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Home My WebLink AboutBLD97-1350 Replace MFG Home - BLD Application - 11/24/1997 Permit No. MASON COUNTY BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628Q PLEASE PRINT #1 Owner 1 E. • Phone# Z3 al>> Z-7rJ� gZ9 Site A dress Fire District# City St_) n. Zip '585.2-9 Digtions to Job Site vGt 1'I I oCl t C] ()n 41IL, rlu h t"716ti Owner Mailing Address City St Zip Lien/Titie Holder Address Clty St Zip #2 Contractor Nam / � Contractor Reg# � Address C� Expiration Date City St Zip Phone# #3 If septic is located on project site, include records. Connect to Septic?—,4� Public Water Supply Well Connect to Sewer System? Name of System (If residential, proof of potable water is required) �7lar�� V #4 Parcel No. cl� - �-�y t JA- Legal Description ) )- 3 3 - #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 bu ding Describe work #7 Type of Job: New_, Add Alt Repair Other #8 MOBILE/MANUFACTURED H ME INFORMATION Model Year Maka Model1�1 � Length Width Serial No. c c� / Q Nov 2 41997 # Bedrooms � # Bathrooms Type of Heat K �- Purchase Price $ ;;';d PERMIT ASSISTANCE CENTER #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: 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 i 029 5 L LO q� IV VV l�VkJv� nU er�c�t are '� 10 APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW i fLj a •. Plumbing Fixtures ($3.35 each) Fee Mechanical Fixtures ($6.75 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 16.75 _ Auto Fire Sprink Sys 35.00 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 16.75 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 OFTHE 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 WITHO T FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDIN EPARTMENT. DEPARTMENT. X OWNER X BY DATE v C DATE FOR OFFICIAL USE ONLY: Accepted by: Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold pproval Planning: — ��5 /l'„ d�/� ✓c' _ Environmental Health: P� Buildi g Plan Review Occupancy Group: Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit 1 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 - MASON COUNTY PERMIT ASSISTANCE CENTER P.O. Box 186, Shelton, WA 98584 NOTIFICATION OF PERMIT CANCELLATION Date: 01/21/99 LEWIS JOHANSON NE 500 SANTA MARIA LANE BELFAIR WA 98528 Permit Number: BLD97-1350 Parcel Number: 123315100094 Project Description: MOBILE HOME Upon review of our records, the Mason County Permit Assistance Center has identified that your building permit was ready to issue on 12/19/97 . Permits are valid for 6 months once approved and at this time we are attempting to clear all unclaimed permits . If you intend to obtain this permit, you must make arrangements to do so within ten working days from the date of this letter. If we do not hear from you within ten days, we will cancel your permit and make arrangements for a building inspector to do a site visit. In the event that your project has been completed and a permit was never issued, you will be assessed penalties as allowed under Mason County Ordinance 37-96 . If your project has been cancelled or if you intend to withdraw the permit, a plan review fee will be due for work that the Permit Assistance Center has already performed during the processing of your permit application. This fee is assessed pursuant to Section 107 of the Uniform Building Code. In addition, a parcel flag will be attached to your property until the fee has been paid. Please be advised that this parcel flag could prohibit future development or improvement of your property. Please call (360) 427-9670, ext. 354 to resolve this matter or if you believe you have received this notice in error. Thank you for your cooperation. Sincerely, -AC� � � Fee Amount Due Kathy Soine, Clerical Assistant Mason County Permit Assistance Center PENDEXPR, rev: 01/15/99 G � ,9 9 91 ' ( 10 t✓o � ! 13 DAIDf N '®R� - RECEIVED DEC 02 1997 l�e�P�c.��n 5L x 28 M W 29) x Cols Nl Washington Home Center, Inc. Floor Plan Ridgedale Classic 2000 DW 4603E - Lewis & Patti Johanson 4603E 0 --------------------- -T Dining Room 11'8"x13'2" �— Living Room Utility i_ ' 17'9"x 16'8" El Master Bedroom 13'2"x14'4" ],�,n i L/ Island Bedroom Bath Study --- 10'2"x 9'6" Kitchen ;; Foyer 10'11"x 9'4" Bath 1 Heat Pump 2 2)4x4 Decks 3 Plant Made French Door White (Pair) 4 Double Door Exchange Blank Wall 5 Skylight 24"x24" 6 rrosticss Hose Bib -- MarT 772001- Specifications subject to change (c)t9%softseu,try. - - -- - - - - w Permit No. ' MASON COUNTY \ate BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton,WA 98584 427-9670 (Calling From: Seattle 464-6968, Belfair 275-4467, Elma 482-5269) �' 1 PLEASE PRINT �j #1 Owner r �v� Phone# dress C e Fire District# .ty l� -Zip Directions to Job Site 2S(� LA J �, � y' Le_ - Ol1-i 1 v G r- 1 14 IF' J 1 Owner Mailing Address City Zip Lien/Title Holder Address City IL IIIAL Zip #2 Contractor Name ol, G� UBI # AddressReg# City �' St Z& ip o cp' tion ate #3 If septic is located on project site, include reco Coo., Connect to Septic? Public Water Supply Well Connect to Sewer System? Name of System (If residential, proof of potable water is required) # arcel No� - C 10Legal Description #5 Building S ua/r�Footage: 1 st FI (D 2nd FI 3rd FI Loft Basement # Bedrooms #bathrooms Deck Other Garage Carport (Circle:Attached or etached? #6 Use of Describe work #7 Type of Job: New—_Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year Make Model Length Width I No. # Bedrooms thT�om of Heat Purchase Price$ #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other Aj op-Q— r show following on the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography Drainage Plan Wells Septic Systems Easements Proposed Improvements Name of Side Street Indicate Directional by (N, S, E, W) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW � r APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW lumbin Fixtures 3.35 each Fee Mechanical Fixtures($6.75 each) No. oilets CIRCLE FUEL TYPE: Gas, Electric, Bat asins Heatpump, Other Bath Tu 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 16.75 _ Auto Fire Sprink Sys 35.00 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 16.75 WORK IS SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COM- TOTAL M CHANICAL $ MENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. OWNERS AFFIDAVIT CONTRACTORS AFF\STE I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I CURRENTLY REGISTERED MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN TH OF WASHINGTON AND I RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OFTHEORDINANVCE 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 13E IN CONFORMANCE CONFORMANCE THEREWITH, NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT MADE WITHO T FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT DEPARTMENT. X OWNER - X BY DATE DATE FOR OFFICIAL USE ONLY: Accepted by: Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: Building Plan Review N e oo V R R(A NCB' /ppP%M0 TLti hiTt -K s 1 T-e p V}N Occupancy Group: Ul—k Type of Const: S IJ Fire Marshal: Other: Special Conditions: FEES 8 801� l3 -Sa = I ( r 8 S C7 Building Permit O$. Plan Check n �-l1•z Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Violation Fee Site Inspection Building State Fee 5,0 Other 00, Other Other Building Valuation: III8 8O TOTAL FEE 77' IL RECEIVED DEC 02 1997