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N CD N O CCDD O a) -p 0 � � CS3 O � C 3 CD CD 7 N CD n Cn CL N O � � -O 0 CD O O CD 0 Cl CD _ m x O > > C� c CS .0 p CD `G 0 O 0 `< O d O c W j -CO 3 �. 3 N y CD Zr � =r a � O 0 O CD CD CD 5. 3 << CD .0 <° v CL C� •CD 6 � =3 o " CD * - 0 m c c X, 3 0 _. c m 0 n � CD CD a CONCRETEftBy ' MECH NI AL 1VIANUFACTURED HOMEFootings/ SetbaDate B y (.-j Ribbons o Dates ' _cGas Pipi g Date By 0 N Foundation Walls Date B y Set-up Date By INSULATION Date By B G / Slab Insulation Floors Final Date By Date /p^3-c23 By Date By FRAMING Walls FIRE DEPT Date By %�_ Date By Date By PLUMBING Attic OTHER Groundwork Date "d--,7 -c-,-3 By 77? Date By WALLBOARD NAILING D.W.V. Date to © U-S By L,o Date Q p By FINAL f NSPECTION Water L n Date By Date By �7L .:. = Date By y —b' "/ � �3 �- "ice:�%j�✓�: S )52/� S Is O CD C Z� S,ED lf5 opp r-qtzzo L s L, zdp- c�•,i ITI N d O O W � v O � OO O I 5LD2 CO3 009 2- Building Permit # MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location ALE t5l &C-L >Are- ��ko� -ticpEfz This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been fo nd: Items Listed below must be corrected to gain code compliance v L--i- o L T —C "x l es 2 Gv wR .7— O SLL Jr- ` - jAj2�cc a o- - — IL`' S t DEL 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 ❑ OK to Y45t, Ut F16o2 4- t4*14&S CA..,I �$( This is not a complete inspection Department j- Date Inspector RL c DO NOT REMOVE THIS TAG 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 On the Web www.co.mason.wa.us APPLICANT I��NFOR CONTRACTOR INFORMATjON Owner T�1 ii� N A N'C 5 F R E A)b E R Contractor Name l Mailing Address Pk&' 4 r%-5 Mailing Address Ci L, �I p City P ty R State W A Zi Code 5l;f Ci State Zip Code Phone 3(' �?) '" `� Other Ph. ( ) `��! ``� Phone L� Other Ph. L � Lien/Title HolderC Contractor Reg.# Exp. E-mail Address E-mail Address ESy PTIC/WATER SYSTEM INFORMATION-Connect to New Septic 1J A Existing Septic � Connect to Sewer stemA Name of Sewer System A-) A Well Water System p ` $me of Water System V A ! PARCEL INFORMATION- 12 digit Tax Parcel No. Fire District Legal Description N W OF T N t Or- .S t= C { Site Address(Please include street name,street number and city) tiL JE ! t.F- dR Xg dvo Q R Directions C to siteMKU�^�.e,�'1. �� 5R� �.�5p�00 �`RA V ((3��.. F4. EF5 ( )) T` CA) _5 14t L L/AA).Q 1-Q0 TL I�1Q A L���'d Will timber be cut and sold in parcel preparation? (Yes/No) )t� Lake k)A River/Creek A-)A Pond 1' Wetland A;A Seasonal Runoff A) Stream A 14 Slopes or Bluffs N PERMANENT RESIDENCEM SEASONAL RESIDENCE❑ ? - ' ! - + I T t i {. TYPE OF JOB-New Add Alt Repair Other Use of Building I Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action? (Yes/No) /)ti Describe Work A b b f } rat-A E K X. Q F HO Q 6F_ I COV(4 0 L E7) _-� A0 f-C OCR No.of Bedroo A No.of Bathrooms SQUARE FOOTAGE- 1st Floor_2nd Floor q 3rd Floor_Loft _Basement A rA Deck /V A Other A,)A sq.ft. A,)A Garage Attached_Detached / + Carport_Attached /�)f) Detached LA MOBILE HOME INFORMATION-Make 0 A Model A2 A Model Year /C) A Length &,) A Width A-)A Serial No. AJ A No.of Bedrooms No.of Bathrooms/1) Type of Heat Ad A Purchase Price$ A.)A Replacement Unit? (Yes/No) Installer Name ii A Certification No. A) f? i NOTICE:THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF I 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.Owner/Builder acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a the Contractor Registration Law RCW 18.27 and am aware of