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HomeMy WebLinkAboutBLD2012-00150 SFR - BLD Permit / Conditions - 3/2/2012 04 c V N N N_ 0 N M r p O N r- p NNE Z � 001� N p .= ap 0 W w N 0 o w- � � c° tiv ° o CMCO C—) Q � � CD o » � g � � o CQ o CD �cN o € QJ NC) m U L = W E Ua rn cLU w U w = :DH C N a1CD J N N Id NO 0U) 0 cm z � C L F- o a) a ti w U) °o a o Q rn 0pw w ° a N N X � ZQQcr- 4) dmwo 0 w mJ � 3 M O C N to N c fn � Q N o~0 N O y N U) W N g OZ � ai a) c vLi s E rn U F- O in =o E U •. a� mLL- •- Z (D z W m a Z = z0Q Y 0 a U) � U Z LLu o N — W a w0z � = mM E 8 � z w U) 0 a` W Z � O M 2 Z m N c CL y w — 0 0 E L) UULO � o 0 0_ (n fn J V O D U U 0 U 0 O c aT0 O c o 0 Q Cl? ~ 5 x0 I— LO t"i ti w ad 0 W z J c N N —02 y q � O O U 0 Q N iri v; L (n N N LL a z S E E N 2 W F- H a o °� W z fn U)UZ F, L) = O Z U m m O C v n W � U) w o. ° o z m LL U) O N 0 U) U-) Z Z �- U z N _Z 00 Ya J w00 Z o00 � JOcn 0 co Q ~LO Oo0 � < z z w0° Q o = =Z o C) CD U OO � N0 c _ ow >o o co c O � & �' � W Z M c rn v z N C14 a) C � (nCU o a oL o E � `C 0 o W O < Q Z H _ LL W M = (A I- Q J V a (1) Z tR a OU u) � U) O d ° O V C)J m Q W C d 0 D O O 3 7 W U 0 0 cc N F- o J ' a N Q O } a 0 m 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 cn 0 0 0 00 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o O o 0 0 0 00 E � c a O o 0 0 0 Cl 0 0 0 0 0 0 0 0 0 0 a) 0 0 0 0 0 0 0 0 0 0 C. 0 0 00 CDN o 0 0 0 0 0 0 0 0 0 0 0 00 0 0 v N N N N N N N N N N N N N N N N Q a) O o 0 0 0 0 0 o O o 0 0 0 0 0 0 N N N N N N N N N N N N_ N_ N N_ N_ N (6 Q 4) (O CO (O u7 V7 O _ L N ++ (n cn to cn cn to to to cn cn cn w (� to (n cn to c - 0) �n M O C U C N d o Lq om ca a tD O O O O O O o 0 M 01 O •a O co N O O u M M M M M M O N (O w n N N Q E +' _ E N O O O O O O N N N r- N O N O 0) c O a O 7 Q EA fA EH fA V) to 69 V) El9 fA EA EA EH 69 69 EA 40 N C ] O L N N N N N N N N N N N N N N N N C a) O 0 0 NNN CCL cn a) M Q W CL N Q wM ) MM M Cl) MMd a UI L) O = C Y Y Y Y Y Y U U U U U U U a) O O O co a) N c C N N a> a) o �- O O s- oC m ii 3 W v Q U Y +' a) N f�6 lC4 lL N N a) N N .� Ccn LL > T >. T 4) LL a) LL U. U N N 3 X N A_- a) E m a�i a3i a3i m m m u- € E N c C a cn rn O 0 d n a ) > > > > > > E d m a) m m E '5 c C ~ uLL � m � � � a�i aai abi � a 3 8 ° and c - cnr cn - fn c rnrn cvmm - C s a : EX LCD c - E o OR a— d o.Zma u N m d c m > ; 2 � aa ¢ O O aawww o ocu N cE 6 C le j p 0 C O C 7 p .N � N O O B " m C 0 c O N O O ,n N a) _ (D to LL LL a- 0)-C O C Q O cn N cnO NO > OOw NC N a) U' WR Z � "' Co O � c° E a 1— N Or OOacn O t rn Z N N > 0 m 0 m N U N c N d LLB 0 0 E .� C +. M E O 7 N J Z J N O V � U m Om °' �' o U. V U c � 0CL am cco 3 Y o > n o Nt a N o V U N v 3c e 'a U oo QN CL a)o m2 o N Na c c N a) jc a) O a) cn > a) O y O5 m cn 3 a) Q — C O �- LL = > n 0 w 0 -0 0 — 3a) O Ez- m vo—i � � .>— aci0 nc O O U Mn m N O U a) y Q O C L ,L O N 0 O U cn C Q Nam .- NN � N � d cQi " @a) � O c NN C7 O N — O Ems' O cn O (d r. 