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HomeMy WebLinkAboutBLD2007-01719 - BLD Permit / Conditions - 9/13/2007 MASON COUNTY PRMTNO �N .nt. ..r, BUILDING PERMIT APPLICATION 426 W. Cedar-PO. Box 186, Shelton WA 98584 Shelton (3 60)427-9670 - Belfair (360) 275-4467 - Elm (360)482-526 On the web wwwxc .mason waus ICTINFORMATIONRACTORINFORMATION Owner ��. �� � � CoCompany Name Ma€ling Address � �allin�address CtyStateiZp Code c Zip Code , Phone Other Ph, Phony Other Ph. L era1 TTitle Holder Cor tr ct R g t Exp. E mail addr , ' " p E Mail Address Drivers Lie.# COB Drivers I ic, DOS SEPTIC /WATER SYSTEM INFORM "I - Connect to I ew Septic g rt -eM Existing Septic L Connect to Water System Name of Water System Weld Sewer Systern Name of Sewer 5ysSys A I _ 2 Tligit 'argil No, Fire District Legal Description Site Address tPtease include street n , street dumber and city Directions to site r" WiI timber beit and said ire pencef prepatatian Yes! a„ Is property within 200 of Saltwater ivar creek r d ` etlan` Seasonal Runoff 6trarn S€opts or Blffs 'c Is this permit submittal si t ° result of a Stop Work Notice,Correction Notice or other enforcement action?Ye TYPE OF JOB - Neyy Add AIt Repair PR ARY FE xI1N F S N Use df rai ding n scribe Work No. of Bedrr om No of Bathroom Square Footage- st loo 2nd Floor 3rd or Basement Deck_ Covered Beck gather S , ft. Garage Attached Detached Carport Attached Detached I N Make t t odel * , Year s Length ,. W dttv erial[ o, ' 0 * No f Bedro a No of BathBathrooms Type of Heat . _ Purchase FriceReplacement Unit? Yes Installer Name t erwtification No, OWNERf BUILDER know ledges submission of inaccurate information may result in stop work order rperrcorit revo. tion, Acknowledgement of such is by signature below. I declare that I dm the owner,owners l gag 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. 1 declare that I have obtained t permission from all the necessary parties. If;Pr.rmis on is required from any eas er t holder car any rather party in interest re arding his application or the work proposed in the applicabon, 1 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 information'provided is a grate and grants prr ployees of Ma onCountyaccess to the above described property and t t r for review and inspection, "his permitlappsca te Ie ar ea null void if work or authorized conatconstruction is not commenced with,r a a t f construction work is suspended fore ,.ppri oil of I8g days,PROF OF CONTINUATION OF WORK IS BY 14 APR, a11 TH rINA TIVITY OF THIS PERMIT i L)d II F 180 DAYS WILL INVA .I tATE T BEEF p"Ft d TION. kb I wk lGi. ,,.r a�m ✓�wa awner!Them Re sf sent Contractor (i care whic one) R II °HIS I Accepted byr w Date ,r IDEPARTMENTAL REVIEW APPOVED 6uildin> De art t ent ' Plannin De artrrlent - __ En ircrn ental Health epart raent „�ri t c 3 , i rmw dire Marshal uildin Permit Fee Site lns edtion Plan Review Fee 'H d l Review fee lubin & Base Per Par nin Feview Fee Mechan a &Base fee Other Wood 1 Gas r Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valoration S TOTAL_FEES MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedi F O.S sx 86, Shelton, 98584 St elt n t 36C) 427 Belfoir 2f t 275-4467 Flrna{360) 492-a2 9 rr the web wrwrwr.cc.mason.wa.us APPUCANT NFORMA13ON CONTRACTORINFORMATION iwrner Co pan ame Mi Mailing Address State dip Code City tate Zip Code P o rte lather 'hx F h rre Other E h. L tle bolder Caitract rr Berg. ddressF Mail Address L.ic. y 10C .. .w lrivers c3 DOB DC .. SEPTIC INFORMATION - Connect to New Septic Exist Septs Connect to Sower System Name f Sewer System I - 2 Digit Parcel No.' Fire IT stric Legal Description Site Address (Pease include streetnare, street rurrroer and city) . Iv Directions to site Is property w thn 209"of Saltwater Lake Fiver I Creek Pond 'yetlartd S asonal Runoff Str arrr Slopes or luffs > 5 TYPE OF JOB - New Add.. ,.