HomeMy WebLinkAboutBLD94-0278 Final Bath House - BLD Permit / Conditions - 8/8/1995 VZ M
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Ping date by
Foundation Walls date by Set Lip
date by INSULATION date by
BG/SLAB Insulation Floors Final
date by date by date by
FRAWalls FIREdMl 7,C>J�J6 by data by date DEFT. by
PLUMBING Attic OTHER
Groundwork date by
date by WALLBOARD NAILING
D.W.V. date by
date by FINAL INS I
Water Line by datif- "-' by date by
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Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION 0
426 W. Cedar/P.O. Box 186, Shelton,WA 98584 427-9670/1-800-562-5628 �Q Oa
PLEASE PRINT
#1 Owner ��� /"` ' ° '" - Phone# C9t3�S3�'
Site Addresses �3Igo 4apatJ� ra V e
"o imp Fire District#
City vt.� 014 _St in Directions to Job Site FhWC Q4 i n►Cor d. ro r - (r0t 3+P8t0.�e.G rs t
° '000��rocee otod'a
3- ry 'A;. ^1A1 .
� s
,0 vw a PSG;K
Owner Mailing Address 1700
City filavt .i' St ZipG&M�
Lien/Title Holder A0
Address
Clty St Zip
i
#2 Contractor Name ��— ' �11 �^'� ri1 Contractor Reg#
Do t. Expiration Date / /
Address
City St Zip Phone#
#3 If septic is located on project site, include records. _ /.
Connect to Septic?S Public Water Supply Well X - ��A
I
Connect to Sewer stem? Name of System ` �
(If residential, proof of potable water is required)
} #4 Parcel No./Z"2
Legal Description Oti-t
1
#5 Building Square Foot ge: (existingdro osed
1 st FI 10 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other sq.ft. /
#6 Use of building a146af 0 " a e- Describe work
k
wg ef' c n aS 5 ko t� t:.�. LA KS -
#7 Type of Job:New Add Alt Repair Other
I
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make Model
Length Width Serial No. .�
4
#Bedrooms #)Bathrooms Type.of Heat
Purchase Price$
#9 Indicate by circling the applicable source if any water is on or ad'acent to subject property:
River Pond Creek Stream Wetland Lake Marsh(Saltwateo Seasonal Runoff Other
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements
Name of Flanking Street Indicate Directional by (N, S, E, W)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
See c zLA
P
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
i
i
O '0
30
Cove
i►tuK
Plumbing Fixtures ($3 each) EPg Mechanical Fixtures ($6 eachl
No. Toilets .3 CIRCLE FUEL TYPE: Gas, Electric,
Bath Basins .3 Heatpump, Other
_Bath Tubs No. Units Fees
L_Showers — Furn BTU
Hot Water Htr .3 — Heatpumps
_Laundry Washer — Vent Systems
f �
—Sinks Spot Vent Fans 1 '
Floor Drains No.. Boilers/Compressors
—Laundry Basins _ HP
Dishwasher No. Air Handling Units
—Disposal _ cfm#
—Urinals No. Fire Protection Systems
_Other — Auto. Fire Alarm Sys 50.00
Fixed Fire Supp. Sys 50.00
Permit Basic Fee 15.00 — Auto Fire Sprink Sys 25.00
TOTAL PLUMBING $a?•�� N Q1bP
Gas Outlets
— Wood, Gas, Pellet Stove
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF
WORK OR CONSTRUCTION AUTHORIZED IS NOT COM-
MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 15.00
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 I
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OF THE 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 DEPARTMENT. DEPARTMENT.
{
X OWNER X BY
DATE DATE
I��1=�iC1�L tJr�C��11�Yx�4�c�pt�'i�y:. Oats
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
Environmental Health:
Building Plan Review
Occupancy Group: R- Type of Const: ,-
Fire Marshal:
Other:
i
i
Special Conditions: FEES
Building Permit Ci 5-G
Plan Check O Q,
Plumbing Fee -7 `0
Mechanical Fee . c37
f
Wood/Gas/Pellet Stove
Radon Monitor
i
Violation Fee
Site Inspection
Building State Fee _ U
Other
Other
Building Valuation: S , , TOTAL FEE c�(� 60
P
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