The URL can be used to link to this page

Home My WebLink AboutBLD97-0596 Final Covered Porch - BLD Permit / Conditions - 9/5/1997 71 S Co rm 1= > 0 IE > Ce', Alk :r > 0 ,maZ Z Cf) "n ab Am f Cf) x 0 OD c 30 acZ o (n Z M fr m MA w A z z > xr Z. z z > > OD no co > 0 z 0 x > b Si r- G9 4 Zo— in <D ITI . 0 7 7 4D ;1; xm Pn z C4 C .mot z cn =r (> W., m cl. s "'D z z 10 00 C)ma =a q_u ell Ol Vr 7� Z OD > 0 < 0 2 m z . z z 7r Z 4 CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by to >r- =r < < Eta 0 1�,Ak0 e) (Deb CL a I"I:,6,� S "r, < Al -n 1� k 2)� 1 +tr M M < 7� Oc z 0) rz =062 az os " ZZ e-+ 47, < cnc T; c z 0 X X 0 a 0 0 f+ 6* 06 0 CL Zr co IUD 0 0 ZD < iz c > 0, ILI 0 0 n--.bz iE :r Z r p z (D O'=it-Lv< > e+ fw F+ 4�6 (n ol &�o 0 10 cl M T3 o w I CL 00 C) M 2),n ki — = -% vi 2) -3 C Cn z IT klo 1�1� T S c Z_za r.z Z T Permit No. MASON COUNTY BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton,WA 98584 427-9670/1-800-562-5628 PLEASE PRINT (Calling From: Seattle 464-6968, Belfair 275-4467, Elma 482-5269) nS, �"✓ c'�(1 �/// #1 ner 0 y-t'v�1N�I Phone# �o�� z?S — (/`t`7 Addres s Q r -5k-i _ Fire District# City e St (D� Zip xDirections to Job Site Owner Mailing Address - K on e— city St Zip Lien/Title Holder Address City St Zip C C,� #2 Contractor Name JD -� toe' Contractor Reg#156 UA)b0* k Address—?' 14V67 - Expiration Date CityCAW St _ Zip d'3 Phone Z�3 'off #3 If septic is located on project site, include records. Connect to Septic? _Public Water Supply Well Connect to Sewer System? Name of System (if sidential, proof of potable water is required) #4 arcel No.2-�1�Z -� 6 0 651 Q ,,/ Legal Description �(�c1 C�c?VT- L-�f a- 3 g�C j S d /�C/ IA) #5 Building Square Footage: 1st FI 2nd FI 3rd FI Loft Bas meot #Bedrooms #bathrooms Deck Other Garage Carport (Circle:Attached or Detached?) lsc � #6 Use of building � x�-�; Describe work #7 Type of Job: New `' Add Alt Repair OthIn [ � 'U If #8 MOBILE/MANUFACTURED HOME INFORMATION v Model Year Make Model AY 2 $ 1997 I Length Wi Serial No. #Bedrooms # Bathrooms Type of Heat r.,.,� �1�+Cf� Purchase Price HEALTH S'� ' ' ' `� � #9 Indicate by circling the applicable source if any water is o 'acent to subject property: River Pond Creek Stream Wetland Lake Ma Salfiroater easonal Runoff Other Show following on the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography Drainage Plan Wells Septic Systems Easements Proposed Improvements Indicate Directional b N S E Name of Side Street y , , , W) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures ($3.35 each) Feg Mechanical Fixtures ($6.75 each) No. Toilets CIRCLE FUEL TYPE: Gas, Electric, th Basins Heatpump, Other Bat Tubs � link Show rs Furn BTU Hot Wat r Htr — Heatpumps —Laundry sher — \Vent Systems Sinks — spot Vent Fans —Floor Drair f f Laund B�asins — WP — Dis asher No. Air H�ndling Udlts —D. posal — cfm# Urinals Ly4, Fi Other — Auto. Fir arm Sys 50•00 Fixed ire pp. Sys �•� Permit Basic Fee 16.75 — Auto ire Spri Sys TOTAL PLUMBING $ No. f G-s Outlets Wood, Gas, Pellet S ve 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 16.75 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 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 DEPARTMENT. DIENT. s X OWNER X DATE DATE ,.A DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold r Approval Planning: 1 l� /3 Environmental Health: is I APA Building Plan Review 1 Occupancy Group: Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permits m o Plan Check ¢`o 0 Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Violation Fee Site Inspection Building State Fee Other Other{ Other Building Valuation: 1 � TOTAL FEE J� 'MASON COUNTY DEPARTMENT OF HEALTH SERVICES , Environmental Health Water Qualify Personal Health PO BOX 1666 SHELTON, WA 98584 - LOCAL(360)427-9670 BELRUR(360)275-4467&4468 Application for Determination of Adequacy TOLL FREE 1-800-562-7798 FAX(360)427-7798 Instructions .. .