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Home My WebLink AboutBLD2007-01970 Cancelled ATF Shed - BLD Application - 11/26/2007 MASON COUNTY PERMIT NO. V� • J (� BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 • Belfair (360) 275-4467• Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION / Owner e 1 Company Name Mailing Address o Mailing Address Ci Iyrtr�4a1p- State i A Zip Code City State p Code Phone&L%-V V-n ILL Other Ph.90 Phone O er Ph. Lien/Title Holder Contractor Reg. # Exp. E mail address E Mail Address Drivers Lic. # l DOB /U-,RG,- 7k Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic xisting Septic Connect to Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION- 12 Digit Parcel No 5- Fire D' rict Legal Description - Site Address(Please include street name, street number and city) Directions to site Wi4 S Will timber be cut and sold in parcel preparation?Yes/ o % Is property within 200'of Saltwater Lake Rfve / reVluffsl5-%, Pond Wetland Seasonal Runoff Stream o e r Is this permit submittal the result of a Stop Work Notice,Cdrre tin r other enforcement action? es o TYRE a dd Alt RepairT_:Othe PRIMARY RESIDENCE ❑ SEASONAL ❑ Use 0 Describe Work No. of Bedrooms No. of Bathrooms 'Stu tageeck 1st Floor 2nd Floor 3rd Floors;r; Basbment Deck overe Other Sq. ft. 3�4 Garage Attached Detached ar ort Attached Detached MANS I FORMATION - Mak' ' Model Year Length Width Serial No. No. of Be s No. of Bathro Type of Heat Purchase Pricrs$ acement Unit? Yes/No Installer Namej:!:�± Certification No. OWNER/BUILDER Acknowledges submission of in ccu�ate in lion may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the o r,owners IeW representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the applicaboN I declare t I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in i rest reg rding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct th roposed. The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF O ONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: Owner/Owners Representative/ClAntractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date k2d DEPARTMENTAL REVIEW APPROVED DENIED NOTES�- Building Department Planning Department Environmental Health department Public Works Depart ent Fire Marshal 11 FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing &Base Fee Planning Review Fee Mechanical &Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES MASON COUNTY PERMIT NO. BUILDING PERMIT APPLICATION 426 W. Cedar • P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Company Name Mailing Address PO 62P Y i 06 Mailing Address City, i 1,YVAal-- State lQa Zip Code -fig 3 City State Zip Code PhoneJ6L•-t(3Y- (-)`/4,C) Other Ph.-W. Phone Other Ph. Lien/Title Holder Contractor Reg. # Exp. E mail address E Mail Address Drivers Lic. # l DOB /U / 7Ss 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 PARCEL INFORMATION - 12 Digit Parcel No. 1 7 ti q C),2,a2 I Fire District Legal Description - ` 1! o? Site Address (Please include street name, street number and city) Directions to site Sla C Will timber be cut and sold in parcel preparation? Yes/ o Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action? es o TYP - dd ___Alt Repair Other�p��jpp PRIMARY RESIDENCE [-I SEASONAL ❑ Use i . Z Describe Work C,eni_lett n; o� No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor Basbment Deck Covered Deck Other Sq. ft. Sao Garage Attached Detached Carport Attached Detached MANS I -FORMATION - Make Mod Year Length Width Serial No. No. of Be s No. of Bathro Type of Heat Purchase Prig$ acement Unit? Yes/No Installer Name Certification 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 information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF O ONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: Owner/Owners Representative/Cidintractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED —'" NOTES Building Department ,t Planning Department 7,2 Environmental Health Department - - Public Works Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planninq Review Fee Mechanical & Base fee Other Wood /Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation S TOTAL FEES III, 0 3 ZOO-' "' --�r'RDVED �� - M ,:'ON ::OUNTY DCD PLANNING SITE PLAN REQUIRED TO BE ON SITE CHANGES SUBJECT TO APPROVAL By— Da L4W if7D9 9 � GA � r ti O � Y »y,gtw,r 3� �t,+ itPt •�rk i� � 4J - t}{�� r��k *��P� ;fit s.� k��{�r��k r.'. K c t•S`` �� rRitt 8 f k, 441 CC,11 �A fir♦ Rk V .[.I 1_ .. ._ Y W •� IW.QC rt"it 'i.'rAlG �y ;3x { i( �4 •y' ptLA- 7 U _ nkmJ-- L4 y 4 ids hr s t ram. K -�. 7. w. t x �I�'t Sftk� �n l r , j i •-w 1 " w . 5 'a { i 427-9670 MASON COUNTY BUILDING DEPARTMENT ALL PERSONS ARE HEREBY ORDERED TO AT ONCE TOP WORK On these Premises at This order is issued because A.M. Posted P.M. 19 By The failure to stop work, the resuming of work without permission from the WARNING Building Official, or the removal, mutilation,destruction or concealment of this Notice is punishable by fine and imprisonment. �► trIF r �•t Alc 16 .QN e t � 1�• t�tix i -Y• y, t ...-r r� r v i n ✓jiAi ,,� t✓-� �1'3.' � (? i�. b 1 � �`.�? y.'��(I. �f `?�, �� •� Sr'b / .. ar � � t � _ X " �} •� r� f , � ' �� r J*1 .� � :� �, �, �r�r r�.. i '� ,�� - y. � �r �r tt 11�•� ,,k, . 3 4. ,,, '� A C( �h .r, i �° I �' �, �. 3 �� •� �, "�.�-,�� '� q 4 t i