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Home My WebLink AboutBLD99-0472 Final Tank Removal - BLD Permit / Conditions - 8/10/1999 T a> --1 J zi V) '0 ' 'i m O 2 d *� CA co -4 M n M rn rt1 rl m r- C — D Cif 0 7J ^ 3J C) rn :E 0 0 : m 61? 6a44 - -i fi -4 0Z > n '.S Ca. l? Q D !" z 70 ;r k I Qv r- x rn --q a a -t v ^ a cn co ca .0. -D6 Ab c Oun M `fir j mwry a o n r -i may ac► M VI in IS m -4 to rn 9. S3 Z 2 x r CO CD co co is is -' L. Cn ' J a) w � p D CA Cri ►'1 C4 C9 Q Ca -f 2 OS CY 4o W (D Cc { i { ip tD t0 t0 Co CD to zo - \ Ch LT Q4 (A z (; 0} lR CO (D 0 W m C1t C}i r3. •`•` -a b W --aK co o 0 Z- o D � zr " 0 0 I `_ -J o i OD In �- � n O ° o� O : . a b = C rn QN z ;! o, v j CQ - z o n m OD Q o � Q c 0 � Z CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons data by Gas Piping date --by- 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. 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Dept. ROUGH DRAFT revision 1 m Gary and Pam Hanson Property 6843 E. Hwy 106, Union, Wa m PERMIT NO: BLD 1'o `, MASON COUNTY BUILDING PERMIT APPLICATION 426 W.Cedar/P.O.Box 186, Shelton,WA 98584 i(�# Ir60 Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle "464"- 96$ APPLICANT INFQRMATION CONTRACTOR IN PRMATI0,N Owner r Contractor Name CaGe a.ck. I#-VA- �1/4 4t Mailing Address L Mailin Address O �9 City State jg2 Zip Code .S�o�- ity Phi hen.. State� Zip Code Phone( U)YW-1150 Other Ph.( � /��/a-��1fd Other Ph,( Lien/Title Holder Contractor Re # �/45G'�? S U s7' Address Expiration / 7 / c00 y 0 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. / UQ U Fire District 4o Legal Description 7:eAtk / Site Address(Please include street name, street number and city) Directions to site— Will Jder �I�G� Will timber be cut and sold in parcel preparation? (Yes/No) __'_ Is your property within 200' of the following: Body of Water (Name) f7�oc' Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair_ Other Use of Building Describe Work lr _ 1�6) No. of Bedroors No.of�rooms SQUARE FOOTAGE-1st Floor 2nd Floor 3rd Floor Loft Basement Deck Other sq ft Act Garage Attached Detached Carport Attached Detached ` MOBILE HOME INFORMATION-Make Model Model Year Length idth Serial No. No. of Bedrooms No. of Bathrooms Type of 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 obtaini g approval. X Date X LtQ<�t'�Ue Date &/5 9L l,� FOR OFFICIAL USE BEYOND THIS POINT Acceptedy, Date Submittal Amount Due Receipt N DEPARTMENTAL:REVIEW A P VED DENIED CONDITION CODES Building Department ) X 17 Occ Group Type Constr. `-41 J4 r Planning Department Environmental Health Department Public Works Department Fire Marshal (U Valuation $ FEES Building Permit Fee Z Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing & Base Fee Public Works Review Fee Mechanical & Base Fee Other Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal ( ) TOTAL FEES .... 1 MASON COUNTY PERMIT NO.: BLO 1 BUILDING PERMIT APPLICA ION 426 W.Cedar/P.O.Box 186,Shelton,WA 9858_ f IY � Shelton 360)427-9670 Belfair 360 275-4467 Elma 360 482-5269 Se the 206 464-6968 APPLICANT INFORMAT19P CONTRACTOR INFORMATION Owner ' trlt f 6 c L Tom` Contractor Name, -.: <1 G 6k.`. Mailing Address U( �^ Mailing Address .�O !)1c, L2!:f City c c. State,, Zip Code .City jit''C Kt�,4-0jt_ State W* Zip Code Phone °'' tf-y � Other Ph. yk�f. `' ' ( ) .. U ( : -.,', ).�,��'�`�� Other Ph.(,,, ,, Lien/Title Holder Contractor Re # Ls1S0-AA=S T Address Expiration , l 7 / ADUU0 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. 3,2233 / / UI9 d Fire District Legal Description °'> ,..4 4 `6 Gf^ IAI Site Address(Please include street name, street number and city) je57. aoq ze�o Directions to site /I o" i.:'-Dr- Will timber be cut and sold in parcel preparation? (Yes/No) r Is your property within 200' of the following: Body of Water (Name) Ile-w4 Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs ' TYPE OF JOB New Add Alt Repair Other Use of Building Describe Work`1:J�� 14-V o A��t,J No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Floor 3r1 Floor Loft Basement Deck Other sq. ft. Garage Attached Detached Carport Attached Detached MOBILE HOME INFORMATION-Make Model Model Year Length 1{Vidth Serial No. No. of Bedrooms No. of Bathrooms Type of e 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-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 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 Date Date E/� FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt N " DEPARTMENTACREVIEW APPROVED DENIED CONDITION CODES Building Department Occ Group Type Constr. Planning Department ✓f Environmental Health Department Public Works Department i Fire Marshal Valuation $ FEES Building Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing & Base Fee Public Works Review Fee Mechanical & Base Fee Other la+l.GfiLd� Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal ( ) :»:: TOTAL FEES