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Home My WebLink AboutBLD99-01025 Cancelled SFR and Garage - BLD Application - 12/2/1999 C � C�Ar�e � I l A/� I r _ PERMIT NO.: BLD Q �oa5 'I ASON COUNTY 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 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner C .� r, L. r�i-,1-\ Nu,SL)ry Contractor Name CAP)N L LL 0oNSr-KLL,77 Ios,� C Mailin,Address F o V c 3 ai;?5 Mailing Address F O BOX I I City I A Nv.V A State WA Zip Code -i oS 8 t3 City Y'n Tt \1 State W A Zip Code 5 r Phone 34o a q 5 -3050ther Ph. 3( 4-) ) V "15�8 Ph.(3too )9q3 - ?b73 Other Ph.( Lien/Title Holder 3 r"ri, Contractor Reg. # CA t�N t=QsIZ- 1 8 Q B Address Expiration 06 0 SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic X Existing Septic Connect to Sewer System Name of Sewer System Well Water System X Name of Water System F, i'J t^ F, t� I LL_ PARCEL INFORMATION-12 digit Tax Parcel No. 1u1 3 aD / 10 / O 3 ycop Fire District Legal Description T-F 2. o F SN 0 T-\r ?L.ra r No Site Address(Please include street name, street number and city) Directions to site L-c) \h— =U> Ih-k— r ow N N:�w k.Iti Ic_ O RPP(Li)( 2 Q 1'hIL1;: S IrF 15 0w L Fr Will timber be cut and sold in parcel preparation? (Yes/No) Is your property within 200' of the following: Body of Water(Name) Saltwater Lake X River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New X Add Alt Repair Other Use of Building Swt-L V' i-/� rI IL E Describe Work t_ P,L c r A SIN(3,Le -FAMILY �23 I C No. of Bedrooms 3 No. of Bathrooms SQUARE FOOTAGE-1st Floor )4 4�_ 2nd Floor -- 3rd Floor Loft -- Basement — Deck — Other sq. ft. Garage 5 I Attached Detached Carport Attached Detached MOBILE HOME INFORMATION-Make Model Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price $ Replacement Unit ?(Yes/No) Installer Name Certification No. 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: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance 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 will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be mad@ without approval first o i n`g proval. X ' 9 Date 1 I C) E X aN Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. DEPARTMENTAL REVIEW A,P VED DENIED CONDITION COPES' Building Dep rt ent Occ Groupl Type Const . Planning Department Environmental Health Department Public Works Department Fire Marshal J Valuation $ FEES Building Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing & Base Fee Public Works Review Fee Mechanical & Base Fee Other Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal ( ) TOTAL FEES - -. PERMIT NO. MASON COUNTY 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 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Did i r 1-� �-X �sorJ Contractor Name �A1'j1.Jl=C Cr Crjw5�6Lu eTto.� �.- Mailing Address t 0 3oX t3 Mailing Address F O Box 11 9 City TA\�u- Y iA State WA Zip Code9P 5 8 S City State WA Zip Code I e 5115 r/ Phone(. Jo 0 3io750ther Ph.( 3(au Ph. 3 ePo W 3- 4, Other Ph.( Lien/Title Holder 5Ar, Contractor Reg. # C.ARN t: a< 18 ;� Q S Address Expiration 10 / 1 oa0 SEPTIC INFORMATION-Connect to New Septic X Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION-12 digit Tax Parcel No. 10 / O 3 `/Co U Fire District Legal Description T-- R. A e1F 1 F S N�zc �►a # 1 O I Site Address(Please include street name, street number and city) ML UJ k I ftK Directions to site 0><p -�. __aIfZ N e 6 ; or- New ►c.►hlc Ro, j ao kVPe,4tic 2 /0 -t1,l Le g I I-IS orA Is your property within 200' of the following: Body of Water (Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add� Alt Repair Other Use of Building S)N LG 1- ri A • 1( R�S.ocation of Fixtures/Units 1st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric X Type of Fixture No. of Fixtures Fees LPG Natural Gas Heatpump Toilets _�_'� / 04 Type of Unit No. of Units Fees Bath Basins / o O Furnace Bath Tubs / - ob. Heatpumps Showers -ZOO Vent Fans Water Heater 7 c 0 Propane Tank Laundry Wsher �— -�cr Gas Outlets Sinks Wood/Gas/Pellet Stove Dishwasher Direct Vent? Other S Other WALL I rL 7 Other Other F)IAN 4-e It,00 Base Fee Base Fee TOTAL. PLUMBING TOTAL MECHANICAL A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT. 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: OWNER AFFIDAVIT-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance 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 will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No chan s shall be made without approv first obta ap val. 9 in'ng �t X Date 114 X_ ( Date U FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. AEPAR7NEEAITAE:R£I EW... APP-RE] p: FfENIED.. AfiDiTl(31V CtyD>f=5 Building Department Occ Group Type Constr. Planning Department Other Other PEES Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing& Base Fee Other Mechanical& Base Fee Other Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( ) Violation Fee TOTAL FEES MASON COUNTY PROJECT SITE INFORMATION Case No. Name i1 AR,I� �� ;ter-� PARCEL NUMBER 1 3 0 Date SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography t•� Well Location (including adjacent) Drainage Plan Names of Streets Easements Names of Fronting Streets Septic System J S DRAW SITE PLAN BELOW Include adjacAproperties if on shoreline or within 100 feet of adjacent property line. adjacent property line4 , , Fadjacent property line I I I I I I I 4 I J V I I V i 1 1 � I I \ I 3o I I my►s 1 I \ I �� PRatos \ I 70 Fled 1 „ � h0' log adjacent property line-) I New kt R �o o I Fadjacent property line SAMPLE SITE PLAN adja�nt property lined _ 3La, _ _ _ f-adjacent property line D 30' rRe�SCRV gel \ A rr, M Q REEKj OPOSGD s¢pt:c T I 1 — VAGNT I I &AMA[.6 % 31 P0.oPmCD / I 1 I So � I 80 I ' I I �' c I /00" I I I I � I /00' I I adjacent property line-,* i t n�. \; Fadjacent properf'line TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the degree of slopes. See sample topography profile.) f"T. ccE V& ,w ` SAMPLE TOPOGRAPHY PROFILE 1�= Hoy di3tontt to ructt,�Yt d�btar.Gt to 510pa toe dis+anam }3 000 does Signature Date