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Home My WebLink AboutBLD99-0698 Replace Deck - BLD Permit / Conditions - 7/29/1999 PERMIT NO.: BLD MASON COUNTY U 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 Owner Contractor Name T, } Mailing Address Mailing Address t `c City State Zip Code City _State : Zip Code Phone( ) Other Ph.( j Ph.( ` i r 4Other Ph.L� Lien/Title Holder Contractor Reg. # Address Expiration 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 r , PARCEL INFORMATION-1(2 digit Tax Parcel No. a i / Fire District Legal Description i s Site Address(Please include street name, street number and city) ; .*. Directions to site Will timber be cut and sold in parcel preparation? (Yes/No) �j� 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 vl" Use of Building Describe Work 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-[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 Date !. _.''I" X c E ,s�. . .; Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by r Date s ' Submittal Amount Due Receipt No.____r� DEPARTM,ENTA VI K,:! t;< APPROVED DENIED' CONDITION CODES Building Department ,• Occ Group Type Constr. Planning Department Environmental Health Department �l`1 .3 2.1 Public Works Department I Fire Marshal Valuation $ FES : ... Building Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing & Base Fee Public Works Review Fee Mechanical & Base Fee Other Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal ( ) ................. TOTAL FEE S ::.:.:............::::::...:.:::. PERMIT 1\10.: BLD 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 APPLICPN-T INFORMATION CONTRACTOR INFORMATION Owner (_J Fz�1, J e)A " i �c ,A -c,,i�, P 4,4,,-,i f lkk Contractor Name Mailing Address OF '-JA Mailing Address State L-*,)J Zip Code City State Z i p Code Phone( Lmj .2 7?1ii-6 Other Ph.L____) Ph. 0 4D t In e r Ph Lien/Title Holder Contractor Reg. # IU,i,,,? Address Expiration 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 —0d4 �a` I 2 �3 C'� Fire District PAR EL INFORMATION-12 oiqit Tax Parcel N 0 Legal Description '1"A t<rieif- It"i - Site Address(Pleage include street name, street number and city) fi K 003k,!'i LUJ 14-(k e,,(,L Directions to site t)� k`�- "T AK X- +U f Will timber be cut and sold in parcel preparation (Yes/No) IJ(a Is your property within 200' of the following: Body of Water (Name) :1-'i L*1-6,'O Saltwater Lake River/Creek— Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB Nev_ Add—Alt_Repair Repair_Other Ve Use of Building Describe Work ,l,a& e No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Floor 3rd Floor -Lofty t Basement Deck era) Other sq. ft. 1 Garage Attached betached,: < carport Attached Detached MOBILE HOME INFORMATION-Make Model Model Year Length Width Serial No.' No. of Bedrooms No. of Bathrooms Typeof 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 gran6s,employ,"s of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of suchjs.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 thi 'permit' 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 than es shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without first obtaining approval. Date X /W57 FOR QFF CIAL USE BEYOND THIS POINT --!7 A X Accepted b Date Submittal Amount Due,/-L/. Receipt No ._,) i PEO)( xDEPARTMENT. FrVIEW _E P, ;1 AP DENIED CONDITION:CODE$. . Building Department Ota��%J(kvj CY Occ Group Type Constr. (AkJ Planning Department Environmental Health Department Public Works Department Fire Marshal Valuation $ .......... ........ .............. .............. ......... .......... ..................... ........ ...... ............................... ........... . . ......... .................................. ........... ........... Building Permit Fee /3 Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing & Base Fee Public Works Review Fee Mechanical & Base Fee Othe Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal TOTALFEES PERMIT NO.: BLD Rt(�cq MASON COUNTY BUILDING PERMIT APPLICATION ll 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 .' r i +- Contractor Name Mailing Address l,J1 i Mailing Address 3.16;: City ,. State '' Zip Code j!t State Zi Code 3 W F:„ f ./ City �.. ��: _ � Zip Code Other Ph.