HomeMy WebLinkAboutBLD2005-02043 Cancelled Garage/Pole Bldg - BLD Permit / Conditions - 1/9/2006 Inspection Line(360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352
Mason County Bldg. III 426 W. Cedar P.O. Box 186
11P4 Shelton,WA 98584
RESIDENTIAL BUILDING PERMIT BLD2005-02043
OWNER: SHAWN KINNEY RECEIVED: 12/2/2005
CONTRACTOR: TOWN & COUNTRY 800-824-9552 LICENSE:TOWNCPF099LT EXP:6/30/2007 ISSUED: 1/9/2006
SITE ADDRESS: 710 E MASON LAKE RD SHELTON EXPIRES: 7/9/2006
PARCEL NUMBER: 321343490033
LEGAL DESCRIPTION: LOT: 3 OF SP#2967 OF S1/2 SW EX
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
GARAGE/POLE BUILDING HWY 3. MASON LAKE RD TOWARD LK LIMERICK. NEW HOMESITE ON
RIGHT. BETWEEN CATFISH LAKE ROAD AND MIKKELSON ROAD
General Information Construction &Occupancy Information Square Footage Information
No.of Bedrooms: Type of Constr.:
Type of Use: SF Insp.Area: OT No.of Bathrooms: Occ. Group: Lot Size: Deck:
Type of Work: ACC Fire Dist.: 5 No.of Stories: Occ. Load: Building:
Valuation: Building Height: Occ. Status: Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front:SW 115.0 Ft. Shoreline: Ft. Water Body: NONE
Rear: NE Ft. Slope: Ft, SEPA?: No
Model: Width: Ft. Side 1: N 110.0 Ft. Shoreline Desig.: Not Applicable
Year: Serial No.: Side 2: S 230.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Plan Check Fee KKK 12/2/2005 $306.83 S12005000
Planning Review Fee KKK 12/2/2005 $155.00 S12005000
EH Plan Review ADR 12/8/2005 $35.00 §12006000
Building State Fee RTB 1/9/2006 $4.50 S12006000
Building Permit Fee RTB 1/9/2006 $472.05 S12006000
Total $973.38
BLD2005-02043 Please referto the following pages for conditions of this permit. 1 of 4
I _ I
CASE NOTES FOR
BLD2005-02043
CONDITIONS FOR
BLD2005-02043
1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division.
There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
X 80W82. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
2) In accordance with international codes and Title 14, Mason County Building Code, "Standards for Fire Apparatus Access Roads,"all new structures that
require an address shall have approved numbers or addresses located at the beginning of long driveways when the address is not clearly visible from the
access road. The numbers shall also be plainly visible and legible from the street or road fronting the property and shall contrast with their background.
Mason County Building Department requires that this be completed prior to calling for any site inspections. A re-inspection fee based on rates as adopted
by the jurisdiction and the international codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting
inspectionswc?
X
3) The internationnl code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150'from an approved
access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where
such road c ct with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road.
X
4) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will
not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building
Department ny further inspections being performed or approvals granted.
X
5) In accordance with international codes and Title 14, Mason County Building Code, "Standards for Fire Apparatus Access Roads,"all new structures that
require an address shall have approved numbers or addresses located at the beginning of long driveways when the address is not clearly visible from the
access road. The numbers shall also be plainly visible and legible from the street or road fronting the property and shall contrast with their background.
Mason County Building Department requires that this be completed prior to calling for any site inspections. A re-inspection fee based on rates as adopted
by the jurisdiction and the.Lnternational codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting
inspections.
X
BLD2005-02043 Please referto the following pages for conditions of this permit. 2 of 4
6) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the
corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building
Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
removal ed documents will result in failure of required building inspections.
Xr
7) This structure is approved as un-heated space. If at any time this building is to be used for anything other than what it is approved for, a change of use
permit shall pplied for, reviewed and approved prior to the change.
X cc..����''//
8) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other
vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2).
X��/�
9) This structure is limited to U-occupancy use only(private garages, carports, sheds, and agricultural buildings.) Any other use will be in violation of the
internation and Mason County Regulations unless a"Change of Use" permit is applied for, reviewed and approved.
X l/"J
10) Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building
Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached
thereto. If documents are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be
charged an s J collected by the Building Department prior to any further inspections being performed or approvals granted.
X
11) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
permit revocation>
X
12) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance o�/ 7
lon, must be reviewed and approved by Mason County prior to construction.
X
13) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED
BUILDING CODE.
The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance
with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Inspector shall be prior to requesting additional inspections.
X
14) All property lines shall be clearly identified at the time of foundation inspection. X
BLD2005-02043 Please referto the following pages for oonditions of this permit. 3 of 4
y
i
l
15) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason Cou �dinances and building regulations.
X
16) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for
action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder hav/wented action from being taken. No more than one extension may be granted.
X
17) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connector flashing. Install metal connectors approved for contact with the new types of pressure treated material.
X
18) Approved p ensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
X
19) Applicatio dges that the structure is only permitted for a use consistent with the current zoning of the parcel.Zoning is RR5.
X
This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a 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 owneror 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 truct re for iew inspection. /
OWN ER O A ENT DATE:
BLD2005-02043 Please referto the following pages for conditions of this permit. 4 of 4
2e BLmc• r1a(TV.)
is•4•a.a
TO LDOKDLfT �• 2•PIWILlt A7 idae.
Z
4-1a(TYP.) Sd ROOF PMQ SCIE•S AT 14'MY Z q4 N
ROOF PIAM FO KN'PER mAT l PURLAN Y HHp AT N•an �� Y(Jj K
NrnE K PEA 1'-a•LAP (AKNL) 1•-4•LAP(U-) 1.) ALL WORK AND MATERIALS SHALL CONFORM TO THE 2003 IBC (INTERNATIONAL BUILDING CODE). o C C o
E I ZraDr°/L2_1� � HNans CONTRACTOR IS RESPONSIBLE FOR ALL METHODS AND MEANS. 2 .o o_a.2
/ rwL FAC1 war TO EACH v
• rta BLOCK!In=W/2-Ia O
I As PUNUHOW TO 2.) TRUSS DESIGN AND FABRICATION SHALL CONFORM TO THE 2003 IBC (INTERNATIONAL
ram/ FASCIA,a 4-1a(TRIP.) cn DEwiK'41-LPKn� BUILDING CODE). ENGINEERING DESIGN AND SHOP DRAWINGS SHALL BEAR
(rP) �N 1-L 6 � SHOWN) 7O THE STAMP OF A PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF WASHINGTON.
2e LOOFmIJf EACH w, >X- I TRUSS BRACING SHALL BE IN ACCORDANCE WITH THE TRUSS DESIGN DRAWING.
SIDE OF POIRLL A(7•Pasr r'°°—°o of LAP Paar PANEL SCE•a FOR RHALS•Tam As SHOWN OR 11 ON 3.) BUILDINGS SHOWN ON THESE PLANS HAVE BEEN DESIGNED FOR THE FOLLOWING
I /%4• >/4 BOUa POST 1/Ile LONG E7 END(1 L:M NOW LOADING
AND LOAD: 25 GORY psf IVBUILDIWI D LOAD: 85 MPH, EXPOSURE B. a
STEEL STRAP TRUSS OR RKIEA
Pfx NOTE O1 x.HOCK EACH WE Rom xIOE oa FXXAVI oRs T�OR RAFTERS(Tw.) SOIL BEARING: 2000 si
•/a 1m was TO OF POST•/"1°m MAY al i`CnIED AW4 AfW ONE WAY
a P
Cost Y•/ ����USED AT SEISMIC DESIGN CATEGORY: D
WALL?cm OR oil DIMENSION rHAL PFR Caaect,aR ExczPr TaE wa. WITH Sa - 150%g MAX.
