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Home My WebLink AboutMIS99-0554 Replace Piling - MIS Permit / Conditions - 9/8/1999 ------------------------- r MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 M 1 El-C E. !_. 1.._ A N E C3 tJ �S Fes" E " M I 'T FOR I NSPFCT I ON:. Al 427 9670 MIS99-0554 PARCEL :322334400020 PLAT : DIV : BLI< : LOT JOB ADDRESS : 7627 E STATE ROUTE 106 UNION APPLICANT : NICK KL.OZE OWNER : NICK S KL O,ZE LEG,AL. : TO 2 Of E114 OF LOT 1 t TIDELANDS DESCRIPTION .PROJECT REPLACE 2BROKEN P �,ON I_ I NG I N FLOATLOAT �A�,EXp�ok PROJECT LOCATION : HWY 101 TO PURDY CUTOFF ROAD TO SR 106 'TO 7627 SR 106 ON LEFT PAST tlN l K�EI� PROJECT NOTES : TYPE AMOUNT BY DATE RECEIPT SHR $ 44 .00 KS 09/08/99 51510 STFE: $ 4 .50 KW 09/02/99 51415 � f PRMT $ 74 .75 Kt/! 09/02/99 514156.'- Y 1�� L! PLCK $ 48 .59 KW 09/02/99 51415 cY Z_I/ ( TOTAL ; 171 .84. -_ O �� WK* R OR AGENT DATE 1118_PA.MT, rev: 04101192 COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED i CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date — by — BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date ay D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by I I I — MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 i F' FRM I T CQNU I T I CAN Case No . : MIS99--0554 f For : NICK S KLOZF Page : 'A 1 ) A , draulic P c, ject Approval from they Washington State Department of Fish & Wildlife rau t -C�rarr` prior to construction . X a 2 ) All upland areas disturbed or newly created by construction activities shall be seeded. vegetated or given some other equivalent type of protection against erosion . �' ) The proposed project must be consistent with all applicable policies and other, proi,(islons o the Shoreline Management Act , its rules , and the Mason County Shoreline 1 Ma t t 1 °O." 4 ) Proper disposal of construction debris, must be on uplands , in such a manner that debris cannot enter wetlands or cause water quality degradation of adjacent waters . 5 ) All construction and demolition debris must be romoved from the beach after project completion . Proper disposal of construction debris must be on land in such a manner i CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date by p W WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date — _ by date — by - I MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 r " sii>iiti E7I T Er or i:d . ..P WH E er qu a I I ty Clegi am, t i ontJ P X � _ 6) All hew treated piling to be used for this project shall recieve a post treatment vacuum of two hours at not less than 22 inches of mercury . Subsequent to release of the vacuum, the piling shall be steamed for a two hour period, followed by ra second vacuum of four hours at 22 inches of mercury . i 7 ) Dock facilities must be maintained in a safe and sound condition . 6 ) Appro ed per dimensions and setbacks, on submitted SIt AAP , 9 ) ThIs permit is limited to the REPLACEMENT OF TWO BROKEN PILING ONLY . No further work Is perm ' tted or authorized under- this permit . All additional work must be approved by ::epHr� permit, rior, to construction . X //, , . , CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date _ by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date by Q W WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by PERMIT NO.: MIS MASON COUNTY • "� MISCELLANEOUS PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968 APPLI �T INFORMATION CONTRACTOR INFORMATION Owner D Z E Contractor Name F.Z. G. Mailing Address 71002.7E S/2 /06 Mailing Address;DO /3e,,w- 376 City JAJ/aKJ Statel.�-/A1 Zip Code 7FJ5ti City State L-JA Zip Code`1,S"� PhoneL_ Other Ph.( ) Ph. -? a Other P u , 7737/S L14fi/Title,MD &J7- I-lAjoA l`f. /L!7!?EA7N Contractor Reg. Address P013 ) LcJA -ZVI-170 Expiration PARCEL INFORMATION-12 digit T x Parcel No. 3,yZ,233 / i /`,�/ GGiDaU Fire District Legal Description E / r. e- Site Address(include s reet name and city 7 Al�- S /.0 li,U ti Directions to site:90Y 161 TU P4124 y cf4e7e'F,- RoA,J T2'� SR 7L' 71017 -fR /DAj� eA-) l Er7— PAST L/lJ//9 X) Will timber be cut and sold in parcel preparation? (Yes/No) Is your property within 200' of the following: Body of Water (Name) llDd,o L-"7AA1 eL Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair L.-- Other Use of Building K '/A//,3 FloA Describe proposed construction T o�.2� iJ2�a�w /`'i�i�6 /ti F/a,a7- SHORELINE PROJECTS New Replacement_ Repair Expansion Bulkhead Material (concrete, rock, wood, etc.) Length Height A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF PERMIT. 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: r OWNER AFFIDAVIT-I certify that I am exempt from the requirements of CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a the Contractor Registration Law RCW 18.27 and am aware of the 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 ordinance requirements regulating the work for which this permit is issued will be done in conformance therewith. No changes shall be made without and all work shall be done in conformance therewith. No changes shall first obtning approval. be made without first obtaining approval. X Date FOR OFFICIAL USE BEYOND THIS POINT ((,, Accepted by Date Submittal Amount Du Receipt No./� DEPARTMENTAL REVIEW R ED PENIEDJ. CONDITION CODES Building Department Occ Grp Type of Const. Planning Department i Environmental Health Department i Public Works Department Fire Marshal r c Valuation $ FEES Building Permit Fee Site Inspection F Plan Review Fee Other UFC Plan Review Fee Other Violation Fee Pre-Paid at Submittal ( ) +< TOTAL FEES