HomeMy WebLinkAboutBLD2001-00637 Final Addition - BLD Permit / Conditions - 6/27/2001 m
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l CONCRETE MECHANICAL MOBILE HOME
t Footings'Setback date by Ribbons
date by Gas Piping date by
Foundation Walls date by Set Up '
date by INSULATION date by
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING FIRE DEPT.
date Walls
date by date by
PLUMBING AttOTHER
Groundwork 's
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
31
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Building Permit # MASON COUNTY
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
Job Location A213 G{
This structure has been inspected by Mason County Building Department
and the following VIOLATION of County Laws and Ordinances has been
f0 UPd:'J / Items Listed below( must be corrected to gain code compliance
le-
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S "ti — L. ►ioo, Cc s
L)C..� T .-•� p z�. �� Ce��K C e�1 e ��•C
You are hereby notified that the above corrections shall be made
BEFORE PROCEEDING WITH ANY FURTHER WORK
W Call for re-inspection when corrections are made before continuing
❑ Make corrections, items will be checked on next inspection
❑ OK to
❑ This is not a complete inspection Department
Date 2 2 — L L Inspector
DO NOT REMOVE THIS TAG
-s '1 . .
vo"CJAeTtl: MECHANICAL MOBILE HOME
t Fyotlrga• date 2 -•3-o ( wL �-� Ftibbaa
date 8 D Gm pov date
FowidatidnWalls date byUP
-� - INSULATION dateby
BG/S1,AB b=Aatbn Floors dal
by dye by date by
FRAMING Waft FIRE DEPT.
date by date by date by
PLUMBING `�Attle OTHER
Groundwork
e date / Z ` 3 -0 / by
D.W.V. WALLBOARD NAILING
to /2 -3 -0 / by date by
Water Line FINAL INSPECTION
date 2 -3 -c- I by c ,/ date by date by
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144N�.55 f C�-- C' e.c-�?N GIB e/ /h� !OY
BL7ildirig Permit # ( 1 MASON COUNTY
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
Job Location C)-� i 3 U "Pp-o iss,) 4,wg -Rd
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
(ACC-e-D OUT 'i RE Ce "'mil'/�1,
NZE8 L FrEn 4 s'r-.
eT r-607-iA ,1 t',,j o-Q- N��us
E iJ r� Lice _ Q.i l i� :� �4t?✓�C iZr
lJi3Z<.C43 RE-, AP-
g'✓✓ ,
Q 5PTf-1 l - t)J R,✓N 0 kA[3',f ye 'icy Gc�✓L+��-Y
v 0 '7-442
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
ake corrections, items will be checked on next inspection
❑ OK to ��� 4 P'eoc"d '
❑ This is not a complete inspection J
Department U i
Date f% Inspector 6)'C"-C-
DO NOT REMOVE THIS TAG
Building Permit # MASON COUNTY
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
Job Location 62 13
This structure has been inspected by Mason County Building Department
and the following VIOLATION of County Laws and Ordinances has been
found: Items Lifted below must be corrected to gain code compliance
r.
-7e,-vhL
,c! 'C '► C C.V 1
You are hereby notified that the above corrections shall be made
BEFORE PROCEEDING WITH ANY FURTHER WORK
X,Call for re-inspection when corrections are made before continuing
❑ Make corrections, items will be checked on next inspection
❑ OK to
❑ This is not a complete inspection Department
Date ! z � Inspector c
DO NOT REMOVE THIS TAG
FORM MUST BE I PERMIT NO.: BLD �" 3?
PLEASE PRESS f
MASON COUNTY
BUILDIN _PERMIT APPLICATION ��� .
• 426 W.Cedar/P.O.Box 186,Shelton,WA 98684
Shelton 360 427-9670 Belfair 360 275-4467 Elmo 360 482-5269 Seattle 206 464-6968
APPLICANT INF III.T914�IWTL'"T'�r3EN r._f. CONTRACTOR INFORMATION
Owner_UE � � Contractor Name wocf"611 QP35-rQucri Do Uu-
Mailing AddressfoU 11 EAST Mailing Address 2S Z L.—r S . A-Jt3 . STE ?�V 1
City,&,fr L"/N State W A Zip Code 9g2y 5 City' V-Qy16TZ--r0 -) State t%j� Zip Codef%
Phone 3( lo)?--)- - - 50 Other Ph.( Ph.(36o )4--V1-6il-7 Other Ph.(SG O )90lb-`19161
Lien/Title Holder Contractor Reg. # 1.30�TVAtc- 0 f,3P$
Address Expiration to/Z_/_ o
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic connect to Sewer
System Name of Sewer System Well__)�,_Water System Name of
Water System
PARCEL INFORMATION-12 digit Tax Parcel No. 1 ��� / _/ Co a%0Fire District
Legal Description
Site Address(Please include street name, street number and city) E
Directions to site EA.S 1 i 0 w rk0-40- A4-i4 ti iU 2..t EVPe-k--
�-eC.>P e-&�in,o -- 'Sc LP CN T0P OF v4I"
Will timber be cut and sold in parcel preparation? (Yes/No) IJQ
Is your property within 200' of the following: Body of Water (Name) Saltwater
Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or
Bluffs
PERMANENT RESIDENCE)Q SEASONAL RESIDENCE❑
TYPE OF JOB New Add_ Alt—Re pair Other Use of Building VES 1 D E19 T
Describe Work PPQ `Nto11 "2 s-iz,Ry gepaco-^ - DG(Dll t6--.to" oor- ¢_wf, I,-J 00 T
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 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 AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a
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 requir ents regulating the or for wh' h this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall done in conforman e t rewit o changes shall be made without
approval. first o taining app I.
X Date X Date On,Of
FOR OFFICIAL USE BEYOND THIS POI T
Accepted b Dat bmittal Amount Due r/ L/• ecei t No.�l�
P P
C/-q
..
DEPARTM.% V -W. APPROVE R!�NIiwD> CD�IDITIf�N �QDt S. ,......::: ::..
_.. ....... _..._ _ _... ....._............ __.
Building Departmen
Occ Group nstr.
Planning Department
Environmental Health Department
C 3Q?,J
Public Works Department
I
Fire Marshal
Valuation $
FEES �
fU
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee S U
Plumbing&Base Fee Planning Review Fee
Mechanical&Base Fee Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal ( )
TOTAL FEES
PERMIT NO.: BLD
MASON COUNTY
BUILDING PERMIT APPLICATION
c��a�
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
APPLICANT INFORMATION CONTRACTOR INFORMATION.
M ;? e1 K'ra .'7 E Y'a :w d� 7
Owner�..•-'.: Contractor Name
Mailing Address(e,Z , �'+,. .'-- t':a'" ° t�.`=. Mailing Address
City P,L # State Zip Code City r-.) Statev.)�'I, Zip Code i
o
"l5Qj Other Ph.( ) Ph. L 1- 6�i 14 Other Ph
Phone �k ,a�, /"�:•>"- -a
Lien/Title Holder Contractor Reg. # ?,)L> 9-1 ''- ,-.7 `, ,,EL I
Address Expiration a r'r
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic,�;/ _Connect to Sewer
System Name of Sewer System Well �Water System Name of
Water System
PARCEL INFORMATION-12 digit Tax Parcel No. s ";tom / d '_ / ' ` ' - Fire District
Legal Description
Site Address(Please include street name, street number and city) r
Directions t0 site ^ ``,"< "'T S AM+ k E9^y a�M_.h. r� S r _a4 ►",a dd r r� c.-x f ,t ti.=_. .. k-
Will timber be cut and sold in parcel preparation? (Yes/No) h,)O
Is your property within 200' of the following: Body of Water (Name) Saltwater
Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or
Bluffs '
PERMANENT RESIDENC54 SEASONAL RESIDENCE❑
TYPE OF JOB New Add y., Alt Repair Other Use of Building
#- ��
Describe Work P�.�3 I:, r 'S.af�rg f G77xst x"8 3��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 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 AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a
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 requirefnents regulating the yOor for wh' h this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall done in conformance t rewit o changes shall be made without
approval. first obtaining apptal. r
X Date
X Date
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date Submittal Amount Due Receipt No.
