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Home My WebLink AboutBLD2001-00383 Cancelled SFR, Deck and Garage - BLD Application - 4/18/2001 PERMIT NO.: BLD 2� 3g3 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 464-6968 APPLICANT INFORMAT N CONTRACTOR INF29MATION Owner V4' Od-✓ r� Contractor Name /Coe-rW� 40 k—w- Mailin Address #40 ` Mailing Address City State jg�Q Zip Code City State Zip Co Phone ,d Other Ph.( Ph.( Other Ph. Lien/Title Holder Contractor Reg. # Address Expiration SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect t Ve System Name of Sewer 24, stem oeras �-' Well Wate stem�N m Water System �-- Z ODU/ PARCEL INFORMATION-12 digit Tax Pa cel No. ire I ct Legal Description 44 cC Site Address(Please include street name, street numbtj and city) IV IX 7srr Dire tions to site 4 -r—o V1 L d+C'r" 64c Will timber be cut an sold in parcel preparation? (Yes/ 0 Is your property within 200' of the following: Body of Wate Saltwater Lake River/Creek Pond Wetland I , no m Slopes or Bluffs PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑ yi TYPE OF JOB New Add-�Alt Re air Use of Buildin Describe Work dvow No. of Bedrooms No. of Bathrooms SQUARE F °TAGE-1 st Flo nd Floor ,31i 4r 3rd Floor Loft Basement Dec rij Other sq. ft. Garage Attached Detached Attach d D the IL MOBILE HOME INFORMATION-Make Model Model Year Length Width Serial 1A IF/ Bedrooms No. of Bathrooms Type of Heat PurchiNeWnAfAIF Replacement Unit ?(Yes/No) Installer Name / ficatt n No. NOTICE: THIS PERMIT BECOMES NULL 8, RK OR CONS TIO AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPEN OR A NED FOR A PE OF 80 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK S OF A PRO S CTION. The owner or agent on owner's behalf,represents that the information provided is accurate d a oyees of Mas C ccess to the above described property and structures for review and inspection of this proje Ackn 1 me uch is by signa e I OWNER AFFIDAVIT-I certify t I am um the require s of CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a Contractor Registration,Law 8.27 a aware of th di ce contractor in the State of Washington and that I am aware of the ordinance requirements for which4hi pe issu d that all wor 'I b on in requirements regulating the work for which this permit is issued and all work conformance therewith.` ha a made witho, 1 g shall be done in conformance therewith. No changes shall be made without approval. first obtaining approval. X V D X Date FO CIAL USE BEYOND THIS POINT Acce l� 0 Submittal Amount Due �r 1 c;•(Po Receipt No. r!� <::;:: .. ::::>:;::><: ... ' `R lVt >... �PPRf?VEp :U: Nliwp;: CSND.ITI ICI> rI7I~ ..: Building D I?AAca-1 'rA5 s A A� U Occ IS T e str. U- - �� Planning Depa ent { Environme Health Department i Public W s Department L shal i a17 93 Valuation $ ' t~ 5 Building Permit Fee tF� 5 Site Inspection i Plan Review Fee 49CrIEH Review Fee Plumbing&Base Fee Planning Review Fee I% Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal ( ) ,r.:. � .:7.% ...... z TOTAL FEES ........... i .... 7.....:sic... � ......:..Er.: ._..._. —T—_...—,-. -rw--ma s.. ...�...,—^--•-.arn-.rwc:ra u.e..rrrT- z-.-,,,.. _ _ _ .. -._ ._... _.._ PERMIT NO.: BLD OV r-W 3 33 MA9WI COUNTY /W 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 6 464-6968 APPLICANT INFORMATI N CONTRACTOR INFO-R r4TION owner 0-V . +� � c�e'`+�^r Contractor Name Mailing Address `4;6 Mailing Address City Y . L,�� . ,! State Zip Code '' City State Zip Code Phone r' Other Ph.( i ) , �- Ph.(_ Other Ph.(_� Lien/Title Holder Contractor Reg. # Address Expiration d FSEPTICMATER SYSTEM_INFORMATION-Connect to New Septic '<.._Existing Septic Connect to Sewer mName of Sewer S stem "" �t �µ Well Water SystemName of r System w .