OF POST U.N.O. V
T. AT EAVE WITH OVERHANG . THRU PURUNAT A P R N SPUCE DETAIL
2 r-,' N ,'-+'-0 2 1-1' O 4.) METAL PANELS SHALL BE BHP NOR CLAD, OR EQUAL HAVING 80 KS! MINIMUM YIELD
STRENGTH. ROOF PANELS SHALL BE FASTENED WITH 114 x 1-1/2• SELF TAPPING cuoieusu
------- ------- - -- SCREWS AT 9" O.C. ALONG EACH PURLIN AND EACH RAKE BEAM AND #12 STRCH SCREWS
BAY WROTH 2e MAX. AT 24. O.C. ALONG EACH LAP. WALL. PANELS SHALL BE FASTENED WITH /9 x 1-1/2•
HH+KE aAa NOTE H ro BLOCK
SELF TAPPING SCREWS AT 9' O.C_ ALONG EACH GIRT. SEE SHT. 1 FOR METAL GAUGE.
x-1a 7OETUL EACH 2m BLOCaC 4-la R EACH Mods WMAL norm 5.) LUMBER SHALL CONFORM TO THE FOLLOWING U.N.O. ON THESE PLANS:
PLnNH 70 EACH MICE PAN EACH SHOE 2X4 THRU 2X12: HF NO. 2
STRUCTURAL POSTS: 4x6 HF NO. 2 S4S
wm 6x6 dK LARGER HF NO.1 ROUGH SAWN dK AS NOTED J
TIE STRAP W/e-,a,1_1/2- BLOCKING: HF STANDARD AND BETTER
SAAE A MR am - , bo SPLICE AT POST 6.) EMBEDDED STRUCTURAL POSTS SHALL BE PRESERVATIVE TREATED FOR 0.60 pd RETENTION p
Rr1E BEAM PER Hut NWE K I IN CONFORMANCE WITH AWPA C15 OR C16. ALL OTHER LUMBER IN CONTACT WITH SOIL OR
PLAN 12. rF,IaA CONCRETE, OR EXPOSED TO WEATHER SHALL BE PRESERVATIVE TREATED FOR 0.40 pcf
O-1a,tAH(!TO OEIMILL RETENTION IN CONFORMANCE WITH AWPA C2. NAILS USED WITH PRESERVATIVE TREATED
NO MWC OR BLOCK RIOT FOR CoNToKxxm RAHQ. - r,a EACH CJRT LUMBER OR BELOW GRADE SHALL BE GALVANIZED. (/)
THE 5DE 1/EH SNRL (S-1a FOR SINGLE SPAN ALTERNTC LOCATION W
PAKE ALLOWED NO AT CORNER POST.)CTTP.) OF TIE SOW
.IN=•/WOm I �ti1 Posy 7.) BOLTS SHALL CONFORM TO ASTM A307 AND HAVE WASHERS UNDER EACH HEAD AND NUT 0
Y4 TO O/POST. J U.N.O. Z
NFL W/6-16d mm.) BLOCK SUME
IE TO CONTINUOUS RAFTERS AM
WALL PALs BLan WATCH 'AS5{q�() 79 3~�OR PER PLAN 8) CORETE INSPECTIONSPECTION S_S NOT REQUIRED.DAY MINIMUM COMPRESSIVE STRENGTH OF 3000 psi. SPECIAL
ORR156 TfIP CN010 PER NOTE#10
OR CAKTINLE14EHm
WPM BEAN 9.) BACKFlLL FOR EMBEDDED POSTS SHALL BE CLEAN SAND.
INCEST DIMENSION OF COMPACTION SHALL BE BY MANUALLY TAMPING WITH A 20 POUND • a
�D1 AT ENDWALL WL POST UAA MINIMUM STEEL TAMPING BAR IN LIFTS NOT TO EXCEED 8'.
SECTION i'
2 1•_ / OVERHANG ENO POST RIDGE CONNECTION AL EAVE GIRT SPLICE c- C5
2 r-r-0• 2 r-r-o•
-- __-- 10.) STEEL STRAP SHALL BE SIMPSON CS16 OR EQUAL DOc
TOE X14L T-offUlm
To Posy W/r1a 11.) 19/32- T1-11 OR LP SIDING MAY BE USED IN PLACE OF METAL PANELS ALONG a
Posy ENDWALLS AND SIDEWALLS. SIDING SHALL BE NAILED WITH 6d COMMON OR 8
'1 aR. FxLE .••.� .•.
