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HomeMy WebLinkAboutBLD2006-01649 SFR - BLD Inspections - 7/18/2024 XYKM P�oxTo GANCELLED EfffS Fipkg y basis Irt%i a Ike By Lrdstar-uzb3 Sy BY r"Saistt I aad r i • LYLA'n N BY BY FIRE DEPARTMENT acbt Dame BY Dais �� � ey DECKS rPRAWNG Da#e �5 ay r PROPANETANKS PLUMBING aatm •Dal OTHER �Y BY blft - $Y B DRYWALL tm� �"rte Saperafiots } RNAL INSPEC t]ON 3y E2asa Hr Date ap a i 0 Pass ctr Request [ ! TYPO Of - Fait D=e By Su 3 rotco riti e,�-i u,•. • F' ass 7/18/Z � ..� � i41� Corn,�,�i�s 5�,�4,rs x 1 o 7 D 3 � 1 l I • i I 1 4 a Printed to From Mason County DMS Printed from Masan County[CMS J7ZAMASON COUNTY 615 W.Alder St.Bldg 8,SHELTON,WA 98584 COMMUNITY SERVICES SHELTON:360427-9670,EXT 352 BELFAIR:360-275-4467,EXT 352 Bui�ng.PknmM},CrnuonmeMa111aaIth.CommuniyNe�Qi ELMA:360-482-5269,EXT 352 www.co.mason.wa.us INSPECTION CARD AND CERTIFICATE OF OCCUPANCY" To schedule an inspection call or visit http://www.co.mason.wa.us/community-services/bid-inspection.php Permit Number BLD2006-01649 Date Issued 09/30/2009 Issued By////'���� Project NEW SFR Site Address 11 N OLYMPIC CT SOUTH Applicant DAVID MOULTON Contractor Contractor Phone Primary Code 201 IBC,IRC,IFC,IEC,IMC,& Type UPC Permit Type NEW SINGLE FAMILY RESIDENCE Occupancy -APPROVED PLANS MUST BE ONSITE FOR ALL INSPECTIONS. -DO NOT PROCEED BEYOND EACH STAGE OR COVER WORK UNTIL APPROVAL IS GRANTED. -THIS CARD MUST BE POSTED IN A CONSPICUOUS LOCATION,FRONT OF THE PREMISES IS BEST FOR MAKING ENTRY. -ALL PERMITS EXPIRE 180 DAYS AFTER THE PERMIT IS ISSUED OR 180 DAYS AFTER DATE OF LAST INSPECTION. -OWNER/AGENT IS RESPONSIBLE FOR REQUESTING ALL INSPECTIONS THROUGH FINAL INSPECTION. `*THIS STRUCTURE MAY NOT BE USED OR OCCUPIED UNTIL ALL APPROVALS ARE GRANTED." PRIOR TO CALLING FOR FINAL INSPECTION,ALL CONDITIONS OF THE PERMIT MUST BE MET Public Works Access/Driveway Other Health Septic Well Deptartment Planning Site Inspection Department Fire Marshall Fire Apparatus Access Fire Sprinkler Auto Fire Alarm Hood and Duct Other Final Building Building Official: Community Services Designee Department Concrete Setbacks Slab Footing Perimeter Point load Footing Footing Interior Footing Decks/Porches Foundation Stem Walls Other _ Rough-In Groundwork Plumbing Framing Groundwork Mechanical Plumbing Groundwork Gas Pipe Mechanical Gas Piping Shear Wall Nailing Underfloor Other Insulation Slab Ceiling Floor Vaulted Ceiling Walls Vapor Barrier Other Wallboard Interior Wall Brace Panels Fire Walls Nailing Other Final Building Manufactured Setbacks Setup Home Concrete Foot/Runners Final Other MASON COUNTY 360-427-9670 Shelton ext. 352 360-275-4467 Belfair ext.352 COMMUNITY DEVELOPMENT 360-482-5269 Elma ext.352 Building,Planning,Fire Marshal 615 W.Alder St. Bldg.8 - Shelton,WA 98584 www.masoncountywa.gov CORRECTION/INSPECTION REPORT PERMIT/CASE NUMBER: RQ Lg6 -rJ) (o y I ADDRESS/LOCATION: 6( N , bl,►w�o:e C.�- S 40 cyj osi— FINDINGS• S 1 1kSQkL" C"nov L ru i= W ,`�h I�G,i(S• ��tRS2 S.t.G�y�t� ��1.�t�� Q� r�� Tvlr��-c Sr, Ma.WLA DW V - lAJ /PTA a (i► 3� auto � 1'e o� o '' tf►N�vt�� SAYS � r G. 17a.� �L �tk�is Gi,�efs And �uwn�ad,>4-s a,�c. .�t�s s 1�.� l�cc�s.� �.�••,.ti t�.r =dzcRB o1 •3 w SAIaSI� 3la L<s a1 Tl.� 3o4'1'ynn Items listed above must be corrected to gain compliance. ❑ THIS IS NOT A COMPLETE INSPECTION ❑ This structure has been inspected by Mason County Building Department and the items listed above are in VIOLATION of Mason County laws and/or ordinances. ❑ Call for re-inspection when corrections are made before proceeding with any further work. Make corrections, items will be checked on the next inspection. OK to Date: sl i -L4 ❑ Please contact our office regarding possible Department: 3 L D structural damage incurred by recent Inspector: "natural/man made"disasters.This is NOT a CORRECTION NOTICE. DO NOT REMOVE THIS TAG MCC14.12 Zo P-t MASON COUNTY 360-427-9670 Shelton ext.352 360-275-4467 Belfair ext.352 COMMUNITY DEVELOPMENT 360-482-5269 Elma ext.352 Building,Planning,Fire Marshal 615 W.Alder St.Bldg.8 - Shelton,WA 98584 www.masoncountywa.gov CORRECTION/INSPECTION REPORT PERMIT/CASE NUMBER: 3LD 2ooG - C�t b'-I R ADDRESS/LOCATION: l 1 FINDINGS: i �L n i�c U W&Lkr S At 13 `U - Su i5 bx o Ail.-S 1h �-►a i d e"1'L- A � J Items listed above must be corrected to gain compliance. ❑ THIS IS NOT A COMPLETE INSPECTION ❑ This structure has been inspected by Mason County Building Department and the items listed above are in VIOLATION of Mason County laws and/or ordinances. ❑ Call for re-inspection when corrections are made before proceeding with any further work. Y Make corrections, items will be checked on the next inspection. ❑ OK to Date: 31/g 12 q ❑ Please contact our office regarding possible Department: structural damage incurred by recent Inspector: "natural/man made"disasters.This is NOT a CORRECTION NOTICE. DO NOT REMOVE THIS TAG MCC14.12 MASON COUNTY 360-427-9670 Shelton ext.352 360-275-4467 Belfair ext.352 COMMUNITY DEVELOPMENT 360-482-5269 Elma ext.352 Building,Planning,Fire Marshal 615 W.Alder St. Bldg.8 - Shelton,WA 98584 www.masoncountywa.gov CORRECTIOWINSPECTION REPORT PERMIT/CASE NUMBER: R(,DZoo(a '0( (&(4 ft ADDRESS/LOCATION: l l t,) p W s,�, c,�- S Wood y,O r!— FINDINGS• k U g a&r p ems, c�...d S Gw�d £u-c.n,Lu �•. �$od,,, — r mac\- ke 3cc'.+n 1-'t o n I\ 5 arks. E;Nd Items listed above must be corrected to gain compliance. ❑ THIS IS NOT A COMPLETE INSPECTION ❑ This structure has been inspected by Mason County Building Department and the items listed above are in VIOLATION of Mason County laws and/or ordinances. ❑ Call for re-inspection when corrections are made before proceeding with any further work. ® Make corrections, items will be checked on the next inspection. ❑ OK to Date: 311.4 Is y ❑ Please contact our office regarding possible Department: -ZLD structural damage incurred by recent "natural/man made"disasters.This is NOT a Inspector: SCk CORRECTION NOTICE. DO NOT REMOVE THIS TAG MCC14.12 INSPECTION RESULTS Page QDMASON COUNTY Department of Community Development COMMUNITY SERVICES 615 W Alder St,Shelton,WA 98584 ------ (360)427.9670 Application# BLD2006-01649 Application NEW SINGLE FAMILY RESIDENCE Application# BLD2006-01649 Type Parcel# 422165100089 Site Address 11 N OLYMPIC CT SOUTH HOODSPORT,WA 98548 3/17/2020-JTL Mech-Pass F/P-Fail ''I,-,Complete caulk and