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N0 � �'> Jm � UY . = N M m rn ° c r- c c � O (D E- O p N LLI m 'in (n C -0Ca) E o � � v v v ti H � o v o - > a a) a) c Via) 00 W � 0D NN " Q c -cc M Q-m �_ Ec >+ CN M QZ O "= a°i ° � -0 `� coda) ~ o o 075 () L a) aca Qa) Q �. .22E " ° rn aa)) p = Q O T � a E .S 2� aci �, c c C �°) � D a U Q V a N a) ° p .0 p U p An _ V) U 0 r•+ -� ++ cn Z o (n N Co m ° a) U Q- N a) c - cNo Q C� m m'0- 6 m c � o m'o � Q N Z O Q C C_, C m C cn ELUH ytC a) mlfa' cmL) ° U - 3LL m W w d C a) a) a) cL)_U c) _ ca LL > rr a)= a) O " m wo p N a) } D k a (n E a) m V > 3 a) O t cn - U cc to k ms w - E ca m E c cn 3 a C- 0 0 i a c c0 p CL c O -a m c a) p •C O C C v o N C > � Off .► ( U -0 m CD m � U m C t 3 p < o •Q a w p cn .V c J- N to rn (a p � 0 -0 0) ov - LLN cCa �° S L °a cCao o O � Qato vwNO O 0) Q� 0 (1) vL cn Z0 O 4) 4) � C `- ° m O " -ate 0) - c N � -0 J F- ea cn c p = Na O 0 a cn a = H � +r 3 m o ° Qc ° 3 0 a) o L s _ c 7 a) (A m (n o m a) . E •tn O r +r O '' m C 0 O 3 N ° (D O N E O -p cn ZZ C 0.4" cc oc a) O (ate > C c N c ajv c c c QQ co cp +� cCL) a.� mL An � Q cu o o o m o � O � w: 5 E rn � Q c E �' ° can �' at c 0 (nU Val CVN . ?� � � of Q Na>i � c c (n 0 a) c ° a ZZ owO cn a a) :3 Q.Ea) c oc camim o u 0 OH OOy C0 - cca0 cn a m v - -' aa) � : o ac W � V � k a' ipu? N � rn .Eai2 a) cwNN ca rn a) N -1 = � O v .v N 7 c N cCa a rn m 0 > � E vi m n. cn J fS o L- CLCM i a) U) C ,� ° L co0 ° � �- rn E a) Ow � C N ° � 2 a 3 , L N � > c 0 ° ° c � O Q O i am a) c) o O N vi in O Q Qd Qa Q ° N o Q I- O a w o 0 ¢ o; Q c E a) ° C. -a a n.s c a) OZ i ° 0 ccv E c rn 0 c O o — N 0 > Q mQ QN E`o 0 m E U � cx O m - O v c C c D ate. v O 'p —0 C N 'C a) to 'a W d ++ to •C N 'O m 3p a) C C p C a 0 a) a) 0 — le O m e m F- t) H c N rn'� p Q � -0 m 0— 0— v 0 Q o wm Z QCm oM > 0 � NE Caa) cn mmEa a) 'Rrn O C J W � _.+ N -a O C ap 0 � O U E L E 0 y C .0 5 � � a CD M aa)) m Q� o ° °) 0) o � v o cc c ° U � a) LLO L E a 0 n. Q � .N a) mEn 0 -' o CL a) c m Cow U- � � d C N c `« a U o c C m o' -a co in 0 a) U m Z �_ d ~ U U (D O ° N '� rn CL a) C'N '� N C a cn m a) a) 3 Y a a) °) " a) C c n U ca R N v � c O 3 - co C cn m - - -- 0 m c O C a) •. ° N : Qw U)) 'yo oc E c c '� `� v7 o C°- C N 0 o °) E �-- > ° C -. mmOs Ez� ° a�i i C.) pc cn O W W �' C � av) oo N -0 m > c -0 c ate) o ° 3 Nv o •- o O W = Q ♦'C.. 7 N N C O rn L p m c a m a) a (n a) O v� N �p Q N Co @ E cn m t N c p N N 0 a) 7 O Q _„ C C «. e- N E cn C O 7 C Q L `- j N a) C Q Q' C 'cn a) ,O►w � N C CT O ` m N N C �+ C 'N c - O m cu .O cn O W Z 3 C a1 Q-�0 d (nL CCL N � -p Co a) -0 +_ O , > cn o 'c L cam 0 a) t a) ° a) m Q � -0U) m � � cc v Eo v, � E Z ° o a) O CU a � Z > Ada wcncmN NNONo Q-a .L a) � c CD a a) U W Q d y 0 r. o Q fl o c-� C > C_ c m O a cca � uaF- j4 0 °: c .v o y� > cLu �cJ? c o ~ 0 N cn OC C c0 0- O N v N Q, a) ; 0 m > Cl 0) � w V vO c-U) cnU � a) o Qa) m Ca) . O 1t c o ma- � a) m mzs a) -, -- � o m � n c a) E ° E ° CL= o c Q JOB h t c (na°> oc °O - o a) 3 p a) s a a o cu< QaOx Q 3 d F- W o .E rnx UH � x Q cox OX F- 00 � x H mmx N 0 N O^ N 0 ^ ^ m LO (.0 ti U w m o (n () C O O 44 C -a ~ U) •_ ` N O L J ° E O U) ° L i° w oca � °� ° a) � � � s a) ° oca O O 3 m o= 0U � � 0 �0),6 � _ caNQ, o cpi rn (UE Q. O C CV Y ° O) o N L O ~ ca C LL 3o mo m 0 c �- 0 2 ° a � N-O tin a�vj J E 0 N U � O U _ U a) �+O N .. O N (a a) C ) C C) U O C O ~}, a) t U w- O +• 3 ,� , O