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HomeMy WebLinkAboutBLD99-0631 Underground Tank - BLD Permit / Conditions - 11/10/1999 PERMIT NO.: q MASON COUNTY q del PLUMBING/MECHANICAL 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 APPLIC T INFORMATION CONTRACTOR INF RMATION/ Owner M c f o Contractor Name / S / Mai' ddre Mailin Address City ��I UC State I Zip Code City 514 State tA4. Zip Code Phone( ) Other Ph.( Ph. - Other Ph. O &471V- 70 Lien/Title Holder Contractor Re # G/S T-r Address Expiration 2600 SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION-12 digit Tax Parcel No. Fire District Legal Description I Lt c I 4 — . Site Address(Please include stfeet name, street number and city) c, J Directions to site Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair Other Use of Building Location of Fixtures/Units 1st Floor 2nd Floor Basement Garage Closet i' PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric Type of Fixture No. of Fixtures Fees LPG Natural Gas Heatpump Toilets Toe of Unit No. of Units Fees Bath Basins Furnace Bath Tubs Heatpumps Showers Vent Fans Water Heater Propane Tank Laundry Wsher Gas Outlets Sinks Wood/Gas/Pellet Stove Dishwasher Direct Vent? _yip Other C3c�c /O Other "' Other �/7GTa'] Other Base Fee 0 Base Fee TOTAL PLUMBING TOTAL MECHANICA A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT. 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-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 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 therewittro lht \nges shall be made without first obtaining shall be done in conf rice therewith. No changes shall be made without appr al. first o rnn appro I. X Date X P44— Date s FOR O --ICIA SE BEYOND THIS P NT Accepted by -Da tSubmittal Amount Due Z• Receipt No.-�zJ,gl :>::>::::>:>.:»>c::::>.::�Jt ?1�R1[11 IE17`�aE.:Ihi1EVti Building Department Fro re—V I Occ Group Type Constr. Planning Department Other / ✓ Other L Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing&Base Fee Other Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( ) Violation Fee TOTAL FEES PERMIT NO.: MASON COUNTY q a� . �. . PLUMBING/MECHANICAL 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 APPLICAJYT INFORMATION CONTRACTOR INF RMATION Owner ti c Contractor Name ' �l 2 Mailing Addre,5ss F '! ' ; Mailin Address CitySlc�rl i State Zip Code ' 1 Y)(� City �//- F State L .�. Zip Code Phone( Other Ph.( Ph. - Other Phi Lien/Title Holder Contractor Re # (,.15 / Address Expiration/ / SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION-12 digit Tax Parcel No. y w. / `_/ ` J I Fire District Legal De ription Site ress(Please include s6eet name, street number and city) j �' • I I Z4rerctions to site Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair Other Use of Building Location of Fixtures/Units 1st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric Type of Fixture No. of Fixtures Fees LPG Natural Gas Heatpump Toilets Type of Unit No. of Units Fees Bath Basins Furnace Bath Tubs Heatpumps Showers Vent Fans Water Heater Propane Tank Laundry Wsher Gas Outlets Sinks Wood/Gas/Pellet Stove Dishwasher Direct Vent?_�O Other ..rC (�:,+1 Other llrlv �rrr�ii-?r Other Other �F ;rfi t"j7 "�� Base Fee t9 L Base Fee TOTAL PLUMBING 777 TOTAL MECHANICA A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT. 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-1 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 therewity.'16"Chonges shall be made without first obtaining shall be done in conf nce therewith. No changes shall be made without approval. first ob iiig appro al. + X Date X Date 19' FOR OFF ICIA USE BEYOND THIS POINT Accepted by Dat Submittal Amount Due C.•qdj Receipt No. f>:>:>:»:>;» i:>?:::: : : NkA . k� D:. Building Department /r) t'E' v 4? Occ Group Type Constr. Planning Department /�l�q , C kk' i Other c Other r� Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing&Base Fee Other Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( ) Violation Fee TOTAL FEES FORM MUST BE COMPLETED IN INK PLEASE PRESS HARD MASON COUNTY PROJECT SITE INFORMATION Case No. Name_gV'C^C4 G:63Cr PARCEL NUMBER S/l .TO 960 14 Date 1-A7-Ff SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography Well Location (including adjacent) Drainage Plan Names of Streets Easements 11 Names of Fronting Streets Septic System 1111 DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line. adjacent property line-> , , E-adjacent property line 1 I 1 I I I I I I I I I I I I I I I I 1 I I I I E I � 430i I FoS PAL I �4�oL Id, I r 1 S OO 1146 t 1 AA_J /0 4,.. lc I lI I adjacent property line-� 1 I <-adjacent property line T SAMPLE SITE PLAN adjar�nt property line 4 p 32.0' so' rruscR,e I E-adjacent property line i SfACGw/AL. �• M fi ,� _�PTSL �30� CREEK \ 1 P I MOM 6 i G44Ewl ]I HOus4 I j PR°PoxD 1 1 14— 60- I I VAGntT T jC,ArtAr.6 3oPosCD � I \ �! �\ T A6R=U.LTMJXAL So' 1 I 1 � 1 I \ 1 \ 1 I 1 /0O' I t"'eLL 1 I I 1 I I adjacent property lined ; c <-adjacent ro ert'line TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the degree of slopes. See sample topography profile.) SAMPLE TOPOGRAPHY PROFILE dista„aw to .•�rtir� U'04� 44Z d�atarc.� to S�oQa. tn¢ dis+annm 4 e ri Signaj6re Date .._s_ PERMIT NO. ESN CO0 P: .4,.1 } ✓'Sly' j� T i i � �W � ► G ► P �,-f 'fl�', iP'PLIGATION ,= v 426�Ni"n�ectarO>Bb7rlii,SJieixbtf�W1� 5884 'Shelton 360 42 �70YSetfalr'r 6b'27 =446�7.Et�Yia 38 48 .d269, ttte 206 464-6968 APPUC T INFORMAT- ION = �' CONTRACTOR iNF 'RIVIATIt Owner O c +, Contracfor.Name / J Mai' ddre MaIPnAddress JOA City State Zip Code City. . State ,"lk__ Zip Code Phone( ) ©ther Ph.( ) Ph; — Other Ph. _570-9 Hoiden Contractor Re .# LI J Address Expiration _/ / Z SEPTIC INFORMATION Connect to New Septic; Existing Septic Co tt .Ct to Sewer System_Name of , Sewef System �< PARCEL INF©17�UTA'>i'1d11i '1'2.tti+�it T_x P�oel'TJi3 a ,,�/; � / Flre Qistnct Legal Pescription Site Address(PI`edso incftlde , ,eet�t' ffo efI'd`et 4 b i ll hlfy) - 1 Directions to situ xx Is your property within 200 d the tol�oy�In� Bbily d ai�i`(Name) Saltwater LakL' Rrvef/CreelS__'I�iY�d VrVtta`KF41, Beasonfil Runoff StreamSlopes or TYPEW j0W4ew Add' Alt Rep i7f, Other Use Of.B.uliding Location of Fixtures/Units Ist.Flool~ 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of`each) MECHANICAL UNITS Fuel Type: Electric TV De of Fixture No. of Fixtures Fees LPG Natural;Gas Heatpump Toilets Type of_Unit o of.Units Fees — Bath Basins .. . Fumace Bs,��.r Bath Tubs Heatpumps Showers ai Vent Fans Water Heater Propane.Tank Laundry Wsher- Gas Outlets