the ordi- contractor in the State of Washington and that I am aware of the ordinance nance requirements for which this permit is issued and that all work will be requirements regulating the work for which this permit is issued and all done in conformance therewith. No changes shall be made without first work shall be done in conformance therewith.No changes shall be made i obtaining 7pproval. without first obtaining approval. X f J ( Date ! J Z) X Date FOR OFFICIAL USE BEYOND THIS JQlKIT- Accepted by Date Submittal Amount Due Receipt No.IN "OW i F' 9av'x4E ! Building De moment ! Occ U. `�Ty e Constr. Planning Department Environmental Health Department I Public Works Department i Fire Marshal r Valuation$ Building Permit Fee Site Inspection I Plan Review Fee EH Review Fee Plumbing&Base Fee Planning Review Fee I Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee State Fee i Violation Fee Pre-Paid at Submittal ( ) � x TOTAL FEES � .✓,:.x+X 3.. :�...v/.F h+9:�»..f l,�nx: `,�`Sf'.r rw/! ,:.1...,.lf.Y sA.�'3�..F5::�:..tT.. K .,s/fr :z:•; MASON COUNTY PERMIT NO. BLD 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 On the Web www.co.mason.wa.us APPLICANT INFOR T CONTRACTOR INFORMATION Owner a"O �A KC E 5 F R E t, bkfk Contractor Name Mailin Address U- C 0 Mailing Address City 0I-4 VA I F, State uJA Zip Code City State Zip Code Phone c360 `� Other Ph. (360) 4'f`785 Phone C Other Ph. L� Lienfl-itle Holder tv IT5 A 04 F E b ESL C. L(r Contractor Reg.# Exp. E-mail Address E-mail Address EyPTIC/WATER SYSTEM INFORMATION-Connect to New Septic A%A Existing Septic Connect to Sewer m stemNANae of Sewer System A) A Well Water System /0 A me of Water System VA PARCEL INFORMATION- 12 digit Tax Parcel No. " _. ! ' / ( f'' Fire District Legal Description N U) OF: 114 E k)I- II OF SIF C a 30 7' 21 AJ R I (A) i LV# AA Site Address(Please include street name,street number and city) �l)t 1 ICE L lc'A I$� AIR R D, G'E 4R. Directions to site PVCA I S K 3 00 VZ A J E.t tU C-S r C&J SA A.'b NIL L fc h, T t i tc IU I.a&rr Will timber be cut and sold in parcel preparation? (Yes/No) Olt 0 Lake VA River/Creek A)A Pond tom'A Wetland AI A Seasonal Runoff A✓ A Stream .g Slopes or Bluffs A) A i PERMANENT RESIDENCE& SEASONAL RESIDENCE❑ r` ! +t C TYPE OF JOB-New Add Alt Repair Other Use of Building tG%1ti! Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action? (Yes/No) A)O Describe Work A D b O )r d l .5C41ZH JE&,b 0 t- NO U 5 E CGA P LC*r _�) A'.A F C CO✓1 , No.of Bedroo A No.of Bathrooms SQUARE FOOTAGE- 1st Floor 2nd Floor i 3rd Floor A) Af Loft Basement A•�� Deck 1V A Other X,19 sq.ft. � ' Garage_Attached_DetachedKA Carport_ l' A Attached 1k`A Detached f MOBILE HOME INFORMATION- Make V A Model V A Model Year i Length k) A Width A. Serial No. A No.of Bedrooms AI' No.of Bathrooms ' Type of Heat i) A Purchase Price$ A)A Replacement Unit? (Yes/No) Installer Name OU A Certification No. A) 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.Owner/Builder acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a the Contractor Registration Law RCW 18.27 and am aware of the ordi- contractor in the State of Washington and that 1 am aware of the ordinance nance requirements for which this permit is issued and that all work will be requirements regulating the work for which this permit is issued and all done in conformance therewith. No changes shall be made without first work shall be done in conformance therewith.No changes shall be made obtaining qpproval. without first obtaining approval. { X V ( C Date t X Date FOR OFFICIAL USE BEYOND THIS FfnD I ,� r j Accepted by ( Date NJU� Sub Amount Due Receipt No. 7 Building Depart rent Occ Group iti ' TypA Constr. Planning Department �� + ./z 0. !" Environmental Health Department f Public Works Department Fire Marshal toot 0 Valuation$ RM WINOX Building Permit Fee Site Inspection Plan Review Fee EH Review Fee i Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal ( ) n' 7'x .