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Home My WebLink AboutBLD2006-01919 Cancelled Final on Expired Permit - BLD Permit / Conditions - 4/30/2007 Inspection Line(360)127-7262 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 too RESIDENTIAL BUILDING PERMIT BLD2006-01919 OWNER: GARY GORDON RECEIVED: 10/30/2006 CONTRACTOR: LICENSE: EXP: ISSUED: 10/30/2006 SITE ADDRESS: 191 NE JOLLY ROGER LN BELFAIR EXPIRES: 4/30/2007 PARCEL NUMBER: 123315100066 LEGAL DESCRIPTION: BEARDS COVE DIV 8 LOT: 66 & PTN DIV 7 LOT 19 BLA AF#400373 PROJECT DESCRIPTION: DIRECTIONS TO SITE: FINAL ON EXPIRED PERMIT NORTHSHORE (SOUTH) TO SANDHILL (RIGHT)TO LARSON BLVD (LEFT) TO LARSON LAKE (LEFT)T JOLLY ROGER (LEFT) General Information Construction &Occupancy Information Square Footage Information No.of Bedrooms: Type of Constr.: Type of Use: MH Insp.Area: No.of Bathrooms: Occ. Group: Lot Size: Deck: Type of Work: NEW Fire Dist.: 2 No.of Stories: Occ. Load: Building: Valuation: Building Height: Occ. Status: Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: Ft. Shoreline: Ft. Water Body: SEPA?: Model: Width: Ft. Rear: Ft. Slope: Ft. Shoreline Desi Side 1: Ft. g" Year: Serial No.: Side 2: Ft. Comp. Plan Desig.: Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Final Expired Permit KS 10/30/200 $58.00 S12006000 Total $58.00 BLD2006-01919 Please referto the following pages for conditions of this permit. 1 of 2 CASE NOTES FOR BLD2006-01919 CONDITIONS FOR BLD2006-01919 This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended fora period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structu review and inspection. / OWN ER OR AGENT: DATE: Z(-)' 3CU- h BLD2006-01919 Please referto the following pages for conditions of this permit. 2 of 2 MASON COUNTYPERMIT NO 0�-Ur • .. 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 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Company Name Mailing Address Mailing Address City State Zip Code City State Zip Code Phone Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. # Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic. Existing Septic Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. Fire District Legal Description Site Address (Please include street name, street number and city) Directions to site Will timber be cut and sold in parcel preparation?Yes/No Is property within 200'of Saltwater Lake River/Creek Pond ff Stream Slopes or Bluffs 15% Wetland Seasonal Runoff p Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building Describe Work` i I,)� � ? , r No. of Bedrooms No. of Bathrooms Square Footage- 1 st Floor' 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make 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. 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, 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 application 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 inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 380 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OFA PRO S INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X - Date: /U' 3J ' U C. Owne Owners Vve/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 Ins ection Plan Review Fee EH Review Fee Plumbing & Base Fee Planninq Review Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES