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Home My WebLink AboutBLD2002-01082 Final ReRoof Storage,Shop - BLD Permit / Conditions - 1/27/2003 Z < o o O ni m $ cn r`n 03 o C) d m oh 2 Gmi D v o o 0 C G n r 00 c `�' m o mmm0 N n O o Z o X 0 U2 rn o � 2 O vkO > � 3 o cD z wm � Z ? (D n Omcn0m m ilD Z a CD -, Zxfn 1 0 CD H O �I N 7 p � NGn rl O O � powm 0 (` D m Z oD i � z � 20 p 3 d o -n ; m Cl) oo ao 0 cn Z oo N m cn a C c° mooDm � `° z 2 mvm � s N � (o m �° rn Z x o p acxX � Zo o m C� � m m n co —� @ ? 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D caoo oQa 00 z O 8 ' a c CL $ CD 1 y omrn rn < m D o' o �, 9a o as CAo Z � m �i � �s CD Pm � 0 �► g � g � CD o c � o moo a z m o 0 N m n c ,< m O � � � .D v_ R 0 c O ZFL 00 m < _ 14 M T N O _ MA:0 N CD m G. 0 a CONCFWM CHANIM MOBILE HOME r -Setback date Ribbons data by Gas Piping date by n Walls date set UP date by INSULATION date by Insulation Floors First date by dam by data by G Wad FIRE DEFT. date by date by OTHER NG Aide Groundwork date by WALLBOARD NAILING by date by date FINAL INSPECTION i eene by dae LZ Z 7- 3 by date by i AN FORM MUST BE COMPLETED IN INK PLEASE PRESS HARD PERMIT NO.: BLD_�'�� MASON COUNTY bl 6`c3� BUILDING PERMIT APPLICATION 426 W.Shelton 360 427-9670 Belfaird360 2775-44678Elma(360 4 2-52696,Shelton,WA. 8Seattle 206 464-6968 OvVner T INFORMATION CONTRACTOR INFORMATION Owner z� ,ram Contractor Name Mailing Address .0 . o city_�l� State_2l� p Mailing Address ,{— Phone Zip Code 4g_ 5_ City State (_� � �Oq'�C, Other Ph.(___� ci Zip Code Lien/Title Holder (---- __Other Ph.( Address Contractor Reg. # Expiration SEPTIC/WAT�%A INFORM N-Connect to New Septic System Ner S m p Existing Septic Connect to Sewer Water Syst Well Water System Name of PARCEL INFORMATION-12 digit Tax Parcel No. Legal Description — / (� / b000p Fire District Site Address(Please i clude street name, street number and city) Directions to site , rr c I Q S p , Will timber be cut and sold in parcel preparation? (Yes/No)�b Is your property within 200' of the following: Body of Water(Name) Lake River/Creek Pond Wetland Seasonal Runoff Saltwater Bluffs Stream Slopes or PERMANENT RESIDENCE SEASONAL RESIDENCE❑ FF1001'-_I-oft PE OF JOB New Add Alt Rep it Other Use of Building `JF scribe Work cJl� `,z(2 �_� �� of Bedrooms `� ico-c No. of Bathrooms SQUARE FOOTAGE-1st Floor Basement 2nd Floor Gara a Deck Other p Attached Detached Carport Attached Detached sq. ft.__ i i MOBILE HOME INFOR ION-Malmo I Length Wi Model Model Year real No. No. of Bedrooms Type of Heat No.Price $ No. of Bathrooms Installer Na Replacement Unit ?(Yes/No) 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 be inspection of this project. Acknowledgment of such is by signature below: half,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and 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 requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining ap royal. shall be done in conformance therewith. No changes shall be made without first obtaining approval. i Date X s Date__ FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal — %O 6 al Amount Due `J Receipt No. DEPf#R;TIVIENT/ ,. APPRQVED DENII»R Bullding Department _ CON.DIT�+3N>�C►�I�S ' Occ Grou -Type Constr. Planning Department Environmental Health Department RECE!V.!-- I r PubliC Works Department i Fire Marshal BELFAI Valuation $ Building Permit Fee --11 Sit. 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 PERMIT NO.: BLD rJL% 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 APPLIC T INFORMATION CONTRACTOR INFORMATION Owner c3..�cic,.t c t� l Contractor Name Mailing Address &c, Mailing Address 4, City (fit k n State�� Zip Code R gam_ City —��State Zip Code Phone( qZ7 O'J2,G Other Ph. Lien/Title Holder �� Ph.( Other Contractor Reg. # Address Expiration SEPTIC/WATER SY3T.W INFORM N-Connect to New Septic Existing Septic Connect to Sewer System N of Sewer S m Well Water System Name of Water Syst PARCEL INFORMATION-12 digit Tax Parcel No. I t / {t / C c,0 C J Fire District Legal Description K p Site Address(Please include street name, street number and city) U ( 2- I Directions to site I .S ry,% , i k S () t i i r1 I (c Scj 0 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 PERMANENT RESIDENCE IX SEASONAL RESIDENCE❑ TYPE OF JOB New Add Alt Rep it Other Use of Building 5F Describe Work 1 au� �-,mA_ .c'E"t'e C L C,-r L`G --A-- R-LC- -- 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 INFOR ION-Ma Model Model Year Length Wi lal No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price Replacement Unit ?(Yes/No) Installer Na Certification No. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR COIW,STRUCTION 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 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 ap royal• first obtaining approval. the Date X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by _Date It 6' Submittal Amount Due . ( .�`� Receipt No. V�S b 1 DEPARTIfStTAI!; RVItI� , APPRQVE[t p!"(uliwD CIC3NDITtI CC?I7I Building Department Occ Group Type Constr. ,> o/ Planning Department Environmental Health Department Public Works Department -BELFAIR OFFICE Fire Marshal i 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- 'aid at Submittal TOTAL FEES