( ) Ph. t t z 5 , r JDther PIn.�� Lien/Title Holder 'I`]r Contractor Reg. # r+c •''*i +�L i�r� Address Expiration / i 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 j i. L.J2r r _ , District PAR MN 12 digit Tax Parcel No. " Legal -- Description rJ1dQURL .� .. � ,;., a, � ;. ,,: • , ,s, - �.. Site Address(Please indJude street name, street number and city)„k I NIC I it, Dlreotions to site - , , t,l q / I �e; ;t ; L.,_.• i1:a r rr. 4 �• r ti r t,- i i..•. E c;S`+;n-. 1 rl-k Will timber be cut and sold in parcel preparation. (Yes/No) Is your property within 200' of the following: Body of Water (Name) `! , /.: ,M Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs i I TYPE OF JOB New Add Alt Repair Other Use of Building Describe Work `r r'I 6n, C c,� No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Floor j 3rd Floor Loft Basement Deck7, 'r_;` Other sq. ft. Garage Attached Detached Carport Attached Detached MOBILE 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. i I 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-[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 �� 17 ��< < �i, '> � i; ,�`, X �•tr,,u.��-':"�.' : ,,�w.�l;• ;✓� wig Date Date �:: '•� FOR OFFICIAL USE BEYOND THIS POINT Accepted by f,' +`.-+, Date f p>: } Submittal Amount Dueg t 1. y Receipt No. DEPARTMENT VIE I. APPROVED DENIED CONDITION CODES Building Department ,pe. I Occ Group Type Constr. A If _ Planning Department 4 Ot Environmental Health Department Public Works Department I jFire Marshal I I I Valuation $ FEI= Building Permit Fee Site Inspection i Plan Review Fee UFC Plan Review Fee j Plumbing & Base Fee Public Works Review Fee Mechanical & Base Fee Other 417 Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal ( ) i ::.�:::::.;..}•::.}::::.:.;x:•}::.:::::.:.;: :.Y::.........:..:..:.: TOTALFEES •}:.:i•}}Y:t:•:•.K}t•:.. :•}YQYY,••,�'i.^:�S:d:Y.w,}:t;:;.wi}}Y.}s,}•r s}•.,:.}}}:::L,i}r;:i:}v.}}::•:i:.'•::::}}}:•:<,�.: ::<:;<;: .:`>:4i},v,:+.-}}}:'+K•}:•Y•:i;i.;3Y:5•}:-}:?•;{•.:i:i:ii•::i:}:n•Y}•Y.•r}::•}:�:•Y}:•}::.•}}}i}:{.;{.y:•:•}}}}}:}} FORM MUST BE COMPLETED IN INK PLEASE PRESS HARD MASON COUNTY PROJECT SITE INFORMATION i+1 Case No. �lf t o'- ctitt l I e►^ PARCEL NUMBER 12 305 -SC/- U OGI.o Date Name In 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 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 line- 1� - Fadjacent property line U I � I 3� IX I � IS I I I I I I I I ' I I I � ' I J ' I ' I ' adjacent property line- E2 WtAQ z- ,4 Fadjacent property line q SAMPLE SITE PLAN adjacent property line's rAFCe.(yVE E-adjacent property line D 30 CRcF IC AL.. i � � I HO nn e i Gral �G,� PRO POSGD S¢Q}i L --}I 1 � — I r� 60• --/50 tl I R i VAGr,jT �rt�� \ I 30 I� V0.oPosCD So' _ T AfiR ICLLLTu..0.AL I I 80* I , I I � I I I I I 1 x /00 --� A 1 adjacent property line- ; a". 'Ilk ; Fad'acent 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 diSt9r+c0.. to StruttL�YG •�� ' 8;st"ar,LG to Slops to dis+ancz to a D to Signature _ D (n C- co I v m a cn o 0 37 m 0 O W W om m m l7pCwmr- mCnC wmm -i - 00 --10 -10 O co a mmv c> DmDCOD = - - mmCp z * 0 -< 0 -Gr z co > m0U) - -I mo0 > 0 > 0M0 -0 7 -0D -i D (D — a -q -- 7" mr I rmmmzo -0rcMcM0 ;r) 0 1 - 0 Cl) M000 I - � 7 mr -0 _0 CO r- > 00tm r oaw a OD rn - - I zN - . C/) 0 - o • 0 m0 :* Mcn -iM Z Z N I M - - . . I -iC m -n0 L7) -IZM0 � Om I I - Zr 0 m D 0MU) CD `2wz m 1 0 - 00mc :DC/) c.a -' j c cmn a = a •J . 1 I z -i D O O fA •• •• •• •• _ o I I Cnpzcm0 D Z.. .. .. I I D CA - M Cl) 000m c, C MOD o r1 v a I 1 m . SJ/ ^, Z Z -L m I Mi0 [A0 1 D 9 " a " z r = w m v 1 v 0 U v Cn I mo .. .. .. .. .. .. - - Z .. 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