HomeMy WebLinkAboutBLD2001-00334 MFH CANCELLED - BLD Permit / Conditions - 5/22/2001 i
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BLA!ding Permit # MASON COUNTY
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
Job Location
This structure has been inspected by Mason County Building Department
and the following VIOLATION of County Laws and Ordinances has been
found: / Items Listed below) must be corrected to gain code compliance
3�
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
76-Make corrections, items will be checked on next inspection
❑ OK to
- -This is not a complete inspectionIu�rc department
Date Inspector �1 P
DO NOT REMOVE THIS TAG
PERMIT NO.: BLD
MASON COUNTY ,, r
BUILDING PERMIT APPLICATION 26DPCW a, .a
426 W.Cedar/P.O.Box 186,Shelton,WA 98584 y'4)
Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner 7e Contractor Name r L E
Mailing Address �'<' Mailing Address
City State Zip Code City State Zip Code
Phone( Other Ph.( ) Ph.( Other Ph.(____)
Lien/Title Holder vi•- Contractor Reg. #
Address ter_. Expiration
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer
System Name of Sewer System Well Water System Name of
Water System
PARCEL INFORMATION-12 digit Tax Parcel No. _ / / G+ U - Fire District /,�.
Legal Description
Site Address(Please include street name, street number and city)
Directions to site i� C�i�f•I{�I / Tv A J?i?Ii4rl� 0 y 1.Pr .34.,UT ! ?, ,wlzass
Will timber be cut and sold in parcel preparation? (Yes/No) Ab
Is your property within 200' of the following:Body of Water(Name) /SOU Saltwater A10
Lake 4 River/Creek Pond Wetland �. Seasonal Runoff�/y(_ Stream &c., Slopes or
Bluffs 1; a
TYPE OF JOB New__.,_Add Alt Repair Other Use of Building
Describe Work
No. of BedroomsNo. of Bathrooms SQUARE FOOTAGE-1st Floor /C.) 2nd Floor
3rd Floor Loft Basement Deck Other sq. ft.
Garage Attached Detached Carport Attached Detached
MOBILE HOME INFORMATION-Make r"Iq0/7TY Model t£ 1,1449 M del Year `-`� h`
Length ' Width ' .<� ` Serial No. No. of Bedrooms- No. of Bathrooms 7—
Type of Heat C Purchase Price $ Y"; G Replacement Unit ?(Yes/No) *
Installer Name s. rlra lCertification No. 1t^ t "y>
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
approval. first obtaining approval.
X Y, j r`{, Date 'f` .3 X Date
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date Submittal Submittal Amount Due Receipt No.
DEPARTMENTAL REVI .. APPROVIRD FNIEt3 CONDITION CQDES
Building Department /f
Occ Group Type Constr.
Planning Department
I
Environmental Health Department
Public Works Department
I
Fire Marshal
Valuation $
FE Es
Building Permit Fee Site Inspection
Plan Review Fee UFC Plan Review Fee
Plumbing & Base Fee Public Works Review Fee
Mechanical & Base Fee Other
Wood/Gas/Pellet Stove Fee Other
Violation Fee Pre-Paid at Submittal ( )
NX
TOTAL FEES
FORM MUST BE COMPLETED IN INK
PLEASE PRESS HARD MASON COUNTY PROJECT SITE INFORMATION
Case No.
Name-3USi).\I 011( Ou 6, f7,) PARCEL NUMBER gZZO-)a - .30- Date Y -//- r-,"/
SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the
site�lan
Lot Dimensions Fences
Existing Structures Driveways
Structure Setbacks Shorelines
Water Lines Topography I
Well Location (including adjacent) Drainage Plan
Names of Streets Easements
Names of Fronting Streets Septic System C
DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line.
adjacent property line- I /lI I E-adjacent property line
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adjacent property line I �,� T►�' � <-adjacent property line
SAMPLE SITE PLAN
adjacent property lined 3zO� _ _ _ E-adjacent property line
I p 30' r RZSZR vE gel
SEs�co.J AL —
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CRFEK I HOM b I
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adjacent property lined E-adjacent ro ert� line
TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the
degree of slopes. See sample topography profile.)
SAMPLE TOPOGRAPHY PROFILE
dist'r,ca. tv
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cim-t'a.,G.t t0
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STATFO� MASON COUNTY
N Department of Community Development
o N ? Planning Division, P O Box 279, Shelton,WA 98684
� N OJ Y (360)427-9670
a0
1864
NOTIFICATION OF AQUIFER RECHARGE AREA
April 24, 2001
JUSTIN RUGGLES
1583 W DAYTON AIRPORT RD
SHELTON WA 98584
Case No.: BLD2001-00334
Parcel No.. 420033100030
Project Description: MANUFACTURED HOME
Dear Applicant:
The subject property is located within an Aquifer Recharge Area. The owner of any site within a
designated Critical Aquifer Recharge Area as identified in the Mason County Critical Aquifer Recharge
Areas map, on which a development proposal is submitted, must record a notice with the Mason
County Auditor.
Once the Title Notification is recorded with the Mason County Auditor's Office, a copy of the notice is
to be submitted to the Mason County Planning Department. This copy is required prior to the
issuance of the Building Permit(s). A form has been attached for your convenience. Please
complete, sign, record and return the form to this office as soon as possible to avoid delays in the
processing of your permit. Please be prepared to pay $8.00 for the first page and $1.00 for each
additional page at the time of recording. Also included for your referral is the Critical Aquifer
Recharge Areas section of the Mason County Resource Ordinance.
Please contact me at (360) 427-9670, ext. 577 if you have questions.
Sincerely,
Richard A. Mraz
Land Use Planner
Mason County Planning Department
Dear P am�'
I have contacted applicant reques i g setback/other information that needs to be
entered into Tidemar . As I have t yet received the information, I am forwarding the
file on to you "incomplet " H efully, the applicant will get the information to me,
which I will then forward to If so, could you please enter the information into
Tidemark?
I am doing this rather,,than holding files or long periods of time. Let me know if this
works for you.
Thanks,
Kristin
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