HomeMy WebLinkAboutBLD93-00962 Cancelled SFR - BLD Application - 1/20/1994 4
" Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
PLEASE PRINT O'V
-4
#1 Owner cv- /-I tM
, hone#
Site Address Fire Dist ' c #
City St Zip
Dire tions to Jo Site
r Ad
* Co •
Owner MailingAddress- 1.2
City K"Ly 71. St_ &* Zip
Lien/Title Holder A)/A
Address
City St Zip
#2 Contractor Name _ Contractor Reg#
Address Expiration date
City St Zip Phone
#3 If septic is located o project site, include records. 7;D
Connect to Septic?_ Public Water Supply Well
(If residential, proof of potable water is required
#4 Parcel No. U -J'o-
Legal Description
43
#5 Buildinar quare Footau ! y
1st F1 2nd Fl '01'rd Fl Loft Ba
sement �.
Deck, #bedrooms #bathroom4 42ROGarage—I1 Q_ *t&=orL_6Q
Garde/Carport: Attached or De�he�+ ST-poeA.C� Wit,
/aV.® Other @S.SZ7 - �'- - �o
#6 Use of building esc a work
#7 Type of Job: New ✓ Add,�---- Alt Repair Demolition
Re-Roof Bulkhead V Other
#8 MOBILE HOME INFORMATION )m
Model Year Make Model
Length Width Serial No.
#Bedrooms #Bathrooms Type of Heat
#9 Any water on or adjacent to property: saltwater ✓ lake
river pond wetland seasonal runoff
other—
��Z�,� --
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements
Name of Flanking Street Scale:
Name of Fronting Street Date:
APPLICANT TO DRAW SITE PLAN BELOW
j;-Nil
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELO
/ 3
AV
w1v �'
'Riumbincr Fixtures Fee, Mechanical Fixtures
No. Tdilets �� Primary Seat Source
-TO- (circle )
Bath Basins
Elect/heatpump other
JBath Tubs t—
Showers \NO. FEE
Hot Water Htr -I_Furn (10
Laundry Washer 1") Heat Pumps
Sinks Vent Sys (Central)
Floor Drains Vent Fans (Spot/Whole)
Laundry Basins _ Boilers/Compressors o2
Dishwasher Disposal HP
Air Handling Unit
Urinals Other cfm.
Fire Protection Systems
Permit Basic Fee \')
TOTAL PLumBING $
Other
Gas Outlets.Hookups
Wood/Pellet as Stove
Other
Permit Basic Fee 1S
TOTAL XECBANICAL $
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK
IS COMMENCED
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT ,
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR
CONTRACTORS REGISTRATION LAW RCN 18.27 , AND AM AWARE IN THE STATE OF WASHINGTON AND I AM AWARE OF THE
OF THE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH
THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
DEPARTMENT. DEPARTMENT.
X OWNER AVIA X BY
DATE DATE
Return permit to: Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
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t
. Y DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond Hold
Approval
Planning:
Environmental Health:
Building Plan Review:
Occupancy Group:
Fire Marshal:
i
Other:
a
FEES
IlSpecial Conditions: II Ilsite Inspection I II
II I
II
II 11 IlBuilding Permit I II
II II I 3ta-� i
II 11 Ilviolation Fee I II
II II I
II II IlViolation Investigation Fee I II
II II I i
II II IlPlan Check
II I I l . db II
I
II II II Plumbing Fee I j II
II 11 IlMechanical Fee
II II I' 'I
II 11 IlWoodstove Fee
II II U II
1, II IlBuilding State Fee I II
I I ,
IlBuilding Valuation: II II TOTAL I g II
A
4
MASON COUNTY
DEPARTMLNT Of GENERAL SERVICES
Mason County Bldg.III 426 W.Cedar
P.O.Box 186 Shelton,Washington 98584
(360)427-9670
BUILDING PARKS&RECREATION FAIRICONVENTION CENTER
ADMINISTRATION
�Tarr�es Clemer��
Re: Permit No. :
Dear V It � vnw
As per your recent request, this Off '7nspection
has noted the above
permit for extension to
keep your y 1996. In order to
permit valid, you ust call for prior to this
date. In the event that you do not call for inspection, the Uniform
Building Code allows for jurisdictions to require the renewal of
building permits. Depending on the length of time of expiration,
there are two methods used. If the permit is expired by less than
one year, renewal may be obtained by paying' half of the original
building permit fee at the discretion of the building official and
if the permit is expired by more than one year, the jurisdiction c
can require that the permit actually be processed as a new permit
with routing to all required departments.
If you should have any further
questions regarding the
validity of permits
please contact the Building Department at
(360) 427-9670, Monday-Friday between the hours of 8 : 00am and
S : 00pm.
Sincerely,
Mason County Building Department"
i
CC: Property File p
177-
Al
S
March 01, 1996 D
ail
MAR
Mason County Dept of General Services c
Mason County Bldg. III 7iENERAL �t�V!(,1=1.'
426 W. Cedar
P.O. Box 186
Shelton, WA. 98584
Re: Permit No.: BLD93-0962
Dear T. Griffey:
I am writing in reference to the above referenced Permit No. BLD93-
0962. Name: James E. Clements, Tahuya, WA.
Due to unexpected unemployment in our family, we have been
unable to proceed with the construction on our property as
anticipated. We are therefore, requesting an extension to our
building permit to allow us time to get monetary funds in order to
proceed.
Please advise regarding the granting of our request for extension on
our building permit.
I thank you in advance for your consideration.
Re ds,
James E. Clements
12912 S.E. 185th Street
Renton, WA. 98058
(206) 235-6365
September 13, 1995
Mr. Larry Water
Mason County Building Department
P.O. Box 186
Shelton, Washington 98584
RE: Building Permit for James E. Clements
NE 21101 NorthShore Rd.
Tahuya, WA.
Dear Larry:
This letter is to advise you that as of this date, we have PUD #3 power at our property on Hood
Canal. Also as of this date, we are attempting to proceed with the financing of the building of our
house. Please extend our building permit on the above referenced property.
Please call me or contact me after your review of this letter with the status of our building permit.
Call me if you have any questions.
Thank You.
James E. Clements
(206) 235-6365 Home
(206) 854-5504 ext 145 Work SEP l
12912;3.E. 185th St.
Renton, WA. 98058 AENERALS�RVICEE
Enclosure/1