a) ._ N ca N p L O a) U �, O N p Cl. a) �c ca '� u�i o L O () C — N (/) N ca > +J L N O O fn a) a) V — (n O ca 'O N fa O) ` L C C C O Ya t aE) 2 � U o c mQ N c a 3 N cn ° 0-0ccaa � � W oo ° � v � p '_ E U o O ' C ++ ca > L_ L -0O C ,N yW ° N (D � L{ Uca � cp ° Ny� f° orn m of n Il 00 ++ U L N O O Y N to N ` a) Q c? cca .cf- a a) caZcca U 3 � ° a) CL X � � rncri uNi ° � v J °' f° 0F� N s m :� ° 0 3oM co E � oc_ L ° m Q N O w 3 d NuiLNo ca Zc000) U � E3 3 3 w p o (a N rn� ca } c 6 :a W 0 (D m ° N coi o ° c 2 n3 0 � -o c ca ca a) — U cam ca c y crnLO fir•= NCO N � � pco rn0aw L 0 06 O N 0 u 0U o wc a) U Q to } cn Co U° N L O L a) O U C L Oro pp C 7 u) C C C) O (a +' CO N �_ C C 7 E N U 06 N •p N C O fLn p C � .r N ° U E N C O or? cUooa o0) > -o -a °3 a) Eocn E O N c '+-� U O N c ca c � c >, O N a) a) C = N O ca U a) +. U ca N O �. N ++ a > cn �. a) C ++ V) .` a) C uJ L N NQo Q 4- C (D v 3 Nc � `X a 0 — ca occ > au'i � F" a) OU O '- a ` a) a) O rn'� N N E N o cn a `O N O Q O-U O O ` 3 L N N N _ N ;� L N d a " p O u) N L LL O C 4) 0 0) N N 0 , p p) +L a) U cn ¢CL o °= L> Qa) Na) �U = a 'O W U( Ca 0 cm w CNO O ' 3: > 0 W o a) ? ca QS > p . 0 E C a O a) C aO c - , NN N v- L U _ cn` na) aOa) to N °oO � - ? 0 - Z> D a) mN N� 0 o W@ o Cl)u e Q �n �ai0 ca ca � ° CL 3Q °) cR > occ � o 'Waa-0 M cn UE U O a) O L U O 3 — 'ca c O) cn ENo � v 3 0 0 0 � 0 a- m � .c :3 O c o Qom E °-;� a) a) -O rnv � 0 'n 2 — o E u, a) c oa) M Y " .520 mr_ c 3 (D o o rn� � o ° U ,°no (D (D3: (DM cnU a) cuv3i � 0ca a`) a) ca «J C) � � o U ° ° o— N N a) c� 'E ao ° LL c " � 3 v - m c � cow a) LL o C Q�ci E � ° fA N W 7 D N O "_ <a O > (a O N C V) N w a) O p u H C a) o . 3 rn ° U oo ` ` a) > c U O Lu � Q � L aci N L c o n c N —v a`�i c 0 E � c e � c Qcn �'� Upca0 .. . ` o c ° tea) '(D D _ �0 0 >+"p C� C :•=- per,,, U p N 7 +� U •a J N O C >,~ N O p N N O �r0- L G) -O a C� C O 0) OLO � I— N v E U o o ca a c � L m E 0 � s c ,� Za d 0 0 ,n � � a a)CL a) -OE ° -Nc a) ,. o pca Ea) a) Na) dcE X o OM mcu� 20 � c X Q - 0 .N (D m 3 o -°O ° C) X QcA � .E � X � � X N 0 N cl _ LO CO m d' � V)) O O t. E c`a3c � 0ma0i o3o vc3 mCD 2 o � mNEumQ1 � a- � � � �'� LO O a) cu Cc � O C" tn O ^ccC 0 in m M c = �� s O O m' 0)� o - y o � m a)D. C. c c � U �• a •N C 0 w 0 V EO � c O m � O C N 0 C.CL 5, m >, " �O C O cu 0 C N O —_ N N m 0 cn O C O ` C U 0) Q-� m m N �+ >+ C N m (u m E a >' 0 aY'i � E 34- v0i °o m C -a E cLng) a? s ° p O �: E cu �, a) c O 0 L O > O 0) w C N C O '00 O O > C �_ U m C Zn N ((nj) O O N L N c 7 U O 40 0 0 N Q0 C" m E v m 0) m cn m E O U -aLmcNE c O > mm O O m cn c !� Q ` Q O O` 0 CM a� Ud (� •3 - ++ y � �0 Q C C L m cu cn ' Q m ;° 0 } O � aiE33 Y - (D c E c>a Nv E rnc0 a 'n o av a� n3a) tcnoN CL > o 0ao -= rn � CL L 3 L > m � Q � E o E m 2 ca) cuQH �- � c_ � -0 0 0Qop (n CL a� to = vi 0 m ' m `" .c O 0-N `t O G. o " O y _ c .. cu 3 0 -C 0 0 W E c 0 `` -0 c Ov0 c c r O N Q-- � O 'u0—i c c O m m N c N ` O �u C j to a) O U) O -0 �« c T o o 0 E O w0- C � 'E 0 " 0 C a) C c OcnE oQ o `° 4)i 0cuo n Q ° — UEca-� Q � c0 � CL0 0 � � OOOmcE om0 ,� a)CL O (D o m °Qo m c a � v - cm N (D N o � o C '- C � p O CL+U - cc`ua " a) mcmu m �__ E m E o N c _ � m E Oc o 0 a cO Eo O .a 0 oov3 me c cu CL O m O Do ti a) o v E -0 � � � CMcu Z'cc � � c m c " o N N c W 0 3 -C O 0 c N U O Q O n `n � w c 3 c 5 0 � U m a) -0 � - w 8 v C Z � O C O N� -0 ton �+ V m m "0 ` 0 cn > O * -0 m O O O mo O m 0) C to > w cu cn of O . V -0 a �- O O O O a. cX- m (n E M m ° � E 0 a O a()) Em •L>-.. a) c0 '« 3oX cOiE � °) mcn = m can rn m � �m. c � � c � .