� RCEL INFORMATION-12 digit Tax Parcel No. Fire District egal Description Al W `ram^ ► �CrP" Site Address(Please include street name, street number and city)_ ME—. karI Dire tions to site .' Mf/y° a/ 4 r--0 -�v�'�" - 16W -AY "'e. ar s e Will timber be cut anesold in parcel preparation? (Yes/ o ' Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland -V Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE 0 SEASONAL RESIDENCE❑ [No. OF JOB New Add Alt Repair Other Use of Building +�'' ✓ �'�+� .°'� e Work vim ' Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Flooror Loft Basement Deck 141 Other sq. ft. /Attached Detached Carport Attached Detached i i 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 which4his 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. '1 first obtaining approval. X t: � � Date %'i 5 X Date FOR OF. ICIAL USE BEYOND THIS POINT R Accepted by 4 4 k.i Date ` 1' I Submittal Amount Due Receipt No. MIi.IITAI: ::EIwVf. APPRQv � DE:f�lilNBI't� N:�7ra Building Department ri, pr iiC.G 11 Occ Group T l e Constr. Planning Department Environmental Health Department Public Works Department I Fire Marshal Valuation $ I 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 ( ) a.: y ... „ ... ;. �: .. TOTAL FEES E PERMIT NO.: BLD MASON COUNTY q y BUILDING PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98684 Shelton 360 427-9670 Belfair 360 275-467 Elma 360 482-5269 Seattle 6 464-6968 APPLICANT INFORMATION CONTRACTOR INFORIVATION Owner 4e ° rP row Contractor Name .� . .. .u. .•' y,w- � Mailing Address d f� fk' Mailing Address City�l ' f •-r4' State" Zip Code �-.'' �7 City State Zip Code Phone( ) r` `l,Other Ph.( ) �t- ;" ' Ph.( � Other Ph.( � Lien/Title Holder Contractor Reg. # Address Expiration .SEPTIC/WATER SYSTEM INFORMATION-Connect,to New Septic-1c , Existing Septic Connect to Sewer System Name of Sewer System 1fUIli�. Well Water System �- Name of Water System 5L-600/ PARCEL INFORMATION-12 digit Tax Parcel No. ��rr•" / / -t�- "` Fire District Legal Description , ` Site Address(Please include street name, street number and city) ' ,.w. ' n, Dire �rtions to site by r Will timber be cut and told in parcel preparation? (Yes/No). Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland .-I Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑ TYPE OF JOB New Add Alt Repair Other Use of Building r el, �a t Describe Work wr runs ,r• No. of Bedrooms�rNo. of Bathrooms SQUARE FOOTAGE-1st Floor ,�'`�::2nd Floor 3rd Floor Loft Basement Deck Other sq. ft. Garage !`/,r 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 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 :, of ;., Date ",� dr# X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date 1; _, Submittal Amount Due `, <, Receipt No. ; . EPART)VIENTA .;:R#wf� IM APPRQv}wf� I ENIED< OtJNDITf OOt . Building Department Oce Group Type Constr. Planning Department Environmental Health Department C Public Works Department Fire Marshal Valuation $ :.: I •`, Building Permit Fee Site Inspection Plan Review Fee tt. EH Review Fee �j 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.: 'MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-"67 Elma 360 482-5269 Seattle 06 464-6968 APPLICANT INFORMAT129 CONTRACTOR INFORMATION Owner Contractor Name MailingAddress 4&W Mailing Address City State g4 Zip Code City State Zip Code Phone( Other Ph.( i' G' ,D Ph.( Other Ph.(� Lien/Title Holder Contractor Reg. # Address Expiration SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System t 2 OL)d PARCEL INFORMAI=digit Tax Parcel No. /1< Fire District Legal Description Site Address(Please include street nam , street 6umber and city) sv.r► Direc wris to site /Si ,�'S u' .