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Da ] 0 £ 0 g� cr ¢& 00 ¢ . 20 § 2f o RW @D 0 �a 019 CL CONCRETEMECHANICAL Footings 5etaack MOBILE HOME date _ _=%cP by date Ribbons Foundation Wails Gas Piping date b date date by Set up — BG/SLAB Insuldfion INSULATION date Floors Flnal FRAMING date _ by %� date by date by Walls FIRE DEPT. PLUMBING date by date by Groundwork Attic OTHER date b �(� , date by D.W.V. WALLBOARD NAILING date by date //-/`f-o d by 7-4 Water Line FINAL INSPECTION date by date /4-L o-D o byC7- rfL_ � date by � niF tri ©�✓ -2- 2 _� O _ / - F FAI .��S �c�7it :tip ;cTuIt Vs (_Ac,.T fj?pcor>too �(� / -/4Y PERMIT NO.: BLD -710 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 84-6968 AFPLICA T INFORMATIO CONTRACTOR INF RNJAT N Owner Contractor Name �'�^� w Mailing Address ZF" W Mai ' Ad res _A_ p _ Ci ,1�rpz� Stat Zi CodeQ !�,2 Cit State Zip Code Phon bra ,2MA Other Ph.( Ph. a Other P . a Lien(Title balder Contractor Reg. # - Address Expiration '`�` / 107 SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Co ct to Sewer System eiSym Well Water System Name of i Water Syste ti I PARCEL INFORMATION-12 digit Tax Parcel No !az V43 /0 8G9 Fire District i Legal Description ' ZF%4 i i Site Address(Ple a includ st t name tree nu er and ci ' W i D ctions to siip /r' /Y 4 Will timber be cut and sold in parcel preparation? (Yes/No) Is your property within 200' of the following: Body of Water(Name) � Saltwater Lake River/Creek Pond Wetland Seasonal Runoff ' Stream Slopes or Bluffs PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑ TYPE OF JOB New Add X Alt Repair Other Us of Buildirw Describe Work , ,I�� j, � n- �.ri ! eV4i,*z No. of Bedrooms No. of Bathrooms SQUARE.FOOTAGE-1st Floor 2nd Floor 3rd Floor Loft Basen1ent 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 WORD IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate anolgrants 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 regula' 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 ormance therewith. No changes shall be made without approval. first obtainingAKroval. X Date X + Date 6 i F 0'POWAL USE BEYOND TH19 MNI Accepted by Date Submittal Amount Due Receipt No. 1 _APPRovE�>::> '113uil Department Occ Group_ Type Constr. S 10 Planning Department Environmental Health Department Public Works Department R Fire Malt'stral .:. Valuation $ , :::.:::::..............................,.::::::::::::.:.:..::::.::::::::.: ...: ...::.::..:........ ..... .. .:.:::..:.::::::::..:::..........:..:......:.:....... .................:.....................:...:..........:........:...:,...........:........::.::.......:.::::........::........::..:....: I Building Permit Fee a a JL S Site Inspection Plan Review Fee l3 ? C( 0 UFC Plan Review Fee Plumbing & Base Fee o Public Works Review Fee Mechanical & Base Fee Lit` 5 o Other STD¢ t{ SQ j Wood/Gas/Pellet Stove Fee Other 1 14�n>11 — Pre-Paid at Submittal ( TOTAL FEES ) +a : `: 2� �� g PERMIT NO.: BLD MASOM-COUNTY BUILDING PERMIT APPLICATION 426rW.Ciedat'1P.O.Box 186,Shelton,WA 98684 Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 825269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFgRM,kT N Owner Contractor Name . 411rla r Mailing Ad-dress AO Maili dd ess � CitvA& Sta a Zip Code �_ City State Zip Code Phone Other Ph.( ) Ph.(�0 )_ Other Ph. 3" Wr 7841 Lien/Title F� Contractor Reg. ## A 41 '�" 6 Address Expiration 41& SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System N�aeWA er?y� m Well Water System Name of Water System dd 1t�� rDir L INFORMATION-12 digit Tax Parcel No. 67> 2 / / d F' District jl � .-+r+..er r escription dress(Please tnclu treet name,,s reef u er and cityQ6i ns to site ,Ig y F ' Will timber be cut and sold in parcel preparation? (Yes/No) Is your property within 200' of the following: Body of Water(Name) Saltwater i Lake River/Creek Pond Wetland Seasonal Runoff ' Stream Slopes or Bluffs 1 PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑ TYPE OF JOB New Add X Alt Re air Other Use pf Buildin Describe Work r +r1e�Vlt .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 i MOBILE HOME INFORMATION-Make A4 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. i i NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF p 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 irants'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 regulati a work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in co manse therewith. No changes shall be made without approval. first obtaining val. X ate X • Date FO O I L USE BEYOND THIS Accepted by Date Submittal Amount Due Receipt No. $uilding Department Occ Group Type Constr. Planning Department Ott ` a Environmental Health Department i Public Works Department' Firs Valuation $ .....:...............:::..........:.......... I .........::::;.::.::.:•.;::::: Building Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee + Plumbing & Base Fee i Public Works Review Fee � Mechanical& Base Fee Other i Wood/Gas/Pellet Stove Fee Other Ii 1 Violation Fee Pre-Paid at SubmittalMEfflEEfflMff TOTAL FEES " :: PERMIT NO.: BL III MASON COUNTY BUILDING PERMIT APPLICATION 426 W.Cedar/P.O.Box 186 Shelton,WA 98584 v Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968 AFPLICAN INFORMATION CONTRACTOR INFO�R MATI Owner r Contractor Name 40,1 4 r} �, Mailin Address r-�.