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CL CL — 3 m � 3 � m t v -, m n m- o : moo cq N @ m 3 O =� m � m :3. °gym 0 � N c~n can m ° R3 o cnCD m 3 < 0 0 5'i m ;� °' c�<i on 93 m m 0 � - 3Q < d sr � o m fl CD3 m a w CL �• CD CD cn W to a) mf=OD 7 M N CL � � = m n v M CL x <n � cQ. ? a m a) CO O o m a 3 a _. <c -n p n o_ y CL (A 3 � S v o m s0 � ? m 8 a, w b - =r CD — > >' m ca a o N N Bm ,< m 3 0 N N O @ w p » N C: to N O 7 m A n ? n m o � o3 m o a1 > > fD rt Lin M C fD n M M_. O n Z O N CONCRETE MECHANICAL MANUFACTURE© HOME 0 0 oy faottnys! Cyr By � _ as* o k4erior Dole By prior,Date BY Dam By � Exterior tyats By Exterior-NO B tisR:trp N t Pakt toad J wed foola . INSULATION Darr By Z BG/SLAM POU ATM care BY Data By FIRE DEPARTMENT mm Roundatton Woft floors Date By Q Dote By i s By DECKS m FRAMINGWads Daft By CA Data By 0*0 By PROPANE TANKS PLUMBING vault Dole By Daw By OTHER Groundwork AM Type* owe By ows, _ BY By oawv DRYWALL r O $at or"*WaN 04ft By sy 3 t °' ay FINAL INSPECTION o Water Lit V t By By i?ata 3/9`-� By b 0 Pass or Re Inspe quest c#. T ps of Insp. Fail Date gate Done By. Con ments c v, 0 FO ST BE COMPLETED IN INK EASE P ESS HARD MASON COUNTY PERMIT N BUILDING PERMIT APPLICATION �� ,U 426 W. Cedar- P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 - Belfair (360) 275-4467 - Elma (360) 482-5269 On the web www.co.mason.wa.us lAPPLIC T I F R - CONTRACTOR INFORMATION City-Owner Company Name Maiti Ad r Mailing Address Phone -o't -(t Zip Code City State Zip Code her Ph. Phone Other Ph. Lien/Title Holde Contractor Reg. # Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMAT - C ect to New Septic Existing Septic Connect to Water System Name of m m Well Sewer Syste Name f S PARCEL INFORMATION - 12 Digit Parcel N Fire Distric Legal Description Site Address (Plea a includ stye t na e, stre �r u-m_ber d i Directions to siOAJD (AJ� �iQS p /2,11).& 1 ST Wax W&Vvii Will timber be cut and sold in parcel preparation?Yes o Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Othe 91�IARRYYg$��S��D �q Use of Building Describe Work " y Nl AL 15p NAL No. of Bedrooms` No. of Bathrooms - Square Footage- 1st Floor — 2nd Floor 3rd Floor Basement Deck 1 Covered Deck '-Other —Sq. ft. Garage -'Attached t- Detached Carport Attached - Detached MANUFACTURED HOME INFO M TI N - Make Model Year Length Width Se I No. of Bedrooms No. of Bathrooms Type le Heat u a e Replacement Unit? Yes/No Installer Name Certification No. 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 grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null & void if work or authorized construction is m not co ced within 18 ays or i construction work is suspended for a period of 180 days. PRO F OF CONTINUATION OF WORK IS BY MEAN OF PROGRESWeesen N.INACTIVITYOF THIS PERMIT APPLICATION OF18 DAYS ILL INVALIDATE THE APPLICATION. X Date: 5 ZG�J7 O r/Ownelive/Contractor (indicate which one) FOR CIAL US EYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Fire Marshal FEES 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 Valuation $ TOTAL FEES : i MASON COUNTY PERMIT N .