-/' d �a:: se r'..' :... ....... :: . ..; 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 On the Web www.co.mason.wa.us APPLICANT INFORMATION, CONTRACTOR INFORMATION Owner �) 9 t ` / #`a+a «3 "' Sa J'- i '� Contractor Name Mailing Address t - ='p "� -Cy .� Mailing Address City 4 - ' + State -`/J Zip Code 7', f _ City State Zip Code ;' / P`i<t. `j Other Ph. .'{.c- `t f c` Phone(_) Other Ph. Phone <-4 f' ' r ..a Lien/Title Holder f � + " �� "� �' ��',rr_ w ` t Contractor Reg.# Exp. E-mail Address E-mail Address SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic ;. ? Existing Septic `-A Connect to Sewer System? AName of Sewer System ; ► Well X Water System Name of Water System k, N PARCEL INFORMATION- 12 digit Tax Parcel No. / / Fire District Legal Description '• +: i'f s C ; r Site Address(Please include street name,street number and city) w 4: i `� k L r 4 a -L 2AJ i J t5 t F I t Directions to site 7L 7 N �` k'iz 4 t s P P "�t� Will timber be cut and sold in parcel preparation? (Yes/No) f... !. Lake =`- ` River/Creek .A Pond r`­ 41 Wetland r`.. A Seasonal Runoff av 3 Stream I r� Slopes or Bluffs t,_ A PERMANENT RESIDENCEN SEASONAL RESIDENCE❑ TYPE OF JOB-New Add x._ Alt Repair Other Use of Building 'i� 1 P E Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action? (Yes/No) r•'._. t� 3 Describe Work f ' >, �` r 3 -b f �.t s? �: t #' e.€ €1� +"� a �' j e' f_r t �- , No.of Bedrooms No.of Bathrooms µ4 SQUARE FOOTAGE- 1st Floors f. 2nd Floor 3rd Floor Loft Basement Deck f'' i Other r sq.ft. i! Garage �.:` ji Attached ;`, r" Detached Carport �t.. , } Attached Detached MOBILE HOME INFORMATION- Make f} Model Y' Model Year Length ` } Width i Serial No. i• No.of Bedrooms R" r No.of Bathrooms Type of Heat ? ,�t Purchase Price$ i,, ,` 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.Owner/Builder acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a the Contractor Registration Law RCW 18.27 and am aware of the ordi- contractor in the State of Washington and that I am aware of the ordinance nance requirements for which this permit is issued and that all work will be requirements regulating the work for which this permit is issued and all done in conformance therewith. No changes shall be made without first work shall be done in conformance therewith.No changes shall be made obtaining approval. without first obtaining approval. X Date X Date FOR OFFICIAL USE BEYOND THIS PNT Accepted by 1 -- r ; Date 7�L " ,� Submittal Amount Due i --. Receipt No `, ?� �A ��.:�... �.....F.� , �•HIS,.'.:: '>_�:. �� :.;,.: r�,F Building Department Occ Group Type Constr. Planning Department -< Environmental Health Department Public Works Department Fire Marshal Valuation$ .. ....,... l<f ,a, ....:::.,ss......;.y;. £,.:. .� Fhi€7 73 nF Y� 9/' z d `�/'y �`�: H i s 7' %^a y •l o.Z.t< a.�/y'r:: „€sF F r, N' r%bi/.. \£�'',1�, ...?� y S 'c 3�a ::t �gav's� i.<;;.hr%>a,.<.: . .s' ?::,,:�?;:<,::.g /..:.�..., :4«i: :€'F�, �, f,.,. -,.r., 3 s Building Permit Fee Site Inspection Plan Review Fee EH Review Feerj, p Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee I Pre-Paid at Submittal ( ) i ����u z F � ✓� xs TOTAL FEES R01N .. ,.s. 