The URL can be used to link to this page

Home My WebLink AboutCOM2000-00140 Cancelled Walk in Cooler - COM Permit / Conditions - 12/14/2000 PERMIT NO.: BLD eJ_ l MASON COUNTY BUILDING PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98684 Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner /(/o�r�,,r�f��niv ��/ s Contractor Name Mailing Address S D A/ A/MEQ Ch.. 2? . Mailing Address City $4:/FA/ip State_/4_ Zip Code 9 8S Z R City State Zip Code Phone( 33G0) Other Ph.( ) Ph.( Other Ph.( Lien/Title Holder Contractor Reg. # Address — JzJ 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 PARCEL INFORMATION-12 digit Tax Parcel No. J1 3 Z--5 / C• 61 6 Fire District_ Legal Description 5?0 V,4 41zQAFjQ C h. L- . B',e;-11CA 1.9 . WA Site Address(Please include street name, street number and city) Directions to site 64r-r %4 3' Ar t7& AL&oN 2-CZ,^e2t{ Will timber be cut and sold in parcel preparation? (Yes/No)_,A10 + Is your property within 200' of the following: Body of Water(Name) a/D& e k. Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream J;;7-54es or Bluffs PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑ TYPE OF JOB New Add Alt__)(__Repair Other Use of Building Describe Work IJAI 46Z m00% S.4e- 1; -It_ i No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Floor 3rd Floor Loft Basement Deck Other sq. ft. F Garage Attached Detached Carport Attached Detached i 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: I i OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I ain 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 Ii approval. first obtaining approval. f AX Date X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted byA Date Submittal Artlount Due Receipt No., ::::>::>.. ....:... ::;; ;...:. ................:::::::::::::.:::::.:.::.::.:............. APP RQVEfl. :>::::.>:.::IPR' MNTAit.R I #+'�f :::::::.;: : .. I : ..... .. ............ .. ..: .. :.. .....:.:. :.:.. ... ... . . ......... . . . .... . ......... . ........... .. ........ ._. . ..................... Building Department Occ Grou -73 Type Constr. �.` Planning Department Environmental Health Department Public Works Department Fire Marshal Valuation $ Sf Y y. N. Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee Other it Wood/Gas/Pellet Stove Fee h* State Fee f Violation Fee. Pre-Paid at Submittal ( ) TOTAL FEES PERMIT NO.: BLD�fomuiVDgbt 4 o MASON COUNTY BUILDING PERMIT APPLICATION ka-tl 426 W.Cedar1P.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 4164rh r,oy A 4?h:S Contractor Name Mailing Address R O Al_: A07E r> C.h. DIF. Mailing Address City .23,A:1f4/,,c- State /s/A Zip Code 7 15 Z City State Zip Code Phone(3aQ Other Ph.( Ph.( Other Ph.( 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 PARCEL INFORMATION-12 digit Tax Parcel No. / Ct1>6/ d 0A Fire District 4 L gal Description ite Address(Please include street name, street number and city) Directions to site •-7" o Al 6-fho-l"n. H e 're- -w TQ Will timber be cut and sold in parcel preparation? (?es/No) A10 Is your property within 200' of the following: Body of Water(Name) A Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or li Bluffs PERMANENT RESIDENCE❑ SEASONAL RESIDENCE 0 TYPE OF JOB New Add Alt ) . Repair Other Use of Building Describe Work. WA[& /wi Cojolw-oe S.4C !"s..,-If. 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 1S 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-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 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 �L , ?LUG OJ Al Date J2 /6!