HomeMy WebLinkAboutBLD93-00299 Final Carport - BLD Permit / Conditions - 4/1/1993 CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
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Foundation Wall& date by Set Up
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BG/SLAB Insulation Floors Final
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FRAMING Walls FIRE DEPT.
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D.W.V. WALLBOARD NALING
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Permit No.BLD
MASON COUNTY
BUILDING PERMIT APPLICATION
6w�
PLEASE PRINT 3--bQqg
#1 Owner Pone# 3 3 y
Site Address '
City 7 St Zip
Directions t Job Site
Owner Mailing Address
City St Zip
Lien/Title Holder
Address
City St Zip
#2 Contractor Name Contractor Reg#
Address Expiration date
City St Zip Phone
#3 If septic is located n�roject site, include records.
Connect to Septic? _ Public Water Supply Well
(If residential, proof of potable water may be required)
#4 Parcel No.!d R02lSJ -Dono
Legal Description Z. f
#5 Building Square Footage: (existing/proposed)
1st Fl / 2nd F1 / 3rd Fl / Loft /
Basement Deck / #bedrooms _ #bathrooms_
Garaged / Carport / (Circle: Attached or Detached?)
Other sq ft X �
#6 Use of building � � DST 7� Describe work
#7 Type of Job: New Add Alt Repair Demolition
Woodstove R -Roof Bulkhead Other sj
II
#S MOBILE HOME INFORMATION
Model Year Make Model j
Length Width No.
#Bedrooms #Batter oMVial
of Heat E
i
i
#9 Any water on or adjace o r er y: saltwater lake j
river pond w 1 n seasonal runoff
other
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences 4
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements
Name of Flanking Street Scale:
Name of Fronting Street Date:
APPLICANT TO DRAW SITE PLAN BELO
V
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOIf
Vv
i
j
it
I
r
P1Ltmb;ncr Fixtures ($2 each) Fee Fee
Vent Systems X 3 .00
No. TbYlets ---- i
Bath Basins Vent Fans X 3 .00
No. Boilers/Compressors
Bath Tubs
,_._ 0-3 HP _�0
Showers
3-15 HP 6.0.4._
Hot Water Htr
15-30 HP 6.00
Laundry Washer
30-50 6.00
Sinks
50 HP 6.00
Floor, Drains
Laun asins No. A Handling Unit
Dishwasher = 10000 Cfm. 7., 0
Disposal > 10000 cfm. 7.50
Urinals Other
Other Evap Coolers
Hoods
Permit Basic Fee 3 .0l-
Fire Suppression
TOTAL PLUMBING $ Domes. Incin.
Comml. Incin.
Reloc/Repair 6 .00
Gas Outlets X 2.00
Mechanical Fixtures Woodstove separate
No. Fuel Types her
Furn < 100K BTU 6.00-
Furn >= 100K 6.00-Furn - Flo 6.00 Permit Bas Fee 10.04.-
Heat P s 6 .22 TOTAL ME =C $-
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION.
AUTHORIZED IS NOT COMMENCEDOR A PERIOD OF 180 DAYS AT CONSTRUCTION
IS SUSPENDED OR ABANDONEDAFTER WORK
IS COMMENCED
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE BREQUIREMEDNTS OF THE IN CERTIFY THAT
ATE OF M A CURRENTLY
REGISTERED
ISATMEREDDCCONTRACTOROT
CONTRACTORS REGISTRATION LAW
OF THE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH
THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN THE
IFORl MIT IS ISSUED
SS THEREWITH. NO ALL
CHANWORK
DONE
WILL
BE IN MADE
CONFORMANCE THEREWITH. NO CHANGES SHALL
THE BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT.
DEPARTMENT.
X BY
OWNER
9,6ii-
tXAT DATE
E
Return permit to: Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, .WA 98584 427-9670/1-800-562-5628
Date:*
FOR OFFICIAL USE. ONLY Accepted. by: C —
4
DEPARTMENTAL REVIEW
FOR OFFICE IISE ONLY .
Approved Conti Hold
Planning: Approval
Environmental Health:
M1
Building plan Revie*'L CONSTRUCTION MUST MEt'1
RE
QUESTIONS PLEASE GALL THIS
O I 3•Z
�O W
Occupancy Group.
Fire Marshall:
Other:
IISPecial Conditions: FEES
II II IISite Inspection I II
II II IlBuilding Permit I l
II II I � II
Il II IlViolation Fee I I
II 0 I II
II If IlViolation Investigation Fee
II II I II
II II IlPlan Check
II
If I IlPlumbing Fee-------,I I
II I II
II If Mechanical Fee
II II I II
II II IlWoodstove Fee l
it II I I II
I II -IlBuilding State Fee
I I II
III Building valuatio I
n: �o� II II l
TOTAL I