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Int.Brace Wall Date By W Date By Date By FINAL INSPECTION o v Water Line Fire Seperation N Date By Data By Date ! By 1 0 `° Pass or Request Inspect. c 0 Type of Insp. Fail Date Date Done By Comments a) `CD o CD N O 8 a 0 _ o m Q � I V \vV MASON COUNTY PEFMT N0Qo09"0 0 6 BUILDING PEFDW APPLICATION 426 W.Canon-P.O.Box 186,Shelton,-WA 9&%K Shelton(360)427-MM-Bair{36%2754467-E Wm(360)482-5269 On the web www w.www wa us APPLICANT INFORMATION CONTRACTOR IN= Owner Mailing Address Address City t.f. State Zip Code Sty—Zip Code Phone 36b 7,#*V 2Z07 Other Ph_ Pttorne Other Lien/7"�e f#Ader � %# Exp- E mail addressEU -QUAIL ,com E Mali Address L ers Lic.# DOB Drivers UC_PTIC I WATER SYSTEM INFORMATION-Connect b New-Septic ND Existing-tic 110 nect to Water System U_Nam of WINer Systern 1 Water Systern Name of Vftw PARCEL INFORMATION-12 Dlg1t Pavicet Fire District Legal Description ICrr I OF Site AddlM-Piea-se Inc kde street name,sbdat narnber artd criy3 Directions to site Kb Will timber be cut and sold in parcel Yes! Is property within.2W of Saltwater Lake — River/Creek -- Pond Wetland - Seasonal Rcaxf Slopes«Bluffs >i5%_. � lethle eMsubmittoldve result ate glop Wbrk MOM Conu ton Nnfice oreM ef action?Y o TYPE OF JOB-New AddV Ate_Repair < Other PRMAARY E5, 11DENCIE❑ ❑ Use of Building a-ADZE_ Describe W t' No.of Bedrooms No-of Bathrooms 0 Squave Footage-let Floor j _2nd 3rd Floor Basement Deck—=—Covered Deck — Other — Sq_ft.Garage — - Attached Detached `— Attached Detached '— MANUFACTURED HOME IN ATM 1-U*9- NZA Model Year Length Width Serial Nfo. No-of Bedrooms No of Bathrooms Type of Heat Purchase Price$ Replacement Unit? Yes/No Installer Name Certification No- /DJLDM Ar wAWg n=tw mkpcfirwoamfat XM*InaslcpwokoodWorpa"n ocaftLihsio 0 11 dog' a Oa# w h Is by eVeft a bdw I dsdw a that l am ttw owner owros IaDal orbs eordrectot:i f far deckuelt01 am er 011 o reodwe this pemt and fo do the work es pnMoeed into appioskm I dadare I tna�re obtained itw immtolon from aHrie necessary pelts.It pwagedori is requkadirwn any eersa= ihalder or any aererpmV in ttttereat cbgwdrgihis apria 9 arthewak papoaed into appiceeicn,i thane obtained wvnW ion from them b apply fWthis j36M*and ocndurtthe work proposed. llhe owneraagert an owrners behalf,repreeertLs itret the iticrrrnedon provided is aoonrlaft and 0"M of ill ; C�uiYamees btire abaedsecr�ed propergt aM strrdrna far review and inspec�icn PROOF OF W N 1f1ORIC w BY �1 ply A PfV)GNM919PBCn01�L / x Date: owner f Owners '=drackmr OndicMwhicham) FOR OFFICIAL USE BEYOND TMS POMIT Accepted by. Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department -� e Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Buildina Permit Fee site Inspection Plan Review Fee EK f luifew Fee Plumbina&Base Fee Planning Reiview Fee Mechanical&Base fee Other Wood/Gas/Pellet Stove Fee I State Fee Violation Fee Pre-Paid at Submittal Valuation$ TOTAL SEES : WE was alma was ENRON - "a monamonspsommossm Samos"SUMMERSMEsomm s ommo m SEE ' � n mass nows Oman was son IF m MM no SIM =ME 0 � Oman 2 11rud � � � ■ SEEN SEEN NIMMONS miss r f CONST&G-11014 PLAN • ___ __ _ CONC. iZETA1NIN_6t_WALL MOPOSAI _ _ MAIN V�E1r✓ � '► �_ � ' __ __ _ _ � _ _ _ _ IZEStDEt tc„ 5rto AEIZ _BVI LDIJgC( NOTE FOUNDfcr)0)4_ BA4 TPAJ4 5TflLA(rF b LAr SEE DEI'l�)L VIEW $ELOVn/ GrZO%WQ ;S�st ACR RE S��E1�1 G� .� -� b'► B DG PLTir.lL Rtztc, 4 PrRF PI F _ 2�1.1- 2.11 WEEP PiP