HomeMy WebLinkAboutMIS93-0766 Cancelled Dock Repair - MIS Application - 6/18/1997 Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION , ,��p
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 �y O
PLEASE PRINT
#1 Owner Zst` V� Phone# O Le PSI ? - 07 4i a
Site Address og I UO?O w Fire District#
City tA I, St 4JO e Zip
Directions to Job Site kt,% lcior 6 1r0,0
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Owner Mailing Address R
City St Zip
Lien/Title Holder &
Address
Clty Z3 St Zip
#2 Contractor Name_AA G pat VX0 Contractor Reg#AQVAAIA$ loreQ
Address F71" 1 D L Expiration Date_/ I o / I `q
City St me Zip °I �°1 .� Phone#, A L 70/7 q and
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No3 a 1 T pl.� I �4 P
Legal Description _ S w,L Y ' a -r R I (o , ^1 R S 7 "' l g ♦ l L .
#5 Building Square Footage: (existing/proposed)
1st FI / 2nd FI / 3rd FI / Loft
Basement / Deck / #bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other sq. ft. /
#6 Use of building Describe work
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make Model
Length Width Serial No. �f I vU
# Bedrooms # Bathrooms Type of Heat D 1993
Purchase Price$ 13EC 0 6
SERVICES
#9 Indicate by circling the applicable source if any water is on or adjacent to subject protagqERAI-
River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements
Name of Flanking Street Indicate Directional by (N, S, E, W)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
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APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton,Washington 98584
(360)427-9670
BUILDING PARKS& RECREATION FAIR/CONVENTION CENTER ADMINISTRATION
JANUARY 8, 1996
RE: PERMIT # 3 —0 )
DEAR r��"\�. L_)(1L 't"ct)
ON 1 1/ THIS OFFICE APPROVED FOR ISSUANCE THE ABOVE
PERMIT NUMBER. PURSUANT TO THE UNIFORM BUILDING CODE, SECTION 304,
THIS PERMIT, ONCE APPROVED FOR ISSUANCE, MUST BE ISSUED WITHIN 180
DAYS TO STAY VALID. FAILURE TO PICK UP THE PERMIT WITHIN THE 180
DAY TIME FRAME W1LL VOID THE PERMIT AND IT WILL BE NECESSARY FOR
YOU TO RE-APPLY FOR THE PERMIT THUS, MEETING ALL NEW REVIEW
REQUIREMENTS.
FURTHER, THE UNIFORM BUILDING CODE, SECTION 304 ALLOWS FOR THE
COLLECTION OF THE PLAN REVIEW FEE IF A PLAN REVIEW HAS BEEN
PERFORMED AND THE PERMIT CANCELED. IN THE EVENT THAT YOU NO LO2:GER
REQUIRE THE PERMIT OR CHOOSE T CANCEL TEE: PERMIT, THE PLAN REVIEW
FEE DUE ON THIS PERMIT IS THE CHECK OR MONEY ORDER
SHOULD BE MADE PAYABLE TO THE MASON COUNTY TREASURER AND SUBMITTED
TO THIS DEPARTMENT FOR PROCESSING. ONCE THE PLAN REVIEW FEE IS
PAID, WE WILL RETURN THE PLANS TO YOU AND CANCEL THE PERMIT
REQUEST.
IF YOU WISH TO OBTAIN YOUR PERMIT NOW, THE AMOUNT DUE FOR YOUR
BUILDING PERMIT IS $ I`_J_� _. 00 • ONCE RECEIVED, WE WILL ISSUE
THE PERMIT, EITHER IN THE OFFICE OR WE CAN PROCESS THE ISSUANCE
THROUGH THE MAIL. THE PERMIT WILL REMAIN VALID FOR A PERIOD OF
180 DAYS. AT THE END OF THIS 180 -DAYS, AN INSPECTION WILL BE
REQUIRED OR A ONE-TIME ONLY EXTENSION CAN BE GRANTED THROUGH LETTER
REQUEST HOWEVER, ALL FUTURE EXTENSIONS MUST BE GRANTED BY PROGRESS
INSPECTIONS .
PLEASE RESPOND TO THIS NOTIFICATION PRIOR TO JANUARY 22, 1996 .
SINCERELY,
KATHLEEN SOINE
BUILDING DEPARTMENT
(306-427 -9670) EX 354
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