DEPARTIVlE ;1gW APPROVED DENIED CDNDITI+DN 0p0S
Building Departme 1,V Lr 7 �A
Occ Group - e Constr. -
Planning Department
Environmental Health Department
Public Works Department
Fire Marshal
00
Valuation $ �� 1
FEES
FPlanReview
rmit Fee Site Inspection
Fee - EH Review Fee
Plumbing&Base Fee 26.00 � Planning Review Fee
O-
Mechanical&Base Fee w'150 oO Other
A�O
Wood/Gas/Pellet Stove Fee State Fee ,\
LN
Violation Fee Pre-Paid at Submittal ( S^ )
TOTAL FEES
PERMIT NO.: BLD
2ESp l-UDlo37
MASON COUNTY
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
APPLICANT INFORMATION CONTRACTOR INFORMATION
Ownerl,j:�0 # C •w ►h +1."� Contractor NameVJ019'1`t-t Vzf-P 000a,5'r'tZt. 4_rt 0f-J t-L&
Mailing AddressZa7_1I f;.A5"T eao• ft yt-- -�, KO- Mailing Address'LVZ ?-,41NUA. AQ44 . `>"F � ''ZtD►
CityP�,t /t+a State w i-\ Zip Code Je—,151-4 CityF44L;lyle(47%>e.J StateWA Zip Code`\t 3 3-1
Phone(t Z •"R,"1f�ca Other Ph.( ) Ph. "i 61[ 7 Other Ph.(-60 )` 4b-��
Lien/Title Holder Contractor Reg. # WO! 14t 4-01 a
Address Expiration t U
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic _Connect to Sewer
System Name of Sewer System Well_�Water System Name of
Water System
P EL INFORMATION-12 d' it Tax P rcel No. L �'� l ` ,G1 / CC- ��C Fire District
egal Description
ite Address(Please include street name, street number and city) _
Directions to site t^.s n 'TV 42 V3 S Ns��.'y r+,a � '►udt� ex t G, r► � ,CJ�i
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
Bluffs
PERMAN NT RESIDENC SEASONAL RESIDENCE❑
TYPE OF JOB New Adder_Alt Repair Other Use of Building R.ES%DEN—r 1 Pii,
Describe Work
No. of Bedrooms No. o B m athroos SQUARE FOOTAGE-1st Floor I 2nd Floor vra kid"r
3rd Floor Loft Basement Deck Other sq. ft.
Garage Attached Detached Carport Attached Detached
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 AFFIDAVIT-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a
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 require ents regulating the yi✓or for wh this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall b done in conformance t rewit o changes shall be made without
approval. first o aining appr I.
X Date
X x� Date
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date Submittal Amount Due Receipt No. -
IJEPARTIVIE E W APPROVED DENIED CONDITIt�N coDES
Building Departmen7 ")< L
Occ Group T. e Constr.
Planning Department
Environmental Health Department
Public Works Department
I
Fire Marshal
Valuation $
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 ( )
TOTAL FEES
FORM MUST BE COMPLETED IN INK PERMIT NO.:
PLEASE PRESS HARD MASON COUNTY
PLUMBING/MECHANICAL 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
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner LEA t'i 661 MktZ-i I fJ Contractor Name Wce--fr1 Elcb C'nos-Te-OL.7not—I'u-L-
Mailing Address (oZV 3 = -T C -Q-,f V+EY'J Mailing Address23.1 wm" k\tE S-TE 1V I
City AL--Vr-s State WA Zip Code 5c�2- City' gKffi0Q:TGt.1 State WP- Zip Codegi333'7
Phone 31ct Other Ph.( Other Ph. 3toc 90g -9'1 e 1
Lien/Title Holder Contractor Reg. # wu T►-+ Q-: <- r-i'3 Pb
Address Expiration 4-&� / -4a- / c..; •1-1 C--
SEPTIC INFORMATION-Connect to New Septic Existing Septic_)�,—Connect to Sewer System Name of
Sewer System
PARCEL INFORMATION-12 digit Tax Parcel No. 1 Z Z 3'Z / "Z�1 / vG Z 1 Fire District
Legal Description
Site Address(Please include street name, street number and city) F-62- 3 Ga d►' tom% ute, pe- To-`-Yo
Directions to site r--AS-T 'Ty,-. Pc-" % 1>i-L'r y 'Ty a-►-% �-� �+ c►�►.� «?&
L 6>r P Q-'L"'!4 o t-10 -;S .: y P G"i Cs P lb i=- t-k+Is your property within 200' of the following: Body of Water(Name) Saltwater
Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or
Bluffs_
TYPE OF JOB New Adder Alt Repair Other Use of Building 1 0` ti -T1P�rl-
Location of Fixtures/Units 1st Floor 2nd Floor X Basement Garage Closet
PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric K
Type of Fixture No. of Fixtures Fees LPG Natural Gas A Heatpump
Toilets 1 Type of Unit No. of Units Fees
Bath Basins Furnace
Bath Tubs Heatpumps
Showers �_ Vent Fans
Water Heater 1 Propane Tank
Laundry Wsher Gas Outlets
Sinks — Wood/Gas/Pellet Stove
Dishwasher Direct Vent?