� 3 - p vc a �c cu 4) o c m cn E 3 0 � 0 m O = 0 V �,tm0" O o a`) cu o E c E 0 -0 ? m m � O - > � ov a) Q-0 (D m a c s- o . ? � � ooON � o � � � (Dam � � aa) 3 may . o >- o c"u O E 'ca o — m O o = o) E — 0 0 0 0 3 E � Q d c > -a X C =' 0 cn cno0v mcu 2 � O Y O con m E cn O � 0 c � E 0 o Q 0 N 0 p � m C' " O 0" 8 0 j � U 7 m V c O 0) N O .- 0' - fu '0 N O N a) U 3 cu cn °) c Oa) C: rnC O c m o EO cu (n E 0 " 0 C 0 O (a ' cn 0 cn V E E O a) cn N >,'0 -0 -0 N 3 Q V C O N C ° m 0 a 0c c m - > c0 -0 0 - (D o 0 Via) ' m0 Q � Edo E O EQ m U 0c Q cu c S '� u (nn O � � � v 0 Ow fl-o vim a o � 0 -aa� 6 co "v Ummaa) acic ° o -Np� � mw- m� y � o com oNoo -o °? can \ t oO co = o � � 3 � mmu) Ninw tU3 C �LVX c%) QX N Q .� o n� m (n- CS _ I- m cnX QD Q o N _ 0 N m N 04 N N rN. (D N N m N N > C U c) C a N C m N O E �_ C N O cn C ° �+ a E a Y O _ Y T N "" m a) (D E N o v m cli � 0 —O CO :d N (O L) N —_ > (n C -a N N CCD (D N 0 O O Q C C N 0- N C. t N N 7 N m N U CLU O a aca N � cOmo N roc W o 2 E () CL n p c — a) (D 0 (n °° Yam L Z N m Q �- U 'N N LO 'C c N L N (n 'a N a 7 c0 >, NL "a N L � L .O N - p Ya 0 N t F" E O N p (n N E O LXL U Q N ) a C U >. W p >, U C c a) c NCD = ' OE00 r, orn N c � N w N ° Nam N 0 O U 0 C N QN CD cn co � U N E CD N O O >. — U c N c U N W O IL a C � N U V N O _C N m N � 'a >, n C W U L N O +C C O V N N co ;' — •= U m p — N 0 a v) o a' vU � E mom „° 3 s m cm N Q cu O a 0 ° v c aNi oNm ° ° c N �� U Z oN L N N E E Q ;.= Y cn Y U W C L O Y N •O , u _ C a -a ° Z a D m m (n != cn NU cic � I—� N Nme � ` a— m m N t � ° a ° m ZAe -0cn o ° rmc c> c ) N oO m o y c m N aci °0N CCm OQ L y tL U 1C1(D M -0 J oN a) Z 0> a) YNN N cn CO X (D CO :OO 0) O a QUY C O (n p Y O m O p N > E 0 n _ U U c� C_ Ua m OL ' �� N c > J N E rn c 0 a)E N C L UN C c O Ocn = = W cp N ON > W° N c � in N p > N NCL � ' ja) 0VEcn pN.two a) °D � cn rn � NcNQ� o cL o �Qv � �_ a) c- rn Y a a) Q N o E — CDa) o ° rn� Q = O � 0 •� 3 Y a U Q a o V 3 cYn o 0 3 — tin m C COY p a U >+ p + a c E ma U � m a cn C w cn vi m p o _ gU -a °) (DCD ) v � � � iv 3u°i ccc Ecn cY-u m C a C N N cp E O J C a) Co (/� 0 0 0 N — v w C L m r- c 'a (n O O U a '++ cn '++ c N c N ° a w M °ro v 5 E ami cU : v cc � � p aa)) � aUi ° cn ao 0 c°i aUi 12 X �5 p ,L (9 O E N N c � O Z QC W (n >. uQi s � "- N U) CLN 0 (OA Y C O co N t°n N y E N U a C s O N m � a C- m a) m O W O (C Y N cn UU O •CmS] a) Na) N >�2 + -a o " O Ya: C 3a) E N � m E 'X �_ a) U wo +. c YQ vC- o (D (n >_, $ "' 'ate a- - � N ( °- Co N N O °a c E a) a N 3 N cn= a O O C E >. 