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Fail Date Date Done By Comments o s y G ?� .1 0 Z y�9i� -r tr�ec- CA o l SS s '3- e s • / m r4LC. - �1 0 y L _ O /►is L� 0 I'i June 2, 2008 This permit was cancelled due to no response from applicant. Should applicant change his/her mind, construction plans are located bottom drawer of case y management for one year. If, after one year from this date, applicant has not p aid for re- instating this permit said plans will be disposed of. r � �y n b � P,� 17' CD 00 z n ° • o y NN N � o � a -P N �p i O O 4 E MASON COUNTY PERMIT NO. ���' r► j� BUILDING PERMIT APPLICATION Shelton WA 98584 MAL 426 W. Cedar• P.O. Box 186, Shelton (360) 427-6 thew eb irw 360) ?75-4467 , Elma (360) 482-5269 Fhone ANT INFORMATION CONTRACTOR INFORMATION �^v Company Name ;��� ^� L—I V CsI to fl._ Mailing Address ddress.., _M l i � ��` Q City Q ^III I_Q State�_ Zip Code-`�.*— +� State Zip Code -�.�Z — -�� c/ Other Ph. - Phone z 7 t t,�-7 ��--- �'� ^ ' —Other Ph Contractor Reg. Exp. Lien/Title Holder E Mail Address „, a ll E mail address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic _X— Existing Septic Connect to Water System Name of Water System Well 'Water System Name of Water System Fire District PARCEL INFORMATION - 12 Digit Parcel No. Legal Description _ reet number and city) Site,Address (Please include street name, st D' ctions to site ill timber b cut and sold in parcel preparation?Yes ° River/Creek Pond Is proplaq-w thin 200'of Saltwater Lake Wetland Seas`bnal Runoff Stream Slopes or Bluffs 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or ther enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Other P IMARY RESIDENCE El SEASONAL ❑ 92 Use of -o a-�'-�^ ° Describe Work 2nd Floor No.of Bathrooms Square ootage-41 st Floo No.of BedC000ms_�-- —�-- - 3rd Floor �"`- Basement Deck Covered Deck Other Sq.ft. Detached Carport Attached Detached Gara "� -- - Attached Year Model MANUFACTURED HOME INFORMATION - Make No.of Bedrooms No.of Bathrooms Length Width Serial No. Replacement Unit? Yes/No Type of Heat Purchase Price$ Certification No. Installer Name work order or result in a OWNER/BUILDER Acknowledg that is the of inaccurate owners formation may ve or the co tractor.I further declare hat I am entitled two receive this such is by signature below.I declareparties.If permission is permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary p �A required from any easement holder or any other party in interest regardingpoedsThe owner or agentn on or the work ownersed in behalf,ee�?ellsefiisMAt,,t fI obtainedti n q permission from them to apply for this permit and conduct the work prop provided is accurate and grants employees of Mason County access to the above described property and structure for review and`nspeclion. PROOF TINU N OF WORK IS BY MEANS OF A PROGRESS INSPECTION. �,_.. Date' � n X wner/Own a resentativ ontrac or indicate which one) � u� Date FOR OFFICIAL USE BEYON POINT Accepte�by: DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department a is Planning Department Environmental Health Departmen I " Public Works Department � Fire Marshal FEES Site Ins ection Building Permit Fee EH Review Fee Plan Review Fee Plumbing &Base Fee Plannin Review Fee Other Mechanical &Base fee y CID State Fee Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal � Violation Fee TOTAL FEES ` Valuation$ 6dLLI�J1,0 _ -- �_:_. FORM MUST BE COMPLETED IN INK PERMIT N01 Ic�a( �I - 0►7�a r7 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 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR I RMATION S ��� Owner Li rld"i b!5 ' Ja1't� Company Name O Mailing Address Maili Addr City State Zip Code City is I FZ State 1A19 Zip Code Phone Other Ph Phone Other Ph. Lien/Title Holder Contractor Reg.# Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic Existing Septir Connect to Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. 0 D D Fire District Legal Description Site Address (Please include street name, street number and city) ✓?L C a 'e Directions to site Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New Add Alt Repair Other Use of Building Location of Fixtures/Units- 1st Floor 2nd Floor Basement Garage—Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS ype of Fixture No. of Fixtures Fees Fuel Type:Electric_ LPQ_ Natural Gas_ Heat Pump_ Toilets Type of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs 1 Heatpumps Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kithen Sinks Wood/Gas/PelletStove Dishwasher �— Kitchen Exhaust Hood Hosebibs Dryer Vent Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OVVNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided' accurate and nts employees of Mason County access to the above described property and structure for review and inspection. PR O ONTIN TIO F OM IS BY MEANS OF A PROGRESS INSPECTION. b Date: X Owner/Owners epresentati /Coritractor indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date Bid Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group-Type Constr. Planning Department Environmental Health Department FEES Plumbing & Base Fee Site Inspection Mechanical &Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES MASON COUNTY PERMIT NO.4.,r � _ T 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 On the web www.co.mason.wa.us APPLICANT INFnIQUATInN CONTRACTOR INFORMATION Owner tt—' � , Company Name "' Y �t_�: . Mailing Address Mailing Address City State Zip Code City ` '' ' State Zip Code—r�LL ) Phone Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg.4 Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic Existing Septic. Connect to Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. , ,c° `r` ' / C' - Fire District L Legal Description Site Address (Please include street name, street number and city) Directions to site Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New Add Alt Repair Other Use of Building Location of Fixtures/Units- 1st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric_ LPC Natural Gas_ Heat Pump_ Toilets l Type of Unit No. of Units Fees Bathroom Sink j Furnace Bath Tubs f Heatpumps Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kithen Sinks Wood/Gas/PelletStove Dishwasher �— Kitchen Exhaust Hood I Hosebibs E Dryer Vent i Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and giants employees of Mason County access to the above described property and structure for review and.kq)Wion. PROOF OF CONTINU/i►TIOKOF WORK IS BY MEANS OF A PROGRESS INSPECTION. f X / .r:, c ,-� Date: Owner/Owners Aepresentatim6 Contractor ''(indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date Bid Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Grour)-Type Constr.- Planning Constr.- Planning Department Environmental Health Department FEES Plumbing & Base Fee Site Inspection Mechanical &Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES Zd}°-�� p or ra' W co 6` C Y � to f Ab a GJ J t rir bD e a.� k R Mason County Dept. of Community Development Mason County Bldg. 3 (360)427-9670 Local 426 W. Cedar (360)275-4467 Belfair P.O. Box 186 (360)482-5269 Elma Shelton, WA 98584 Notification of Permit Cancellation March 07, 2008 MARIO GOMEZ NE 3328 OLD BELFAIR HWY BELFAIR WA 98528 Case No.: BLD2007-01267 Parcel No.: 123094190072 Proiect Description: CONSTRUCT ACCESSORY DWELLING UNIT. Dear Applicant: Upon review of our records, the Mason County Permit Assistance Center has identified that your building permit application has been inactive since 08/15/2007. Permits must make some progress every six months. I If you intend to keep this permit active, you need to contact me within ten (10) working days from the date of this letter. If we do not hear from you within the that time, your permit will I be cancelled and a building inspector will make a site visit. In the event that your project has a been completed and a permit was never issued, you will be assessed penalties as allowed under Mason County Title 14 and Mason County Title 15. If your project has been cancelled or if you wish to withdraw the permit, please notify me as soon as possible at (360)427-9670, ext. 616. If you feel that you have recieved this notice in error please contact me. Thank you for your cooperation. Sincerely, Charell Holcomb i March 07, 2008 BLD2007-01267 4 MASON COUNTY DEPARTMENT OF HEALTH SERVICES July 25, 2007 PO BOX 1666 Shelton WA 98584 Shelton (360)427-9670 Fax (360)427-8442 MARIO GOMEZ Elma (360)482-5269 NE 3328 OLD BELFAIR HWY BELFAIR WA 98528 Belfair (360)275 4467 Case No.: BLD2007-01267 Parcel No.: 123094190072 Dear Applicant: Your building permit cannot be approved by Mason County Environmental Health until the following are completed and turned in: Please see comments at the end of this letter. Please call me at(360)427-9670, ext. 554 if you have any questions. Sincerely, Trish Woolett tw@co.mason.wa.us Environmental Health Mason County Health Services Comments: RECIEVED CAPACITY TEST AND WATER SAMPLE RESULTS. DUE TO SECOND CONNECTION ON WELL, MUST BE APPROVED TWO PARTY WELL. SEE ATTACHED PACKAGE. 7/25/2007 1 of 1 BLD2007-01267 J(p (� add in h�,KE irv�pC�'�en Card M6016 mod 4 U, ann �1 • � E t'� M MASON COUNTY DEPMTMENT OF COMMUNITY DEVELOPMENT WSECI VIAL Compliance Application Owner. Telephone: ZW o gZ Parcel#: (Zz 3o q V qoo '7Z bVoe-j Me,Lrl Type.of project ( New Residence ( )Addidon ( ) Remodel Sq. Ft. Total Q 1 flow. Floor: Z or. Heated Basement: of hewed area.: [ Heating System: itl(Ewft wall heater O ElecW Central Furnace OLPG Furnace O Heat Pump with Electric Fumace O Heat Pump with Gas Furnace . O BONK,specify fuel type O Other:S Glazing p Prescrl five Option see reverse side circle one: 1 it IV Compliance _ _ . Peroentage. Method O Co ent Performance Chapter 5—catubson wiodahee s required % `o"e C) Systems analysis, Cha er 4 Whole House Ventjlatlon system p Whole House Ventilation using a Heat Ventilation t8l"D to 's window a waN tress Recovery Ventilation System (VUQ 303.4.4) System vents (VIAQ 303.4.1) Check one O Whole House Ventila w*Integrated O Whole House Ventilation using an inline With a Forced Air System (VIAQ 303.4.2) supply fan. (VUQ 303.4.3 Window & Door Schedule (f needed, attsd►an additional ) Total Manufacturer Roomnocadon U-Factor W1 , avantltY Feet Windows: (Q . ,4 cL. e h Z.z- o�o i Windows: Total Sq.fk o Doom. . Doors:Total Sq. Ft Total window and door area � divided b total sq.ft of heated area._.J. Z = b '1Gof 9lasing Total window&.door area i e. .`: 5/14/2008 Charell Holcomb Re: BLD2007-01267 Marlo Gomez— From: Trish Wooled To: Charell Holcomb Date: 5/14/2008 11:45 AM Subject: Re: BLD2007-01267— Mario Gomez—ADU Attachments: Trish Woolett.vcf Go ahead and cancell it does not appear he has done anything to start the approval process. Tricia Woolett Permit Specialist II Mason County Public Health Environmental Health 360.427.9670 ext. 554 fax 360.427,8442 tw@co.mason.wa.us >>>Charell Holcomb 5/12/2008 9:42 AM>>> Trish: Have you heard anything from Mr.Gomez? All he needs is the two party well approval. I send out a letter on March 7th and have not had a response. I'm planning on canceling it unless you have other ideas?? II �i i 1 V