HomeMy WebLinkAboutMIS97-0492 Final Foundation - MIS Permit / Conditions - 9/24/1997 -+ -4 o D o ti c o
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date q-,-241- by date by
MIS
MASON COUNTY
MISCELLANEOUS PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 • 427-9670
PLEASE PRINT x
#1 Owner tTE.�U���pR-fHE �>�O-��7" '0�� Fire District#
Site Address FIELD pN �� City
Mail Address D• I WILL A�AG NrtN
City S LTo�l TIDEM W,MM —St '-Jzt Zip
Applicant _ ASSIGNED _Phone#
Applicant Address
City St Zip
Directions to Site:
#2 Parcel No. -7'?
Legal Description t, 0 - -Z TIZ A OF91360
#3 Indicate by circling the applicable source if any water is on or adjacent to the property site:
saltwater lake river creek stream pond wetland seasonal runoff marsh other
#4 Project Start Date ' �-� " - 1 Project Completion Date
#5 Use of Buildiing Describe proposed construction
==:AD
n I L= %rf ".-a LJ u.; L__J
AOG fig f�7
'Depending upon the type of permit,a floor plan and plot plan may be required.
"This permit is valid for 180 days from the date of issuance. gEALTH SE 1 V'iuES
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT 1 n
I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED CON-
MENTS OF THE CONTRACTORS REGISTRATION LAW TRACTOR IN THE STATE OF WASHINGTON AND I AM
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AWARE OF THE ORDINAN E REQUIREMENTS REGULAT
ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT ING THE WORK FOR WHI THE PERMIT IS ISSUED AND
IS ISSUED AND THAT ALL WORK DONE WILL BE IN CON- ALL WORK DON ILL E IN CONFORMANCE THERE-
FORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITH. NO CHA ALL BE MADE WITHOUT FIRST
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILD- OBTAINING A P L FR M B ILDING DEPART-
ING DEPARTMENT. MENT.
X OWN X BY
DATE _ DATE "L ' r7
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Wells
Water Lines Shorelines
Drainage Plan Easements
Septic Systems Name of Fronting Street Indicate directional by
Proposed Improvements Name of Flanking Street N, S, E, W etc.
PLOT PLAN AREA
0
FOR OFFICIAL USE ONLY:Accepted by:' _` - Date
DEPARTMENTAL REVIEW
FOR OFFICIAL USE ONLY
Planning APP COND APP HOLD
211
Building
Fire Marshal
Other
Special Conditions Fees
Permit Fee $ ��• �`�
Plan Check
Other
Other
State Building Fee
TOTAL DUE $
(13 I5
LD BUI ING PERMIT # S � ��
Y
L
DATE ��
Planner Area �1
12 I US - �C� - 0/o o-w
CHECKLIST FOR PROPOSED CONSTRUCTION
Yes No I
i
[ ] Within 200 FT of designated shoreline, wetland, or
associated wetland
Where?
[ ] [ 7 Proposed construction on/over/in wetland
[ 7 [ Proposed construction within floodplain
[/] Eagle nest
[ ]I [ ] —
State road access needed
[ ] [ ] Commercial Development (parking standards, sign
ordinance, public works review, other applicable
agencies)
[ ] [ ] Mobile Home or RV Park
[ ] [ ] Exempt from building permit application
[ ) [ ] Exempt from SEPA process (WAC 197-11-305 AC -197-11-800)
[ ] [ ) Meets all requirements (which� ect ' n(s)�� SMP does
proposed construction pertai n'A) �\ji9
C�
[ ] [ l Variance or Conditiona U Pq i e ed
[ 7 Ex[ ) empt from Shoreli e b n 1 velo_pment Permit
process (Wac 173-14 - 4
I ) [ ] Exempt from Substa a ^Develop ent, but within Army
Corp. jurisdiction A17414r115)
I ) I ] Aadress .�e•_=d� ci � ��,'Y'���\r\j
MASON COUNTY
PRE-SUBMISSION CONFERENCE APPLICATION
Mason County uses the pre-submission conference to assist applicants in
preparing proposals which are consistent with all Mason County, City of Shelton
(when applicable) and PUD concerns and regulations. At the pre-submission
conference representatives of all relevant departments will be in attendance and
will be able to inform you of the regulations and standards with which your
proposal must comply. Pre-submission conferences are only held on Wednesdays
and are approximately 60 minutes in length. Seven copies of a detailed site plan
shall be submitted one week prior to the conference. The site plan must contain all
setbacks between proposed and existing structures and the property lines. If
applicable, please show all critical areas (shorelines, wetlands, landslide hazard
areas). All existing and proposed structures must be shown and labeled with their
use and the type of construction materials to be used (i.e. stick built, modular,
etc). PLEASE PRINT rvhen completing this application.
Applicants Name:
Contractor:
Contact: Telephone #
New Project: Expansion or remodel of existing use:
Describe Project:
Site Address:
Tax Parcel Number:
******************* For Official Use *******************
Meeting Date & Time:
Location:
:ge No. 1 CASE HISTORY FOR CASE NO.: MIS97-0492
MARK CORLEY
Ell RIDGECREST DR N UNION OV
19/12/97
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd v�
Code Sent Done Done Date By
------- ------------------------------ -------- -------- -------- --------------------------------------- ---- --- -------- ---
MISA010 Application received 08/04/97 / / 08/06/97 DONE KW 08/07/97 TJ
MISA011 WARNING!! SEE PARCEL FLAG / / / / / / 08/06/97 KW
MISA015 Waiver in File / / / / 08/06/97 DONE KW 08/06/97 KW
MISA050 Approved For Issuance / / / / 09/05/97 DONE NJP 09/05/97 NJP
MISA500 (F) Issue permit / / / / 09/05/97 DONE TMJ 09/05/97 NJP
MISB110 Structural Plan Review 08/27/97 / / 09/05/97 DONE WLC 09/OS/97 WLC
MISB127 Planning Pre-Review 08/07/97 / / 08/08/97 DONE MMS 08/08/97 MMS i
MISB128 Addressing 08/06/97 / / 08/07/97 DONE TMJ 08/20/97 GMM
MISB130 Planning Review 08/08/97 / / 08/27/97 PEND HRF 08/27/97 HRF
MISB135 RLC Checklist Review / / / / 08/25/97 Steep slopes on site. Geotechnical DONE HRF 08/27/97 HRF
Assessment submitted.
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