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Q �N U)QCo 0. m N C O c: (n CU) O"O OS c Eo • C v a2 0 E °° CX a) Q a 'Fa a 4- Q c L O Q i • •_ > o o`UOQ O) O m O a Ad W U) Nd vaXic�o Q.w Eg co mac CuE ow� c Ca N c �. v L 0. G v Q Q N d c 0 cO � •C '0(ncn y ( p a) (n ca N c Co N •c OC _ p a C G .p U) v N 00 C EO O E Q 0cc ooa) vim = Oa> O N ` � a o � c � E �°) � >. Z rn� of n y *4 Ord Cw � cv 8fn0 CL 2 W o v aa)) U E y° E p C• L >o•'� EFj o Q p 0 o c o = L o a i o c ;d Q o 'Ot a) O- D O a aD w o0 oN Qo ° = OO camel m > my CL m Qo 3 (n O `y o C N Q o � X Q c(aa X- X Q Q � � .Q ca �C tq W o a (n � X a)a= a) m w o 0.M am Z N L E U C CDM co O m O m N N M MASON COUNTY PERMIT NO Ae)1,2 - t�SO 3 BUILDING PERMIT APPLICATION _ 426 W. Cedar- P.O. Box 186, Shelton, WA 98584 � 5 Shelton (360) 427-9670- Belfair(360) 275-4467- Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMA 1710N CONTRACTOR INFORMATION Owner ,j 4� / i,j 6 r-t Company Name O�'� s 7 f�,�1� Mailin Address ZJ Z3 7 S'- Mailin Address �'d 60 x City �r ° State Zip Code S A l y R City �-���s6 State WA Zip Code Phone .-06'6S`b -962L Other Ph. Phone �,(°`77? •6s'fOther Ph. Lien/Title Holder J-) _1C Contractor Reg.# 993'"0 Exp. E mail address Jp 42%`6 A ca' -cwf , XA-7t E Mq,ii Address �.""l Co Drivers Lic.# JA4A Tk I T P y 76 t-AJ DOB-6 s.3 Drivers Lic.# D B SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic Existing Septic X Connect to Water System Name of Water System Well Water System Name of Water System ss-n AD,�a�� PARCEL INFORMATION- 12 Digit Parcel No zzUz-s'o cr 5'085 __ Fire District s` Legal Description Lbf' dP-:itat33'6 Pr) '-rQ 0 C G'. I_ S Site Address (Please include stree 2 name, s reet number and city) SSDEw/� Si Directions -r o ✓�Id'd'tQ�it,� . Will timber be cut and sold in parcel preparation?Yes/No Is property within 200'of Saltwater Ve-3 Lake NC River/Creek 40 Pond Wetland d10 Seasonal Runoff AJO Stream PO Slopes or Bluffs ] 15% le'r Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?YestNo TYPE OF JOB-New Add Alt Repair Other PRIMARY RESIDENCE ® SEASONAL E]Use of Building AiCs� e- ca Describe Work Al Rss-, Fe i-Ce- Of 11)1r!% Basement en No. of Rathrooms z Square Footage-1 st Floor g a f 2nd Floor _ — Deck Covered Deck Other Sq.ft. Garage Attached —Detached Carport Attached Detached MANUFACTURED HOME INFORMATION -Make Model Year Length Width enal No. No.of Bedrooms o-of Bathroom Typ Purchase Price$ lace U nit? Yes/No Installer Name Certification No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in astop work order or penTd revocation.Acknowledgement of such is by signature below.I declare that 1 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 permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in Me application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that fhe information provided is accu a and gran mployees of Mason County access to the above described property and structure for review and inspection. PR _ C NU O F CORINS BY MEANS OF A PROGRESS INSPECTION. XAL Dater 21 6! 