seal. Seal all exterior vertical corners and at sub-floor and base plate intersection. �-Seal all penetrations through top and bottom plates Complete draft stopping at all horizontal penetrations through studs,joist and rafters (3)-All plumbing must be under test at time of inspection Joshua Luck FRAMING/PLUMBING/MECHANICAL 08/03/2021 SCHEDULED K-Secure all plumbing vents and drains at mid story/mid- an -Seal and insulate around all windows and doors Install blocking between floor joist over beam in crawl Install lag bolts/screws at deck ledgers Electrical complete and approved by L&I Make corrections,items will be checked on the next inspection. OK to insulate walls&ceiling. Provide photos of items#2, #3 at next Inspection #GENERAL OBSERVATIONS AWAITING I i... aA�isctip.tb_n INSP_E CT_IO_N __ 8tatw Status Date Printed r i 0un Printed from Masan County [CMS $< Mason County Mason County - Division of Community Development 615 W.Alder St. Bldg.8 Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us CANGL L FPROJECT 6-01649 NEW SINGLE FAMILY RESIDENCE ESCRIPTION: NEW SFR ISSUED: 09/30/2009 ESS: 11 N OLYMPIC CT SOUTH HOODSPORT EXPIRES: 01/25/2022 PARCEL: 422165100089 APPLICANT: DAVID MOULTON OWNER: 123 XXX XX,XX 00000 FEES: Paid Due Mechanical Base Fee $23.50 $0.00 ADJUST--Plan Check Fee ($40.95) $0.00 Building Permit Fee $141.00 $0.00 Building Permit Fee $141.00 $0.00 Building Permit Fee S141.00 $0.00 Building Permit Fee S734.75 $0.00 Building Permit Fee $734.75 $0.00 Building Permit Fee $734.75 $0.00 EH Plan Review $75.00 $0.00 Building State Fee $4.50 $0.00 Address Fee S140.00 $0.00 Plan Check Fee S518.54 $0.00 Plan Check Fee $518.54 $0.00 Plumbing Base Fee $20.00 $0.00 Building Re-inspect Fee $80.00 $0.00 Additional Plan Check Fee $73.00 $0.00 Mechanical Fee $98.75 $0.00 Building Permit Fee $367.38 $0.00 Building Permit Fee $367.38 $0.00 Building Permit Fee $367.38 $0.00 Plumbing Fee $54.00 $0.00 Planning Review Fee $155.00 $0.00 Printecb 'Core Benne9 on:08102,'2021 03:47 PM '' '°"�"��'" -"" ' Y Y Page t of 2 my DIMS Mason County v ' Mason County - Division of Community Development 615 W. Alder St. Bldg.8 Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us NEW SINGLE FAMILY RESIDENCE BLD2006-01649 Planning Review Fee $155.00 $0.00 Planning Review Fee $155.00 $0.00 Totals : $5,759.27 $0.00 REQUIRED INSPECTIONS Inspection- General Observation Framing/Plumbing/Mechanical Footing Inspection Framing/Plumbing/Mechanical Footing Inspection Insulation Inspection Progress Inspection BLD-Final Inspection Progress Inspection Progress Inspection Progress Inspection I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of Laws and Ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state/local law regulating construction or the performance of construction. Issued By: Contractor or Authorized Agent: Date: Printed by Corey Bennett on:08!022021 03:47 PM Page 2 of 2 my ENS, Y 4 Mason County Mason County - Division of Community Development f 615 W.Alder St. Bldg.8 Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us FPRE 6-01649 NEW SINGLE FAMILY RESIDENCE ESCRIPTION: NEW SFR ISSUED: 09/30/2009 ESS: 11 N OLYMPIC CT SOUTH HOODSPORT EXPIRES: 