HomeMy WebLinkAboutCOM2001-00093 Car Wash Vending Roof - COM Permit / Conditions - 9/7/2000 i
iCONCPSM MECHANICAL MOB LE HOME
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SS PERMIT NO.: BLD'ASE P kol
R E HARD MASON COUNTY
BUILDING PERMIT APPLICATION i
426 W.Cedar/P.O.Box 186,Shelton,WA 98684 /
I?,4 427-9670 Belfair 360 2754467 Elma 360 482-5269 Seattle 206 464-6968
APPLICANT NF RMATION CONTRACTOR INFORMATION
Owner ,r• L Contractor Name
Ma lina Address Mailing Ad res ro
City State Zip Code City tate Zip Code
Phone her Ph.L� Ph. Z7S- �fO_UDther Ph.0
Lien/Title Holder Cont actor Reg. #
Address Expiration l l 90n1
[S:EPTICIWATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer
tem N e o wer System Well Water System Name of
ter System , 2.
PARCEL INFORMATION-12 digit Tax Parcel No. IZ 3 / Z,�/ Fire District 'Z
Legal Description
Site Address(Please include street name, street number and city)
Directions to site
Will timber be cut and sold in parcel preparation? (Yes/No) M2 cony 300/-op/a19
Is your property within 200' of the following: Body of Water(Name) &fA Saltwater
Lake River/Creed Pond Wetland Seasonal Ru o f Stream Slopes or
Bluffs
PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑
TYPE OF JOB New_K Add Alt Repair Other U of Building
Describe Work J 1 No. of Bedrooms No. of Bathrooms SQUARE FOOTAG -1st Floor�2nd Floor Q7
3rd Floor Loft Basement Deck Other sq. ft.
j Garage Attached Detached Carport Attached Detached
MOBILE HOME INFORMATION-Make Model Model Year
Length Width Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price $ Replacement Unit ?(Yes/No)
Installer Name Certification No.
NOTICE: THIS PERMIT BECOMES NULL&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 the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without
;\J
I. first taining ap I--Date — X Date -7--Of
FOR OFFICIAL USE BEY VD THI POINT
i Accepted by Datee_�ubmittal Amount Due l Receipt No. 5-fVd
:<<:<:> <:>::: '# EP#�►RTMNT :::RI!~ktlV4f:; »:`: : `APPRQVEt� DB:(�i1. 1 �NI3a1'iN eClp .
... ......... ......... .
Building Department Coyvar 7vf VendJr7 mach:r»ez
Occ Group Type Constr.
I Planning Department
' Environmental Health Department
Public Works Department
Fire Marshal
III
Valuation $
:01as I mg mmm ..g �y a 5
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbing&Base Fee Planning Review Fee
Mechanical&Base Fee Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal ( )
y
x TOTAL FEES
MASON COUNTY PERMIT NO.: BLD
cowl u��.�r3
r
BUILDING 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
APPLICANT NFORMATION,` CONTRACTOR INFORMATION
Owner i� Contractor Name
Maili Address Mailing Address
City State Zip Code City tate Zip Code fAC�Go%i
PhoneqAMW
her Ph.( Ph. 27S-S4pU0ther Ph.(` )
Lien/Titf—e-Flolder Cont ctor Reg. Q Z .4,( t
Address Expiration
i
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer
System Na a of wer System Well Water System Name of
Water System
PARCEL INFORMATION-12 digit Tax Parcel No. IZ.' / _/ �'p(�Z„ Fire District "7.
Legal Description JUJ Y4. :7 7-'R AZ
Site Address(Please includb street name, street number and city) s
Directions to site 6AU6 6 1b
Will timber be cut and sold in parcel preparation? (Yes/No) 442cons 300/ - ap/Q1y
Is your property within 200' of the following: Body of Water (Name)_ Saltwater
Lake River/Creek Pond Wetland Seasonal Ru o f Stream Slopes or
Bluffs
PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑
TYPE OF JOB New_,&Add Alt Repair Other Usaof Building
Describe Work
No. of Bedrooms No. of Bathrooms SQUARE FOOTAG -1s Floor 2nd Floor Cr
3rd Floor Loft Basement Deck Other sq. ft.
Garage Attached Detached Carport Attached Detached
MOBILE HOME INFORMATION-Make Model Model Year
Length Width Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price $ Replacement Unit ?(Yes/No)
Installer Name Certification No.
1
NOTICE: THIS PERMIT BECOMES NULL&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:
i
I OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-[certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without
j a al. first btaining ap al.
i
C X Date X Date -7 a
I
FOR OFFICIAL USE BEY VD THI POINT
Accepted by Dat r ubmittal Amount Due Receipt No. '�r (� t
i u�
. ..