77Owner/Owners Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department jwx Planning Department5 P 1 240 UVp Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fe Site inspection Plan Review Fee �✓o r o 70S •/ EH Review Fee Plumbing& Base Fe 9 f -7° + 5 Planning Review Fee Mechanical& Base fee s� -fzy16 4D Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal o Valuation$ :5e-G VeAl -- <39 01 Alill(p •30 1 TOTAL FEES NI" i i%LDING MASON COUNTY PERMIT NO.,QI'1 L�1o� • 56 I PERMIT APPLICATION _ 426 W. Cedar- P.O. Box 186, Shelton, WA 98584 � 5 Shelton (360) 427-9670- Belfair(360) 275-4467- Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMA/�TION CONTRACTOR INF RMATION Owner 4 , s%- w� �r� Company Name o�- S' -7—//', Co =or� Mail dress j 2-3? s Mailin Address /'d a n x zs city Ti,, too 1 State Zip Code y R City F+o1>b z, State Wki Zip Code Phone .k 06.6.S b G6 S- Other Ph. Phone 3�°+771 -6_6Other Ph. Lien/Title Holder A `'C Contractor Reg. Exp. rasa/iZ E mail address 'To 1, P 0'6 po cc `c``ft , X't E Mail Address 0� 1— Drivers Lic.# ujA-rk l�r P I176 L-A� DOB 6 Drivers Lic.# D B SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic Existing Septic X Connect to Water System Name of Water System Well Water System Name of Water System W« PARCEL INFORMATION- 12 Digit Parcel No z z o'z s%p 9 a 0 B Fire District s' Legal Description LE-L �- ° j� ��'f� Cr� fQ $ Q C- a' Site Address(Please include stree�a name, s reet number and city) ss�fFAhC-1e �� �k, &~ Directions tQR I ���3 a'~� � —`� S. I iV y�re Cr--� a �w f ccj `ro /V v l�: Lori ti«�� Will timber be cut and sold in parcel preparation?Yes/No Is property within 200'of Saltwater Vd.S.S Lake A10 River/Creek J�C) Pond J-)6 Wetland )0 Seasonal Runoff A.)O Stream AA) 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 eyof e o�f�Building Afsr a Kc— Describe Work AJe- ' kes-1 a � 8 g r 2nd Floor � No. of Rathrooms � Square Footage- 1st Floor > r Basement_ - Deck A oCI Covered Deck H ?? Other Sq.ft. Garage 8 0 Attached X—Detached Carport Attached Detached MANUFACTURED HOME INF TION - Make Model Year Length Width erial No. No. of Bedrooms �No of Bathroom _ TypePurchase Price$ lace nit? Yes/ 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 obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accu We and g mployees of Mason County access to the above described property and structure for review and inspection. PR :� UA IO F S BY MEANS OF A PROGRESS INSPECTION. rT X '� Date Owner/Owners Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department ,j y g 7a Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee Site Inspection y. Plan Review Fee EH Review Fee MAR 217012 Plumbing&Base Fee PlanningReview Fee Mechanical& Base fee Other XC;ON COl1 - . Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation$ TOTAL FEES MASON COUNTY NPERMIT O.-'icd4201 a - CC INQuIVIBING/MECHANICAL� PERMI TAPS APPLICATION Shelton(360)427-9670•Belfair(360)275-4467•Elma(360)482-5269 n the web"MO APPLICANT INFORMATION CONTRACTOR INFORMATION Owner I o L`�- P �``f�' �/ Company Name �•fz `�Y/�° C`' `sf' Mailin Address �- � Z I �� ��- _s Mailin Address pG OD A, a 6- City es 020 ,-�c-j State w Zip Code 9 812 E!) City 11-Ij f ki State--L-If—Zip Code Phone-k,o6-fo22--663A-Other Ph. Phone �61' '779`b�s�� Other Ph. Lien/Title Holder AJ Contractor Reg.#Tr,1 ti 5TC 99 3 ma Exp E mail address y 5 1,1, P v" C!!L �v`' `` ` E Mail Address v`'�``f -'�''�' 3`'�`1`ten'"`�' ` CC)I%- Drivers Lic.#VAT&r,T P y76 L�t1 DOB 6 �� s3 Drivers Lic.