GALVANIZED BOX NAILS AT 4' O.C. ALONG PANEL EDGES AND 12' O.C. IN FIELD. �
o POST r� ALL EDGES OF SIDING TO BE BLOCKED. FOR SHIPLAPPED EDGES BOTH PANELS SHALL o
HN
DWYER NAILED BE EDGE NAIL WITH 6d AT 4" O.C. IN ACCORDANCE WITH MANUFACTURER'S SPECIFICATIONS.
WEAL FARMPOST Im�]DHR¢s rm 12.) CONSTRUCTION OPTIONS WHERE SHOWN ARE AT THE BUILDER'S DISCRETION.
' :JS} A CONCRETE SA&TIC e
.�.._,.. ..,, FOR tl!T PER IHOTE/4 .•c�• lPPF71 1Y!)F SOL
4 wROEIE r,;•. 13.) NAILS ARE COMMON WIRE, UNLESS NOTED OTHERWISE NAILS INSTALLED IN C'
IL7lE: to OAL FLOORSAe P'•. .•{7-•
ILAT FTC PRESERVATIVE TREATED LUMBER TO BE HOT DIPPED GALVANIZED OR EQUIVALENT.
ALTERNATE 24.O �jS 2d P.T.O•FT ..ry:...T: p5 ... •:
•
i
PER 4•MIN' �`::• - M.. 89X FILL A
TRUSS ANCHOR — .
2s HET. FACE a SAW PER
41P90N SETA,a'
NAL■ r1a r/ ,a IULS I -;14 .,, ;:r NOTE p
2 8 T-IM NHL AdST��PER I AROUND
'•`•-, R
—TO4Ei1Q r�yp ,]�YF(1' I! i tif'w.I: d COFCIQE PAD
an
or
ALT 0.1D1•A.i-//46 FOR�RN�PosTs /�/ / CONCREM MCI P()
LOPED NAL• IY m
6f— Pm PUN 1 S+t!
BED
1 W �-BASE GIRT DETAILDIED NG W h
PUFLIN (2)25 BLOCK BETWEEN W
w E W
• a 1raAC+`aR�NALS z
'•� ,a FROM PURLM NAL BLOCKS./
BLOM(TYP.) •14•—STADOFIED 14y69 �� 0
1Mw STRAP am
OK BLOCX
9WP90IH Nu EAJ f N.ILv AA Z o
PULN ETD TO TRUSS 00
(n
— Q
War Olt RAFTER.
) / EXPIRES ta3J20/06
STEEL STRAP J 2• •/<�
to TO BLOCK
EA soE
W�Doo SCRCE'W 1 AT(BOOM At(6) OF DeL BLDcx
JGA W WOOD�AT
WHEWLSCM OF SIM=
EXAM s•-a'AM FW
1I-ra TOTIL ./> STm STRAP r BRACE 75X OF
PER NOR/I, 1ad•,2-aa.�
PER CALL POST.
2F4 r
?oE
OS X.1'WOODALL POST SIR
D fIR-r HOLDEsLY FAACH MAY
1
50'-0" }
DETAIL 8/2ST
W
ATO ACE OF 12'-0" 12'-0" 12'-0" 14'-0" Z g
BLDG_ LINE METAL ROOFlNG PER y
X NOTE +4, SHEET 2. 12 _
�- -- ------- -t -------;-- ------------------ -� (29 GAUGE)
-------- I � 4 cc oa;p e
PURUN PER DETAILS
�4x6 x6 x6 I x8 6x6 3/2 do 4 2 0
POST POST POST POST POST
I
II II I I I I OPTIONAL EAVE f 1
i o 2) 2x1 O I o o OVERHANG PER
I RAKE BEAM II II I I I I DETAIL 2/2. -
iv PER DETAIL I I ,� tV TRUSS SUPPORT BLOCK TRUSS BY OTHERS o
5D/2 I o PER DETAIL 2/2.
' II II 4" CONC. SLAB 0 - I I
22 I I II I (BY OTHERS) 3I Z
POST PER PLAN
O I (TYP) I to I o_
is
\ � w
of
cV �-4x8 suasl w�
POST I II I I POST POST I 111 29 GA. METAL >_GIRTS PER DETAIL 12/2 D_
WALL CLADDfNG
a PER NOTE 4,
I � OP O 2.