�...Al . .. R pair. . _Other L1se of Building Location of Fixtures/Units - 1"st Floor- 2rrd Floor Basement Cara e Closet I F T (Shaw 1urrrber of eacrrt Cf IC- AL UNITS ae of F xture No, of fixtures Foes Fuel T"ype:Flectri t P Natural Gas . Heat Pump ToiletsU It No of Units Fees Bathroom Slob Furnace Bath Tubs Heatpurrtps Showers Spot Vent Fan Water Heater Propane T"an Clothes Washer Gas Cutlets K it hen Sinks P rx/Trill ellet Stove Tishwrasher Kitchen Fxhaust l Ha sebibs Dryer lent Other Other Base Fee Base Fee TOTAL ILL L Sl l TOTAL MECHANICAL ()M9ER/BUILDER 6ckn wtedçjs subrrason of naccuratinaccurate information may rcc`in a st to w k carder or permit revocation Prat of such a ty signature below ldeckm that I m the ow icr,owr ers lopal rep re ntati or the contractor,l further deckra that 1 any entitled to receive this permit ar d to do the work as pr in thecopapplication.! lare tt tat 1 have obtained the pai"rrai i ar from all the ocasaary parties.If permission is required fror . ny casement der car y ther party in interest regardn this application ar tfae rl proposed in the aoplication,I have btai permissio oi them to apply for roil and corel the v r proposed, The rwoer car a sston owners behalf«reprocents that the info tion pry accurate aid grants er ip of Min County a to tfr above d property a structure for rev`ew and inspection PR O NTINUATION BY MEANS OF A PROGRESS INSPECTION Gate: nsr lOwners t sntativo/Contractor {indicate which tenet FOR OFFICIAL POINT Accepted d Planninp F'd_.w ,CM Date 1 JLiz j Bid Pd, Receipt N . 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IntericrDate By Interior-Date By bate By O -Exterior Date 1U / -i By 1,01 Exterior-Date By z INSULATION Set-up G7 Point Load!Isolated Footings Date By m BG I SLAB INSULATION Z Date By Data By FIRE DEPARTMENT C[1 Foundation Wails Floors Data By Date By Data By DECKS FRAMING Wails Date By Date By Data Lay PROPANE TANKS PLUMBING Vault Date By Date By OTHER Groundwork Attic Typo: Date By Date By Gate By tt:t�tV DRYWALL Type, tnt.Brace Wall Date By W Date By Date FINAL INSPECTION t� Water Line Fire Soporatioo Date By Date By Date By Ct iD W aPass or Request Inspect. o 2. Type of Insp. Fail Date Date Done By Comments 14 j!J v_ 2C-5 I A7fr t 1 1-4O as vr' O -ti CONCRETE MECG ICA NUFAC URED HOME 0 tn By � Foo tint Setbacks Ipirt t crass; Interior Dale< By I tenor-Date By tty Ext D te By Bxt,rrnr_L atet� 0 tt t Load Isolated G SLAB INSULATION Z INSULATION t 1 , �� 3 t } rya FIRE DEPARTMENT F Foundation Waits Walls Date By gate By Data y DECKS FRAMING Wattle Date, By gists a t By PROPANE TANKS Vaultskate y PLUMBING Groundwork Attic mate Eby `y . ati By DRYWALL DWV Type. tat Brace Walt By � tBy Data BFINAL INSPECTION Water Line Fire Sapration, Lk By D ByDate $ y Pass orJuest Inspect Ins p. Fail Date Date Done By Comments to � .wnn'n„ enmwea, «,,,m ax•.mmwWc. ,�am..a O «�. .. t5m S __ U!y ,ppyySw: a uu«„..�umwmri�,.e waeww�sw�w wm+uw^mw.'+ murz.+a oa+s.,x+aw'-wv..w:�xw-e+aaww,wrou+en w,x+vrw.w mrorc+a�+.u.mm.-w.,.b� �.awwm �Y r ACCESS & GRADE INSPECTION PERMIT #: - `. `--t l 71' ADDRESS 3 V 8LQ l _1 INSPECTOR DATE:/ //J , DRIVEWAY ACCESS t ten the I Width: I b Surface: Size of turn-around: Condition of shoulders: Vertical clearance: need Dost at end of drivewaywith€tiveaessumbers. GRADE,OF DRIVEWAY' ` ` r %, OF ROAD % ROAD ACCESS Length: Width: Surface: .Condition of shoulders: Vertical clearance: BURN PERMIT REQUIRED FOR LAND CLEARING FIRE. ( ) LOTINSIDESMZ, 4X4FIRESONLY. LOT INSIDE UGA, NO OUTDOOR BURNING PERMITTED. LOT TOO SMALL FOR: BURN PERMITS 4X4 FIRES. REMARKS ) iA-) Z_QL r '—f' f a (continue remarks on back � a C D w • TM x.: r _