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HomeMy WebLinkAboutBLD94-0287 Final SFR - BLD Permit / Conditions - 12/14/1994 rn rr rr* 1-4 1 rr cr -.4 ar 771 up mk % t " IM C 3W ac fr. -rl NO! 3p; 0 Jb CP�z :z ri T > Jb CD wa CJ 1.0 x ) O < < cn c :z CO) z -M 4D 1.4 10 CIL 7= f'° OD A A CONCRETE MEC L MOBILE HOME Footings date Ribbons dates[Gi'� by(PA Gas Piping date by Foundation WaNs date by Set UP date (b INSULATION date by BG/SLAB Insulation 3rs Final Floo date try 1� da � date by FRANdate / bt by dilate by d DEPT.f.to by PLUMBING Attic OTHER Groundwork lt by date date Bo AFID Date NG D.W.V. t/ 7 Q by dat1eV� � u by Water Line FINAL INSPECTION date ajL CP by date t rr date by hIZA "8'k- TJarza4 1-N R--WA L( t of Rmatt Am tny P u 40 s G�2x rJo*" t� IA ro e i « t. 'Si✓'V--4 72 7 11 a. t 7-1 ul • �:n..� -�:�. :� _ .�T<e �; ws�J °.'�. ne. ^.�F' .fir ^ .'�� �lF Sr �i � .`•'i. f i rr F h r y 3). : s F Yr at 'ri �* � -"-2 n'3 �� 'S fir• ."";% - I — fF 0 f -r O .� ;. ."!' ...•:. ,.i.'.; '3 fit"C 's - aC .. .. .. CA NA V s ~~ L u ar ... _ CJI 4 $2 ...3 'f) e'er !'•3 � +^..`s �" ik tom. � +..-, rn .:2, L j f i If f' _ I 'v- _M 0 OQ 73, CA o cn x Oo c 0 �r%x Ol Z cn 00- O C: iZ clp, ca coo 1 1 • • • • 1 w WIN,M- ow I - / - - ME mqjv�� i.__ ate. 7 G`I�orL"._ , I I_.. 11c.././ �/,� t / — — '' .' :/. 1..._ /.l) _.�/,_ LI .. ' I�'I ' • Ry,HAM WER,as M � M WN 911,ZM I A U- Y i I�'_/! ► .•a._..NA' ■ i s i i �- � �' � u IN $.f o DPQ, ermit No. && COUNTY BUILDING PERMIT APPLICATION �0 0 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427 9670/1 800 562 5628 �V 0 PLEASE PRINT #1 Owner K.-n,4 Lt.-,k Phone# -7 7 7- s -7 - r Site Address f2d- Fire District#" City An4in - St WA Zip 19"d Directions to Job Site }�4.. Tk NWT 3 frowk AIlwi -ru-n Lam.-P{- pV% 61--ptVIL4✓ Lamp �t.f �� C� M �C PrbDGr7•/ Dh �� i.�" ha,d S �. .OI Owner Mailing Address I T o©5 b 9 AVE: �✓ City Lynnwocel St—WA _Zip 9503 6 i Lien/Title Holder Saw, Address j city St Zip #2 Contractor Name C h,',, 11-S Contractor Reg#CYIIOPT 0117 P1 Address 19oo 5 A B AVE W Expiration Date OcO (,_I / I q City Lynn(reod St 4/ Zip j/So3 a Phone# -1-71/—O 4-'3 #3 If septic is located on project site, include records. Connect to Septic?_Itg_Public Water Supply Well Connect to Sewer System? Name of System (if residential, proof of potable water is required) a I #4 Parcel No 2al - -Qo0'�e Legal Demon #5 Building Square Footage: xisting/proposed) 1st FI / L dd 2nd Fi / rd FI / Loft / Basement V r Deck / *bedrooms / 3 #bathrooms / � l�Q Garage / y3z Carport / (Circle:Attached or Detached?) Other _ sq.ft. / #6 Use of building S ,�tl� Faw,;�y 9ez,'d,.&,kr. Describe work #7 Type of Job:New, _Add Alt_Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year Make Mode) Length Width Serial No. #Bedrooms Bathrooms Type..of-Heat Purchase Price$ #9 Indicate by circling the licabie source if any water is are or, nt to subject prgperty: River Pond Creek ( ream Wetland Lake Marsh Seasonal Runoff Other Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences W Structure Setbacks-, Driveways L Water Lines Shorelines Drainage Plan Topography Septic Systems Wells N Proposed Improvements Easements indicate Direodorfal N, S E, . Name of Flanking Street in relation to lot Ian._ IL Name of Fronting Street- p p APPLICANT TO DP,&Im b• . a � � r APPLICANT Ta DST T( t i f Plumbing Fixtures(�3 each) Em Mechanical l~iidures(S6 each) No._Toilets CIRCLE FUEL TYPE: Gas, lectri 2 Bath Basins Heatpump, Other 2. Bath Tubs NCL Units Fees R Showers _ Furn BTU I Hot Water Htr 3 _ Heatpumps I Laundry Washer _ Vent Systems Sinks f� Spot Vent Fans _Floor Drains Ng,, Boilers7Comoressors _Laundry Basins _ HP 1 Dishwasher Ny L Air Handling Units _Disposal _ cfm# _Urinals JyQ, Fire Protectio_,n Systems Auto. Fire Alarm Sys R 50d/Hf Fixed Fite Supp. Sys. 50•00 Permit Basic Fee 15.00 Auto Fire Sprink Sys 25•00 TOTAL PLUMBING $ �J� NL Other - Gas Outlets hood Gas, Pellet Stove 7 Fore NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COM- MEN=WITI I loo DAYS OR IF CONSTRUCTION OR Permit Basic Fee - 15.00 WORK IIS SUSPENDED OR ABANDONED FOR A PERIOD OF IW-DADA ANY TWE AFTER WORK IS �_ TOTAL MECHANICAL $_ t.�°� .-PI -IN E tON OF WORK IS BY MEA OF A P IKE ItIN. OWNS S AFFIDAVIT. CONTRACTORS AFFIDAVIT 4 I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED f MENT$ OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I RCW-I&2 ,<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 EP RTMEN DEPART ' T. X OWNER64 X BY DATE ��/�I DATE 3h by gg :. ­1114", ffi i:t^` .......... DEPARTMENTAL REVIEW FOR OFFICE USE ONLY nppro�ed Conti. Hold Appmal Planning: 3 � Environmental Health: Building Plan Review Lu ' y/F y Occupancy Group: '�� Type of Const: �^ Fire Marshal: Other: f Special Conditions: FEES Building Permit 5 Plan Check Plumbing Fee $ Mechanical Fee iQO C!�+�WPellet Stove Radon Monitor Violation Fee a N. A — �-�-- Site InspectionK Building State Fee , Other Other Co .50 Building Valuation: TOTAL FEE It 4 1 1 4' rn 1 / v q 1 R s� t t 83 $ 1 1 1 1 1 I 1 1 1 QQQ , 1 1 1 1 ' 1 1 1 1 1 1 1 I 1 1 1 1 1 1 I 1 1 1 i 1 1 , t / 1 1 , 1 1 , I 1 , 1 1 , 1 1 i 1 1 1 1 , 1 1 , 1 1 , 1 1 , i 1 , I 1 1 1 I i , 1 1 1 i 1 1 1 1 , 1 , 1 1 1 1 1 I 1 1 1 1 1 I 1 1 1 1 7 / 1 ; 1 1 1 t 1 , 1 , 1 1 • 1 1 1 1/ 1 t t 1 11 1 ; 1 1 1 1 ; 1 1 IN ON ar �m t q f t fit 1 , + 1 1 1 1 1 1 I M 1 1 6Rm S x g i i 1 1 1 1 1 1 1 1 1 1 1 t 1 , 1 1 , 1 t , f + , 1 1 , 1 1 , 1 I + 1 1 , i 1 , { i i 1 I , + 1 , 1 I I 1 1 , f 1 , 1 1 , I 1 , 1 1 , I 1 , 1 I , 1 1 , 1 1 , I 1 , 1 1 , I i , 1 1 i 1 i , 1 1 , 1 I I 1 i 1 I I , I 1 , 1 1 � 1 1 , I 1 1 I 1 , 1 1 t ' 1 , 1 1 1 i 1, 1 1 1 I 1 QQQG���JJJ , 1 1 , 1 I I 1 , 1 1 , I i , 1 1 , I f _ � s A i