•'L...Q'+....�..{n....S....i.....t...t......:.•..h..r.v...ti:3.Sti.•..}:..r.}h:.....v v.:..r.Wf..vr..{....v..n;...r.'.N:::..f.....,...y..E.....:.....:....r.:..:.�.L:......:..r.I...:....ry...}{:...-.n:.{..7.t..:..:..:.�::...1.•.y3..�:.:....:��.k.:..vi...}.J�1...��.:..�....•....:r....v......:....::.v-.:J-.M.r/...�..v..•.:.:v.:-:.::::::....::..:vt::.v?.•:-.v.4.:t.:..{t}.{:...rv�..n}..�:t.k Jn y.;j{a•:.,:i(;:`•.::;.:{;.nYvy ::0tivva.i:t�t...L:::•Ay:�i n}:.:iti.:.x..•'}...v.{:::'..}...tv.Y}:w.}•:..f{::..C.{:�...::..,v:.:b..::4..-{.;l5v:1::J+A..:.{..tif}.w:•�.:t r.:::}.:r.:`r�v.•}x.r.•....;L...•vi..,•n}..w.:.{t.•�.::6.:::.r::::�}.:.:13:.:.:..�'t}•...::..:..{:r.-}.rR. hn4v.:..•:..:sVr::.::'.::.�vv..t.=::::.�th...:t.v...:r..�x:...,:..•x:.....:.�.:::.._:t:.:.:e:;.�r:ivi.�:.�nv..8.!...:..-'r..1.••.�t..1.•...'v•\.�}.vt..V.C.....}v:.3.v•.r...:h.n...:v..n..... .v.N..........�•:...:......::O•.....$."....:.......#..h.,.v...v..r.{.t.::.vv..itt ...............:. ..}.3...v.r.:..t.V.-•�.itifi.�:l^:(J.��}+!..C.„�'.•{.�'.•x5i.(..::F•{..••}.:.�.::.i:r:fd::Moll"¢t.. :n.. ON; ff v��i . ................. "-{.v?v:qth:.�:.}t•.,t•ti.}•:h:Y v••:.•::,s.}:•:.x'.i.:w.:s:.4iti..}:vv}:.<:.:::S?.:>::.j:_::>:.'..ii:i:•:.i:v?:`.;Ki:v:'.•`-:?r.::{:::.vv.ii:}?.::i::Fi..:w:.?::Xv.;i:.:_•:<:.!{:v•.+i:•{..?:'s�::.:.?:=w:n>.:..:}'v:...i:?:.f:iv.kr.:.i:.>t:.;•i::.v::i:ti.•:::.�..:;:J.:.:{ r:}st.::'i:}.:r?-}:1•}.t}n. .t:Y{:;v.q•v.}}}+:} •?:}.;`:{'i:�.i•:'r.�:?.:?..v:r:•.:.-:}f....,i;:::{.fi:?{..C.>} .:i .. PART 1: Applicant/Parcel--I�dentification Name of Applicant �J N� Date. ' 9 b Mailing Address 1111 .Soh a S � �� 1� Telephone yZ(, - (�G9`l Sly.."(o•� �IAa q� - Assessor's Parcel Number :M- 00010 Tvpe of Water System Check One): Reason for Appheation Check One): Public/Community Water System(2 or more X Building perms N o'Pz, —Cod—) ❑ Land use application,if so.. ❑ Individual water source(one ownection),if so.. ❑ Division of land ❑ Well #of Parcels? ❑ Spring/surface water SPH9 ❑ Other(explain) o Boundary lime adjustment ❑ Other(explain) {�� , A Cal it1 b• a { Siu PART 2: •,J Water System Information Complete the section appropriate for the type of water system being evaluated for adequacy: jS Public Water System Name of Water System Water Facility Inventory(VvT])Number: ❑ The water purveyor has filed a letter granting blanket hookups to this water system. ❑ I am the manager of this water system The water system has been approved for services. There are presently connecions m use. This will be the connection. water system is able and willing to proviTe—water to this(these)connections without e�the limits of the water system or any limits set by state and local regulation. Signature of Water System Manager Date W_7 H:1HDATAWRCHIMEIWATERAD3.TIT Update:October20,1995 'Aw . Individual Water f3,'ell i ❑ Water well repoil(attach to application).Depth lt. ❑ Well capacity test(attach to application) gpm gpd Ifell ca acity tests are often petfonned by the well driller at the time the well is constructed. Test results rom ihese tests are noted on the water well report. Results fivin these tests will be accepted prthe water well report cannot be located by the applicant or i•jthe water well report does not have a