N N NAL CLAD DING
'x4' ER
O11,o SHEET 2
� �1 DETAIL 13/2I i WNDOW Ir FLOOR
WALL ABOVE 28
OFZ=
�I
r�6 PPOSE 63'x6'8' �� I OST Z DOOR I- ----I --- --- - I I I
Pno
( I1I IlI II III
SRU
w_ O
SRU
, , PS- ---------- '-------------------- OT � NPR' DEEP
212x12 FOO IGS E u 0DETAIL 16/2 w�
X I I RAKE BEAM
/�
1 PER DETAIL
o PER PLAN
PLAN I I SD/2
x6 6x6 , X TYPICAL SECTION THRU CLEARSPAN
18 POST POST 1
12' x 12' SRU o
g
ax,o Ad
POST
------ 2x6x12• LONG ATTACHED � C !!
14'-0" ro I a ,oa WITH �S
!/ o
r
ATTACH LONG PRESSURE eLoac.
ATTACH GIRT ro BLOCK wrtH TMO ATTACH•LONG PRESSURE CHORD
T
ROWS 1Od NAlS AT a-o. ATTACH TRUSS BOTTOM 1Od ro ` Y
BLOC(wTTH Two Rows ,Od NMS
ATa- oa W
�!1 p 19969 1�
PL" 3-iad STRAP AATTWALL GIRT ro ` 'C,C 0��4
3-,Ad BOTTOM wWrrH � l�NAL
,TMAJ' NAILS /
40*11 WALL GIRT TRlJSS EXPIRES 08/20/06 /O
+ + �
I+ +
+
I+
sYPSON LSTH+O
E �ACH SwE. 2TA:1 Y LONG ATTACHED ° STRAP ATTACHED ro
ro PAST wrtH a ,oa NNlS ° TRUSS SUPPORT TRUSS BOTTOM O>iO1tD Z
ATTACH GAIT TO WTTH AND WALL GIRT WITH W
(3) Tod NAIS BLOCK PER PLAN Odx3- NAILS
O
RAID BEAM POST PER Z U
EACH SIDE PLAN STRAP A 1.5T14O� aTAACa• LDNG PRESSURE BLOCK. POST � Z
Of POST. STRAP ATTACHED TO ATTACH WALL GIRT ro BLOCK WFTH PER PLAN
ATTACHMENT AROUND POST RAKE BEAM WALL GM AND TENT TWO ROWS 1Od flAlS AT a• o.a O
PER SD/2. V)
LOWER WALL CIKT SwPSCN NT STRAP BENT AS Q
S
POST SHOWN AND ATTACHED
PER PLAN WTTH 1OdT3' NAGS
DRAG CONNECTION LOWER GIRT ATATCa• LONG PRESSURE BLOCK
ATTACH WALL GYRT TO BLOCK WITH
(2) AT UPPER ROOF TWO Rows 1oa was AT a• o.�
DRAG CONNECTION
28
1 ,•-T'�" meet
2
900.29'
\ 10' VEGITATION BUFFER O
OR
O\
Ito 'Pr
R100'-0" 1
a 0 0 h PROPOSED NEW
�g Q \ WELL LOCATION
,yo /
a �
R100'-0 1
t
9s -- i
WELL
LOCATION
PRE PLAT
,o.
/
/
furl -`%CS`0!a COUNTY GCS
/ SITE PLAN F:�-tiU,?ED TO BE ON SITE
/ CHANGES SUBJECT 10 r:'PrGVAL
Cy
NORTH
Site
$t�AvlK # h�\�OL� No. ' Description Date
Carlson's Custom Construction, Inc. KIMAF-y SITE PLAN
MAS04 LgKE
Project number Project Number
8111 Incline Drive SE SlfP-%- QR t V A g85$y Date Issue Date PAGE 1
Olympia, WA 98513 -D%,Y 'FA4xC&0f 31134 31 90033 Drawn by Author
(360) 791-8495 Lo-r 3 1 S •T'. -IT A! 1(P7 IChecked by Checker Scale 1"=60'-0"
TOW[)M Lm Suite C•16521 Highway 99•Lynnwood,WA 98037-3161
POST FRAME BUILDINGS Everett:(425) Headquarters:
Puyallup:(743)640 9552 Building Design
74�T�n� Administrative Headquarters: (425)743-1555
FAX: (425)742-,*M Toll Free: 1-600-824-9552
°' • Contractors LIC.!:MWNCPF099LT
Quality:Our Future Depends On It.'
