HomeMy WebLinkAboutMIS99-0298 Final ReRoof - MIS Permit / Conditions - 7/9/1999 MASON COUNTY
Mason County Bldg. III 426 W. Cedar ]---�
P.O. Box 186 Shelton, Washington 98584
4`.Jf 1 S Ca E L_. L. ^ N E C)1.3 P UF Fj m I K FOR INSPECTIONS CALL 4 2 7--9670
MI599--0298 PARCEL :2233152O0045 PLAT :COPLO D I V a BLK i LOT : 45
JOB ADDRESS : 211 NE COLLINS PL. TAHUYA
APPLICANT : ANDY COLSON 275-8834
OWNER: ANDY COLSON 275-8834
LEGAL : COLLI#S LAKE 13 ELK: LOT, 45 NE 211 COLLINS MACE
PROJECT DESCRIPTION ,
Re-root . Not entire .
PROJECT L.00AT I ON
north shore rd . , rt . on bel fair tahuya rd .rt . on coliins lk . rd . It . nn aollins place n .e .
PROJECT NOTES ,
1
TYPE AMOUNT BY DATE RECEIPT
STFE $ 4 .50 KS 06/ 14/99 1527
RERF SI 42 .00 KS 06114/99 152.7
TOTAL : 46 .50 6iiN R OR AGENT El` '
MIS-PINT, rev, 04101192
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
datb by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by dale 7 _ / / by %/? date by
FORM MUST BE COMPLETED IN INK l
PLEASE PRESS HARD PERMIT NO. MIS '`���
MASON COUNTY
MISCELLANEOUS PERMIT APPLICATION
426 W.Cedar/P.O.Box 186,Shelton,WA 98584
Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968
APPLIC T IN 0RMATION CONTRACTOR INFOR_MA ION
Owner cc) Contractor Name C—C
Mailing Address I ( fi— o AuL Mqi ng Address '
City State Zip Code City o State tJN. Zip Code
Phone( Other Ph.( Ph..(_!,, 0 3.27 Other Ph.( 6 0 ) 176/ 72.?9Lien/Title Holder Contractor Reg. # CC i CL/ **--k 0 K E
Address Expiration_L/_�/ U
PARCEL INFORM TION;12 di it Tax P rcel No. �a1 3 / / O Fire District
Legal Description 5
Site Address(include stre it nam e and cit 14
Directions sit Ic��e. Sly .9- ,J /� �f�2— ti
L2 K. Co (,N 5 /2d L� C o 1"
Will timber be cut and sold in parcel preparation? (Yes/No)
Is your property within 200' of the following: Body of Water (Name) Saltwater
Lake River/Creek Pond Wetland Seasonal unoff Stream Slopes or
Bluffs
TYPE OF JOB New Add Alt Repair Other Use of Building
Describe proposed construction ^ ', AXE oo�
SHORELINE PROJECTS New Replacement Repair Expansion
Bulkhead Material (concrete, rock, wood, etc.) Length Height
A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF PERMIT.
NOTICE: THIS PERMIT BECOMES NULL R 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 CONTRACTOR'S AFFIDAVIT-1 certify that I m currently registered as a
the Contractor Registration Law RCW 18.27 and am aware of the contractor in the State of Washington and at I am aware of the
ordinance requirements for which this permit is issued and that all work o Hance re firemen's regulating he rk for which this permit is issued
will be done in conformance therewith. No changes shall be made without and II work hall be done in conf r nce with. No changes shall
first obtaining approval. be m e with t first obtaining royal.
X Date L L a ate
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date q�h Submittal Amount Due Tom. Receipt No.
Ei
DEPARTMENTAL REVIE APPROVED DENIED CONDITION CODES
Building Department IG r�-r,;n far of icOY,�..��r1C�
Occ Grp Type of Const.
Planning Department
Environmental Health Department
Public Works Department
Fire Marshal
Valuation $
FEES
Building Permit Fee Site Inspection
Plan Review Fee Other e _
UFC Plan Review Fee Other (a►IC1. yt�rr ICfx l
Violation Fee Pre-Paid at Submittal ( )
TOTA L FEES
5
I