01/25/2022 PARCEL: 422165100089 APPLICANT: DAVID MOULTON OWNER: 123 XXX XX,XX 00000 FEES: Paid Due Mechanical Base Fee $23.50 $0.00 ADJUST-Plan Check Fee ($40.95) $0.00 Building Permit Fee $141.00 $0.00 Building Permit Fee $141.00 $0.00 Building Permit Fee $141.00 $0.00 Building Permit Fee $734.75 $0.00 Building Permit Fee $734.75 $0.00 Building Permit Fee $734.75 $0.00 EH Plan Review $75.00 $0.00 Building State Fee $4.50 $0.00 Address Fee $140.00 $0.00 Plan Check Fee $518.54 $0.00 Plan Check Fee $518.54 $0.00 Plumbing Base Fee $20.00 $0.00 Building Re-inspect Fee $80.00 $0.00 Additional Plan Check Fee $73.00 $0.00 Mechanical Fee $98.75 $0.00 Building Permit Fee $367.38 $0.00 Building Permit Fee $367.38 $0.00 Building Permit Fee $367.38 $0.00 Plumbing Fee $54,00 $0,00 Planning Review Fee $155.00 $0.00 SAS Printed by'Coreyfenneff on otmi2021 0147PM ' .. .E _F Unty r, S Page 1 of 2 Mason County Mason County - Division of Community Development 615 W. Alder St. Bldg.8 Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us NEW SINGLE FAMILY RESIDENCE BLD2006-01649 Planning Review Fee $155.00 $0.00 Planning Review Fee $155.00 $0.00 Totals : $5,759.27 $0.00 REQUIRED INSPECTIONS Inspection - General Observation Framing/Plumbing/Mechanical Footing Inspection Framing/Plumbing/Mechanical Footing Inspection Insulation Inspection Progress Inspection BLD-Final Inspection Progress Inspection Progress Inspection Progress Inspection I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of Laws and Ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state/local law regulating construction or the performance of construction. Issued By: Contractor or Authorized Agent: Date: Printed by:Corey Bennett on W0212021 03.47 PM € C n � DMS Page 2 0`2 nt'y DNAS MASON COUNTY 360-427-9670 Shelton ext.352 360-275-4467 Belfair ext.352 (D COMMUNITY SERVICES 360-482-5269 Elma ext.352 Building,Planning,Environmental Health,Community Health 615 W.Alder St.Bldg.8 - Shelton,WA 98584 www.co.mason.wa.us CORRECTION/INSPECTION REPORT PERMIT/CASE NUMBER: Tj�WL —0 jbq(� ADDRESS/LOCATION: tJ QL 1f NM CT FINDINGS: ',,, ors S4-1 �ct'�`�U4*�t'L;1'J � 1�-r�`�C3StJ� mow►-`..? �C.G'l�`+-�J Items listed above must be corrected to isain compliance. [) THIS IS NOT A COMPLETE INSPECTION [1 This structure has been inspected by Mason County Building Department and the items listed above are in VIOLATION of Mason County laws and/or ordinances. [1 Call for re-inspection when corrections are made before proceeding with any further work. Make corrections, items will be checked on the next inspection. f-] OK to Date: ❑ Please contact our office regarding possible Department: '[ structural damage incurred by recent Inspector: rj "natural/man made"disasters.This is NOT a CORRECTION NOTICE. DO NOT REMOVE THIS TAG Printed From Mason Count,, MCC141.12 Printed from Mason County DMS 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 Shelton,WA 98584 RESIDENTIAL BUILDING PERMIT BLD2006-01649 OWNER: DAVID MOULTON RECEIVED: 9/12/2006 CONTRACTOR: LICENSE: EXP: _ ..ISSUED: 6/11/2007 SITE ADDRESS: 11 N OLYMPIC CT SOUTH HOODSPORT EXPIRES: 1/10/2009 PARCEL NUMBER: 422165100089 LEGAL DESCRIPTION: LAKE CUSHMAN#10 