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HomeMy WebLinkAboutBLD2016-01039 Cancelled Carport - BLD Permit / Conditions - 10/24/2017 cd. ................ o CONCRETE MECHANICAL MANUFACTURED HOME o Date By > Footings f Setbacks Gas Piping Ribbons r— Interior Date By Interior-Date By Date C) ay M C� w Exterior Date By Exterior-Date By — Set-up C_ co Point L 98 oad I Isolated Footin — INSULATION Date By > ic BG I SLAB INSULATION M Date By Date By FIRE DEPARTMENT CD Foundation Walls Floors Date By ...... 90 Date By Data By DECKS r- FRAMING Walls Date By z Date By Data By PROPANE TANKS > PLUMBING Vault Data By Date By OTHER Groundwork Attic Typw Date By Date By Data By D.W.v DRYWALL Type- Int Brace Wall Date By Date By Date By CD FINAL INSPECTION tV mWater Line Fire Separation co Date By Date By Date tab, a) Pass or Request Inspect. Co Type of Insp. Fail Date Date Done By Comments (D 0 0 _0 (D 0 0 0 En 0 5 (D 0 Inspection Line(360)427-7262 #18i4 , MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County 615 W Alder St Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD2016-01039 OWNER: JAMES & LINDA WHALEY RECEIVED: 10/17/2016 CONTRACTOR: WEST COAST METAL BUILDINGS 1.503.566.7788 LICENSE: WESTCCM966MR EXP: 7/24/: ISSUED: 11/9/2016 SITE ADDRESS: 1781 NE BLACKSMITH DR BELFAIR EXPIRES: 5/9/2017 PARCEL NUMBER: 223107800410 LEGAL DESCRIPTION: TR 41 OF SURVEY 10/138 (S1/2 NW) PROJECT DESCRIPTION: DIRECTIONS TO SITE: NEW 26X65 METAL CARPORT KIT HWY 3 TO OLD BELFAIR HWY, TO BEAR CREEK DEWATTO, TO NE BLACKSMITH DR, 2 MILES ON DIRT RD. General Information Construction&Occupancy Information Square Footage Information No. of Bedrooms: Type of Constr.: VB Type of Use: SF Insp.Area: No. of Bathrooms: Occ. Group: U Lot Size: Deck: Type of Work: ACC Fire Dist.: 8 No. of Stories: 1 Occ. Load: Building: Carport-Detached 1,690 Valuation: Building Height: 11 Occ. Status: Unknown Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: Ft. Shoreline: 68.0 Ft. Water Body: Type N Stream Rear: Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Side 1: Ft. Shoreline Desig.: Not Applicable Year: Serial No.: Side 2: Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Plan Check Fee AMP 10/17/201 $73.00 S2201600000001 Planning Review Fee AMP 10/17/201 $205.00 S2201600000001 Building State Fee AMP 10/17/201 $4.50 S2201600000001 Building Permit Fee AMP 10/17/201 $ 141.00 S2201600000001 EH Minor Plan Review AMP 10/20/201 $ 100.00 S1201600000001 Total $523.50 Please refer to the following pages for conditions of this permit. Page 1 of 4 BLD2016 01039 9 P 9 P 9 CASE NOTES FOR BLD2016-01039 CONDITIONS FOR BLD2016-01039 1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800-6 7-09 The=�ersqnigning this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 2) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building Depa nt prior to any further inspections being performed or approvals granted. 3) Ow r Ayent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X AA 4) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or removp#of approved documents will result in failure of required building inspections. X 5) This structure is approved as unheated space. To be considered unheated space the area may be provided with a heating system that does not exceed energy usage of 1 watt per sq. ft., or 3.4 Btu/h per sq. ft. A permit and approval shall be required prior to installation of any heating system. When a heating system exceeds 1 watt per sq. ft(or 3.4 btu/h per sq. ft) the heated space shall be insulated in accordance with the energy code in effect ythea of permit application. 