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HomeMy WebLinkAboutBLD2004-00831 Cancelled MFG Home BLD11709 Mobile Home #40 - BLD Permit / Conditions - 6/1/2004 Inspection Line(360)127-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT LD2004-00831 OWNER: RITA COLLETT RECEIVED: 6/1/2004 CONTRACTOR: LICENSE: EXP: ISSUED: 6/22/2004 SITE ADDRESS: 20 NE ROESSEL RD SPACE 40 BELFAIR EXPIRES: 12/22/2004 PARCEL NUMBER: 123325000050 LEGAL DESCRIPTION: SAM B. THELER'S HOME & GAR TRS TR 20 20 NE ROESSEL RD PROJECT DESCRIPTION: DIRECTIONS TO SITE: MANUFACTURED HOME HWY 3 TO GOLDEN BELL PARK SPACE 40 General Information Construction & Occupancy Information Square Footage Information No. of Bedrooms: 3 Type of Constr.: V-N Type of Use: MH Insp. Area: OT No. 2 Occ. Group: R-3 Lot Size: Deck: Type of Work: NEW Fire Dist.: 2 No. of Occ. Load: Building: Valuation: Building Height: Occ. Status: Primary Basement: Manufactured Home Information ck Information Shoreline & Planning Information Make:SKYLINE Length: 44 Ft. Front: Shoreline: Ft. Water Body: NONE Rear: IN Slope: Ft. SEPA?: Unkn Model:KENSINGT( Width: 28 Ft. Shoreline Desig.: bWtiAppl1cable Side 1: W 10.0 Ft. Year:2004 Serial No.: BS9105105 Side 2: E 5.0 F Comp. Plan Desig.: Urban Growth Area Plumbing Fixtures Mechanical Fix FEES Type Qty. Type Qt . Type By Date Amount Receipt Mobile Home Submittal Fee NJP 6/1/2004 $214.50 S22004 Planning Review Fee NJP 6/1/2004 $155.00 S22004 Building State Fee LDK 6/11/200A $4.50 S22004 Mobile Home Issuance Fee LDK 6/11/2oo4 $214.50 S22004 EH Plan Review CEW 6/18/2004 $75.00 S22004 Total $663.50 BLD2004-00831 Please referto the following pages for conditions of this permit. 1 of 5 � v N O A 'O Xaom 1 1 X5 0' 3 u < 0 X � -10 (op C o XD1 D xa -V O w O C O OCD Vm TO N _ OW O On ^ C NN (D (D C w p O o m CD 0 (DOC OCD O O a J O m . ° 3 o -o s 0. 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N n `G T p 0 N C S U -I 0 m 3 O ('j 0 Cm) M ry CD 0 0 m (D O -� °- SOCOD C CD -< y CD 3 ^" p1 » m m N J N 3 3 - m - O S 0 CD 0 T k / / j } 2 ` f \ ( a \ & 0 -/) ( \ fE ( % \\ � 0� { 7 } ( E » ) ( E ! s k / § � \ \ � ) ( \ R \3 [ ! 0 \ \� 0 ® [ ( � }\ E & 7 %) 2 0 ; & a ; {\ / ( ƒ _ } & } ) 01 Wl r 0 o CONCRETE MECHANICAL MANUFACTURED HOME 0 -f' Footings/Setbacks Date B y Ribbons 0 co Date By Gas Piping Date By Foundation Walls Date B y Set-up Date By INSULATION Date By B G / Slab Insulation Floors Final Date By Date By Date By FRAMING Walls FIRE DEPT Date By Date By Date By PLUMBING Attic OTHER Groundwork Date By Date By WALLBOARD NAILING D.W.V. Date By Date By FINAL INSPECTION Water Line Date By T Date By Date By s-5E zc- 0 0 � � O a 8 N r a 0 y o y 5 o oo CD w � � y 0 Building Permit # y cl- 3` MASON COUNTY ` BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location c 2 :::D c /W t;1 C/ This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items Listed below must be corrected to gain code compliance You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ This is not a complete inspection Department Date Inspector ■ �� s NuT Mo *V T F , T '%X MASON COUNTY DEPARTMENT OF HEALTH SERVICES Environmental Health Personal Health PO BOX 1666 SHELTON, WA 98584 LOCAL (360)427-9670 BELFAIR (360) 275-4467 Application for Determination of Adequacy FAX (360)427-7798 Instructions 1. Complete Part 1. No determination can be made until Part 1 is fully completed. 2. Complete only the portion of Part 2 applying to the type of water system utilized. 3. Submit completed application, with attachments to the health department for review. PART 1: Applicant/Parcel Identification Name of Applicant C n 1�a71— Date c Mailing Address lglo y7 d,k Aklc Telephon6ltG G97-3�L Assessor's Parcel Number �7DeW // 3 j,:9 — 56 000g Type of Water System (Check One): Reason for Application (Check One): -�r­Public/community water system(2 or se- Building permit more connections) 14- New ❑ Private Two-Party ❑ Replace Existing Structure ❑ Individual well (one connection) ❑ Land use application, if so... ❑ Well ❑ Division of land ❑ Spring/surface water #of parcels? ❑ Other(explain) SPH2 - ❑ Boundary line adjustment ❑ Other(explain) PART 2: Water System Information Complete the section appropriate for the type of water system being evaluated for adequacy: Public Water System/Private Two-Party Name of Water System r2 [�j;e, U 'A-r! y ]::)Lc7k> cry/ Water Facility Inventory (WF1)Number(enter"none"for Two-Party): L S 3 5c(3 O The water purveyor has filed a letter granting blanket hookups to this water system. I am the manager of this water system. The water system has been approved for h'yC services. There are presently yS" connections in use. This will be the connection. T'n—T s water system is able and willing to provide water to this(these onnections witho ut excee mg the limits of the water system or any limits set by state and local regulation. Signature of Water System Manage l t Date - y H:I WELL;WA TERAD3.WP.DOC Update:March 22, 1999 Mason County Permit Assistance Center Planning Intake Checklist Owners Name: Date: — — Project: Ma n Reviewed By: Commercial Developme - YES Oj Comments: Planner: SAL GBM /RAM) DMJ SC Site lan: North Arrow "roperty Dimensions: 5 X. -70 O rl 0-'�Streets and Driveways Shown. Road name: , ks I3 I wa er k5LFUdInS, erne,weans, etc.) lY Topography slopes)- roposed Structure Setbacks (Dreption/Setback). F: S / 10 R: N / S1 ( / /0 S2: / of Utility and Drainage Easements: Yes No (if yes enter condition#5022) L,1nL(AQ W n Other Easements U-r\LM d i1 n A Qn H 06 (1k eraut ee e dition#0010) Pr C o State A e add condition#0020) Standard Conditions to be added to all Building permits that planning reviews: #5019 and#0700 Shoreline and Planning Info V Setbacks: Shoreline: t A- . Slope: �Neo Sho line Designation: Comprehensive Plan: Rural Zoning: t Applicable ❑ Agricultural ❑ RR 2.5 5 10 20 ❑ Urban ❑ In-holding ❑ RMF ❑ Rural ❑ LTCFL ❑ RC 1 2 3 ❑ Conservancy ❑ Rural ❑ RI ❑ Natural ❑ RAC ❑ RNR ❑ Unknown ❑ �,QC-Hamlet ❑ RT 13'Urban Growth Area ❑ MPR ❑ Unknown �1 [I Unknown Water Body(type of water if unnamed): no 1^y� SEPA: Yes o U Flood Plain: YES N Unknflwn-Map# Aquifer Recharge: YES NO [ own) Map# Tags/Cases: RLC/SPI Case: C) 6-Year Dev. Moratorium: YES Eagle Nest Tag: YES O Other YES ?* Addressing: Check box if needed ❑ Reviewed by: �i1 .3 Z Zo m w -oN fn�to� IJJ Z rn� WQm Z ¢ m� W ® oo z = OOom w Z Z ycn�XXw c O t 1 >>QO p € r 0L- \/ G) 0)a a ag V WOMEN 0 D o I O � Ze- I � Z ' m m F_ LL a d N nr � M 0 4 .A ' Ntln� vl nvt ❑ £ 0 0QO • 7 = ^ ~ J W oLLA O a z N 0 IIII [ IN N O ---------- 3 3 Ndni Q © 0 im r W J Q w O m Q m z N Z m S 0 � LI ao O s rn /Hsym CL Now ■■■■■■■■■■■■■�■■�■■■■■■■■■■■■■� ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■MM■MOMMM■MMMO■iii`ii'rwimm■■OE ■■■■■■■MOM■■■■■■■■■■■■■■■■■■■■� ■■MMM■M■MM■M■MMMMMMMEME000MMMM■ ■■■ ■■■■■■MMMMr ERRMTRI t --�J�O■EE■■■ mom■■■■■■■■■■■S■■■■■■i■■■■■■■■■ ■■■M■■■■O■N1!l1Ou■■■■■■■■■■■■■■■■ ■■i����■�■s,/1! fll !■■■■■■■■■■■■■■■■■ Ell■■MMM■■M% ■,■■MMMM■sE■■■■■■■■■ IN 111M."awdlumig-INNIMMMIll Ill ■11■■■■111■■■O1i■;■'9PUMM■O■OI�ME■OMMM■ ■11■EOM■ ■■■■1�■■►:■OOEOEII!!l1MEIll EM■M■ MEMO No ■©■��i� `■■■lIIIG�!■[I■■■�■■■■■■MEMO■■ No NONE ■MNOII■IO■OOMi�■'■■�7O■■■■■■Ill■ENONE ■A■■E�i C�a■■��i■■OMME■■■■OM■■EEO■ ■le■■'I!�!■I■■■■G,:C■■' NONE■■■■■■■M■■■E■■■■�■■■■■EOMEN NONE - ----- - - ------ --------- r FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO.� PLEASE PRESS HARD BUILDING PERMIT APPLICATION 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 APPLICANT INFORM ION CONTRACTOR INFORMATIO Owner i O Company Name 'o I c,!t--n nfe F u Mailjng Ad es O Mail g Address City State W ,Zip Code 3 City T—State Zip Code yS7'370 Phone — ther Ph. Phon DOther Ph. Lien/Title Holder t i Contractor Reg. -�L c Exp. E mail address E Mail Address Drivers Lic. # A 0 11Q? DOB 5' %S /f Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Water System�� Name of Water System PARCEL INFORMATION - 12 Digit Parcel No. r y Fire District _ Legal Description Site Address (Please include street name, street number and city) Dir coons to site— f °�/n /+C �� c/ Will timber b cut and sold in p rcel preparation?Yes / o Is property wi hin 200'of Saltwater A10 Lake River/Creek JIA Pond Wetland —Seasonal RunoffA/nStream Slopes or Bluffs 1 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - Ne Add_Alt_ Repair_Other PRIMARY RESIDENCE SEASONAL ❑ Use of Building Describe ork No. of Bedrooms -1 o. of Bathrooms Square Footage - 1 st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOJI(IE INFORMATION; Make I i L i lyct �-I- ��_ .Model ' S o a Year Length Width Serial No. - - o. of Bedrooms 3 No Bathrooms _ Type of Heat L I..=cTc- a Purchase Price $ d oe �� v Replacement Unit? Yes o Installer Name '> .�t Certification IN 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 permis- sion from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this applica- tion or the <proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. X Date: z O Owner Owners Representative/Contractor (indicate which one) FOR OFFI AU7ggE BE IN T OINT �i b G Accepted by: g Pd Ck#�y � Date Bld Pd- d Eieceipt No., DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Public Works Department Fire Marshal t _ FEES Building Permit Fee Site Ins ection 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 I Pre-Paid at Submittal Valuation $ TOTAL FEES MASON COUNTY PERMIT NO. BUILDING PERMIT APPLICATION 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 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner h f71E Company Name-•.C.i Mailing Address i x r ` Mailing Address ,' City - ; z State t Zip CCity i State vt, Zip Code 'S Phone! Other Ph. Phone -:: -,r> 7- z , �- - Other Ph. Lien/Title Holder le A.R Contractor Reg. ` Exp. E mail address Mail Address Drivers Lic.#LQ I '^ &AI DOB i i 0; I Drivers Lic. # DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System . Name of Water System Well Water System ' Name of Water System PARCEL INFORMATION - 12 Digit Parcel No. Fire District s Legal Description Site Address (Please include street name, street number and city)fV , Directions to site Er 'r.rx :5 A f 1,..,t Will timber b cut and sold in"p rcel p Is property within 200'of Saltwater r`f-.eparati Lon?Yes/ENo � 1 ` " � ake `e/: River/Creek rhr', Pond tt:r��: Wetland_! r, Seasonal Runoff +t 'f; Stream Slopes or Bluffs > 15% 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_Other PRIMARY RESIDENCE SEASONAL Use of Building 6< Describe Work Kj No. of Bedrooms--72_ o.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, r r r C ,._Model, y. .� ,• , YearZ.x_ Length +�f Width •r�. Serial No. >/ 5`+ <� No.of Bedrooms-JNo i Bathrooms Type of Heat Purchase Price $ nn > Replacement Unit? Yes �N Installer Name - -•/•>F J h 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 permis- sion from all the necessary parties.If permission is required from any easement holder or any other party in interest reg'arding this plica- tion or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct thb-work X l '�. a Date: Owner)/Owners Representative/Contractor (indicate which one) s% FOR OFFICIAL,USE BEYQNpT I$ POINT CLDAR ST: Accepted by/ Y Pfahn0g Pd Ck# � r' Date " =�Bld Pd, Receipt No,_" DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Departmentp-.aj V-N Planning Department Environmental Health Department blic Works Dep Pu artment Fire Marshal FEES Building Permit Fee Site Ins ection 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. BUILDING PERMIT APPLICATION 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 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner `, r ..- , Company Name- , Mailing Address - ,- < Mailing Address "> ._ City 'State Zip Code City�_State Zip Code Phone — Other Ph. Phone Other Ph. Lien/Title Holder�' 6 Qom% Contractor Reg. .'r: Ex P E mail address E Mail Address Drivers Lic.#r Q DOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Water System Name of Water System zry. ` PARCEL INFORMATION - 12 Digit Parcel No. Fire District Legal Description M Site Address (Please include street name, street number and city) ' Dirgctions to site g'c.>/.e / /J ,, s: s' / r " r ( t Will timber b cut and sold in p rcel preparation?Yes /Mg) Is property within 200'of Saltwater '.'£.. Laken j,,' River/Creek Pond Wetland Seasonal Runoff ;tJ,'" Stream , ;< Slopes or Bluffs J 15% 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_Other PRIMARY RESIDENCE Q SEASONAL E]Use of Building rL ,"" Describe Work No. of Bedrooms No. of Bathrooms .oc.. Square Footage - 1 st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Makf SKIL;r] e Model ,: . '4; t '�YearZ:< ` Length Width < .`-• Serial No. S -Jr r A- ^f! No. of Bedrooms jNo, of Bathrooms Type of Heat c•-. Purchase Price $ /a ,,,^ Replacement Unit? Yes 9 No.' Installer Name f >- i �i'si/ O f c 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 permis- sion from all the necessary parties.If permission is required from any easement holder or any other party in interest regatdinb this alp))lica- tion or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the-work proposed. X i e rG. Date: rRepresentative/ ( ;f Owner/Owners Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT ST Accepted by:,!' `Planning Pd Ck# Date - i - Bid Pd -Receipt No.`. -' DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department t4 ko Environmental Health Department Public Works 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 MASON COUNTY PERMIT NO._ BUILDING PERMIT APPLICATION 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 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Company Name Mailing Address Mailing Address City State Zip Code City State Zip Code Phone Other Ph. Phone Other Ph. Lien/Title Holder+e _ Contractor Reg.ifi' Exp. E mail address E Mail Address Drivers Lic.# r-.' ' DOB _ Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Water System ✓ Name of Water System_;" r j PARCEL INFORMATION - 12 Digit Parcel No. Fire District Legal Description Site Address (Please include street name, street number and city) Directions to site < x Will timber be cut and sold in p rcel preparation?Yes/; or Is property within 200'of Saltwater Lake�_River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs J 15% 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_Other PRIMARY RESIDENCE \ SEASONAL E]Use of Buildings ,✓ Describe Work No. of Bedrooms - No. of Bathrooms r Square Footage - 1 st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage Attached Detached Carport_ Attached Detached MANUFACTURED HOME INFORMATION Make l:` )<Y/- 1 n f° Model • ' 'Year -'_' Length TWidth Serial No. r _ �No. of Bedrooms No,of�Bathrooms Type of Heat - Purchase Price Replacement Unit? Yes 7 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 gbtaineo th ermis- sion from all the necessary parties.If permission is required from any easement holder or any other party in interest reggrdirlg Miapplica- tion or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. X Date: i 1 L 9 Owner/Owners Representative/Contractor (indicate which one) � FOR OFFICIAL USE BEYONQTHIS POINT ` Accepted by; Planning Pd Ck# Date Bld Pd Receipt No. DEPARTMENTAL REVIEW JAPPROVED DENIED NOTES Building Department Planning Department Environmental Health Department 6441 t a' Public Works Department Fire Marshal FEES Building Permit Fee MIJEES ection Plan Review Fee w Fee =27,1� Plumbing & Base Fee Review Fee Mechanical & Base fee Wood/Gas/Pellet Stove Fee Violation Fee at Submittal Valuation $ 1194 Mason County Dept. of Community Development Mason County Bldg. 3 426 W. Cedar P.O. Box 186 (360) 427-9670 Local (360)482-5269 Elma Shelton, WA 98584 (360) 275-4467 Belfair Notice to Obtain Final Inspection November 08, 2007 RITA COLLETT P O BOX 1615 PORT ORCHARD WA 98366 Case No.: BLD2004-00831 Parcel No.: 123325000050 Proiect Description: MANUFACTURED HOME The Mason County Department of Community Development is currently reviewing all permits that are expired and have not been approved for occupancy and use. • Pursuant to Mason County Code, Title 14 Building and Construction, a permit and final inspection for this type of activity is required under the 2006 International Building Code and your property is currently in violation status of occupancy and use. Please contact our office to make the necessary arrangements 21 days from the date of this letter. Failure to contact our office to make the necessary scheduled inspections will result in enforcement actions. To bring your site into compliance, you must schedule an inspection. One (1) $64.00 site investigation fee will need to be paid prior to inspection along with any outstanding fees currently due on your building permit. For every inspection required after that, you will be charged $64.00 again, per inspection until final inspection and conditions are met. To schedule an inspection, please call (360) 427-9670 ext. 262. If you should have any questions regarding this notification, please contact me at (360) 427-9670 ext 359. Sincerely, Ar--t-y / L Terry Ryan Mason County Department of Community Development Cc: Property File November 08, 2007 BLD2004-00831 BUILDING PERMIT APPLICATION1N , MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 n DATE ISSUED PERMIT NO. OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE DIRECTIONS TO JOB SITE LEGAL sit^"tr), `- rr,.. �-. 11-a' : / = 1LS 4crElp nlri ,%',:• rr . DESCR. �' 1n p Od 06N 6e�L fl9/ otfE ji9k'K / H, NAME MAIL ADDRESS CITY R STATE LICENSE NO. PHONE CONTRACTOR USE OF BUILDING OV✓94 Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE [] REMOVE Describe work: Q / /N�TA<c agzE Or1Gs Valuation of work: $ _ p G PLAN CHECK FEE PERMIT Ff,E l7 7 0. o A. s Vfs SPECIAL CONDITIONS: BEDROOMS_ IDECKS — CARPORT C NOTICE BATHROOMS_— TOTAL SO. FT. GARAGE ATTACHED it SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT Il OR AIR CONDITIONING. TOTAL SO. FT. FIREPLACE i I DETACHED L; THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS AT ANYTIME AFTER I Certify that I am a currently registered contractor In WORK IS COMMENCED. the State of Washington and I the aware of the FOROFFICE USE ONLY ordinance requirements regulating the work for which the permit is issued and all work done will be in conformance therewith. PERMANENT SHORELINES Il SEASONAL C FLOODPLAIN J Firm E.D. NO. S.E.P.A. L By Special Approvals IN OUT YES APPROVED NO _. Lic. No. Date ZONING PLANNING DEPT, HEALTH DEPT. OWNERS AFFIDAVIT PUBLIC WORKS I certify that I am exempt from the requirements of the FIRE MARSHAL contract or registration law RCW 18.27, and am aware BUILDING DEPT. of the Mason County ordinance requirements for which this permit is issued and that all work done will ROAD ACCESS be in conforman/cceey7,therewith. MOTOR VEHICLE PERMIT Owner� �' �'w Date /a �47'•": PLICATION A CE ED BY PLA�/S CHECK BY A V�BPPROD FOR ISSUANCE M.O. CASH N CHECK VALIDATION CK. M.O. CASH RMIT VALIDATION C� ■■i■iiii■5%`i n!' I ■■■■■■■■■■■■■■■■■ ■11■■■�I�'■' l�:�Ivi■■■■//■!■■■■■■■■■■■ ■11■!III;■■■■■■!!!►'%■■\G'��'1 ; .■■■I■■■■■■■■ ■0■■�■'�■■■l111G■■[I■�a■■61Ml�ltill�l■■�l�■■■■ ■iJ■■■■''■■■■■!t■■■■lilti�liiii►i�44�liill�i■■■il�Y�lii■■■■ ■�.�■ice■■■■■■■��■■tee■■■■■■■■■■■■■■ --------------------------------- r