�w X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by Dateahq Submittal Amount Due Receipt No ' :.;::;;;;:.;,:.:.:.......;...:...:.....:.......:.....:':...;:.;...... .:.......:...:.:;>::.......:::,:......:.:......:..;......::;:.::;<...:..;.:......._:,.:.:.::<:::::...........:::::.:::::::::::..; _:,......:...: :::..:...:...........::.::.::.::... ...........::.....:. AIF!RQafED::< :R. i l «::>>:<:<. . .................... _.......E?E.NtER <<<`; >: Ot7 NI F `i I i O+OF :>::>:>:>::>::>::>::>:>: :> .. .................. .. . ....... . ._ _. _............ _.. .. . ..... ............... ..........................._...... .. ....... . Building Department Occ Group Type Constr. Planning Department /l l WU Environmental Health Department Public Works Department I Fire Marshal 1 Valuation $ rr."�z.:ca,m::4'^ "u•<::✓ 3.8'?`.: ... ..mo.;; : •ta:. ,�, .Gt .:�Jl. 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 ( ) TOTAL FEES �D PERMIT NO.: BLD !"^"' MASON COUNTY BUILDING PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98684 Shelton 360 427-9670 Belfair 360 276-4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Contractor Name Mailing Address ;r r AI t �w/,. ?{3 Mailing Address City ;t / � State k Zip Code ;~ '� City State Zip Code ( trr Phone 4 _ Other Ph.( Ph.( Other Ph.(� O) ' 4 u. .,� Lien/Title Holder _ , w,.,, 1 r . 9 Contractor Reg. # Address z Expiration 'SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System Well Water System,,_. P of Water System PARCEL INFORMATION-12 digit Tax Parcel No. L �3 5 / / ` Fire District Legal Description -"rc ";;r r .^ ...,; x" f�V. R •. ,.�' ,,e., t,VA Site Address(Please include street name, street number and city) Directions to site 6 s)T �..< A,IA,-1 6 -t/ ?KI f Will timber be cut and sold in parcel preparation? (Yes/No) A.'t) I Is your property within 200' of the following: Body of Water(Name) A i _ a- + k'. Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑ TYPE OF JOB New Add Alt_)L_Repair Other Use of Building Describe Work iv-:a >Lr 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-I 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 N .i Date J.::.' 'f'�G r`l X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by DateSubmittal Amount Due ,1s Receipt No.' ...............:...:..:....::.............:..:.._.:..::::::..:...:.:.........:::..:::::.::::::.: .... Building Department Occ Group Type Constr. Planning Department Environmental Health Department Public Works Department Fire Marshal Valuation $ ,a .. 'fir�' '?" rq t i Building Permit Fee Site Inspection Plan Review Fee EH Review Fee a7S�Ud Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal ( ) . l TOTAL FEES FORM MUST BE COMPLETED IN INK PLEASE PRESS HARD MASON COUNTY PROJECT SITE INFORMATION Case No. Name Alc>grh M PARCEL NUMBER Date Date 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 ro ert line. adjacent property line-> , , <—adjacent property line I I I I I I I I I I I I I I I I I I I I I AITAct4e I I I I I I I I I I I I I I I I I I I I I I I I I I I adjacent property lined I I E-adjacent property line SAMPLE SITE PLAN adja�nt property lined 3iO� _ Fadjacent property line D 30' rrr�.seavEI SE.ASc%J AL I ^7 fi L CREE1, I' c I Honn t j I A .GnatN I Houses I j PrA4F1 I 1 R VACANT I T L*ARAv6 \ I I '5 P0.oPmC0 \ 50 —�JI \ � AbRiCLLLTu.RAL I �. I I I , 1 \ I /00 I I `" e-LL 1 I � /00' adjacent property line4 ; ! '. In. <-adjacent pro pert'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 dt3+ar.cs to ►YtCrlL1�L drstaru. to Slopes f-c¢ distancm to s. I I i 1'Q/lfl/1�J K sigri6ture Date i MASON COUNTY PROJECT SITE INFORMATION rc)W Z Case No. Name 1V0/11"- 111 5� rr _ - PARCEL NUMBERS 2 (?OflD 'I DateJ�/_n SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the i 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 lined , , <—adjacent property line I � I I ' I , I i I 1 , I 1 I 1 � f I I I , I I � , I i I I � , I I I I II I I I 1 ' adjacent'property line-> <-adjacent property line i SAMPLE SITE PLAN f adja t property line4 3z_o' E-adjacent property line I 17 so• 1aEse-t:vi L I. CRF�K i. � A. fi HOM:6 i .GCi6.tN ! y Prig Pawn sapti c VACANT i CrARA66 4 I 30 $O Its\\ vooPosCa , \ T A4R ZCtLLT41iAL I I 1 \ /00' t...eLL 1 I x /00' I a j adjacent property line4 E-adjacent properij line I t TOPOGRAPHY PROFILE(Show aside view of property. Show slopes, cuts and fills. if possible include height and the I degree of slopes. See sample topography profile.) ; SAMPLE TOPOGRAPHY PROFILE i k I dt3-F�s+ta tv r'uLf'La.Y6 dib't'av+Lt to I slop= •ta¢ j f ads+air- J *e i j 4 dL t444 .