6) The"approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" site plan is not on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the Buildin Department prior to any further inspections being performed or approvals granted. XA v BLD2016-01039 Please refer to the following pages for conditions of this permit. Page 2 of 4 7) TH�E FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, FIRM-NATIVE SOIL. X" 8) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other Wcrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). 9) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150' from an approved access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where such r d connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X Zn 10) The use, handling and storage of haz ous materials or flammable and combustible liquids in excess of 10 gallons is not allowed without the approval of the Mason County Fire Marshal. X_ 11) This structure is limited to U-occupancy use only (private garages, carports, sheds, and agricultural buildings.) Any other use will be in violation of the inter tional codes and Mason County Regulations unless a "Change of Use" permit is applied for, reviewed and approved. X 1 12) Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached thereto. If documents are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be X arg d shall be collected by the Building Department prior to any further inspections being performed or approvals granted. 13) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in perm evocation. X 14) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be loca d within 25' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project. X 15) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County Xrdina eeppr regulation, must be reviewed and approved by Mason County prior to construction. BLD2016-01039 Please refer to the following pages for conditions of this permit. Page 3 of 4 16) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Ins r shall be made prior to requesting additional inspections. X ct -A 17) All property lines shall be clearly identified at the time of foundation inspection. X 18) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason o nty ordinances and building regulations. X� - 19) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder hpve prevented action from being taken. No more than one extension may be granted. X �& 20) Retaining walls needed to support a sur arge such as structures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X 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 contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERM[ PPLICATI OF 180 DAYS WILL INVALIDATE THE APPLICATION. (::: I— 1!�a �� Zola nature Date L1/V-,-)A (A) FN6�, - REPRESENTATIVE - CONTRACTOR Print Name (Circle one to indicate) BLD2016-01039 Please refer to the following pages for conditions of this permit. Page 4 of 4 Name �,�O w 1, Parcel# a a3 o - �D BLD#D'AU'kQ— Q (V J� RECEI� Mason County BUILDING OCT 17 20% Department of Community Development Small U cel Stormwater Management Application/Worksheet (page 1 of 2) Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development,or redevelopment',with more than 2,000 square feet of impervious surface2. 'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. 2Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area *All dimensions in feet Buildings X 6�1 n L 3 S X Z cf = (c, Measurements for buildings are taken at the perimeter of the farthest projections(example: �jC/ v CO b`tL X y = / .� 6 b eaves/gutters) f.^ , X Z 7 = ►�OI.�i:b CO, ��Y JMj�I _ I L(f r i F-0L, �i Driveways X = �.% 1.� 7�15 U C,A'T�DA) W i� C = �� X Z �$DO Length of drive begins at the right of way X Parkin Areas X © X _ goo Any paved,gravel or packed area per definition above table X c/0 = q8D Patios/Walks X = ^ t X - _ C Any paved,gravel or packed area per definition above table X = Others X C45 X / .�N� _ 5 3 If the total impervious area of the proposed site ark X i� �(On) ,= y j development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Total Impervious Surface Area (sum of all areas) 10 SG If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read,acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that 1 am the owner,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described p f/or/rev. w and inspection as may he required. !�V Owner gent/Contractor(circle one)Date: 7ZZDI,6 If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign the information provided on page 2 of 2. J►�'�5 t5 ,��f� 2vo/oo0s� C.�T (,�" gc2t���{���'� /J����z �3���5 PaoP 1 nf? i F , s-vam Wks Pc iS Ea iN A L Name,)A,vt f5 lJt*L Y ,I k Parcel# �.� 3 l o - 7�-®0 5�i0 BLD# U h# - 6 l 03 q Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) Based Upon the information you have provided a Stormwater Site Plan 7S Required for this development activity. Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater Management in this jurisdiction.A complete copy of the ordinance can be found on the Mason County website: httv///www.co.mason.wa—us/code/commissioners/index.htm Please follow the links to"Title 14,Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70).You will receive a copy of the Public Works document entitled"Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan".This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details*are to be installed in their entirety AND no part of the stormwater system adversely affects any septic system(see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE A) The relevant details from Managing Storm Drainage on Small Loty, The Small Parcel Stormwater Site Plan will be installed in their entirety AND the system will be located as not to adversely affect any Sept, systems on this,or an other,p c 1. �Q�tii. �S B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the syste will be located as not to adversely affect any septic systems on this,or any other,parcel. If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at: Phone: (360)-427-9670 EXT.450 Mail:P 0 Box 1850,Shelton WA 98584 Physical:415 N 6th St,Shelton WA 98584 If this development has,or will have,a septic/drainfield system you may need to contact Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or any other,parcel.You may also wish to consult with the septic design professional involved with the project.Mason County Division of Environmental Health can be reached at: Phone:(360)-427-9670 EXT.352 Mail: P 0 Box 1666, Shelton WA 98584 Physical:426 W Cedar St,Shelton WA 98584 A condition will be added to the building permit that states,in part,that all conditions the stormwater site plan will be met prior to a request for final inspection of the building permit. Owner/Builder/Agent Acknowledges that 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,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- descnb pro fo review and inspection as may he required. X Y V Owner/Agent/Contractor(circle one)Date: `� l VZO 16 S /VOJ'b fl� 6,6 I d F —74-iS �PPLItA�vN/r..?oL 5 Nap?nf') MAN UFACTURED BY: / 4 _� �� [4]PEAK BRACE 3 (4]PEAK BRACE 1.A 1.B 3 [2]ROOF BEAM I I 12 g ;ROOFJ BEAM 3 I L 16, Z 2 � 16 2 3 _ � 3 � I [5]KNEE BRACE-SEE TABLEE3.1FOR LENGTH TABLE 3.1 FOR LENGTH R 5232 Salem Dallas Hwy NW li Salem,OR.97304 C a c 1] T COLUMN POST �1:1-866-404-7788,Fax:1-503-566-8833 (1]COLUMN POST �'V�� ENGINEERED BY: NING PLAN N OCT 2016 615 �3 3 [3)BASE RAIL W �d@I \3�( A&A ENGINEERING [3]BASE RAIL tj — > C[VII,•STRUCTURAL S ees 1 5911 Renai—ce Place,Snne B•Tokdo,OH 4362j3 1 t TeL 419-292-1983•F..419-292-0955 � � � � j www.aa<npneers.mm 29'-91/2" 29-91/2" DRAWING INFORMATION TYP. A-FRAME SECTION TYP.REGULAR FRAME SECTION PROJECT: 30'-0"WIDE DUILDINGS i [2]ROOF BEAM SCALE:NT5 [2]ROOF BEAM 12 SCALE:NTS ROOF MEMBER LOCF TION: STATE OF WASHINGTON 12 � I PROXECT NO.: 037-1rJ-113q' SHET TITLE: [4]PEAK BRACE li FRAME SECTIONS & 1/8"FILLET-1 1/2"LG.Cd18" " DETAILS C.C.STITCH WELD BOTH [4]PEAK BRACE [4] PEAK BRACE-DOUBLED ALONG b 51DES STAGGERED-TYP. 1/8"FILLET-1 1/2"LG. 8" SHEET NO.: 3 111 ROOF MEMBER TILL EAVE.ATTACH WITH [5]KNEE BRACE-ATTACH C.C.STITCH WELD BOTH P I 1/8"FILLET-1 1/2"LG.0 8"C.C.STITCH DRAM LAK DATE:8/23/16 WITH(2)[23]FASTENERS SIDES STAGGERED TYP. WELD BOTH SIDES STAGGERED-TYP. G E.5. [5]KNEE BRACE-ATTACH CHECKED BY:OAA DATE:8/23/16 [6]6"LG.CONNECTOR SLEEVE WITH(2)(23]FASTENERS PEAK BRACE CONNECTION DETAIL5( LEGAL INFORMATION -FIELD BOLT W/[23] E.S. SCALE:NTS a DUPLICATION OF THIS DRAWING IN WHOLE OR FASTENERS-SEE TABLE 3.2 [6]8"LG.CONNECTOR SLEEVE- PART"STRICTLY FORBIODEN.ANYONE DOING 50 WILL FOR NO.OF FASTENERS REQD. FIELD BOLT W/ 23 FASTENERS BE PROSECUTED UNDER THE FULL EXTENT OF THE LAW. [ ] 1 COLUMN POST -DRArNG5 VALID UP TO I YEAR FROM DATE OF ISSUE. [t]COLUMN POST -SEE TABLE 3.2 FOR NO. (J 4; FASTENERS REQD. SEA;F: [1]COLUMN POST [6]6"LG.CONNECTOR SLEEVE -FIELD BOLT W/[23J p' A B U. A.'A'-FRAME EAVE DETAIL 1 B.REGULAR FRAME FASTENERS-SEE TABLE 3.2 Q4 O� WAS SCALE:NITS FOR NO.OF FASTENERS REQD. TABLE 3.1: KNEE BRACE SCHEDULE [2]ROOFBEAM N [T7)STRAIGHT BRACKET.SECURE UP TO 8' 24 TO PB SUPPORT AND ROOF 9'TO 12' 36 BEAMS OR PEAK BRACE W/(4) [3J BASE RAIL aF3 TEKS SDS.E5. (15]PB SUPPORT-FOR PEAK BRALE5 LOWER TM^"'�'�' 6ASE DETAIL 40277 T.6LE 3.2 FASTENER SCHEDULE (48)PEAK BRACE SCALE:NTS 3 ASS GISTER �111 IGNAL - 105 TO 125 4 NOTE:COLUMN POST MAY BE ADJUSTED t1"FOR LEVELING. 130 TO 155 67 P11 SUPPORT DETAIL MANUFACTURER 15 NOT RESPONSIBLE FOR LEVELING OF GROUND DATEEXPIRES: 11/09/2016 160 TO 180 8 SCALE:Nrs11 4 AND/OR CONCRETE SURFACE PROVIDED BY OTHERS. DATE SIGNED: AUG 23 2016 i ENVIRONMENTAL RECEIVED HEALTH r XT 17 2016 615 W. Alder Street 22310-78-00410 (Parcel Number) 1781 NE BLACKSMITH DR BELFAIR Building Permit application to place WHALEY,JAMES M JR&LINDA M 26'x65' RV Carport in prior 27'x66' Non Conforming Mobile Home Page 1/4 location. r 6 .. r 242' + 212` ' r....,-rr •• - - MCP SRLIC O H AD LTM OCT 2 1,:2016 CEW RECEIVED ENVIRONMENTAL U(,f 17 2016 HEALTH 615 W. Alder Street 22310-78-0 410 Parcel Number) LL 1781 NE BLACKSMITH DR BELFAIR . WHALEY,DAMES M JR& LINDA M i -; Page 2/4 � A Lower 1 Meadow W ^` of w^ W ParkinB�'^ •b Septic&Drainfleld 010lot Purnp :' House NorthMeter pa�kiryo Base • e. Ak 14 Asti— .!i y' _ _ ! • EN10iRCN , NTAL RECEIVED ED OCT 17 zots 615 W. Alder Street 22310-78-00410 (Parcel Number) 1781 NE BLACKSMITH DR BELFAIR WHALEY,JAMES M JR &LINDA M Page 4/4 Ho. Former . W 26, X 65' RV caw;h rt rock anchors. NE anchored TO be set on gravel and i *NT5 Building Permit application to place 26'x65' RV Carport in prior 27x66' Non Conforming Mobile Home location. i; RECEIVED OCT 17 2016 PLANNNG 615 W. Alder Street APPROVED COUNIN DCD PLANNING j;-1 E: PLAN REQUIRED TO BE ON SITE .1ANGES SUBJET TO APPROVAL 7v 'Date—11,N U- I Lp 22310-78-00410(Parcel Number) structures on East 1781 NE BLACKSMITH DR BELFAIR side of stream. WHALEY,JAMES M JR&LINDA M Seasonal Stream Page 3/4 ■ lope Stormwater 212 Gutter #tA re drainage 42' 50+ C —TV RV Cleanout 7 RVCleanou 16 1 to build site sca Z 6 CQA rn 1 33 1 6'1 104 11 105' 3' Meter Bas e,+ ell Headc, 142 C7 Transformer 26' ■ NE Blacksmith Dr 30' 30' road/Utility Easement on 2 sides cr&- t^-o,- s(44e- ptawv- i S A-Peoy I/z- PLANNWG: e'\11 SETBACKS ARE IN -,-',7SURED FROM THE FUR �RCD T "DJECTION OF TH' RECEIVED BUILDING ,.€ OCT 17 2016 Q c Nrt MASON COUNTY PERMIT NO. 1 1CO � ���W. Alder Street � ,31 DEPARTMENT OF COM ITY DEVELOPMENT BUILDING•PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 -_ Mason County Bldg.III,426 West Cedar Street (360)275-4467 Bel-fair ext.352 185e PO Box 279,Shelton,WA 98584 (360)482-5269 Elma ext.352 BUILDING PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:..] W/4 ')'G.&"J' i NAME:I/l� t'_ �/L�✓ MAILING ADD4SS: 566 MAILING ADDRESS:5.Z3 CITY:6&L.F'+11/-- STATE: WA- ZIP: 1-`e CITYCDAQLL(WI STATE: q K ZIP:2 43V � PHONE: CELL:dS d/3 9�� PHONEL031, vly - 7)OS CELL: EMAIL: EMAIL: 4�n1'SAW, �L'Y� X�Si�N4Y�2ESoc�EC.�S,��n;� L&I REG# G(I A EXP. PARCEL INFORMATION: / PARCEL NUMBER(12 DIGIT NUMBER) 9j3 i C> 7y j)o q 10 FIRE DISTRICT LEGAL DESCRIPTTQN(ABBREVIATED). itI Q ��% �tr;' /011.;e 65 1,2 Ale,) SITE ADDRESS 7S 1 / lc c ei t- 1-74 CITY ti .2 W s DIRECTIONS TO SITE ADDRESS ilJ,,' i A'21-" IS PROPERTY WITHIN 200 Ft. SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF K STREAM❑ DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES N J b (r TYPE OF JOB: NEW ❑ ADDITION ❑ ALTERATION❑ REPAIR❑ OTHER IScT` E USE OF STRUCTURE(RESIDENCE,GARAGE ETC.)_ CAA Pry 2T /-v v P V IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS DESCRIBE WORK 1 �. GJj LPDJ! Co)t� c -T Pe—A GC O L J✓ /�iv&5 �. / l� - 9��,r��fr cJAS "' V C. 1LI 0-' f.S 0 X J+ J-0 0 y 4- SOUAREFOOTAGE: /00'7' 5L.Pt,6, I` .� �e4�,"J c� �z'CJl, •'`ANC-I cyS. Lev �S /b I ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.& BASEMENT sq.ft. DECK sq.ft. COVERED DECK sq.ft.STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. ATTACHED❑ DETACHED❑ CAI PORT sq.ft. ATTACHED❑ DETACHED MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER 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 contractor.I further declare that 1 am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permittapplication becomes null&void if work or authorized construction is not commenced within 180 days or if Bon truction yvork is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS OF INS INfIC� I OF THIS PERMIT APPLICATION OF 180 DAYS WILL RIVALIDATE THE APPLICATION. /O f / Signature of Applican X /REPRESENTATIVE/CONTRACTOR Print Name (CIRCLE TO INDICATE) DEPARTMENTAL REVIEW APPROVED 'DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT