HomeMy WebLinkAboutBLD2012-00355 SFR Final - BLD Permit / Conditions - 5/21/2012 Inspection Line (360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. III 426 W. Cedar P.O. Box 186
11 Shelton, WA 98584
010
RESIDENTIAL BUILDING PERMIT BLD2012-00355
OWNER: L. BRECK HESS RECEIVED: 5/21/2012
CONTRACTOR: LICENSE: EXP: ISSUED: 5/21/2012
SITE ADDRESS: 780 E COULTER CREEK RD BELFAIR EXPIRES: 11/21/2012
PARCEL NUMBER: 122091290030
LEGAL DESCRIPTION: N 112 W 1/2 SW NW NE TR 1 OF SIP#1499
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
FINAL ON EXPIRED 1976 PERMIT
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: Type of Constr.:
Type of Use: SF Insp. Area: No. of Bathrooms: Occ, Group: Lot Size: Deck:
Type of Work: ? Fire Dist.: 2 No. of Stories: Occ. Load: Building:
Valuation: Building Height: Occ. Status: Basement:
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: Ft. Shoreline: Ft.
Water Body:
SEPA?:
Model: Width: Ft. Rear: Ft. Slope: Ft. Shoreline Desi
Side 1: Ft. g..
Year: Serial No.: Side 2: Ft. Comp. Plan Desig.:
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Final Expired Permit GMM 5/21/2012 $73.00 S1 2 0 1 2 000 000 01
Total $ 73.00
BLD2012-00355 Please refer to the following pages for conditions of this permit. Page 1 of 3
to
o CONCRETE MECHANICAL MANUFACTURED HOME
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N Footings I Setbacks Date
By
Ribbons
Piping tM
o Intenor Date By interior•Date By Dale By r
ccr! Exterior Date By Exterior-Date BSet-up
INSULATION
Point Load I Isolated Footings Date By M
BG f SLAB INSULATION n
Date By Data By FIRE DEPARTMENT T
Foundation Wails Floors Date By
Date By Data By DECKS
FRAMING waits Date By
Date By Data By PROPANE TANKS
PLUMBING Wautt Data By
Date By OTHER
Groundwork Attic
Type-
Date By Date By Date By
o.W.H DRYWALL Type-
-0 Date By
Int.Brace Wall Date By
m Date By FINAL INSPECTION 0
y Water Line Fire Separation N
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Date By Date By Date By
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BUILDING PEWIT AMICATIdN �
MASON COUNTY
P.O. Box 188 Shelton, Washington 9&%4
DATE ISSUED.If"
�c��"7G
PERMIT NO.
OWNER d3mVM6&7-.A/
cITY A z E
DIRECTIONS Ir
TO JOB SITE
LEGAL / (O SEE ATTACHED SHEET)
DESCR.
CONTRACTOR NAME MAli DDRESS CITY i STATE LICENSE NO. PHONE
o yYL
USE OF D
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: S PLAN CHECK FEE PERMIT FEEaD,
jr SPECIAL CONDITIONS:
�TION ACCEPTED B PLANS CHECK BY APPR D FOR ISSUANCE Typo of Occupancy Dlvlslon
B / Oonst. M N Group
Guf Gc+ Sin of Bldg. No. of Max.
(Total) Sq. Ft. stories Ooc. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.!A)AlalR
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is Issued and all work done will be In Special AADmaIs Required RscNvsd Not RaquhW
conformance therewith. ZONING
�-, HEALTH DEPT. 7W
Firm PUBLIC WORKS
ROAD DEPT.
By
Lic. No. Date
a,£sr> *,.5 377-'WZl
OWNERS AFFIDAVIT
certify that I am exempt from the requirements of the N O T I C E
Contract or registration law RCW 18.27, and am aware SEPARATE PERMITS ARE RECUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
which this p*mlt is Issued and that all work done will
be In conformance It orowi THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORQED
Y IS NOT COMMENCED NATHIN 12D DAYS, OR IF OONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 12D DAYS AT ANY TIME AFTER
Owner to. l�zWORK IS COMMENCED.
P CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS w �>�er`+ 0� '�S� �piZ S?7IP ��y• Q�e Sr i
a
LEGAL �
DESCRIPTION LOT BLK ADDITION
SITE AREA Sq. Ft ib�inn"EA OF SITE OCCUPIED BY BUILDINGS_ D Sq.Ft.
INSTRUCTIONS TO APPLICANT
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"-20' ARE
FILED WITH PERMIT APPLICATION. (EACH BUILD;NG SITE MUST HAVE A SEPARATE PLOT PLAN.)
FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN-
SIONS.SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA-
TION P"'D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR.
TION THEREOF.
® INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"-20'
ZZ
Q
c
I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without
first obtaining approval.
__QLl � �r�^ r\
N AM[l61 OF OWN R S) OF SITE 6 STRUCTURCM) (PRINT) IGNA F OWN R(A01 �11. . R �111
DOS�N�OT�WRITEE BELOW THIS LINE / t� /
APPROVED 04 ��. A 161,6 -��'S � 4 /_X Z2:
DISTRICT AS NOTED '�'�-�C.� DA—�—�-�
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