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 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION— owner �� T0N F R IE�A) k IF� 1FRAARE4 UJ. Contractor Name Mailing Address Mailing Address City State WA Zip Code 1?8528 City State Zip Code Phone('16D ) Other Ph.(Jg�D ) Y? -?8S6 Ph'( Other Ph.( Lien/Title Holder K i TSAP FEA ERA L CRFbji uNtb Contractor Reg. # Address NRtVELL Si 646156' N UJA Expiration SEPTIC INFORMATION-Connect to New Septic_JA Existing Septic DC.. Connect to Sewer System PA Name of Sewer System k)A PARCEL INFORMATION- 12 digit Tax Parcel No. Q / / (� Fire District Legal Description A)W ©F I•MIE A)a % OF St EC . 30, T 2101 R( a)4 LV.M � Site Address(Please include street name, street number and city) Directions to site FYQ A SR 3 00 `1'2A✓IE L W kS( D SAtJ40 A 1 C L k A . 7-URA)' L E4 A otorb (?EIFA)ft AI ,AwoR fth, MAyL;:7Z YC0YZS � 15T N0U,5C ON L157FI-, Is your property within 200'of the following: Body of Water (Name) N Saltwater NA Lake River/Creek _Pond JV A Wetland Seasonal Runoff A)A Stream /wA Slopes or Bluffs O AX TYPE OF JOB New Add _Alt Repair Other Use of Building 1401-4 E Location of Fixtures/Units 1st Floor X_ 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 Bathroom Sink Furnace Bath Tubs Heatpumps Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kitchen Sinks ! Wood/Gas/Pellet Stove Dishwasher I Kitchen Exhaust Hood Hosebibs 1 Dryer Vent Other(CIF / Other ELE(7_ L M/1l'f�OZ Base Fee HIIEAI`lEP.S 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 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 appro al. first obtaining approval. X Date a X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. NRtTIQNG3S3 Building DeK731 Occ Grou �I++��,, Type ConstO Planning Department Other Other SEES 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 ( ) Violation Fee TOTAL FEES MASON COUNTY DEPARTMENT OF HEALTH SERVICES EEEEMMM July 15, 2003 PO BOX 1666 SHELTON, WA 98584 SHELTON (360)427-9670 FAX (360)427-7798 ELMA (360)482-5269 JOHN FRENDER BELFAIR (360) 275-4467 P.O. BOX 2055 SEATTLE (206)464-6968 BELFAIR WA 98528 Case No.:BLD2003-00921 Parcel No.:123307590092 Dear Applicant: Your building permit cannot be approved by Mason County Environmental Health until the following are completed and turned in: Report within the last three years from either a septic tank pumper or an Operation and Maintenance Specialist. Please call me at(360)427-9670, ext. 279 if you have any questions. Sincerely, Amanda Reynolds Environmental Health Mason County Health Services Comments: 7/15/2003 1 of 1 BLD2003-00921 O Ul 72 d N — O V) a- ~i— N am WLL3 � 2 pd J ta) 0 4 A n # UJ it # uJ F-_ J � U o aA '40 LU I 5 CO CC oe �~ Q Q � Z5 � CC L5 N c be N Uuj Q 1t/ V z LU W Q � o w Q z_ LL � � O oc cz °- � � a � 2 w M _ J � J T 4 -09 p z !U Q N < f a O LJJ � N W CL — U9 da En ae Z. o000 Q p Cl >' w t— cn CL Z a=) ct o � cn N 0 H V m a i i V � z -� vu � - w a $ = zwvi LL cn o tr LU 2vvjj � 2Z w --5 � O , O 0 e►, 2 uj E.. w < 23 w O = �- tY 9 - w 4j lrt O� U- o W � � � Cq ne Z T tLe Jfl 4e viJ � v +Ls f CD - lei U q O V) p O M to A o ,I ca fl V, �' Jo fl W d + 2 2 a � � � �,.. LtJ vj 5 to w ae Vi J w vj a Ul Q ::2 �W � i jJQF- I' v1 %A CC Q , w LL _ LIJ i G y yj wF— W w w � aQzo v, i o cl Q (I � 4 04 H � V2 � - � � w �� tL ' o � c5 W ,Q 4 p 4 O oe CA � � Q U a � � w W/ Q o 0 o I' (L C¢L _Q Z Z --j -2 w Q m � O