# DOB SEPTIC INFORMATION -Connect to New Septic Existing Septic� Connect to Sewer System Name of Sewer System PARCEL INFORMATION-12 Digit Parcel No �-� �-b f o`/ © �3' Fire District 4 Legal Description /-eIt : >- I G sp#2S$S6 j�- A,7 74 8 tD G, /. 5- Site Address(Please include street name,{street number and city) s-s0 E_ AbL e- .��'� s c Direction$to site �tw�i�+-� i s/atc� +�/) J j�, R c v 4'�o/e- 4e.:: c Aj.(-,,I.e, To k- relS Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% %'e s TYPE OF JOB -New C�Add Alt Repair Other Use of Building Location of Fixtures/Units- 1 st Floo 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Tyne of Fixture No.of Fixtures Fees Fuel Type:Electric_LPG Natural Gas_Heat Purnp h_ Toilets _;L Type of Unit No.of Units Fees Bathroom Sink 1`7 Furnace At 12 Bath Tubs / Heatpumps H P Showers Spot Vent Fan y Water Heater Propane Tank Clothes Washer f Gas OutLats ? Kithen Sinks Wood6 ellet Stove Dishwasher Kitchen Exhaust Hood Hosebibs Dryer Vent r Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL 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 permission from all the necessary parties.if permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,1 have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is rate and g ees of Mason County access to the above described property aril structure for review and inspection. P u N BY MEANS OF A PROGRESS INSPECTION. X Date:3 Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND T IS POINT Accepted bi._/Mz Planning Pd Ck# Date Bid Pd Receipt No. DEPARTM NTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group Tyoe Constr. Planning Department Environmental Health Department FEESvigil Plumbing&Base Fee Site Inspection Mechanical&Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES Contractors or Tradespeople Printer Friendly Page Page 1 of 1 General/Specialty Contractor A business registered as a construction contractor with L&I to perform construction work within the scope of its specialty.A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name JOHN S TRAPP CONSTRUCTION INC UBI No. 602214071 Phone 3607796528 Status Active Address Po Box 25 License No. JOHNSTC983MQ Suite/Apt. License Type Construction Contractor City Poulsbo Effective Date 7/18/2002 State WA Expiration Date 7/30/2012 Zip 98370 Suspend Date County Kitsap Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Business Owner Information Name Role I Effective Date Expiration Date TRAPP,JOHN STEPHEN President 07/18/2002 TRAPP,CARRIE ALICE Vice President 07/18/2002 Bond Information Bond Bond Company Name Bond Account Numbed Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 1 jCBIC ISE5670 07/01/2002 jUntil Cancelled 1 1 $12,000.00 07/18/2002 Assignment of Savings Information No records found for the previous 6 year period Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date 5 jCBIC JINSSE5670 07/01/2006 jUntil Cancelled 1 $1,000,000.0005/19/2006 4 jCBIC JINSSE5670 07/01/2005 07/01/2006 1 $1,000,000.00 06/22/2005 Summons/Complaint Information No unsatisfied complaints on file within prior 6 year period Warrant Information No unsatisfied warrants on file within prior 6 year period