HomeMy WebLinkAboutBLD2003-00797 Pier Ramp and Float - BLD Permit / Conditions - 6/9/2003 I . ,
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PERMIT NO.: BLD
FORM MUST BE COMPLETED IN INK
PLEASE PRESS HARD MASON COUNTY
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 Seattle 206 464-6968
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner ( `7 Contractor Name
Mailing Address # Mailing Address �,
City �, State WA Zip Code `Z City State_14[� Zip Code z
71
Phone() Other Ph.(_� Ph.(-go Other Ph..0
Lien/Title Holder Contractor Reg. # S/ ' A �A
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. / / d`c Fire District
Legal Description 5eZ;ri 33 T 2— K 0-9 W lk-11' NALc
Site Address(Please include street name, stye t number and city) �. A WAII
Directions to site &�EI�C I Ml/k' � �- UMG7j &1,&0 SR l C&
Will timber be cut and sold in parcel preparation? (Yes/No) ,
Is your property within 200' of the following: Body of Water (Name) j Saltwater
Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or
Bluffs
PERMANENT RESIDENCE❑ SEASONAL RESIDENCE
TYPE OF JOB New Add Alt Repair Other Use of Building
Describe Work I j- "
No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Floor
3rd Floor Loft Basement Deck Other ?l 4 ru 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 describel&opgrt6an dd structures for review and
inspection of this project. Acknowledgment of such is by signature below: ii jj����
OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I c ��t cu"r r ntly registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washing urlb of the ordinance
requirements for which this permit is issued and that all work will be done in requirements regulating the work f��i��i �is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance the 811 be made without
Lappro4val first obtaining approval.
A -7 V,!O 3
JO
Date X Date
/1 FOR OFFIC AL USE BEYOND THIS POINT /Z)
Accepted by MAIL- Dattj /5`DLSubmittal Amount Due � Rece4litl4o.
�EPARTMENTAI» FE1/I'EW APPROVED DEN#Ep CO pS
Building
Department
Occ
Type Constr.
Planning Department
Environmental Health Department
Public Works Department
i
Fire Marshal
Valuation $
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 ( )
TOTAL FEES
PERMIT NO.: BLD
MASON COUNTY
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 Seattle 206 464-6968
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Contractor Name
Mailing Address k Mailing Address
City State Zip Code { City State Zip Code
Phone( . •' ) �. Other Ph.( ) Ph.( _. ) :Other Ph.0
Lien/Title Holder , Contractor Reg. # t
Address Expiration / T /
I
EPTICfWATER 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. / W / Fire District
Legal Description
Site Address(Please include street name, street number and city) J
Directions to site
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 3
TYPE OF JOB Newer Add Alt Repair Other Use of Building
Describe Work
No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Floor
3rd Floor Loft Basement Deck Other ° sq. ft. .l
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 8,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.
f'
X Date y X Date
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date ` Submittal Amount Due Receipt No.
D PARTM!ENTAL. REVIEW ::APPROVED D NIE 6oNDIT1oN Co
Building Department
Occ Group Type Constr.
Planning Department
Environmental Health Department '���
Public Works Department
i
Fire Marshal `
Valuation $
..FEES
Building Permit Fee Sine Inspection
Plan Review Fee EH Review Fee
Plumbing&Base Fee Planning Review Fee
Mechanical&Base Fee Other
Wood/Gas/Pellet Stove Fee State Fee
A..
Violation Fee Pre-Paid at Submittal ( )
TOTAL FEES
PERMIT NO.: BLD
MASON COUNTY
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 Seattle 206 464-6968
APPLICANT INFORMATION CONTRACTOR INFORMATION
i„ t: Contractor Name
Owner 1
Mailing Address r i,.t. !I"' Mailing Address I
City State ILL Zip Code ~{'^ City ilk a ; - State ;4;'1, Zip Code
Phone( sh °`' 2A Other Ph.( Ph.( 'r_)
Lien/Title Holder
Contractor Reg. #
Address
Expiration_. /_-_E_/ J
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. Z 2,?43 Fire District
LegSite es x ' R s(P ease include street name,"� stet number nod city) ��l', �t I Fttt
Directions to site !`I; , �' ) 4, t k 1 ,§ .; ' '
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 RESIDENCE13
TYPE OF JOB New Add Alt Repair Other Use of Building
Describe Work t ' do t-t ;1 �,Q
No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Floor
3rd Floor Loft Basement Deck Other i s 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. T ,° f, x first obtaining approval.