� e BUILDING PERMIT APPLICATION �b 426 W. Cedar- P.O. Box 186, Shelton, WA 98584 I Shelton (360) 427-9670 - Belfair(360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLIC T 1 F R ATIO / CONTRACTOR INFORMATION i Owner (0 Company Name Maili Ad r Mailing Address city L Phone - t Zip Code City State Zip Code her Ph. Phone Other Ph. Lien/Title Holde Contractor Reg. # Exp. i E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATPf & ct to New Septic Existing Septic Connect to U1�tter System Name ofmWell Sewer Syste Namm e PARCEL INFORMATION - 12 Digit Parcel N Fire Distric Legal Description Site Address (Plea a includ stre t na e, streeli umber and i Directions to site " v IN ! (�:rZS Qf { �3 /L Q D s Will timber be cut and sold in parcel preparation?Yes o Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs> 15% — Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No i TYPE OF4013 -New Add Alt Repair Othe P I Al Y Q SID FA$�NAL ❑ w Use of Building Describe Work JJ�r'►►�f`- �30!` No. of Bedrooms` No. of Bathrooms- ' Square Footage- 1st Floor ""' 2nd Floor. 3rd Floor "" Basement ""` DeA '-— Covered Deck ...- Other ~-- Sq. ft. Garage --•-- Attached= "`--- Detached Carport Attached Det MANUFACTURED HOME INFO M TI N - Make are_Model , Length Width Se I No. of Bedrooms No. of Bathrooms I Type of Heat ur a e Replacement Unit? Yes/No Installer Name Certification No. 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 grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null & void if work or authorized construction is not com ced within 18 ays or i construction work is suspended for a period of 180 days.PRO F OF CONTINUATION OF WORK IS BY MEAN OF PROGRES IN C N.INACTIVITY OF THIS PERMIT APPLICATION OF?K. AY S ILL INVALIDATE THE APPLICATION. X Date: O r/Owners a resen ative/Contractor (indicate which one) FOR CIAL US EYOND THIS POINT Accepted by: t Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department M, /O - - D Planning Department , Environmental Health Department Fire Marshal FEES Building Permit Fee Site inspection 011 .?OD D Plan Review Fee 1igj 3° / .9 EH Review Fee .3, c,LCp Plumbing & Base Fee Planninq Review Fee Mechanical & Base fee Other Wood/Gas/ Pellet Stove Fee State Fee �- Violation Fee EN FZ003-Cw er 9 .5- Pre-Paid at Submittal Valuation $ Joy%9 /D �} TOTAL FEES MASON COUNTY PERMIT NC ? ' t -- � ;-� BUILDING PERMIT APPLICATION . 6 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 APPLIC T I F R�IIATIO At2Z!! CONTRACTOR INFORMATION Owner t �s (J Company Name Maili Ad r Mailing Address Phone - !� Zip Code City State Zip Code pther Ph. Phone Other Ph. Lien/Title Holde IC F U k Contractor Reg. # Exp. E mail address `— E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATPfS - G ect to New Septic Existing Septic Connect to Water System Name of m Well _ Sewer System__ Name -- PARCEL INFORMATION - 12 Digit Parcel N Fire District Legal Description '4M- ii Site Address(Plea§e includg street name, stre dumber and ci )) L �t f Directions to si # 3 -r, IN% Lat 3 / , Q t 3c .. Will timber be cut and sold in parcel preparation?Yes Is property within 200'of Saltwater �"" Lake _River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs> 151/o Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Othe P Ip�II11ARY SID Use of Building Describe Work{ � � �( "t/ /6dF- ,,, M . ,%tPNAL No. of Bedrooms ""~'- No. of Bathrooms — Square Footage- 1st Floor ~-- 2nd Floor -.-�- 3rd Floor =­ Basement Deck — Covered Deck Other ---- Sq. ft. Garage --~ Attached Detached Carport "-"" Attached Detached MANUFACTURED HOME INFORMATION - Make Model far Length—Width—Se I No. of Bedrooms No. of Bathrooms Type of Heat ur a e $ Replacement Unit? Yes/ No Installer Name Certification No. 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 grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 18 ays or i construction work is suspended for a period of 180 days.PRO F OF CONTINUATION OF WORK IS BY MEANSOFAPROGRES IN .EC N.INACTIVITYOFTHISPERMITAPPLICATIONO I DAYS ILL INVALIDATE THEAPPLICATION. ,- ZG77 X .. ,�: Date: O n r/Owners a 06resen ative/Contractor (indicate which one) FOR CIAL US EYOND THIS POINT Accepted by:-. ,; Date 4i DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning De artment _. Environmental Health Department Fire Marshal 1-7 FEES Buildin Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Plannin Review Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES MASON COUNTY PERMIT NO, r BUILDING PERMIT APPLICATION ► 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 • Belfair 360 ( ) 275-44 67 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLIC T INFO R AT ION CONTRACTOR INFORMATION Owner t '�� �' Company Name Mailin_q ddr ss Mailing Address City I Zip Code 2, <. City State Zip Code Phone �"%>•KEtate Other Ph. Phone - Other Ph. Lien/Title HolderAb i;s='L IL f Contractor Reg. # Exp. E mail address ~- E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATPfS toffSs' ect to New Septic Existing Septic Connect to Water System Name of m Well Sewer Systern Name tets - PARCEL INFORMATION - 12 Digit Parcel No. ,. Fire District: Legal Description _ _, - Site Address(Plea a include street name, stree number and ciw rj � C lr . `f .� L t,�C f Directions to site - f) f t=� 4: . y c Pc u U ► ITSri i. i r Will timber be cut and sold in parcel preparation?Yes¢No, Is property within 200'of Saltwater Lake C=River/Creek Pond Wetland Seasonal Runoff '-- Stream Slopes or Bluffs 5159/6 Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Otherk PRIMA Y B SIDEIXCE S NAL ❑ Use of Building Describe Work: 1} 1 At ai l nrt i ff- ��df` r p No. of Bedrooms'"' No. of Bathrooms M--- Square Footage- 1st Floor 2nd Floor -- 3rd Floor — _ Basement Deck -- Covered Deck ­ Other Sq. ft. Garage - Attached Detached Carport Attached ~- Detached MANUFACTURED HOME INFORMATI N - Make Model Length Width Se al NCO. No. of Bedrooms No. of Bathrooms Type of Heat— $ Replacement Unit? Yes/No Installer Name Certification No. 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 grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 18Q4ays or if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS OFA PROGRESS INSPECT40N.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAY SPILL INVALIDATE THEAPPLICATION. X l x _ Y t 1 A 41 Date: w O ner/Owners,Represen ative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date >` DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planninq Review Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES r Z 3v� , N a cm • 'CD � l'Plonf�scl� . -- yu� PARK 04Ew p�.� PLANNING: H ALL SETBACKS ARE MEASURED FROM THE FURTHEST / Gay- - F ROJECTION OF THE BUILDING TIC _ tNK nL ,�(A CA be. 114-m D Ravvway . •• � l M�� �P�r fit` GDIP Woo J�T1j 14 3_ gas%x �<���Rvt ,p.F ,T �.f 1.5 a ri 05'X3r — K���►Zv��rJ 3X ' ros• -tip x3;--- - -�-��-- SC-'_RVt�O. F_. , s• --------- TE5T liol 5' ev E✓Pmelh `�rat/. 5 qNt) La A h f�LL GR�J�rLL�LSAM Lo n M Ruud s A*2. �8"'-fir• GRAv. to SaNb L%+ AM �- t,� o L 0 6LD�K1 �,/ _TKMO OW s To ZN Su Ate •/ Ivt1 3 e)C--1 Lit 1\tty%I HeLiT. lb . PLOT PLAN IvT<� QW)JER: MAEnN Gdu►N EAGLES pwp gd, PARCEL * 11332 50 Wood Joyce Job Certified Des Septic Systeo riM♦ �, gor F I --;b -_ a OC � r 03 e � - _ •� •� DMZ _._ _. ... -Cl ' g a •,, - d9n itt 110 `� D I•: don ALA+ l '•. `. ox rtwl ��rif C �� r'. '''• •,. k �P`a'I fir, of e •` 1 IC 1 :• "I EXIME Ic 7Q t f7 3 � �. � "'`" ,. / Noss ,. _-:�.-• h 6 1 z -•--•�, y S 00'p�0'!0 Eb 34.J 9�y a V r— r—. nay `` 4 ' OJ o 0 3 z = JCixw� r" gat gawp+, p t - ■RMN61tl�t o Z j� m 0) V" = C L m m CO = rn z G z m Z 40 a N c � v Mason County Planning Intake'Checklist Owners Na : IV Date: b R1RCEIVED Project: Reviewed By: Commercial Developn, ES NO Comments: AUG 31M PLANNER: GBM TS CMM PBC RDH REC MASON COUNTY. fA " Plan:orth Arrow roperty Dimensions: X treets and Driveways Shown. Road name:ll Existing Structures shown with setbacks ell Location, Septic and Drain-field Shown with setbacks dentify all surface water (str ans, ponds; shoreline, wetlands, natural or historic drainage, defined drainage ditches) Topography (slopes) Proposed Stru�ctyre Set ks (Di ction back): 1 F: /` R: / nNo 1: E//�S2. 0 / Utility and Drainage Easements: Yes (if yes enter condition #5022) Other Easements 00 N cessory Appurtenances: e / Heatpump Variance applied for: Yes No parking spaces allotted Yes / No County Access Permit Needed condition #0010) � tate Access Permit Needed (add condition #0020) � ^� Standard Conditions to be added to all Building permits' ialanning reviews: #5019 and #0700 Site Access: Are there any i edime is (do s/gates) that my restrict access to your site? 3 Is the site clearly marked? How? Address Name Critical Areas: ❑ Other: Setbacks: Shoreline: Slope: S reline Designation: Comprehensive Plan: r_RR Zoning: of Applicable ❑ Agricultural2.5 5 10 20 ❑ Urban ❑ In-holding RMF ❑ Rural ❑ LTCFL ❑ RC 1 2 3 ❑ Conservancy ❑ Rural ❑ RI ❑ Natural ❑ RAC ❑ RNR ❑ Unknown ❑ RCC-Hamlet Urban Growth Area ❑ MPR ❑ Unknown ❑ Unknown Water Body (type wat r if unnamed): - SEPA: Yes/ No Un no Flood Plain: YES/NO nkno n Map# Aquifer Recharge: YES/NO no n Map# Tags/Cases: RLC/SPI Case: 6-Year Dev. Moratorium: YE Eagle Nest Tag: YES/ Other Y O Revised: 07-10-2007 1915671 MASON CO WA 03/04/2008D 09:42 RM MISC DIR II COMM III IIIIEVELOPMIIIIIIENT IIII IIII#17046 Rec Fee: $42.00 Pages: 1 I IIIII IIIIII IIIIIII (IIII IIIIII III IIIII IIII'IIII IIII I RETURN DOCUMENT TO: Mason County Department of Community Development/Building Division Attn: Mindi Brock PO Box 186, Shelton, WA 98584 Addendum to Certificate of Non-Conforming Development Taxpayer/Title Owner, Current: Fraternal Order Eagles Aerie 4226 Taxpayer/Title Owner, At Time of Violation: Same Site Address: 80 NE Alder Creek Ln., Belfair, WA Legal Description: Sam B Theler's Home & Garden Tracts, Tr 34 ex. RAN& 34-A Lot 2 of SP 96 Parcel No.: 12332-50-00084 The recording of this document amends and releases AF#1894077 regarding the placement of a non-permitted 8' x 7' x 40' storage container recorded on April 16, 2007. Compliance has been met with issuance of permit and final inspection performed under COM2007-00107. Dated this 3rd day of March, 2008. Mindi Brock Building Inspector/Code Enforcement I certify that I know or have satisfactory evidence that Mindi Brock is the person who appeared before me, and said person acknowledged that she signed this instrument and acknowledged it to be her free and voluntary act for the uses and purposes therein mentioned in this instrument. Given under my hand and official seal this 3rd day of March, 2008 �o�eOERA Cp��9���'''' NoTAq f► - �'�► N ARY PUBLIC in and for the ''�•,��F�f N��' ate of Washington, residing at i�h���N�An���� ` Shelton . My term expires // l5 ao i0 .