HomeMy WebLinkAboutCOM2012-00086 CLASSROOM - COM Permit / Conditions - 4/3/2013 n
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� CONCRETE MECHANICAL MANUFACTURED HOME
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Foundation Walls Floors Date By
Date By [)ate By DECKS
FRAMING Walls Date By
Date By Data Y PROPANE TANKS
PLUMBING Vault Date 13Y
Date By OTHER
Groundwork Attic
Date By Date By Type
Dale
DRYWALL Type
InL Brace Wall Date By
Dale By— Date By
FINAL INSPECTI Q
Water Line Fire Sepo ration _L
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01 ii
MASON COUNTY PERMIT NO.C61'y12.�I
BUILDING PERMIT APPLICATION
426 W. Cedar• P.O. Box 136, Shelton,WA 98594
Shelton (360) 427-9670•Belfair(360)275-4467•Eima(360) 482-5269
On the web www.co.mason.wa us
APPLICANT RePR ON CONTRACTOR INFORMATION
Owner 1 t 1`j1�Gs� t Company Name
Mair1n0Address'7tbL4e_. — �'. ►'1iv Mailing Address
Cam_State ?`+ Zip Code city, Zip Code
Pho r Phone Other Ph
Lien/Trite Ho! tra Conctor R # EXP.
E mail addre ` E Mail Address
Drivers Lic.# p Drivers Lic.# 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 C=7 X,
PARCEL INFORMATION-12 Digit Parcel No - Fire District
Legal Description
alum
Site Address(Please includ t3-eet name,street number d city) �-' r
c
D ions tg,Site
a i L
Will timber be cut and sold in parcel preparation?Ye a
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
Is this permit submittal thq result of a Stop Work Notice,Correction Diotice or other enforcement action?Yes/No
PE OF JOB-New Add Alt Repair ther PRiMAP` IF)EC NE 1-1 SEASONAL ❑
Use of Building Describe Work- �'�`'`� �-m� �'�S%.
No. of Bedrooms No.of Bathrooms Square Footage-1st Floor 2nd Floor
3rd Floor Basement Deck Covered Deck Other Sq.fL
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.
OVVNER/E3 JLDER,cimowledges submission of inaccurate information may result in a stop work order or permt revocation.Acknowledgement of
such is try signature below.I declare tfrat I am the owner,owners legal representafive,or the contractor.I further declare that I am entitled to receive this
pemift and to do the work as proposed in the application.I declare that I have obtained the permission from all tine necessary parties If pemission is
required from any easement hoider,or any other party in interest regarding this application or the work proposed in the applicafion,I have obtained
permission from them th apply for this permit and conduct the work proposed. The owner or agent on owners behatf,represents that the inbanafion
provided is a=zate and grants employees of Mason Courrty access to the above descrbed property and structure for review and inspection.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION.
X Date.
Owner/Owners Representafive/Contractor (mcficate which one)
FOR OFFICIAL USE BEYOND THIS POINT Accepted by. Date
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Planning Department bo /1
Environmental Health Department
Public Works Department
Fire Marshal T ,',-
FEES
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbing&Base Fee Piannin Review Fee
Mechanical &Base fee Other
Wood/Gas/Pellet Stove Fee State Fee
[Violation Fee Pre-Paid at Submittal
valuation$ TOTAL FEES
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N Foothigs ISetbacks GasPipingons M
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co rn Extern Dam By Exterior-Date By t- O
Point Load t Isolated FootingsBG I SLAB
INS Date €�y v
��r s�.AIB ICJSI?I_l4'1`IQW
Dat� By Data By FIRE DEPARTMENT
Foundation Walls Floors Date By
Hate By Data By DECKS
FRAMING Walls Date By
Date By Data _ By PR+UF'AN E TANKS
PLUMBING vautt Date ey
calf, By OTHER
Groundwork Attic
Date B Date By Type-
Date By
D_va v DRYWALLype_ 0
InL Brake Wall
Da* By 0
Data By
Date By N
Water Line Fire Sops ration CDFINAL INSPECTION j
Date By Clete By Date By tV
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Type of Insp. Fail Date D�k� Done �y Cc�mirrt�n�s Co
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C.77
Permit# MASON COUNTY
BUILDING III 426 W. CEDAR
SHELTON, WASHINGTO14 98584
(360) 427-9670
CORRECTION NOT� ICE
Job Location
This structure has been inspected by Mason County Building Department
and the following VIOLATION of County Laws Ond Ordinances has been
found: Items listed below must be corrected to gain compliance
be
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 ❑ please contact our office
Make corrections, items will be checked on next inspection regarding possible structural
❑ OK to damage incurred by recent
"natural/man made"
❑This is not a complete inspection disasters.This is NOT
Date -7 Z3 Department CORRECTION NOTICE.
Inspector
DO NOT REMOVE THIS TAG
Permit# MASON COUNTY
BUILDING III 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
Job Location G �
This structure has been inspected by Mason County Building Department
and the following VIOLATION of County Laws and Ordinances has been
found: Its listed below must be corrected to gain compliance
l_ Per c&,-,Tit` S 6--, " r.. -+-
b u
You are hereby notified that the above corrections shall be made
BEFORE PROCEEDING WITH ANY FURTHER WORK
Ij Call for re-inspection when corrections are made before continuing ❑ please contact our office
❑ Make corrections, items will be checked on next inspection regarding possible structural
❑ OK to damage incurred by recent
This is not a complete inspection "natural/man made"
❑ p p disasters.This is NOT a
Date 12 -3 0 —/3 Department 8 LI CORRECTION NOTICE.
Inspector Lc
DO NOT REMOVE THIS TAG