Other Other �D ELCG r�
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT.
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 AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contr ctor in the State of Was"ton 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 or k r whicl,this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall'be done in c n rman ther ith. changes shall be made without
approval. first btaining ap ov I. }
)( Date X Date
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date Submittal Amount Due Receipt No.
APPROt1E[i`'...::0ENIE0`: OOR[Dl1I:Q1U CtiDES
Building Department
Occ Group Type Constr.
Planning Department
Other
Other
,.
»: .......................
Permit Fee Site Inspection
Plan Review Fee UFC Plan Review Fee
Plumbing&Base Fee Other
LMechanical&Base Fee Other
s/Pellet Stove Fee Pre-Paid at Submittal ( )
Fee TOTAL FEES
PERMIT NO.:
MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W.Cedar/P.O.Box 186,Shelton,WA 98684
Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner ',-'Cad � `; ryy'N Iz-"I Contractor Name t„0"-
Mailing Address_6z..1 ',' EA, <.,--t t.. , 9Z, Mailing Address 2, 6y� . <. N.g E S-T� i v i
City State t-,atl Zip Code "� _ Cit State U Zip Code 3 2-"7
Phone('-(;LD ?-I's-110o Other Ph.( � Ph. �. ,�, " �; ',+i Other Ph.(3°.V c, 90 ) L,_�
Lien/Title Holder Contractor Reg. # o .:-t'I-t iz-
Address Expiration �F*Aw
SEPTIC INFORMATION-Connect to New Septic Existing Septic '_Connect to Sewer System Name of
Sewer System
PARCEL INFORMATION-12 digit Tax Parcel No. ! a 2. Fire District
Legal Description
Site Address(Please include street name, street number and city)_f2p2.I a tw,tz `V Ii:w t ate. f)e
Directions to site �..n t tea.-.. �orz. .ig°b� �.���a -v a,2_r..) a �- ..-t r��� c',9 t-
't,. Ph 4�,o a..a-,/\ cirri "�� S".Z fJ!`
Is your property within 200' of the following: Body of Water(Name) Saltwater
Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or
Bluffs
TYPE OF JOB New Adder Alt Repair Other Use of Building 9 E S I O i�:. 1-4 711`11,L_
Location of Fixtures/Units 1st Floor 2nd Floor�_Basement Garage Closet
PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric X
Type of Fixture No. of Fixtures Fees LPG Natural Gas * Heatpump
Toilets Type of Unit No. of Units Fees
Bath Basins Furnace
Bath Tubs Heatpumps
Showers Vent Fans
Water Heater �_ Propane Tank
Laundry Wsher Gas Outlets
Sinks _ Wood/Gas/Pellet Stove
Dishwasher Direct Vent?
Other Othe WA`-"" -- '
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT.
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 AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contr ctor in the State of Was>ngton and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done in requi ments regulating the ork f whic I,his permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall a done in c f mancPthere ith. ophanges shall be made without
approval. first btaining app ov .
X Date X c` 2-1
' Date +
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date Submittal Amount Due Receipt No.
Di##�TM�UT '. EVK ' .........APFtVIwW' ' I�I'IE#3DR[t)f#IQN CGIR€S
Building Department
Occ Group Type Constr.
Planning Department
Other
Other
Permit Fee Site Inspection
Plan Review Fee UFC Plan Review Fee
Plumbing&Base Fee Other
Mechanical&Base Fee Other
Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal
Violation Fee TOTAL FEES
FORM MUST BE COMPLETED IN INK
PLEASE PRESS HARD MASON COUNTY PROJECT SITE INFORMATION
Case No.
