HomeMy WebLinkAboutMIS95-00566 Cancelled ReRoof - MIS Permit / Conditions - 1/6/1999 MASON COUNTY
Mason County Bldg. III 426 W. Cedar n 1
P.O. Box 186 Shelton, Washington 98584 I"
M I S C F 1... L_A N F. fJ U4.3 P E: R M I T FOR INSPECTIONS CALL. 427-9670
MIS96--0566 PARCEL t222335200038 Pi.AT vMAPLO DI V t B1.K t LOT t
JOB ADDRESS : E 2.441 MASON LAKE DR E SHELTON
APPLICANTt DON FAUI-K 770-9461
OWNER - DON FAULK 770-9461 P�RMiEy�plRp+T10N
LEGAL, WINGS S1111 S1111F ADD 11 11 SI NULL gt Vo
PROJECT DESCR 1 PT I ON : DAT� gY
tear off shakes and Install comp root
PROJECT LOCATIONt
Take Meson Benson road off Highway 3 � Go pant Fire Station to dead end and take right . Go to
2441 Mason Lake Drive E and take left . House is gray color
PRO..IFCT NOTES t
TYPE AMOUNT BY DATE RECEIPT
RERF $ 25 .00 NJP 07/31 /95 39799
STFF $ 4 , 50 NJP 07/31 /95 39799
TOTAL : ?9 .50 W ER N7 DATE
1IS-FI1T, row, l41/t/92 COMPLIANCE TO ATTACHED CONDITIONS IS
' REQUIRED
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date b date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
PI— RM I 'T C: C-) hJ0 1 T 1 (3N
Case No , : MI S95-0566
Fort DON FAUI K
Page : 1
1 ) 1HE FMOL 1 T I ON A DISPOSAL OF DEMOI I T 1 ON DEBRIS MUST MFFT Rr-OI) I RFMENTS AS PER MASON
COUIJ REGULATIONS
2 ) ALL CO STRUCTION MI MEET OR EXCEED ALL LOCAL CODES AND UBG
REQU I R SITS
3 ) PURSUANT TO 1991 UNIFORM BUILDING CODE , SECTION 305(C ) AND SECTION $513, ALL. SITES MUS1
HAVE' APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO FEE PLAINLY VISIBLE
AND LEGIBLE FROM THE STRFFT OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING I
DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS) . A '
REINSPECT 1 ON FEE , BASED ON RATES IN TABLE 3A OF THE 1991 UNIFORM BUILDING CODE WILL BE I
ASS F FI) IF7RICONTRICTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING
INS C 1 I ONS
X. _
I
I
I
MASON COUNTY MIS
MISCELLANEOUS PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 • 427-9670
PLEASE PRINT
#1 Owner /EZ"L � Phone # 770 — Fire District#
Site Address _f �_�f�/ /rlit�l Gam_ D ' City
Mail Address
City Id St � . Zip ��&7
Applicant „13 Phone# 4/4al —"/. .
Applicant Address 5er7F- 2e-A Zf 2'16e6z'4
City St Lt/w, Zip
Directions to Site:
A/,6,Ea - .
�� A
2_4��& Mrtaf A/ 2�I?-"- F 4- 7'� 64_z= � Z2�!w.s z;- /s
#2 Parcel No. az-7—��-_IS-T G2m.3er
Legal Description // eljhiq/'05's SGl.✓N_y S`i90r=
#3 Indicate by circling the applicable source if any water is on or adjacent to the property site:
saltwater lak river creek stream pond wetland seasonal runoff marsh other
#4 Project Start Date 7�5'l—��� Project Completion Date
#5 Use of Buildiing_ 1/V Describe proposed construction
S
"Depending upon the type of permit,a floor plan and plot plan may be required.
'This permit is valid for 180 days from the date of issuance.
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED CON-
MENTS OF THE CONTRACTORS REGISTRATION LAW TRACTOR IN THE STATE OF WASHINGTON AND I AM
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AWARE OF THE ORDINANCE REQUIREMENTS REGULAT-
ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT ING THE WORK FOR WHICH THE PERMIT IS ISSUED AND
IS ISSUED AND THAT ALL WORK DONE WILL BE IN CON- ALL WORK DONE WILL BE IN CONFORMANCE THERE-
FORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITH. NO CHANGES SHA MADE WITHOUT FIRST
WITHOUT FIRSTOBTAINING APPROVAL FROM THE BUILD- OBTAINING APPROVA ROM BUILDING DEPART-
ING DEPARTMENT. MENT.
X OWNER X BY
DATE DATE
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Wells
Water Lines Shorelines
Drainage Plan Easements
Septic Systems Name of Fronting Street Indicate directional by
Proposed Improvements Name of Flanking Street N, S, E, W etc.
PLOT PLAN AREA
FOR OFFICIAL USE ONLY:Accepted by: Gate:
DEPARTMENTAL REVIEW
FOR OFFICIAL USE ONLY
Planning APP COND APP HOLD
Building
Fire Marshal
Other
Special Conditions Fees
Permit Fee $
Plan Check
Other
Other
State Building Fee
TOTAL DUE $