HomeMy WebLinkAboutBLD98-00315 Mobile Home Space 30 - BLD Permit / Conditions - 4/23/1998 Qts
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Setup 4IDe- .45 / cr /
Opte by INSULATION date — - ,5,re by L-�
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING Attic OTHER
Groundwork
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
-7w,
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it
V--1v 48
y Permit No.
MASON COUNTY -
BUILDING PERMIT APPLICATION
426 W.Cedar/P.O. Box 186, Shelton,WA 98584 427-9670
(Calling From: Seattle 464-6968, Belfair 275-4467, Elma 482-5269)
PLEASE PRINT
#1 er Phone#
Site Add a C �"'� aftt� �l D Fire District#
City SIA Zip
Directions to A Site
lalke
f
Owner Mailin Address
City St Gt, Zlp
Lien/Title Holder
Address
City St Zip
#2 Contractor Nam UBI #
Address Contractor Reg#
City St Zip Phone# Expiration Date /_J
#3 If septic is located on project site, include records.
I P P 1
Connect to Septic?X _Public Water Supply JC Well
Connect to Sewer System? Name of System
(if resi ential, proof of potable water is re uired 11 04_/t_,�..
1aaao--5o - ri oo 141� Ir✓-�J YY)obc,(.�- j lryl
Parcel No.19,9 0`D - SrZ? - b
-------tkLegal Description /�C• 7`
��
#5 Building Square Footage: V
1st FI 2nd FI 3rd FI Loft Basement
#Bedrooms #bathrooms 6-S Deck Other
Garage Carport (Circle:Attached or Detached?)
#6 Use of building Lnp 0.S/ b1'C Describe,work
#7 Type of Job: New Add Alt Repair Other
I� r �; !► IVY
ID
#$ ni
Model Year M a Make model
Length Sv3 Width Serial No.
#Bedrooms _#Bathrooms _Type of Heat eiaM ip1 C j ERW ASSISTANCE CENTER
Purchase Price$ 103. �9a
#9 Indicate by circling the applicable source if any water is on or adjacent to subject property:
. _I__ u_-..L. c.,ls.....a... 0--^nnl Dunn# r)thar
'Show following on the site plan
Lot Dimensions Fences
Existing Structures Driveways
Structure Setbacks Shorelines
Water Lines Topography
Drainage Plan Wells
Septic Systems Easements
Proposed Improvements Indicate Directional by (N, S, E, W)
Name of Side Street in relation to.plot plan
Name of Fronting Street
APPLICANT TO DRAW SITE PLAN BELOW
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al
g� I t rCr
--- _ 10
30' e2P W i
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Srt�� ZS
Plumbing Fixtures($3.45 each) Fee Mechanical Fixtures ($7.00 each)
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
Bath Basins Heatpump, Other
Bath Tubs No.- Units Fees
Showers I Furn BTU
Hot Water Htr _ Heatpumps
_Laundry sher _ Vent Systems
Sinks _ Spot Vent Fans
Floor No. Boilers/Compressors
Laund HP
Dishwas r No. Air Handling Units
_Disposal _ cfm#
Urinals No. Fire Protection Systems
Other _ Auto. Fire Alarm Sys 50•00
Fixed Fire Supp. Sys 50.00
Permit Basic Fee 17.25 _ Auto Fire Sprink Sys 35•00
TOTAL PLUMBING $ No. Other
Gas Outlets
Wood, Gas, Pellet Stove
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF _
WORK OR CONSTRUCTION AUTHORIZED IS NOT COM-
MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 17.25
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD TOTAL MECHANICAL $
OF 180 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED. PROOF OF CONTINUATION OF WORK IS BY
MEANS OF A PROGRESS INSPECTION.
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED
MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OFTHE ORDINANCE REQUIREMENTS REGU-
ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED
MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE
CONFORMANCE THEREWITH.NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT
MADE WITHOUT FIRST OBTAINING A PR VAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. DEPARTMENT.
X OWNER X BY
DATE DATE
k
f�E')R 0 � lr4L USE C?NLY<Acptecf
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
Environmental Health:
Building Plan Review
Occupancy Group: Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit
Plan Check
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Violation Fee
Site Inspection
Building State Fee
Other
Other
Other
FF-cr--
IBuildi=qValuation: T�T�
DEPARTMENTAL)REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Plann g: Ak 4404 1 04 4
Environmental Health:
Building Plan Review
Occupancy Group: Type of Const:
Fire Marshal.-
Other:
it
Special Conditions: FEES
Building Permit
Plan Check
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Violation Fee
Site Inspection
Building State Fee
Other
Other
Other
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
Environmental Health:
i
I
Building Plan Review
y-�3
Occupancy Group: Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit
Plan Check
Plumbing Fee
Mechanical Fee
s
Wood/Gas/Pellet Stove
Violation Fee
Site Inspection
Building State Fee
Other
5�
Other
Other �y• �