Name PARCEL NUMBER VA�na gy M_Q\n Date
SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the
site plan
Lot Dimensions Fences w
Existing Structures Driveways
Structure Setbacks Shorelines
Water Lines Topography S N
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 lined I C3 I 4�, �, ���, I Fadjacent property line
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Filt
5 i O�f i tl,;T] i ��
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adjacent property lined <' 2, I <—adjacent property line
SAMPLE SITE PLAN
adja�nt property line-� azo' _ _ E-adjacent property line
D so �sz�se,Rve gel
CREE14 \ I � � fi Honn t I Griatni
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1
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adjacent propert lined ; ► ' \; Fadjacent ro ert'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
d1.S+a .cam fin
1 � ruct4..r�
dcat�►,c� to
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7
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Signature Date
MASON COUNTY PROJECT SITE INFORMATION
Case No.
Name'`=;=1`' _ PARCEL NUMBER
Date
SHOW THE FOLLOWING ON SITE PLAN Show Direction by indic8tiong N, S, E, W in relation to the
site plan
11FLotDimensions 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 pro erties if on shoreline or within 100 feet of adjacent ro ert line.
adjacent property line I < I E-adjacent property line
I
a.
I I
LL I
.f
I
I
adjacent properly line4 ' . �, I E-adjacent ro ert line
SAMPLE SITE PLAN
adja1 nt property line4
I p 3zO� 30, Fadjacent property line
SEASO%J AL_
Crt�K G4aEN u I
I F � HOc..LSLL
I. 1 Pr10PasLD 5eP}C� ----�I
1*--- b c
VAGn,T i T C AMAC.4
30 I ,%
I� PP.cPosCD
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adjacent property line4
I �Ate` \i Fadjacent ro ert 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
E dist�r.�m to
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Signature Date
C 5-1�5v
Bvrr.DsrrG PSRMST � T3�fool -av(�3� _
DATE -7/g/61
Planner Area
Parcel # 22 0(--)2
CHECKLIST FOR PROPOSED CONSTRUCTION
Comp Plan
Designation UGA RAC RCC RA - For 1H
Yes No
[ ] [Within 200 FT of SMP designated shoreline, wetlands,
etc.
Where?
[� [ ] Located near possible Critical Area,
What Kind? (Wetlands, Streams, Lakes, lope )
[ ] [LA RLC already done?
[ ] [ ] Proposed construction within floodplain
[ ] [kr' Eagle nest
[ ] Vv Six year moratorium
[ ] [✓� Multi-Setbacks
[ ] • (vj' State road access needed
[ ] M Commercial Development (parking standards, sign
ordinance, public works review, other applicable
agencies)
[ ] (Mobile Home or RV Park
JUN-21-2001 13:02 FROM-PENINSULA TRUSS +360-275-0475 T-5T0 P.001/005 F-488
N° 1 2710
Fax(360)275-0475 ORDER REOZ ST
f A Division of PLC Enterprises,Inc. /_{� y►�
` NAME 1�f b r�1, Ent� LLJn S�rucT1 C'n JOB NAME pe-W�t�Inarl)"n
ADDRESS DELIVERY ADDRESS � C��l 3 Gap ew hop A
PHONE `i 7 7 — (P0 PHONE
DATE TRUSSES NEEDED LOCATION (LEGAL DESCRIPTION)
DEAR CUSTOMER As of thle date me folk wing ordor of trusses and domporgm has oW antlered
as!mown ttoww. Unless wa art notittod of any disctepancles wshln 48 hares,wo will proceed wim
prodjcl,ttn. A:bUSse►eta unique for VW siluepttrr,return or raneeltetion aoydnd that Ilms it not
.Ilowod wunouc permission.
QTY PITCH SPAN OVHG CUT TRUSS TYPE PRICE TOTAL
EACH
rx),& '' ty F. S. 66{1 t
13 4IL �a' ! " LDrnrhon
SPECIAL INSTRUCTIONS
TERMS ins uHn,NET t0ln,O.A.C. F.O.B.PLATE LINE OR SITE PER CONTRACT,PROVIDING 9UILOINO I$ACCESSIBLE,DRIVER IS SOLE JUDGE OF ACCESSIBILITY. I.59�pet ptOnln t7tet9ed On tlslpvont aeedunu.