X Date X Date
/ FOR OFFICIAL USE BEYOND THIS POINT
' r
Accepted by " Datd ..Submittal Amount Due / / Receipt No.
DEPAR7MENTAI»REVI{~W APPROVED DENIED CONDITION CODES
Building Department
Occ Group Type Constr.
Planning Department \\1 `< ►
Environmental Health Department ��1
Public Works Department ! C c9f
I
Fire Marshal
,p
Valuation $
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
PERMIT NO.: BLD
MASON COUNTY
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 Seattle 206 464-6968
APPLICANT INFORMATION CONTRACTOR INFORMATION
I ..,: Contractor Name �i,k s y
Owner l t �LL4, i ti
i a ,:c Mailing Address ' '
Mailing Address of N g
City t tA' r* State 'Atir i Zip Code ( City r r 41: State T� Zip Code
Phone(ne( . Other Ph.( ) Ph. ry, f s�y,� , /Other Ph (—�
Lien/Title Holder Contractor Reg # i.
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
TION-12 digit Tax Parcel No. 1. Fire District
/ S ' / r f'.`'X
PARCEL]NF5?RMA f
Legal Description *#:',�, a i� d »I
Site Address(Please include street name, strut number and city) f.may e �
Directions to site . c,; -.,I :, ii, A ,
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 O SEASONAL RESIDENCE[3
TYPE OF JOB New /. Add Alt Repair Other Use of Building
Describe Work ;,. 3 f_ 4 El
No. of Bedrooms No of Bathrooms SQUARE FOOTAGE-1st Floor2nd Floor
3rd Floor Loft Basement Deck Other ,: r i.!`;}', sq. ft. '°c
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. ! +, r,.� ,; first obtaining approval.
2
X t v; Date X Date
" FOR OFFICIAL USE BEYOND THIS POINT '
Accepted by Date ' _Submittal Amount Due .f` lX Receipt No.
Of»PARTMENTAI» REVfEW aPPRovEQ DENIED rCCONI�ITION cpQEs
Building Department
Occ Group Type Constr.
Planning Department
Environmental Health Department �Qo
Public Works Department
Fire Marshal !
Valuation $
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
TOTAL FEES
Proposed picr.ra-p
and float
NORTH
APPROVED
HOODC SON COUNTY DCj PLANNING
SITE PLAN REQUIRED TO BE ON SITE
CHANGES SUBJECT TO APPROVAL
By 0/2 -- Date L L2 J
—— —— —— Bulkhead
House
Sid" 1/0
20" Bulkhead
G Y'
2 9• Touhy residence ZO
Natural beach
GG
Storage
Property line
Driveway
ID
e
HIGHWAY 106
f r •.
Reference:Tuohy,Mike fF:
Tuohy Project Location: � � � App:Marine Surveys and Assessments
In:Hood Canal near Union
Section 33,Township 22N,Range 03W a;` x t Purpose:Construct new pier,ramp and float
7311 East SR 106,Union,WA 98592 � - :{ Datum MI LW
Lat:N 47*20.954' Long:W 123'03.87' ` `
Adjacent Property Owners:
1) John Nordstrom
- 3 2) John Nordstrom
€ v r �Vr. F f�
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Printed from TOPO! @1999 Wildflower Productions (www.topo.com)
2'wide4 grating
HOOD CANAL
3 stub pilings 6'BY 20'
8'BY 25'FLOAT FINGER FLOATS
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NORTH
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ASCII COUNTY DCD NLANNI",!G
SITE LAN REQUIRED TO BE ON SI'fr
S C NGES SUBJECT TO APPROVAL
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Float stop details
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Pier,Ramp and Float Project