SinksWood/G.as/Peliet Stove 3' r�' ' M•�, •Othk Y ,pt'�''R;1 S"! t Ottler c • . > b Qasel#lee - a 'kI �sK YI,�Y TOTAL MCANICA A FLOt'� ED DINI�INGI�tN THE TYPE OF FIX'1�URE/UNIT NOTICE tHiS t' #M f`• Gil?fi?Wt� li: C IVSTI+tUbTlOjgLAb Ht`�Jti`ZEL IS`(�dtie 'V1141ENCED`WITHiN 180.DAY$OR IF CONSTRU C O CTI iq f (� F.16ZI�A�re Alt AKif Ti*i DER Tfi�WORK Is COMMENCED PROOF OF.CQ M /> Fi1tC1 Bin'Nli�dN O�1�tt'sRES ,INSPECTION. Tice tswner or agent on owner's behalf,represents that the F �, Information protriitsd is act:wtafe.ani �talnts erhlploiees oI' s#oIi'Corlfy access the above described property and structures for review and; inspection of this project: Ackni wl dgrrtent of sts by sigliature,below:- OWNER AFFIDAVIT-1 certify that I ani exempt'from the requirements of the CONTRACTOR'S AFFIDAVIT4 certify that I am currently registered as a Contractor Registration Law RCW 18.2Z and am aware of3tie ortlinanee, contractor in the State of Washington and that I am aware of the'ordinance requirements for which this `Milt Is issued and tt*'all work will be done in requirements regulating the work for which this permit is issued and all work. conformance the o. nges shall be made without first obtaining shall be'done In conf nee therewith. No changes shall be made without appr first o n appro 1. .i...- X Date X Date �I-O i—f s FOR O I lubiA SE BEYOND THIS P NT ?f Accepted by D Submittal Amount Due G.• Receipt No. I ,�� ?t Building Dq*ftBnt * r. rA 000 Pidrining Departme Other Other �YkNk � x; S 9 y !r d y F?nk Y• ?PN(fti<'Fee :; ? Sike 009CHo11 e Plan Review Fee UFf; Ian Review Fee Plumbing&Base Fee Other Mechanical&Base Fee Other,,: p Wood/Gas/Pellet Stove Fee P(e-Paid at Submittal«, Violation Fee TOTAL FEES F .yam C. 99 a y� S Q V D C. C Z Cl) to Cl) p { m :s o Q 1 1� » lb --1 01 --1 C o Z D C DMZ 71 r ` Z f Z: CA N W 4D rr -1 D .40 W to » 'o t9 t� P3 0 V) 0 -4 > 39 s w D «. » Z C .r ab Z A 7E -< tfi 2 s M13 t77 Q m N is to �r _ -mod -• -% t:? 6° D tit «s.V `..j air tom!! m m E qD WC i j t'x (it -� N .. w o cl i N (D -L -� Q i $° o x ' � 1 0 O I C C Cn Z .. O a ` J s ? (p O Q 9 1 0 00 p ri IA L � I � l 1 I � � . l COS MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date by Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMM Walls FIRE DEPT. date by date by PLUMlSll i date e by OTHER Groundwork date date by D.W.V. WALLBOARD NAIL= , date by date by Water Line FINAL INSPECTION date by date by date by f - i I' II I Building Permit# MASON COUWTY ^ A r BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 C1 .11- 110-111-1 , - _ _kFwc_ �v Job Location I t 9 71 +4o �,/ lo(,, This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items Listed below must be corrected to gain code compliance Gc G cz A .Cj. Aq � r c--P �C' 4Je._ n c. .S o4-, Z• CA A= C. / Ole Cit gueA ,4P, (� ! o! r oft •/+ G G Gyt e, yL G f fA-) � Glw.4G �^� / T ♦J ✓l 7 r 04 loe cr ' You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ OK to ❑ This is not a complete inspection Department P f Date �' 9 Inspector DO NOT A VET TAG W s e - is 17 �V t tea' $ n p r,✓ .. C4 AZ! coo 3 't C G C40 µ m to 0 a 1C2 rF V aD Get G to ? a .� 2 Cl) 4 cc a 0 cra ! Q t) pr ca�i � 0 ID $s X ^ rf r!' a � � r► 0 art s+ O _ � 4cnz 0 z "S O C'a : (Q CA 40 o10 ao z < ma 00Q CA cl) � m° a ca cr e * a a .I �,