• At OV i 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 Add Alt Repair Other Use of Building E Location of Fixtures/Units 1st Floor 2nd Floor Basement Garage Closet I� PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric Type of Fixture No. of Fixtures Fees LPG Natural Gas Heatpump ,. Toilets Type of Unit No. of U its. Fees Bath Basins Furnace 1 Bath Tubs Heatpumps Showers �� Vent Fans Water Heater �� Propane Tank �r j Laundry Wsher L Gas Outlets Sinks �� Wood/Gas/Pellet Stove Dishwashers Direct Vent? Other 0 Other OK y K o%✓l t Other' S r3�B 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: k 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 approval. �!/ first obtaining approval. X Date 7'7�g not X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by K� ' }_ Date �LISJci Submittal Amount Due Receipt No. >::<:::>:::::<:>::::>::;::>::::>::::>:::>. I�R±QVIQ::::<:>»:t'lENIF#3>::>:«:>::;::>::>::>::.:::.:<.;;:;;.>:.;:.;::<;;.;:.;:.;:.;;:.;:. Building Dep rt ent i Occ Grou -/Type Constr. (11 Planning Dep rtment Other Other :>:::: < >::::» : >::>::::>::::>:<:::»::>::::>::::»:>::>:<:::>t<:::»::>::>::>:>:<:»:::::::>::>::>::>::>::»::»»>::»»::>::>::>: Permit Fee ��- < <- Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing&Base Fee Other Mechanical&Base Fee Other I Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( ) Violation Fee TOTAL FEES i i MASON COUNTY PROJECT SITE INFORMATION Case No. Name �i�/�`�,�5 � PARCEL NUMBER/ 42 - / Date '-/ SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography f,�J Well Location (including adjacent) Drainage Plan Names of Streets Easements Names of Fronting Streets Septic System !' DRAW SITE PLAN BELOW Include adjacent o ertles if on shoreline or within 100 feet of adjacent property lined adjacent property line. (radjacent property fine I I I I I I I y 1 i I 1 1 r l I I I I adjacent pro ert lined ' ' E-adjacent propeqy±2e i SAMPLE SITE PLAN adjaTt property line-. , i I v aLc _ Fadjacent property line SE 4CG w!AL I P 3O u �3�1 t CREEK \ '' A fi HOM 6 _" J. t y .Grxa.eu 1 F 4V I HOc.a.sG. 1 PraoPaua s:pr:C_ 1 t+ - 6 a• 1 VAGn,T I R I I � C.ARAtd \ I \ I I I /DO I I � /00' I ' I I I adjacent oronpov!inA4 ! FORM LEASEPMUST PRESS HARD COUNTY ,PROJECT SITE INFORMATION D IN INK PLEASE PRESS HARD 'Y' Case No. Name '141V7e0S D!/4/�j✓-ram PARCEL NUMBER/7�G�"—ZZ�4/`� Date 34-11r-4' SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg IN, S, E, W in relation to the site�plan Lot Dimensions Fences ,Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography i Well Location (including adjacent) Drainage Plan Names of Streets Easements Names of Fronting Streets Se em 11 DRAW SITE PLAN BELOW Include ad'ac es if on shoreline or within 100 feet of adjacent property line. adjacent property line- I E-adjacent property line I I 4V � I I / I I I I I I I I I �I / I 1! I I I I l I I I I y- I I 1 I I I I I I I I adjacent pro pert lined I I E-adjacent property line SAMPLE SITE PLAN adja t property lined 2LO, _ Fadjacent property line v sa raEscmve CREEK i � A fi MOM 6 I GnslN I H°usa I j Ptl°PaseD sQQt:a �I 1 — \\ I 1q-- 60, I I VACANT CrARA66 I i I(� P0.oPoscD $O•—�I I \ \ T A6R iCLLlTuJiAL I I I I , /00" c.reLL I I j x /00' I "O I adjacent propert line-� ; r F f. ; adjacent 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 dt s+ar%Ge, to ruci'4.Nc zo dcatar,cc to Slops. to¢ dis+ana� /!�—natuCre Date MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Permit Processing/Inspections/Addressing Mason County Bldg.III 426 W.Cedar P.O.Box 186 Shelton,WA 98584 (360) 427-9670 Belfair(360) 275-4467 Elma (360) 482-5269 Seattle (206) 464-6968 April 20, 2001 James Roundtree 11066 State Route 3 Port Orchard, WA 98367 RE: Permit Submittal Dear Mr. Roundtree, On April 18, 2001, a building permit application was received by the Belfair Annex for construction of a new single family residence at Tiger Lake Terrace Tracts, Lot 14 & 15. At the time of submittal, there were missing items that you indicated would be provided at a later date. This letter is to inform you that the permit will be receipted and entered into the