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Home My WebLink AboutBLD2008-00260 Cancelled Carport/Storage - BLD Application - 9/30/2008 Sept. 30, 2008 BLD2008-00260 This permit was cancelled per letter from applicant. Applicant has 1 year from cancellation date to reactivate this permit. Plans are located in file cabinent in case management. RECEIVED September 30,2008 IXT 06 26 426 W: CEDAR ST. Permit Center Attn: Genie P.O.Box 186 Shelton,WA 98584 Dear Genie: Please cancel the permit for my carport. Thank you, Norm Dornblaser .. ..... ,.... ..: ,. ,��!+1wr.'^'Y. ..,., .. a':+svro*:.+,�.,...,1-, .z,..:'.�^',,pr:•TF„'A?�'ri'.++?'�!; IP . ��'°y�""�Y"g".7 MASON COUNTY PERMIT NO. 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 INFORMATIO' CONTRACTOR INFORMATION Owner A b a Company Name 0 W A/g Mailing Address Mailing Address City _'Y C=)'�I-) ►►ti State W4 Zip Code — City State Zip Code Phone , Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. # Exp. Email address 2ilMkli�L-A<" (2�jj?CtjpLr-PC ,Qjk E Mail Address Drivers Lic. # )a L1 DOB -J J Z. 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) 0 I Directions to site Will timber be cut and sold in parcel preppration?Yes/ c Is property within 200' of Saltwater Lake n_River/Creek Pond�� Wetland Seasonal Runoff Stream Slopes or Bluffs 15 0 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 OtherT � PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building Describe Work /I'r+ No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor Basement Deck—__7_Govered Dech1 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 Pnse.,$ 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 informaticn 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 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEAN$ F PROGRESSS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 17 DAYS WILL INVALIDATE THEAPPLICATION. Date: Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVE DENIED NOTES Building Department V 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 FORM MUST BE COMPLETED IN INK PERMIT NO. PLEASE PRESS HARD MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 27S-4467 Elma(360)482-5269 Seattle(206)464-6968 APPLICANT INMary&Norm Dornblaser CONTRACTOR INFORMATION �I Owner 301 E.Wallace Kneeland Blvd. Contractor Name 910AIC F QMCS Mailing Addres;Suite 224,Box 291 Mailing ddress 11 No Q6: . City ,WA 98584 Shelton _r City vYALLU State W Zip Code 4937� Phone(��) - Other Ph.(J�D ) 5 F, - 3 Ph.(ZS3 ) 041D-tSV9 Other Ph. Lien/Title Holder Contractor Reg. # N i Lt Address 1 7 1 Expiration It / o'7 / oS SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION- 12 digit Tax Parcel No. / / `Z Fire District Legal Description 1 2 'Z L7Z / — Site Address (Please include street name, street number and city) Directions to site ^U — - G _ok 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 Location of Fixtures/Units 1st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Fuel Type: Electric Type of Fixture No. of Fixtures Fees LPG Natural Gas Heatpump Toilets -Z Type of Unit No. of Units Fees Bathroom Sink Z Furnace Bath Tubs Z Heatpumps Showers --Tc/ Spot Vent Fan Water Heater 1 Propane Tank Clothes Washer r Gas Outlets Kitchen Sinks l Wood/Gas/Pellet Stove Dishwasher / Kitchen Exhaust Hood Hosebibs Z Dryer Vent Other other FiQ Z< A U 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-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 made without approval. first obtai pr X�!!� X Date x Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. DEPARTMENTAL REVIEW AP8R6 D...;'DENIEl7 CONDITION CODES Ruildina Department - Occ GfOU Type Constr. Planning Department Other Other FEES 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 ( I Violation Fee TOTAL FEES