HomeMy WebLinkAboutBLD98-00378 Deck Space 36 - BLD Permit / Conditions - 5/15/1998 T, 61)
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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 FRAMING by date by date by
Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
� Permit No. BLD 17 _ a379
MASON-COUNTY
•0;0 : BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton,WA 98584 427-9670/1-800-562-5628
(Calling From: Seattle 464-6968, Belfair 275-4467 Elma 482-5269
PLEASE PRINT /� �` / I" �,,C�
#1 Owner 'Alm v 0J+a . V 1 . � Phone# t b —
Site Address Fire District# 5 k
City St 'V Va. Zip
Directions to J Site '
Owner il'rlg Address
City l Stv �p
Lien/Title HoI44r
Address
City St Zip
#2 Contractor Name I'T _ � T . (, Contractor Reg#�l/D✓'�h�a�3
Address L� C l'1/ IV ( iration Date_
St zp Phone#
Rrc.k_
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply Well
Connect to Sewer System? Name of System
(if residential, proof of potable water is required)
#4 rcel No. o�0 _ _ ` 7��f :J�► �� V f �I dCJC� ® 2�--
Legal Descriptio
#5 Building Square Footage:
1st FI 2nd FI 3rd FI Loft Basement
#Bedrooms #bathrooms Deck Other
Garage Carport (Circle:Attached or Detached?)
3
a
#6 Use of building Describe work
#7 Type of Job: New Add Alt Repair Other Die -
#8 MOBILE/MANUFACTURED HOME INFORMATION — -
Model Year Make Model
Length Width Serial No. �1
#Bedrooms #Bathrooms Type of Heat 3
Purchase Price$ 4
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
F
S Yk
-- - - --- -_�o
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
i
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I
i
i
$0 "'
Plumbing Fixtures ($3.35 each) Fee Mechanical Fixtures ($6.75 each)
No._Toilets CIRCLE FUEL TYPE: Gas, Electric,
_Bath Basins Heatpump, Other
_Bath Tubs No. ni Fees
—Showers l — Furn BTU
_Hot Water Htr // — Heatpumps
_Laundry Wash' — Vent Systems
_Sinks _ Spot Vent Fans
_Floor Drains No. BoilersL Compressors
—Laundry Basins — HP
fOiirt
washer No. Air Handling Units
osal — �#
als � Fire Protection Systems
er — Auto. Fire Alarm Sys �•�
Fixed Fire Supp. Sys 50•00
Permit Basic Fee 16.75 — 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- 16.75
MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee
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 1
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 APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING
'! THE BUILDING EPA EN
DEPARTMENT.
X OWNER X BY
DATE DATE
k l U
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
[Approved Cond. Hold
Approval
Planning:
I _
I'
Environmental Health:
i
u
M
Building Plan Review -zJ-7 Oa/i %L,cK w -1peck s d.%A.
Occupancy Group: Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
`$O Building Permit
Plan Check o
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Violation Fee
Site Inspection
Building State Fee 5 v
Other
Other
Other
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
Environmental Health:
Building Plan Review y Z7-9�F 0c./t '�cx-t< ' u(w 17ecks rut
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