. ..... PARTM NTAI:;:R
APPRQVED t); NIEI : CON IT0 CODES
i
Building Depa ment Cov�Nr p, y�,��;r MCI 6k-, ,)�
Occ Group C str /
Planning Department
i Environmental Health Department
i
i
Public Works Department
I
Fire Marshal
'i
i
` Valuation $
i
FEI=S
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbing&Base Fee Planning Review Fee
Mechanical&Base Fee Other
Wood/Gas/Pellet Stove Fee State Fee
i
Violation Fee Pre-Paid at Submittal ( )
TOTAL FEES
YX 3
PERMIT NO.: BLD
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W.Cedar/P.O.Box 186,Shelton,WA 98584
Shelton 360 42T-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968
APPLICANT INFORMATION
CONTRACTOR INFORMATION
Owner r� C.
Contractor Name t
Maili Ad ress Mailing Ad Ss 0
City y State Zip Code City tate Zip Code 5,, .C,>-',,
Phone her Ph.( ) Ph. 2"7S� L}Dther Ph.0
Lien/Title Holder Cont actor Reg. #�"" If.TC 1 f$2 AA I
Address Expiration / Z.« / Z!UDA., ,
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer
System Na a of wer System Well Water System Name of
Water System
PARCfiiL INFORMATION-12 di it Tax Parcel No. lym-S-216 Fire.District
Description Ai
Address(Please include street name, street number and city) . seddff
i ections to site c,/
Will timber be cut and sold in parcel preparation? (Yes/No) Cr-n e7 « e7
Is your property within 200' of the following: Body of Water(Name) Saltwater
Lake River/Creek Pond Wetland Seasonal Ru off Stream Slopes or
Bluffs
PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑
TYPE OF JOB New Add Alt Repair Other
i
Describe Work.
No. of Bedrooms No. of Bathrooms SQUARE'FOOTAG -1s Floor 2nd Floor 011)1�
13rd Floor Loft Basement Deck Other 2.1 An 4 sq. ft.
Garage Attached Detached Carport Attached Detached
MOBILE HOME INFORMATION-Make Model Model Year
Length Width Serial No. No.of Bedrooms No. of Bathrooms
Type of Heat Purchase Price $ Replacement Unit ?(Yes/No)
Installer Name Certification No.
i
NOTICE: THIS PERMIT BECOMES NULL&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 the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without
a p I. first taining ap 1.
X AAAA Date '' •■•�.. X Date • 7.O
FOR OFFICIAL USE BEY D THI POINT
Accepted by DatSubmittal Amount Due f• ' Receipt No.
#7t R 11 1t1( �AP:PRt) CON
TV iGEPAR.TWEI
it �rl�•^�f �; r,r; ,.r>' Building Department
Occ Group Type Constr.
Planning Department L
d
IEnvironmental Health Department
i
Public Works Department
Fire Marshal
;
Valuation $
FE
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbing&Base Fee Planning Review Fee
Mechanical&Base Fee Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal ( )
I TOTAL FEES
Q C '� Mq3
PERMIT NO.' BLD
ASE CRESS HARD MASON COUNTY
BUILDING PERMIT APPLICATION
426 W.Cedar/P.O.Box 186,Shelton,WA 98684
l"`41 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968
APPLICANT NF RMATION CONTRACTOR INFORMATION
Owner �► L Contractor Name cl
Mailiu Address to Mailing Ad ress to
City State Zip Code City 1r tate Zip Code
Phone her Ph.(� Ph. Z7S—��UDther PH
Lien/Title Holder Cont actor Reg. #
Address Expiration l l 7_00z —
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer
System N e o wer System Well Water SystemKName of
Water System 2..
PARCEL INFORMATION-12 digit Tax Parcel No. IZg / Z�/ 511212 Fire District 'Z
Legal Description
Site Address(Please include street name, street number and city)
Directions to site
Will timber be cut and sold in parcel preparation? (Yes/No) �1 con, 300!-oo,aq
Is your property within 200' of the following: Body of Water(Name) Saltwater
Lake River/Creek Pond Wetland Seasonal Ru o f Stream Slopes or
Bluffs
PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑
TYPE OF JOB New Add Alt Repair Other U of Building
Describe Work J v 1 —
No. of Bedrooms No. of Bathrooms SQUARE FOOTAG -1st Floor— 2nd Floor (�
3rd Floor Loft Basement Deck Other Z.M b Lp sq. ft.
Garage Attached Detached Carport Attached Detached
MOBILE HOME INFORMATION-Make Model Model Year
Length Width Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price $ Replacement Unit ?(Yes/No)
Installer Name Certification No.
NOTICE: THIS PERMIT BECOMES NULL&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-]certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without
a p I. first taining ap I.
X Date �— X DateoL
FOR OFFICIAL USE BEY VD THI POINT
Accepted by Dat G ubmittal Amount Due l Receipt No.
D EAR?MENTAL: R 1tI V APPR VEt� D; Ai11»D; .. ONDITft')N.C.�pl .:
Building Department cnvter r rendir7 rrlacr7:ne5
Occ Group Type Constr.
Planning Department
Environmental Health Department
Public Works Department
I
Fire Marshal
Valuation $
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbing&Base Fee Planning Review Fee
Mechanical&Base Fee Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal ( )
TOTAL FEES