TR 89 PROJECT DESCRIPTION: DIRECTIONS TO SITE: NEW SFR Hwy 119 to Potlach Cushman Rd. Go left to Kokanee Ridge Dr.Left to first culdesac on left corner lot. Kokanee Ridge and S.Olympic Ct. General Information Construction&Occupancy Information Square Footage Information o.of Bedrooms: 1 Type of Constr: V-B Type of Use: SF Insp.Area: No.of Bathrooms: 1 Occ.Group: R-3 Lot Size: Deck: Type of Work: NEW Fire Dist.: 18 No.of Stories: 2 Occ.Load: Building:864 Valuation: Building Height: Occ.Status: Seasonal Basement: Loft 216 Manufactured Home Information etback Iniogn tipn Shoreline&Planning Information Make: Length: Ft. no W 33.0 Ft. Shorellp e: Ft. Water o y: NONE Re E 10.0 Ft. Sloe: Ft. SEPA9: No Model: Width: Ft. ide 1: S 56.0 Ft. Shoreline Desig.: Not Applicable Year: Serial No.: Si e2; N 1U. Ft. Comp.Plan Desig.: Rural Plumbing Fixtures Mechanical tures FEES Type Qty. Type Qty. Type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee KS 9/12/2006 $518.54 S12006000 Hosebibs 1 Gas Outlets 2 Planning Review Fee KS 9/12/2006 $155.00 S12006000 Kitchen Sink 1 Propane Tank 1 1 Address Fee GMM 9/17/2006 $140.00 S22007000 Lavatories 1 Ventilation Fan // 1 Building Permit Fee JRN 9/25/2006 $734.75 §22007000 Water Closets(Toilets) 1 Propane Stove 1 Building State Fee JRN 9/25/2006 $4.50 S22007000 Water Heaters 1 Dryer Vent 1 Plumbing Base Fee JRN 9/25/2006 $20.00 S22007000 Bath Tubs 1 Plumbing Fee JRN 9/25/2006 $54.00 S22007000 Clothes Washer 1 Mechanical Base Fee JRN 9/25/2006 $23.50 S22007000 Mechanical Fee JRN 9/25/2006 $98.75 S220070o0 ADJUST—Plan Check Fee JRN 9/25/2006 -$40.95 §22007000 EH Plan Review ADR 4/4/2007 $75.00 §P2007000 l Building Permit Fee KS 7/10/2008 $367.38 S12006000 J Total $2.150.47 BLD2006-01649 Please refer to the following pages for conditions of this permit. 1 of 5 r - ■ moms IS m* sag, m ME Rows— I RARE M iiim ommii �ii°moluiiii manlimm ■ I■i m■►t n■■immom®ie■■■.■■s■ ■ ■CM0,1111SW■R■■AI■■■ ■■J■.■■■■ lm No ■. 1\t■1t■►11■.m■■ N—=- Em■■■ Wo A.&"qm MEN ■■ �M NINE mmomm OEM . Q6MmMMMM ■..■■ERESIM■■■■►1■.■ ■ ■■■ ■ ►�■■i.■■..■■■■■■■..■.Imm MEN� . ■� -H �ee►�■r�■■.■■■■■■■■■■a■ imp_% ■ a I A �KL ON In -woo - . ■ . ri Sir.' r�. �■a ■ ■ ■■■■ ■■■■ ■ ■ MCI 1 a N■®■Ird��a_ ■■■ u■ara aaaom � ■■■■il as aname KNOWN MEN ■r �► ri ��■■ li Aram Lon as 0 m am -lillmommmmumn m a ■ ■■aiaa�■ ilamossooLlwam►ra■ ,■a■■1Al ■a�i00 a ■a■■■■■a■■ w■EM1111, rt 1111 RM11111411 mMIF 'jIms Run■ �i■ ■ IM 0 wk%11 ■■■■I ■■■E ■r■�■ ■S� ■■■■■■■■■■RE r/ if ■■■ 0 mumalmem ppar, 0 am u i ✓ . nv.Health: r r ♦r • 'i PERMIT NO.-- MASON COUNTY BUILDING PERMIT APPLICATION 426 W.Cedar-P.O.Box 186,Shelton,WA 98584 Shelton(360)427-13670-Belfair(360j 275-4467-Elma(360),482-5260 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner I &(A /_ ZIKI Company Name. Mailing Address "ailing Address ZQ L /3 -474 City State Zip Code City tate_�.. Zip CocleQ2947 --- Phone 15 iif40 K- Zy U 7—Other Ph;7r=rl 2'$iCJP N ? Phone Other Ph. Lien]Title Holder Contractor Reg.# i Exp. Yi4-A Address E mail address -1 44 Drivers Lic.#AA 6 CA�1-7,0M 14 9 1 i2M,7DOq Drivers Lic.