-_�Y.Ir Mailin dr ss - + +$ City '�» Staa Zip Code�+ � ! City State OW Zip Code 'f Phone(R,ca ,� Other Ph.( Ph.( Ygd T.7Other Ph.( '. 4 ) Lien/Title Hader Contractor Re #_� `CC. #/ Address Expiration / / 0 7 SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic N, Connect to Sewer System Name eww r .st Well Water System 7�Name of Water System +4 f: PARCEL INFORMATION-12 digit Tax Parcel No. �� / / 0 C`. Fire District Legal Description ve Site Address(Please include street name, t eet rjpmJLer and city Dir tions to site2 ,r+ , f Will timber be cut and sold in parcel preparation? (Yes/No) Is your property within 200' of the following: Body of Water(Name) Saltwater. Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑ TYPE OF JOB New Add X Alt Re air Other Use Df Building Describe Work 4°�6► Wit. 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_ 10 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 WORKI.S BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and o ants 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 regulatingffie work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in co ance therewith. No changes shall be made without approval. first obtaining apyowal. X ate X Date 6' 7 FOR OFICl/ L USE BEYOND THIS T r krr Accepted by Date Submittal Amount Due Receipt No. t7�PAR �ICy1VDI1��N Q+C��fM�:;.::;:::: ;::: Building Department Occ Group Type Constr. Planning Department .I=nvironmental Health Department Public Works Department Fire Ma(shza, Valuation $ Building Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing & Base Fee Public Works Review Fee Mechanical & Base Fee r I� maw Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal ( ) :< TOTAL FEES FORM MUST BE COMPLETED IN INK PERMIT NO.: 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 Seattle 206 64-6968 APPLICA INFOR IOIy CONTRACTOR INF MAT N Owner Contractor Name Maili ess Ma'' d es Cit _ State Zip Code Cit State, Zip Code Phone( ),.-7zayJg 56ther Ph.( Ph.c7!6a Other Ph.(:J�Q ) Lien/Ti}je_Holder Contractor Reg. # S Address ExpirationQ / / SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMAT N-12 'git ax arc el N . ! �J Fire District Legal Description Site Address(Please inclu eet.nam stye n ber and Dire ions to siteO-5�,o*"y 1�9 Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs 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 Fuel Type: Electric Type of Fixture No. of Fixtures Fees LPG Natural Gas Heatpump Toilets Type of Unit No. of Units Fees Bath Basins Furnace Bath Tubs Heatpumps Showers �_ Vent Fans Water Heater Propane Tank Laundry Wsher Gas Outlets Sinks _ Wood/Gas/Pellet Stove Dishwasher Direct Vent? Other Other Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT. 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 AFFIDAVIT4 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 regulatW 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 c rmance therewith. No changes shall be made without approval. first obtaining ova X Date X Date a FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. >::;::>::: Ate. : 1itC>tlEif> :Cbt ><<` ><> >> ><><>>>< > ><< .Building Department Occ Group Type Constr. Planning Department Other Other Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing&Base Fee Other Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( ) i Violation Fee TOTAL FEES ma es' tial Plan Review nt hecklist a Conditions on reverse - - BLD2000- 00? ( 9' Area Information Applicant: L r-o u SM L-n+ Lot Size: Building: as g Construction: Occupancy: Basement: Deck: W 6 Bedrooms: Type of Const: 5 W Garage: Att/Det Bathrooms: of Occupancy Group: R3 Carport: AttlDet Stories: _.� Occupancy Load: Cvr porch: Bldg Height: Occupancy Status: Other: �k, .:.�,c`��'".'�' ':n'��.r:_^,.�,.'`::,-c. "`^..:�z'� vs: ":'•,,-„l.-:.:..� �.. `c!,,. i,�-=_ _ ^:'�'_�`:�.xti,;v':;"."'v�-'�4. •�'. '.,c. ,�: li Plumbing: Mechanical: Water Closets: 't 7.00 Furnace: 13.25 Lavatories: a 7.00 Heat Pump: - 9.50 Bathtubs 1 7.00 , 0 Vent Fans: 3 6.50 1y,-50 Showers: 1 7.00 Range Hoods: - 9.50 Waxer Heaters: 7.00 Wood Stoves: - 42.00 Clothes Washers: 7.00 Gas Stoves: 42.00 Kitchen Sinks: 7.00 Propane Tank: - 9.50 Laundry Sinks: 7.00 Gas Outlets: - r Dishwashers: 7.00 List gas appliances Hose Bibbs: I 500 Subtotal Qp Subtotal t i.Sc� Base Fee 20.00 Base Fee 22.00 Total Plumbing 0,00 p Total Mechanical 1.50 Valuation: Fees: Um Square feet Amoamt Dwelling R3: Ja•� 52.18 11,q--j0,0 y Plan Review: 13). `t(o Garage Ul: 18.92 Building Permit: Deck: `f l0 9.50 ►a,00 State Bldg : N, 50 Covered Deck: 12.85 Mechanical Subtotal: LI,So Carport: 12.85 Mechanical Base: Storage: 11.00 Plumbing Subtotal: 4 ,o Basement: 15.58 Plumbing Base: 0�0 OO Remodel <50% (oQ 16.00 %yo,°o Y Remodel >50% 52.18 Total Fees $ Prepared by: _ Total Valuation $ 13, 1G9. C? I Date: 0103000 1: f f f 1 4 i t. / 1 i tt �REGIOTERED-�1S PRQVIDED BY LAW-AS C'U1 ST CONT GENERAL. LEESCC*066JH;.04/04/200DATE1 . EFFECTIVE ,DATE 04/0$/1g94 "° LEE'S CONSTRUCTION .CO 7026 CADMAw LN. NW S- .SEABECK WA 9$380 �Ngnatu t { sued by DBPARTMEI iNDST'RIES