https:Hfortress.wa.gov/lni/bbip/Print.aspx 3/21/2012 ACCESS & GRADE INSPECTION BLD 3 LO ZD12- ADDRESS: INSPECTOR: �� DATE OF INSPECTION: Z�7/ FIRE SPRINKLER REQUIRED? (circle) NO YES IF fire sprinkler required, was notification letter mailed? DATE MAILED: DRIVEWAY ACCESS ( ) need post at access of driveway with reflective address numbers Length: Width: Surface: Size of turn-around: Condition of shoulders: Vertical clearance: GRADE OF DRIVEWAY %, OF ROAD % ROAD ACCESS Length: Width: Surface: Condition of Shoulders: Vertical clearance: (� BURN PERMIT REQUIRED FOR LAND CLEARING FIRE. (� LOT INSIDE UGA—NO OUTDOOR BURNING PERMITTED. LOT TOO SMALL FOR: BURN PERMITS 4 X 4 FIRES 2 X 3 FIRES PASSED ( ) FAILED ( ) ON HOLD ( ) REMARKS: of Ll& 1 "-f, LiT, iO/�� �i ��GO Zvi IA�4,c rl` 71-�C � . Planner. Grace Allan Rebecca L 4". "' ` - 'j MASON COUNTY PLANNING INTAKE CHECKLIST Owners Name: 6 h[) zg+ K 16�S Date: ,3-�]-I-aC3t a Project:— es e-Fe) Commercial ?: yes no Site Plan: �orth Arrow 1e�roperty Dimensions: x Irregular Shape( yes no Streets and Driveways shown ' ,e Road Frontage Name: n v U-) All Existing Structures Shown with setbacks and use. Identified Surface water(streams,ponds, shoreline,wetlands,natural/historic drainage, defined drainage) �I'opography (slopes) !-lo�:s.+ou)GA6t-`�� Wts-f— 1'Mmimum Structure Setbacks (direction/setback): F: _/ � 1 /� S2 � /�( Utility and Drai Ease &yesno (if yes enter condition #5022) XOther Easements ir-iccesso A urtenances: p Heat pump rY PP oes site plan show lan ' s ❑ Variance applied for: yes no Parking spaces allotted: (Les no Access Permit eded (add condition #0010) Access Permit needed (add condition 90020) ward Planning conditions: 95019 and #700 ❑ Are there any impediments (dogs/gates) that may restrict access to your site? yes no ❑ If yes, do we need appointment? yes no 61+�OJYI. ❑ Is site clearly marked? Address Name Other ��Lp jt, La-A ZONING ` UGA'S ALLYNBELFAIR/SHELTON Rural LAND DESIGNATIONS J GC J PF J R-1 R-IP J RC 1 RR 2.5 J AGRICULTURAL J POS J FR J R-2 J R-1R J RC 2 RR 5 J LTCFL J BI j GC-CI J R-3 J RI J RC 3 J RR 10 J IN-HOLDING J HC J LTA--J R-5 J RT J RMF J RR 20 J TRIBAL J T J MU J R-10 J RT/RTC J RNR J MxP ) BP J vc J RAC Critical Areas: treams,ponds, shoreline,wetlands&ste slopes) Shoreline Desi at' n: ❑ ❑ Urban �ural ❑ Conservancy ❑ Natural Water Body: SEPA: yes no unknown VloodPlain: ye no unknown- ap# `Y Aquifer Recharge: yes no unknown Map# MAF,,, 2 201Z - Tags/Cases: MXSOM OOiJN i j RLC/SPI: 1 206 2,Zq 6 year Reforestation: yes no Eagle Nest Tag: yes no Other/North Bay Sewer: yes - o ...,. ... ,. 4, 9xvrl59 J NON ul9B9Ti(144�4df�Y5191:�bP�,'6'�A o'Pb�]x1,"�d`si+r� � � ub+s�p �i�p�saa bym pimp �/ sui M huo� p u WOO/M Nd1d l K N L sdau,xp :aR9 laa4S I 12 „ I Y N s a of r E �F o q U" a B 8 \ w g $ _ CD r pia a `' a b R ° o IRV 20 Rl 12 3 b a E i .b I u 3 �^ ss�f - i n I e L tS p i yy Z 6 74 a al lilt x, I, I �I AEl NA(s2U.N nL 177fk'.:i1 S3'1NYH� US Nv 3n 01 c'3eF'1.03M NYId 311S BNINNVId CDC,AlNflOO NOSVW - o3AOdddV . v..�...mmv.. — - - - - _ - rvW r m u .. .�y..r a w1*o•+w y m A,-_1I(�\.I ,91n4f.... 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