eLL I I I I i /00' I % I t adjacent property line-> t '. c 4-adjacent propertV line TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the degree of slopes. See sample topography profile.) SAMPLE TOPOGRAPHY PROFILE dis+a»u. to dis't'ar.GG to S�epa fic¢ t 4 ley dia+ae+cwz to a Signature Date 2X 6 tN R NAIL- 4) To EXts% s 74J DS, -RAF i ER 5 ANcydAf3D-WlTH -- sADD46 S (Ty P) . . _f7X1? .w�NAeRR 71 6" WALL Dotal SLAt3 /o� Ofi SOOT]-/ E L-E v (L 00K JN G IV OR T H /o_o, f'lX-Ep .SL-I D)N6- FOR TABLE 7-6 WIND BtiEAI{ IDovR WIND BA4AK �----- 10- 7 WEsT ELEV „ (,L<ooY)N(, E ST o^ IN Clcl V v � j n W J 41 a- r N Ir -I T W 41 Q to IN tal fl ku Z x k (Z< W v z Cl < c N �c_efl � CQ w o h o d I, 4. o ff? �, v E— � � � � , Li- w % v � `z !D o N ,� q O o V Q I Y t a (D R m n V o cnz m v c: C -' 11 O 19 � � � mA a 21 g 8 C) c�� i1w � .a � Qgoo Co � m � v m � �° � pro c ( c o X w700 nO CCD (� o r Djj Z Z fA Z O �► O �Q m G� fib coIz OD -n 0 -4 Z oD 0 z CA W � c w m 0 -1 W gm s ji -n M •• 'n n r 9 m n z m QSL 1 T X o ° n CO) � c p cn r o U) N z m x °D p 0 �; T m 3 mpo m r 3odc co) 0 c, 3 5 �° s = N � Om Z m o o � atn c� occ O G) n °, ', kwaoo � �' � o rD- CA -p m CL � o z m —1 � o� IA n rn X O O 0 OT p CD r m �, �o " m a - o r O O 'n pp o 03 w e �, � m -11 CA m anm C o Z -n o o: fmit rn X c mom m 3 X - 0 o= O O mm CL vW Zn cogv b , o g C) �• 4 000 4'rn N O o C) CQ � X >C �X nt7(7Z - -` X„a� - D a c7� tp "� 406 a -� � Aim ACC m °' � Sl a so �� 0 Z ma Q m c� a — "-.. O � � p m < m — m Z -' ea -I m c ©19cO -1 m ) Q � _ a m m m — Z aka ss' O �cm `'� `m' � �' t� _ �j a ^°cr go u Ow W 333c X � a ° Oz q �a Q 2 Z p KI 3 — � Morn W yCOD o 8 C rvnQ' rn � AI CM FL _ St 5 g � ; mXtaD -1 A ? , 30ag a m � n Q � nOr- m 4 = m.VO o c nm 5 _mc I10a o ` c ? npr 2m. N p 1 = mom, coo ND CDa m rn Zpv mm 7$ b Z �—� o ? c ;Opcog o Of W °° o -Nr� o o a 0 - aw Z — mmv� 7 cni a �ii' k CQrn m m 0 o y a o Zp o n ssw � a � Z 0 � P. Z °o CZ �m -< m OO ° m -% a n e mo. m t� "iZ o n m0 m -a a) -� N OR ;: caNm mo � a mC) i N Z � r c O 0 c com = o '< cn n z > v, CD 4. 0 I N -i Cl y 0 Q Cr =y "n (,3 c (D m o• � d � a � � a �o p -7 a m y 0 ® o 0 o l a fA C o m 2 -+ a Rt o �' o0 In o c � o m m 'a o ° fJ 0O o � W N N m a a .o 0 to B ? W n o DCOCAI vol 1 0 r: o 3 w W =r _ m 50. „ COR CD $ N m 0. "CD r ? o'N FL 40 y! J CD N g a 0 cm ft m k i r Cam' MECHANICAL MOBILE HOME .� FOQ Setback date Ribbons date by Gas Piping date by Foundlm Wails date by Set Up daRs by INSULATION date by BG/SLAB Insulation Floors Final date by FRAMING date by date date Wall FIRE DEPT. PLUMBING date by dateby OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date J/`. ,C5"—..6_f) by Z date by v /,eO A AS'--c5cc) �— C'j7' Z � VI 9l c6