WARNING:BACK CHARGES WILL NOT BE ACCEPTED REGARDLESS OF FAULT,w1mOUT PRIOR NOTIFICATION BY CUSTOMER WITHIN 9e HOURS AND INVESTIGATED BY Asmunsula Tfusa. NO EXCEPTIONS.
PAYMENT ARRANGEMENTS SIGNATURE
WARNING:00 NOT CUT OR OTHERWISE ALTER TRUSSES BEFORE CONSULTING WITH MANUFACTURER. PROPERLY BRACE TRUSSES I AW TPI-BWT-78
4 JUN-21-2001 13:02 FROM-PENINSULA TRUSS +360-275-0475 T-570 P.002/005 F-488
• JUN-21-2001 13:03 FROM-PENINSULA TRUSS +380-2T5-04T5 T-5T0 P.003/005 F-488
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MASON COUNTY PERMIT ASSISTANCE CENTER PLANS SUBMITTAL CHECKLIST
Owners naW In
me: 1 Date ('
Project: Reviewed by:_S ?
Documents:
Accurate site plan attached to each set of plans (road setback + /sideyards < 10? y-)r)44- )
Topography attached to each set of plans \
Energy Code application (heat fuel type A !'" ►
Mechanical/Plumbing application complete (water heater fuel type &location: 1 ►
Contractor registration#OR provide written notice "Hiring a Contractor or Remodeler
Engineering/design criteria:_96-snow load, 80 mph wind/exp, seismic zone 3 (Scope? )
Construction Plans: (3 sets)
X Plans legible Recognized scale Cross Section
Elevation Roof framing h Deck framing
X Foundation plan Floor framing,all levels Floor plan (use of rooms)
DETAIL: (Include wood species and grade, i.e. DF#2, HF#2, PT, etc.)
Roof framing detail (species, size, &spacing).r,r,cX,
S Wall framing detail (size, species, &spacing)
Bearing wall ht exceeding 10 ft requires engineering
Floor beams(size, species, &spacing)
X, Floor joists (size, spacing, species)Q-AYJ)
X Header and beam (size &species for openings over 4 ftl 4X I d
Foundation (size, steel, anchoring)lox
Concrete walls (Reinforcement detail, >8 ft requies engineering)
Non-conventional framing (steel structures, foam core, log, etc. requires full engineering)
Fire separation walls shown on plans
Point loads identified, calculations provided if needed.
Slab insulation shown
X Stairs/Handrails on stairs with more than 3 risers
Guardrails on landings greater than 30" above grade
Location of furnace identified on plan, where?
--- Propane appliances in basement (3" screened floor drain to o/s,2 combustion vents)
Fireplace/Stove information shown
Window sizes marked
Covered porch detail (Use ICBO Chapter detail? )
Braced wall lines clearly marked on plans (Within 8 ft of corner, n.t.e. 25 ft o.c., table 23-IV-C-1)
r' Interior braced wall lines required for boxes greater than 34 ft
5 Do plans meet UBC prescriptive braced wall line requirements?
UNUSUAL SHAPES:
Roof or floor extend more than 6 feet beyond brace wall line or ICBO detail. (2320.5.4.2)
Openings greater than 12 feet or 50% of the least floor area. (2320.5.4.4)
Braced wall lines do not meet in a perpendicular direction. (2320.5.4.6)
Braced wall lines offset the vertical plane from the foundation
(2xl 2 NTE 48", 2x10 NTE 40", no offset in 2x8 or smaller) (2320.5.4.1)
Floor and roof is laterally supported by braced wall lines on all edges (2326.5.4.4)
The end of a braced wall panel extends more than 1 ft over an opening in the floor below
(BWP may extend over an opening 8 ft or less in width when the header is 4x12 or more,
U.B.C. section 2320.5.4.3)
Engineered documents (Engineering required/included? ►
Design criteria-snow load , wind 80 mph, exposure C, seismic zone 3
Engineered data transferred onto the plans
Structural general notes&calculations, 2 sets
(Specify scope of work, project location, design criteria, etc)
Washington State licensed engineers or architect signature and eng. expiration date
COMMENTS:
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