HomeMy WebLinkAboutBLD2021-01173 Pre-Inspection - BLD Inspections - 8/9/2020 PERMIT NO. a -�f!73
it �w MASON COUNTY -
DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING•PLANNING•FIRE MARSHAL
WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.35
615 W.Alder St-Bldg#8 (360)275-4467 Belfair ext.352 '
s54 w Shelton,WA 98584 (360)482-5269 Elma ext.352
PRE-INSPECTION APPLICATION
$80 00 Fee rWuired prior to Inspection 1 �O
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#1. Owner N� k Daytime Phone# 2
Site Address City O(ice C1S
Mailing Address e_-
City '7Gc nit GL Sty Zip
Applicant 7"�>.k (_'OV� s
Address-71A`_ Y 1
City St ip#2. Parcel No. [I2 digits]: �� �v'���— /7%(Legal Description: t
#3. Purpose of Pre-Inspection.'_�e"_�CAk1 la
#4. Use of Building
#5. Indicate by circling the applicable source if any water is on or adjacent to subject property-
• Saltwater•Lake-•Stream•Marsh•River•Pond`Wetland•Seasonal Runoff•Other r, <ifX
46. Directions to Site:
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Show following on the site plan below:Lot Dimensions,Existing Structures,Structure Setbacks,Water Lines,Septic Systems,
Flood Zones,Wells,Shorelines,Easements,Name of Flanking&Frontage Streets.
Indicate direction by N,S,E,W,etc
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Applicant Signature: ,Date:
FOR OFFICIAL USE ONLY: Accepted By: Date:
Receipt No. Referred To:
I:1CommunityDevelopment\Alder-Updated FormslBuilding Pre-inspection request-Alder [Rev:Jan 2019)
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FOR OFFICIAL USE ONLY Fpp dived proposal
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Planning:
Building:
Fire Marshal:
Special Conditions
Lion inquest-Alder [Rev:Jan 2019]
I:\Community)>evelapmeat\A1der-Updated Forms\Building Pre-inspea
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TOPOGRAPHY PROF
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Direction: Scale: Approval: for once use
Building Permit number: Building:
Date of Planning:
Owner/Applicant:
application: Env. Health:
Parcel Number: