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Fail Date Date Done By Comments CA - (D 0 ------------ (D qJ141(b) L4116116 Lz)+ _ P /,,,s-r C-INk 0 73 ........................................ cn _0 CD ............ 0 MASON COUNTY PERMIT NO-A `"'j-7-^01 G 1 BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton WA 98584 f Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web vvww.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner ` Iu r� ht �S0` P S Company Na e -- Mailing Address '° ' { �° ` r Mailing Address City �rtal� r. _StateWA- Zip Code rt 4a q City State Zip Code Phone ` / / $ Other Ph. Phone Other Ph. Lien/Title Holder _ Contractor Reg. # Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. 7i Fire District Legal Description Site Address (Please include street name, street number and city) Directions to site Will timber be cut and sold in parcel preparation?Yes/No Is property within 200'of Saltwater Lake River/Creek on Wetland Seasonal Runoff Stream Slopes or Bluffs 15% Is this permit submittal the result of a Stop Work Notice,Correction Notic a or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair ther PRIMARY RESIDENCE ❑-SEASONAL ❑ Use of Building Describe Work No. of Bedrooms No. of Bathrooms Square Footage- 1st F or 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 edrooms No. of Bathrooms Type of Heat Purchase Price $ Replacement Unit? Yes/ No Installer Name Cerffication 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 informaticn provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application beccimes null & void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 ays. PROOF OF CONTINUATION OF WORK IS BY MEANS OF.A. O PROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION 80 DAYS WILL INVALIDATE THE APPLICATION. X i. T Date: .-�ewne ' iners fitepresentative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accep ed by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee Site Ins e ion Plan Review Fee EH Review Ifee Plumbing & Base Fee Planning R view Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stave Fee• State Fee Violation Fee Pre-Paid a Submittal Valuation $ TOTAL FEES Mason County Dept. of Community Development Mason County Bldg. 3 426 W. Cedar IP14 P.O. Box 186 (360) 427-9670 Local (360)482-5269 Elma Shelton,WA 98584 (360) 275-4467 Belfair Notice to Obtain Final Inspection March 23, 2010 '(eA vlcl f_� (30.)e j 0/0 SL-e� (�v�5 s t jk_ Ss�t Ov-2y+ Case No.: BLD2007-01569 Parcel No.: 420125100036 Proiect Description: REROOF SFR The Mason County Department of Community Develo iment is currently reviewing all permits that are expired and have not been approved �or occupancy and use. Pursuant to Mason County Code, Title 14 Building and Construction, a permit and final inspection for this type of activity is required undeilhe 2006 International Building Code or the code your permit was issued and our property is currently in violation status of occupancy and use. Please contact our office to make the necessary arrangements 21 days from the date of this letter. Failure to contact our office to make the necessary scheduled inspections may result in enforcement actions. j To bring your site into compliance, you must schedule an inspection. One (1) $73.00 site investigation fee will need to be paid prior to inspection along with any outstanding fees currently due on your building permit. For every inspection required after that, you may be charged $73.00 again, per inspection until final inspection and conditions are met. To schedule an inspection, please call (360) 427-9670 ext. 262. If you should have any questions regarding this notification, please contact me at (360) 427-9670 ext 726. Sincerely, Larry Kelly Mason County Department of Community Development Cc: Property File March 23, 2010 BLD2007-01569