+f Q - .wry rs► l Date Sig ture I i n o cn < o g V CA CD o. -� No CCDDmmo CD � '� 7C C- c X N � 0) " c 0, o Z o ac °'• o C p 0 � D c -to � ism O m ; fin m 2! r n mrnrno �• co c � z � M 0rD � CO) K) Crn � zo o D �• � ..1i. NC 0 � � 9 ;0o * � ns o O wo rn -� z � a� � rn� go �; z omtnom fD o " = w z � cn � X o CO) CAl< 0) a 3 (n � � zz �C n 0 .a'. m CD � wZ � 0 C c Z � � o = o0DD Cr p. C CD CD mN r00 � lACn O z m � � 0zz 0D 2 mDD N m o � 00 O C A ^' m Zvmir n * '� o + CD 0 --I o M D O 60 n M n 0 o v C.) r w s vi m M 406 H W o = n C � C c cD N " S. c �, F Z m m n z O . � o N W CAr � 0CD 0 w Z CD c > CD CA ? � D Co + Z a T D r3 a s Cn = o -C -i w CD n = = N m �. 3 7 ` O � � p+ ..tQ m =r CDCO) y Z y D � IT1 H c n °� m o m ' m O m r v, Cl 03 o o CA Z 0 H a a X c —1 M O cD o Cnic m V o $ z 0 0 r4 0 en � o 10 000 d r o 0 � CD o m o o T 00 �, O 0 �p '0 _ m yN ; na .. o JClo 0 m� 0 @ ( c c ..• m rn ^wo -1 0 � _ CCD m O mmm o � (D 23 Pv " p 09 o oo � O --Jo w -q -LQ -' D Q cod -+ bh m ipN O 0 0 0 w N 0 0 0 N N n 0 0) v v v 0 0 o X -w (nDDMDm 0 ? D M0 X vm(r-n �� Q)'m = -4VC � cj) or- 0CD =T D � vWaom _ mn � Zc 55 � v.i o - �aoo mnmmwMj = � 0m co mco D � cK 0 (n0 -1mc- a -a30 -0 O -uO � W -4 c •v < Mzo o . 0 -o < oDZ � mMa- =, B = = 0 o On � Cl) � KCZ OZNmvo kk om -iCD , 0 v0 0y mnMo zm� m _oo oaZ -1(nCMO 00 a = mv n O M ) O � a� a cC - � �� p o � - -p � c D pp co o � zr � � � mO (Ao - Z mm o0 -0 ZDmOmZo O F@ o *. * v; p * mK m a� D = ZO DO0 ce my -1Z � � 03 sr= m — r@ xoOC 0 o' Qg, ' M ZOO 0 � Om -i _n 0 Z � — Qr� O -i � m CD c o OCO Z z o () -pvZCam= paco rn Zc zrC- p � � v — � (D D - � n O -i -v c 0 c � -0 9 -a y -lo -O = = vm CO ' l -' amvMrnm CL c CD OccCD O Ca0 acc 0- m rn o cn CW -I � n o � ai — am 0 M (D x t7 Cl) � -1 0 Mr — m — m -i 0 y -ni � -p � pvX3 X = y o r � .Zp1 O CD ,mom, 0�1 Zip vim, mc � m - n co go c � " Z � n '' o ,q0o MD � � M m M � 0 O -f Dmr � 00 a 0 _ — m m <D o Co O c) v p r- — Z � Zv c ao II 0 o v .. o v � 2v = OWO • Drn co aw cn w 2 ADC -�; 3 mm Dmm m -i - -1gN as coo 0 a � � ZD CCD 2 o _R M Zvi Cl. Op � pOr Cr > mDvp o co � M � � X cD O D W (n `< CD o < � c - v 0 — v cnzzzmq � c ao omo o ao D = Z o 0 DZCOO (n o o c� DOr c: co � Z m � m - Zr- a , 'a o Oc0p �• a A mvm a C mmZ -< N _. a. CD N ? (gym N 3 C yM CD c pmrnCCOD R o w � = - to * 2Nz 0 0 OZ o b Z r < co) o Zc � o °Dm �. � m �� z _tv m � o � v_i -n a --IzpOy � �-► _ Oyu � N D — �' O '" s m (� a m 0 mOtzz � 0 f° 0 � o O � 0 rK o � � mv � � � 0 „ pm N � m y D � DDm < �, _ 0 3 y OZA o O W = is XcM C) a mac. - M n. = z KD to ovZm °r° z � o c o Z ;ucam �CD � O ai5 n y � z -uZmk S 'o � '" o (nnm :3 Z � � 3 mG)M -Im D ca CD s WDz o o rr- O m v a a cn � mcm Oa 5 oa m � vCi KCD co cow o � 0zc -4 =CD y a a o mZ N Z c m z � mmMM �' o a -S .v ov � m 0 G) FMCD y n r w 0 w 0 0 ] - ¥ K $ g7 o q� m o q Go- m 2 kk / ' c o q � 0 c m . Ems § 0 9 . (D CD -n (D W c Vim / to a« < , 2 $ & o � mF • o30 § ■ 12.m = ■ coCD gym2 ' 0 . / :3 U ' . 0 � k . % 0 n o k � CIL 2 0 m / � ® Z 70 ( 0 CD 0 § _ 6 % ] . O xq k k - 2 k 0 2 ƒ -0 m m ® � E JJ # � 0 � g m a ;a ƒ 2 E 2 CD 2 - $ ! ■ . o a , 2 , 2 \ ■ q 90 & ƒ 9 Co > m . (D / n k / e o - - - § ; Cl m 0 (D a 9L � ƒ CD � i $ � k - CL 8 @ 8 8 8 0cn ' E 0 -0k k k § § an. (D k . � �