HomeMy WebLinkAboutBLD93-0541 Final SFR - BLD Permit / Conditions - 8/13/1993 7 77
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CONCRETE • : HOME
Footings-Setback date r
Foundation a
date , by te by Set Up
BG/SLAS Insulation Flom Final
date by
.� i i
idate by
OTHER40 Walls FIRE DEPT.
date t-7, 22-ofM byD date by date by
PLUMBING Attic
date by Groundwork
date C9K by
Water ,
date by L date by!� � .; ; bi
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Permit Nc:BLD-
' MASON COUNTY
BUILDING PERMIT APPLICATION
PLEASE PRINT L c
#1 Owner n L l :t : ., ,+ t. Phone# i - Z
Site Address _i<.- k-, t r, . A it ,
City A 1 114 St W, Zip, `I
,
Directions to Job Site ti _s 0' 4'e-
01
4
Owner Mailing Address
City / ,t -fi :, St Zip ti
Lien/Title Holder inrate. k L-. ,-
Address _ i ,w C'' .., - k >-
City A 0"4 _ St Zip � 1
#2 Contractor Name b l o Contractor Reg#
Address Expiration date
City St Zip Phone
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply Well
(If residential, proof of potable water may be required)
#4 Parcel No. L) - - 6 () D13.
Legal Description
#5 Building Square Footage: (existing/proposed)
Ist Fl(,,, 2nd Fl �J� 3rd Fl K') Loft
Basement, / Deck .,J / #bedroc®s�`#bathrooms
Garage '� / Carport N, / (Circle: Attachec3; or Detached?)
Other— �;� sq ft __.
#6 Use of building o - - - Describe work Lied LJ ,F)
#7 Type of _Job: New x- Add Alt Repair Demomolition
Woodstove Re-Roof Bulkhead Other
#8 MOBILE HOME INFORMATION
Model Year �L� Make iti Model P
Length_ Width Serial No.
#Bedrooms #Bathrooms Type of Heat
#9 Any water on or adjacent to property: saltwater :�,. t lakes
river pond wetland 1:: seasonal runoff
other f,, ,
HMt.umbing Fixtures ($2 each) rM
'No.-&Toilets Vent Systems X 3 .00 3_(P
Bath Basins G
Vent Fans % .3.00
t-Bath Tubs c No. Boilers/C=Wressors
Showers Kos_ 0-3 HP 6.00
t. Hot Water ,Htr ,- 3 AG ie, 3-15 AP 6.00
—Laundry Washer 3
—�-� L)adj. 15-3 0 HP 6.00_
Sinks LIgL 30-50 HP .og
Floor Drains 1 WL 50 + HP 6.00
Laundry Basins No. Air Handling wait
Dishwasher AAW—<= 10000 efm. -. 7,50
Disposal ti 3 LWL> 10000 ctm. 7.50
talurinals Other
Other �Aovap Coolers
� -�` 40_1Hoods _
Permit Basic Fee 3 .01 �Qi Fire Suppression _
TOTAL PLDHBSNG $ _ Domes. Incin.
S
�,(0 t LComml. Incin.
I4echanical Reloc/Repair 6.00
Fixtures a s Outlets X 2.00
No. Fael Types oodstove - ag
hv-&e.Furn < 100K BTU 6.00_ Other
h -Pura >- 100K BTU 6.00
F Floor 6.00 Permit Basic Fee 15.(�
ti -
Heat Pumps 6.00 _ TOTAL MC CAL
WAD
XMCS: . T=8 PW=r BBCOMRS NOLL AND VOID IF WORK OR CONSTRUCTION
AUTHORI$8D I3 NOT CO ED ,WTTBIN.180 DAYS, OR IF CONSTRUCTION OR 'WORK
IS SUSPENDED OR ABANDOMM FOR A 'PERIOD OF 180 .DAYS AT ANYTME AFTER WORK
IS COMMEtPCED
CROM is AMMAVIT ` RIM TRACT = AFr=VST
I CERTIFY TRAT i AN EXEMPT FROM�, t IROEMTS OF THE I CERTIFY ?BAT I AN A CURRENTLY REGISTERED OONTRACTaR -
OOMIRACTORS REGISTRATION LAI�°ICli' , AND * A M IM THE STATE OF MRSOM7106'AIM1 I "AA `AifA OF ?k
OF THE Mow .C",TT GR{UIR4=1 FIE NMICN ORDINANCE =4200U,.49Ati11N:.TIIE,..:UM FOR UNla
THIS PERMIT 13 ISSUED AND TNAT ALL UDC DUNE WILL BE IN THE PERMIT IS ISSUE AM ALL WORNC DONE WILL BE IN
CONFORMANCE TREREWITN. NO CURSES SNALL BE MADE COMFWMANCE TRB'REWITN. NO CNAMIa .SHALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITH= FIRST OBTAINING APPROVAL FROM TER BUILDING
DEPARTMENT. OEPARTNENT.
x own=-wt 19, Z BY
DATS DATE
Ratura pasmi t to: DaPartment of General. Services
426 W. Cedar/*.0. Box 186, Sbolton, IPA , 98584 427-9670/1-800-562-5628
FOR OFFICIAL USE OMY: Accepted by:,ILL E Date: 2 'f
DEPARTMENTAL REVIEW 4W y.
FOR- OFFICH U= WLY r
App,owd card NOW
Approves
Planning:
Bavironmental Health:
Building Plan Review:
Occupancy Group:
Fire Marshall:
other:
Ilspecial conditions: I lsite Inspection i Ii
I q n n
A
II Wilding Permit 135�.6Z) �( .
it I (violation Fee I If
II I I
I (violation 1=est4gation'`Fte I II
II I Plan check 1175 5f,� If
II 11 Plumbing Fee 11
II I � � , II
Il I -Umechanical Fee L ' If
it II Ilwoodstove Fee I II
it II
If I (Building sttte Fae 00. II
I I' g.' n ;
IIBuilding valuation:,
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