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HomeMy WebLinkAboutCOM2013-00034 Cancelled - COM Permit / Conditions - 3/5/2013 MASON COUNTY DEPT. OF COMMUNITY DEVEL.(--)PMENT nspection Line (36U)427-7262 Mason County Bldg. 3 426 W. Cedar P.O Box 186 hone: (360)427-9670, exL 352 Shelton, WA, 98584 i COMMERCIAL BUILDING PERMIT COM2013-00034 OWNER: MCKINNEY RECEIVED: 3/5/2013 CONTRACTOR: PLUMB SIGNS INC 253-473-3323 LICENSE: PLUMB SIGNS INC EXP: 11/10/2013 ISSUED: 3/27/2013 SITEADDRESS: 23150 NE STATE ROUTE 3 BELFAIR EXPIRES: 9/27/2013 PARCEL NUMBER: 123325000033 LEGAL DESCRIPTION: SAM B. THELER'S HOME &GAR TRS LOT: B OF SIP#424 (R) PTN TR 13- PROJECT DESCRIPTION: DIRECTIONS TO SI FOLLOW RT T BELFAIR TO E ADDRESS ON THE RIGHT SIDE (STATE FA TH LIPP HO NAL TRAVEL, CANNABIS CARE FOUNDATI General Information Cons uct' Occupancy Information Type of Use: BUSINESS Insp.Area: No. nits: Type of Constr.: Type of Work: SGN Fire Dist.: 2 N o Bath oms: Occ. Group: Of Valuation: $ 14,500.00 N .of S ies- Exit Design. Load: B ding ei Pre-Manufacture Unit I ormation Square Footage Information Make. Lengt Lot Size: : Model: Width: Building: Year: Serial No.: Basement: Parking Spaces: Setback In rmation Shoreline& Planning Information Front: Ft. Shoreli Ft. Rear: Ft. ope: Ft. Water Body: Shoreline Desig.: Side 1: Ft. SEPA?: Comp. Plan Desig.: Side 2: Ft. Fire Protection System Information Auto Fire Alarm System?: Emergency Key Box?: Standpipe?: Auto Fire Sprinkler System?: Access Road?: Fire Extinguishers?: Fixed Fire Suppression System?: Fire Hydrants?: Fire Lanes?: COM2013-00034 Please refer to the following pages for conditions of this permit. 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Fail Date Date Done By Comments v m .91 .p MASON COUtJTY PERMIT N0.r6TjZO13 -OD&j - 1 BUILDING PERMIT APPLICATION 1 426 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 FC Klh,\ ou Company Name l°�4M� sOiZ�s Mailin ss 1315 IJ� 5(a— -3 Mailing Address 909 S a�• City State LZA Zip Code S15Z r0-5 City State %JA Zip Code 4AYo 9 Phone lSl —7,4-6 lgrtt Other Ph. Phoneds3 -V 73 • 3 aas Other Ph. Lien/Title Holder HC ICI Contractor Reg. #X&AfendL n77ms Exp. /1'1e*A3 1 E mail address C W to S Macs Cn M E Mail Address War re, Cu m h'.i,:.',= � t r'• Drivers Lic. # \55 W DOB 1 Drivers Lic. #W ISSMw M 3¢i i F 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 Legal Description Site Address (Please include street name, street number and city) 13 I Directions to site Will timber be cut and sold in parcel preparation?Yes/No Is property within 200' of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff 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 Describe Work No. of Bedrooms No. 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 HOME INFORMATION - Make 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. 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 a curate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF NUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X sent - Date: .��2 y 2C 1 caner/Owner Re re /Contractor (indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date-3 .S Z-61 DEPARTMENTAL REVIEW RARO ED DENIED NOTES Building Department Planning Department ?t ! Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee Site Inspection 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 Pre-Paid at Submittal Valuation $ i TOTAL FEES