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HomeMy WebLinkAboutBLD98-0014 Final SFR, Garage, Fireplace and Propane - BLD Permit / Conditions - 5/10/1999 Permit No.Qi-pokoo 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#� (�� Y1 =7 93 A Fire District# ite Address d - �� :}, 5 CD[3 City St Ip Dir ions to Job Site Ynotvlocj L c2ci i5kv1j44_K /o e j2_ Owner Mailing_Address 43.0 ox ya6 City St A- Zip Lien/Title Holder uA Address City St Zip #2 Contractor me(lo tA"c�yLs as4, L9A UBI # 600 Addressa gox `f�& Contractor Reg City �5h&AA"'% St G•'s;- Zip 98 s8X Phone#�27 793/ Expiration Date_y gel #3 If septic is located on project site, include records. Connect to Septic?'5e_' _Public Water Supply_Well Connect to Sewer System? Name of System " (If residential, proof of potable water is required) i #4 Parcel No 2J 2O8 Legal Description o+,P 5, to , I 8 9 #5 Building Square Footage: 1 st FI f� 1y732nd FI 3rd FI Loft Basement i #Bedrooms #bathrooms Z Deck Other Garage a e-4n- Carport (Circle:Attached or Detached?) #6 Use of building Describe work �� l`/7� � ss � o�r►� #7 Type of Job: New Add Alt Repair D #8 MOBILE/MANUFACTURED HOME INFORMATION JAN 1 31995 Model Year Make Model Le h width Se ' I No. PERMIT ASSISTANCE CENTER #Bedrooms #Ba rooms ype of Heat Purchase Price$ #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other 'Show.following on the site plan S Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines ``L L19 Water Lines Topography Drainage Plan Wells Septic Systems Easements Proposed Improvements Name of Side Street Indicate Directional by (N, S, E, W) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW T 93 Ap A� -� <- 30 �� ��� � �' �� 100 20 y APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures ($3.45 each) Fee Mechanical Fixtures ($7.00 each) No.:Z Toilets CIRCLE FUEL TYPE: Gas lectric, Bath Basins Heatpump, Other . - Bath Tubs No. nit Fees Showers _ Furn BTU I Hot Water Htr _ Heatpumps Laundry Washer Vent Systems coo ,Sinks Spot Vent Fans Floor Drains No. Boilers/Compressors _Laundry Basins _ HP J_Dishwasher No. Air Handling Units _Disposal _ cfm# Urinals No. Fire Protection Systems _Other _ Auto. Fire Alarm Sys 50•00 14 S = 9 _ Fixed Fire Supp. Sys 50•00 Permit Basic Fee 17.25 _ Auto Fire Sprink Sys 35•00 TOTAL PLUMBING $ JS•Zb No. Other Gas Outlets 21 Wood, as, ellet Stove 34' c NOTICE: THIS PERMIT BECOMES NULL AND VOID IF 5 f'A*V*0C7 77 •off WORK OR CONSTRUCTION AUTHORIZED IS NOT COM- it 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. i 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 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 WORKFOR 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 DEPARTMENT. DEPARTMENT. F X OWNER X BY DATE /—`7— '9 .c3 DATE F u FOR fl=F#DIAL USE OILY l�epted y> DEPARTMENTAL REVIEW FOR OFFICE USE ONLY F roved Cond. Hold Approval Planning: C74cf4vt I AwL Environmental Health: Building Plan Review T cp'mt 1. W Occupancy Group: A.3 u-t Type of Const: StJ Fire Marshal: Other: Special Conditions: FEES q 73 7- q 7 _ (r,�� 2-31 Building Permit qJr , S 0 4 93 x I f I -7 G Z- Plan Check C.7 r :z 7 04 SI Plumbing Fee ,ST,21d Mechanical Fee 66, Wood�Pellet Stove 3 Violation Fee Site Inspection Building State Fee 14 Other ( Jr 00 Other So Other Building Valuation: Z 7 r 45-1 TOTAL FEE 2 MASON COUNTY DEPARTMENT OF HEALTH SERVICES , Environmental Health Water Quality Personal Health PO BOX 1666 SHELTON,WA 98584 LOCAL (360)427-9670 BELFAIR(360)275-4467&4468 Application for Determination of Adequacy TOLL FREE 1-800-562-5628 FAX(360)427-7798 Instructions . I Olapletmd 1 N. nt be made unkl Part i ao*r+vleted 2, Complete Only thoi pt4iorr of Part 2 applying to the type cif water:system used: 3, . Subutit cti, Ieted;.ap lt�a�t©��wi at�actmae�ts�o tlly beet� ,at�e�t�©r dew. __`:. PART 1: Applicant/Parcel Identification Name of Applicant -J C e r Date Mailing Address Po a ox Telephone q-Z 7--75 3 r � Assessor's Parcel Number /'G �� n 'D v'a'�,�tu7� ��a' ' 1 Type o Water System Check One : Reason or Application Check One): Public/Community Water System(2 or more Building pit connections) ❑ Land use application,if so.. ❑ Individual water source(one connection),if so.. ❑ Division of land ❑ Well #of Parcels9 ❑ Spring/surface water SPH9 i IJ no N DJ ❑ Other(explain) ❑ Boundary e a justment ❑ Other(explain) eep PART 2: Water System Information HEALTH SERVICES Complete the section appropriate for the type of water system being evaluated for adequacy: Public Water System Name of Water System C oa Water Facility Inventory (WFI)Number: ❑ The water purveyor has filed a letter granting blanket hookups to this water system. I am the er of this water system. The water system has been approved for S services. There are presently connections m use. This will be the Z connection. water system is able and %Nn mg to pro a water to this(these)connections without exceec�mg the limits of the water system or any limits set by state and local regulation. Date 2��'ITLvDa'+- Signature of Water System Manager � H.IWDATAWRCHjMWATERAD3.WP Update:October 20,1995 W-7 m o a o t» (�-os-� > 40 a�► rw" as amara sti. ram„ A " L7 O r •v c, es Q C7 L6 CA r m EA crt Ct1 _ AtriDCOAS «- - maoCxt Zc� -cLa < r Z m �c aar oess r` A 7Ci C! Ctt r- -«4 T CJ t3 D Q A !jY m.i") "o f) 't! A -� A a a. earye=a c +r'+ -E4 m tr i r !t! rrt �p Z C) a °!on•� " c, m r !t "Es f/! r A O Q t4 r + co '-+ as. LSD • fii t Z N -+ • � m O :x Zak -i. m—c rn •.• ,-t xt Z .�. t�I i m •.• •• t -i C O CJ -1 Z M +► n ' w. w=_s •- -- .. .. . . t ZXM Cl) Z i 0 - 00 ];3c rm = 0 s = nQ go mm .. i i Zto L72Gmp b s ns- ea i i 33 « ••i « 7S s'e m ® f3 2•0 as i t iYi ."E) m '"• .+ a. r',sase"+ s s 9a. 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A O M .a a, !S1 m Ltit a! m lit Rs i o as .a .o Z Z w a+r ar ar CA Q OZ ... Ewa sw alR•++ Eta � O � t') C3 S �'► W a. a as ar o+ e+r C � D m s ao a ua T D -► m 0 < O m� o. a. eAm — 3r < r �� " MO mom :'� t9t� oor =� -saa c ... . h catty -• w � � °=: t N � C -4 310C) � . m VV "a a "U ytNA i» va — — — w r . my O � -sr c r .. .. t tsis amiss * I t v ch G� t31 t9 a i9' r s r Oon rs0Z m Ao m mr r : mw O D . m Q ,.. r i i ae 00a l ,. .. �:. m 61 f w a ass m i m .•4b Qv .. aQ _ rn CONCRETE MECHANICAL MOBILE HOME Footings- date ' Ribbons date 7 Gas piping date by Foundation Walls date by Set Up date by INSULATION date by BGISLAB Insulation Floors Final date by date by date by FRAMING Walls / FIRE DEPT. `fie by date O—Z6 $' by /,� - date by PLUMBING Attic' OTHER Groundwork date ate D.W.V. 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