system but will not be processed. It will be placed on hold status until all of the required information is submitted. Mason County policy requires that the application packet be complete or rejected at the time of submittal. Future incomplete submittals will not be accepted by staff and will be returned to you for completion prior to acceptance. Sin y, ami y Building Ins ctor/Code Enforcement Cc: Property File Larry Waters, Building Inspector Kim Knapp, Belfair Staff i I I I MASON COUNTY PERMIT ASSISTANCE CENTER Mason County Bldg.111426 W.Cedar P.O.Box 186 Shelton,WA 985M (360) 427-9670 Belfair(360) 275-4467 Elma (360)482-5269 Seattle (206) 464-6968 June 6, 2001 Mr. James Roundtree 11066 State Route 3 Port Orchard, WA 98367 RE: Permit Submittal for new house on lots 14&15 Tiger Lake Terrace Tracts. Dear Mr. Roundtree, On April 20, 2001, Tami Griffey, Mason County Building Inspector/Code Enforcement Officer, sent a letter concerning the subject property listed above. I am presently ready to start the plan review process,but unable to proceed because the information requested by Miss Griffey has not been submitted. Please submit information listed on a plans submittal checklist marked needed,that is ingldpd with#�''s letter, and then I can proceed with the plan review process. a VyMason Plans Examiner Cc: Project file Larry Waters, Building Official Kim Knapp,Belfair Staff Mark Core, Building Inspector t MASON COUNTY DEPARTMENT OF HEALTH SERVICES Environmental Health Personal Health PO BOX 1666 SHELTON,WA 98584 LOCAL(360)427-9670 BELFAIR(360)275-4467&4468 Application for Determination of Adequacy Instructions :.:.:::::::::.::::::::: :::::::::..:: .: .::::::::::::.. f :: .:..............................................:..:._:::::::::........::.......................... .. :.;:.;:-;:.;:.::.. .. >:Il.... :.:..t!?:.A'. .2 :��....... ...:..... ................ ..........:::.:::::::.. !.::::::::::........................... .. .........:::::..:.:..::::.::.::.::::::. .:........................ ......::::::: :::::::.1 ......................... ?1 .:::::::.:._:: .::::::............................:.:::.::::::.::::::::::::.. :. .:::::::......:.:..::......:............ .....? p::::...................................:...:::::::::.:::::::::.::.::::::....................................................:.::::::::::::........................... .. ....................................... >:.:<:>::>::>:<:::>::>:�t�Izittlit> .feted::. : �#�.:• 111x:a�sn�antS::fa:t�e::�caltlt:: ......e1tt::�c:�:�.e�rx::=::;.�;:>:::<:>::>::::::::::>::>::::»:r>::>::�<�.;::::<:>:::: PART 1: Applicant/Parcel Identification PL--, UT —STA —MTER Name of Applicant �✓ 'vy � �.✓ ��ate ��/o -o i Mailing Address ,/'O- �Z-7— Telephone A"'e AS w L Assessor's Parcel Number T e o Water System Check One): Reason orA licatton Check One): Public/Community Water System(2 or more W10' Building permit connections) ❑ Land use application,if so.. ❑ Individual water source(one connection),if so.. ❑ Division of land ❑ Well #of Parcels? ❑ Spring/surface water SPH9 - ❑ Other(explain) ❑ Boundary line adjustment ❑ Other(explain) PART 2: Water System Information Complete the section appropriate for the type of water system being evaluated for adequacy: Public Water System Name of Water System i2'6� 441Z -� 6 72,l d Water Facility Inventory(WFI)Number: zp t 3 7AJ ❑ The water purveyor has filed a letter granting blanket hookups to this water system. �( I am them or of this water system. The water system has been approved for services. There are presently_ connections m use. This will be the connection water system is able and willing to rove a water to this(these) ections i out exceeding the limits of the water system or any limits set by state and local regu atio Signature of Water System Manager \ Date 10 D 1 H.IWDATAURCIHMWATMD3.WP Update:March A 1"9 W - 7