# DOB SEPTIC I WATER SYSTEM INFORMATION-Connect to New Septic— 1 Existing Septic Connect to Water System L° Name of Water System Well Sewer System--'/ Name of Sewer System PARCEL INFORMATION-12 Digit Parcel No. �47 ;116 :Z-O, 17'In Vey I Fire District Legal Description X a 7-**q "4 Site Address(Please include street name,street number and city) 12 Directions to site LJ_rl,4r 1 Z �4," k'.r Will timber be cut and sold in parcel preparation?Yes No Is property within 200'of Saltwater 4�-,) Lake ;Y_4,-River Creek and Wetland_ `�_ Seasonal Runoff_-Zy,,,, Stream Bluffs 15 t %---/1�4 Z_,, $lopes or Blu Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB-New V Add Alt Repair Other PRIN�kRY RESIDENCE 0 SEASONAL_ . Use of Building ,,L'v Describe Work 4 sa No.of Bedroom_- J-' No.of Bathrooms__1 Square Footage-1st Floor_ 6� 2nd Floor Z 62 3rd Floor Basement ItT Deck 44 Covered Deck &.�4 Other Sq.ft. Garage. Attached—4-, (_Detached —Carport arport—1 111j�_Attached. Az-1A Detached MANUFACTURED HOME INFORMATION-Make Model Year Length_Width_��0 ;,Bedrooms- —Nerronga—throoms Type of Heat Purc4se. - e Re_p lacemCKtUdnit? 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, Isiah all are that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I hav, ..Al'e the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or e work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work prWse4. Tt: or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason Cou , acdess above described property and structure for review and inspection.This permit/application becomes mill&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days.PROOF OF C0A0I9tWM0j%1qKjS BY MEANS OFAPR GRESS I SPECTICI�INACTIVITY OF THIS PERMIT APPLICATION OF 1p DAYS MLINVALIDATETHEAPPLICATION. X 41t4"4e Date'-;'4 ;7 Owner I Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by, Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee Site Inspection i Plan Review Fee EH Review Fee i 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 {L�/' 61�7�`� PLUMBING/MECHANICAL 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 : Mailing Address City Rtate Zip Code -- City Mate Zip Code Phone'� - Other Ph. 7 Phone Other Ph. Lien/Title Holder —""p Contractor Reg.# Exp. E mail address -_ EMail Address Drivers Lic # %DOB Drivers Lic.# DOB SEPTIC INFORMATION-Connect to New Septic Existing Septic .r - Connect to Sewer System Name of Sewer System PARCEL INFORMATION-12 Digit Parcel No. ' ? ^' ! 1 Fire District Legal Description� � Site Address(Please include street name;street number and city) '` I Al t, F` Directions to site f L 44...., �r Is property within 200'of Saltwater Lake River!Creek Pond '-- Wetland Seasonal Runoff 'f Stream Slopes or Bluffs> 15% TYPE OF JOB-New :- Add Alt Repair Other Use of Building Location of Fixtures/Units-1 st Floor, `"_` 2nd Floor Basement �'`, Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:Electnr­ LPCaL Natural Gas_ Heat Pump_ Toilets '+. Type of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs ? HeaSpot Vent Ft Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer F Gas Oyk Kithen Sinks ' WoodCla*`PeuetStove f Dishwasher Kitchen Exhaust Hood 2 Hosebibs Dryer Vent 'I Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OJVIER/BULDER 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 9pplicalw 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 ir>spection. PROOF OF CONTINUATION OF VVOR)US BY MEANS OF A PROGRESS INSPECT IOW X . , Date: Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date Bld Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group—Type Group—Type Con tr.— Planning Department Environmental Health Department FEES Plumbing&Base Fee Site Ins action Mechanical&Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES Request To Revise AnApproved Plan Name Permit Number:BLD2004-- © 00 Phone Number da Parcel Number Y - '9 J f i.✓ .►� Project Address / C> .�41 Mailing Address r [ h^• Please provide a complete,detailed descupti d of the proposed revisions to the appr � Os' S v T T x ky f KNo Are two sets of the revised plans or addendum indicating the changes included? ❑�Yees Ys ❑ No Are the approved site plans included? ❑ No Are the revisions clearly and accurately identified on the plans or addendum? Yes Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes No If Yes,Has the engineer or architect approved this revision? ❑ Yes No No Is a stamped and signed approval included with this request? ❑ Yes ed' tan will be a ved without the written consent of the en ineer and/or architect of ote:No structural changes to a"deli record. footprint or location of the structure? ❑ Yes Does the proposed revision modify the No If Yes,Is a revised site plan,with all new setback dimensions included with this request? ❑ yes i kNo Additional information: y�'' �` Date: Applicant's signature /%�'Y/`L / ' Race>red e0r - i omoe use omy i Date sent Assigned To Approved By Date f' Original Valuation: B. ( r•Ftr_ QItT161 Additional Valuation: x S S sq.Ft. P. nl rate sq.Ft. x s $ --- Total New Valuation S Additional Feei: P.W. Additional Platuiing Dept. S Additional Plan Review S T Additional Conditions/Comments: Additional Building Permit S 1 N t ea Additional Plumbing 5-------- J Additional Mechanical $_------- Additional E.H.Dept. $�--- r Other Total Amount Due: 5--------- �� Amount To Be Paid Up-Front Ste_ ■ i �i■ 1■�G � `hI�i ■■� ■ �n■rart■■ ■■�■il�1!■�I■n■I■r�■■■■■ ■it■■1■■ ■!7■. ■■I■■■■■IlriiiW■■■■ ■ I ■�1■ %►\I■�\ti ■I■EN��1111■■�■orl. ■■■■I' ■�1■� 1\� 1\I \�■ ■u■ =ri■■■■■■■ ■■■i� , try■■ ►�■ ■ ■ ►�■■ \t■►►� t■■■�■i■ �■■■INN ■■■I■■ ■■■■■■■■■■\ \U■■a■■■: _�■■O■■■■ ■■■■I■ ■�■■■■a■■■■ ■ �■■■■ ■■■■■■ ■■ins ► ■■■■■■■■■ ■1�■■� - © ■■ ■ ■ ■ ■! e■. E�II ■■■NOME- , ■■■■��■ ■ ■ ■■■■■■■■■Imam �I■■ �■■■■ ■■■■■■■■R ©■■ ■■ so ■■■■■■■�n�:rr�►■■ i■■■■ ■■■ ■■■■■■■■rl ip—l—IRA■.r_ art., fir• �!�■ r r Building Permit# MASON� ON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427.9670 CORRECTION NOTICE Job Location i 1 This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items Listed below must be^corrected to gain code compliance f �h 0�e6. 4-0 � ., awt IVz' -e-y ors c— rIAX F a ryc Z J Co--1 rJ✓c, of a Un Syr G fv C L You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK )4, Call for re-inspection when corrections are made before continuing' ❑ Make corrections, items will be checked on next inspection ❑ OK to ❑ This is+not fa complete inspection Department LO Date T111-7J 1A Inspector DO NOT REMOVE THIS TAG