ZEN,
P ASE CHECK FLOOR PLAN
Roll-up doors fit in Bays SS Wind MPH Draw North Arrow in Circle
Roll-up doors will not hit Truss g Wind Exposure
(� Roof Pitch Eave Height O
Snow Load 8 Minimum Clearance
1 7 - t y
I INSV T�prl 1 t4 Ti4 P FoOF ONLY
(I Q n.
4 Sctkttp Bo,-�P-'s rue ton orw jr! ®r4tAl 1
I-.Z 3 .aea-
W r tct,1„ ►9` 3
y
i
t-1
i
l
i
I t
i t
tr
BUILDING ELEVATION
Customer has verified and approved the orientation of the building to the North and verifies that all items specified in Paragraph B of the contract are
shown on this drawing and vice versa. Customer Name: ig)C,40Lie K U mgy Lead# S74 P�o
Customer Signature � �
White-Customer Copy Canary-Office Copy Pink-Accounting 01995 Perma-gilt Industries FR-85 12/04
it k1ss
MASON COUNTY PERMIT NO. /w� "'e,&
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 t - Company Name-ToarN ! Caua'Tl y Btj It 01H65
Mailing Addressll E . •D&K-116noAL 16111VE Mailing Address I&S.11 _99
City%mr-L7 n State W_Zip Code 9 AS M City L_ Nnoh State U_ Zip Code_9 P37
Phone 316Q-9,12116-g8q I Other Ph.3(oo-Mg 0- It►1 Phone &2n-A;z+ qSsa Other Ph. -7 S'
Lien/Title Holder hl. IA Contractor Reg.#TDWN ePIF O°Ig1.T Exp. 7
E mail address N fA E Mail Address TEICw3 wr . Coh
Drivers Lic.# 1 DOB Drivers Lic.# W IA DOB N `A
SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic On Existing Septic No
Connect to Water System N o Name of Water System :A
Well N o Water Systems Name of Water System N I A
PARCEL INFORMATION - 12 Digit Parcel No. 5.2.05H 34 cloo-53 Fire District
Legal Description_ku-1 3 , ST * Vg67
Site Address (Please include street name, street number and city) NASoN LAtcr KaA V . 5NtL-row
Directions to 5ite w`/ -tr &. NA5oN I-Atye iQpw D Tou,AR-e LA ft t,IAA ER KK hIlIkIii Hnh!3 IMF 0A'1
N Kr_ KC A I KKjLL5pf4 kioA V
Will timber be cut and sold in parcel preparation?Yes/ o
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes.
TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑
Use of Building GAFA61E Describe Work F�iatcT 'DI LQ GAP or W►lo PIVAD146
No. of Bedrooms No.of Bathrooms Square Footage- 1 st Floor 2nd Floor
I 3rd Floor —Basement Deck Covered Deck Other Sq.ft.
I Garage 136 Ell Attached Detached Z Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make N 1A 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.
I 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 permis-
sion from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this applica-
tion or thew rk p po i the application, I have obtained permission from them to apply for this permit and conduct the work prroposed.
i
X Date: I 111�j LLS
Owner/Owners Representative/ ontracto (indicate which one) T 2
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by: Planning Pd Ck# Date Bld Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department MV VI/0' 1
Planning Department
Environmental Health Department
Public Works Department
Fire Marshal
FEES
Building Permit Fee Site Inspection
Plan Review Fee -706• _3 EH Review Fee
Plumbing & Base Fee Planning Review Fee
Mechanical & Base fee Other
Wood/Gas/Pellet Stove Fee State Fee y
Violation Fee 0 .� ' d� Pre-Paid at Submittal
Valuation $ l rO3 . 6G TOTAL FEES