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HomeMy WebLinkAboutMIS93-0563 Cancelled Dock Extension and Piling - MIS Application - 11/20/1997 Permit No. MASON COUNTY --�:> `BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 /�GJ �5 PLEASE PRINT#1 Owner Sala �0 I) , SR' . Phone ZC 4)6 O 9 2,J 3 Site Address E , I c) 1 (I 141-x 10(o Fire District# City LXQ I n d W A -St_VIA Zipg95x72- Directions to Job Site F I d 'Ujp -f-0 10 6 0 N sd ltrq StMk-E 0 F 74,00r�:. C-F) Nflz- . Owner Mailing Address , to I ( I )4u-3c1 (o fo City ( �. tl 10 St A Zip 9 2- Lien/Title Holder QL 12iO ECflE R F3L S \3 r r-)[ S Address E L. 1 Clty St L)J Zip 2 9 /��� es,�io�e �onstru i�h #2 Contractor Name - Contractor Reg# Address Be/fa r Expiration Da e City Bel {a wo+t3 St Zip � Phone #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 No.*32236 - 5 ( - 00610,jt Legal Description9=F-P,r-,- L5EflcH 71HRK #5 Building Square Footage: (existing/proposed) 1 st FI / 2nd FI / 3rd FI / Loft / Basement / Deck / #bedrooms / #bathrooms / Garage / Carport / (Circle:Attached or Detached?) Other sq. ft. / r #6 Use of building �xh��hq c'©CK /s `� l�� �' "S �_ Describe work #7 Type of Job: New Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year Make Model Length Width Serial No. # Bedrooms # Bathrooms Type of Heat Purchase Price$ #9 Indicate by circling the applicable source if any water is ;;F ' nt to subject property: River Pond Creek Stream Wetland Lake MarshSeasonal Runoff Other Show following on the site plan Lot Dimensions Flood Zones i Existing Structures Fences Structure Setbacks Driveways Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed Improvements Easements Indicate Directional by (N, S, E, W) Name of Flanking Street Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW 0C-jq 0 �S wlc 7 ar, o�ELt! Ai E 15 SEt>WA O Q MF3KETT�of/off 1=�r TI'i15 flW� ® 3 Q WILL MAKE t'C' rv'►&S-r poi '� ScA�t; 3 b l�rrw LocsT+o� of fitowT. / rC' W �7�A 55 APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures ($3 each) Fee Mechanical Fixtures (r$6 each) No. Toilets CIRCLE FUEL TYPE: Gas, Electric, Bath Basins Heatpump, Other Bath Tubs No. Units Fees Showers Furn BTU Hot Water Htr Heatpumps Laundry Washer Vent Systems Sinks Spot Vent Fans Floor Drains No. Boilers/Compressors _Laundry Basins _ HP Dishwasher No. Air Handling Units _Disposal _ cfm# Urinals No. Fire Protection Systems Other Auto. Fire Alarm Sys 50.00 Fixed Fire Supp. Sys 50.00 Permit Basic Fee 15.00 _ Auto Fire Sprink Sys 25.00 TOTAL PLUMBING $ No. Other Gas Outlets Wood, Gas, Pellet Stove NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COM- MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 15.00 WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OF THE ORDINANCE REQUIREMENTS REGU- ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE CONFORMANCE THEREWITH. NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDI D PA/R�TME DEPARTMENT. X OWNER `'\/ X BY DATE 20 /�y DATE FOR OFFICIAL USE ONLY: Accepted by: Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval oe Planning: Environmental Health: Building Plan Review Occupancy Group: Do LV— Type of Const: S-N Fire Marshal: Other: Special Conditions: FEES Building Permit a o� Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other Other Building Valuation: TOTAL FEE R 9•S`D -i � 09 October 1994 YV vim/ MASON COUNTY GENERAL SERVICES P.O. Box 186 Shelton, WA 98584 Dear Director Byrne: We were granted a building permit (Number M1593-0563 ) on November 16 , 1993 . This is a permit to pull and re-drive 5 of the pilings in our dock facility. My husband' s health has not been good, and we have been unable to commence the work for which the permit was granted. He has now had a complete hip replacement, and we should be able to commence work on the project by sometime next Spring. I called your office and was told that it would probably not be too difficult to get the permit extended (would another year be OK? ) , as long as I sent a letter requesting an extension due to hardship. Please could you let me know the decision on this extension as soon as possible, in writing to the below address . Thank you very much for your time. Sincerely, Betty Kay Anderson (Mrs . Roy) E. 10111 Hwy. 106 Union, WA 98592 t MASON COUNTY DEPARTMENT of GENERAL SERVICES Mason County Bldg. III 426 W.Cedar P.O. Box 186 Shelton,Washington 98584 (206)427-9670 BUILDING PARKS& RECREATION FAIR/CONVENTION CENTER ADMINISTRATION Ain L/Ju S-) l c bb_. V8�590'� Re: Permit No. : Dear 7 / // � As per your recent recruest, th : office has noted the above permit for extension to ' /�-- ,c" 1995 . In order to keep your permit valid, you must call for inspection prior to this date . In the event that you do not cal; for inspection, the Uniform Building Code allows for jurisdictions to require the renewal of building permits. Depending on the length of time of expiration, there are two methods used. If the permit is expired by less than one year, renewal may be obtained by paying half of the original building permit fee at the discretion of the building official and if the permit is expired by more than one year, the jurisdiction can require that the permit actually be processed as a new permit with routing to all required departments . If you should have any further gt.estions regarding the validity of permits, please contact the Building Department at (206) 427-9670, Monday-Friday between the hours of 8 : 00am and 5 : 00pm. Sincerely, on County Bui d' ng epartment cc: Property File ,07 yea a G� S �� fir' /