capacity test,a well capacity test,which provides stabilization of draw-down and recovery data, must be performed by a licensed contractor. ❑ Satisfactory bacteriological test(attach to application) Individual SpnnglSurface Water 113 WDDE permit(attach to application) ❑ Method of disinfection ❑ I have reason to believe that this water source can provide at least 800 gallons per day and/or provides water at a rate of 2 gallons per minute based on the following observations. AUTHOR OF STATEMENT DATE RELATIONSHIP TO APPLICANT In addition to providing the above statement,the applicant will need to arrange an on site inspection by the health department prior to determination of adequacy. Departmental use only. Do not write below this line. x:w::.............::::::::::::v{:xv:•. ..:..:. ........ ...... .:::. v..... v..v::xw:::::x•:�::::x:x :..w-Y::?�:•}.. :rk•...:.:-}~.:......'- ..x......a..................... .....:.x+:{3..:.............v................{...<}:;n:::w.v:::;:x.......::xv:.v:.v:::::::w:::::::::::•::::::.••.........................n.::::::.•}:-:Yx{.::::.............. :...... - :yl•••.:;:::•.✓:i:{{:tiy:..v.:.?..v....-..i:•v: ;: �iti{.':•:'::i::•:}{vtivii: •:�}f:mot:i?�'�ir i•??:::}::}}}:??•:{.. i?'{"?•'vrij:�3f�?•�%:YY•`ri•' .� �'�.'•:v'~. ..•.{.... ...{. /.•tl.F. i}it+X?•�}?_ :::• .}rx.,}{.•}.r�k�:..r..} .. �v:+?•i`-'•. •:::}n:?v:r:n•::.k:vv}:::. .v.Yfi:r•-tir: r. v..:........x..:::............:... ••.:.. }::::::.:n...........................wnv:.x.......:....:. ......... xx :::::: ................ .}..:....... �......v:::::v: ::}k......................... --.- r.:v:::.v:.v::.v::::nv:x•.:.v::....:.::..:...:........:.•:::::::.............r.Y.+Y�.............................::::::nv::::.v:::::::::::::.�::::::::•vv::.v:::.v::•:r:r.r..::.::}}:?v}:?}.:r�}}i::?:=i%..................x...:....x:.}::w.�: :.%i:::}i: �::ti}�:}i?:.�'�� -'•-\i}Y:::•:;i:�:i �:?�:'.:;}:�::`:<::?'<Y:•,:�::iiii=:-i:i:::::-:::y:--?••• ::}:.:-i"�::]'Cvtiisi':rv:is :i::i:::j::::y:::::is�::::?i::':'::i:_:i {:}:::•-';i::ti.•'.:j:::::ii::•:ti::•:il-:•:;•:?: . :�:.+:;. ..... � . :: ::x:.._:: :•`�s-::•.......................... i:: =:>:: f..v . Y- ............ ..xr�}.::•.v:w:k. ::� :..� .... .vv::.:-::i.......•-...:.v.....::...... n.--:x...:.::.-n.v: .}:{+•:v-..:_:. t:Xi''vi A•,� Yji r• I'rit t: l3t�i} d •� .. " ..........::.;-::::::x ..,.. •.: x...:{ •:..:.::x{ }:a;- x.{.:..:xvv:::x:?::{-::::-:::::.v::::::.:..::..-.-w::.v::•:::r:r:.:x::..vx:.v.::.v..:::r..• ....:...... x........ - .................................r r........x.....x..........x.....'Y....}Y-}}+:{-}Xv ....................................:.v:.v::::::}.-v}r!.:F:}}}::xv.....^......k..f...kv?.:{.}:}?^v}};v......x.v••:xv::x -.: - :......... x............................... ....v.v.. Y...{.}.:Fv...................-vv:::::::::::::::::xv�::::::x:w:•:::v::..;....;.•..,...-:...::::::::::::::::x-:.v:••: .} r..}' :............v.......vm v:::n{.^•: {.:{x:??................................\?:v........... ....... - t:..v-.•%.:xv...:...:.:::::::............,.. x-.v..+f.-:r A.{•:v`5_h...;.:.;}•x x::"^:} ..:.............................:....\:..:rv:::::^:{nY:}v}}::••..x.r ::.:. v v ::-::::-:..-vv:}'•-•.}-v::...:-.v-.v:.. :..f. .a.:v...........x..r.r...:•:::..•• ..:..r.. }.......v �:?!.}-v-.v.:}}vv•:::::-:}:i}:?:•}: v?v':::'.r-:..":F...:... w::::::r :•v`•'-::it{+r}-:}: .}:+ }i:- .!.: ..f. •:.{•{y;:Y rn;:C:{. ;;:�?; .}:'� .i'y, x..}.:::r n.. :.�3:.,...kx r:-:�r-{d 5....}., ciT ` }?�. x Y" a{i Y.: c.:�."¢:Y:% ..t}?./.•�^.">cti ..?tak.: ?.' .k. �' 'i��:b}:{?}.c?:?ram.?::.':n ,+-.��:,x?fY•F.^•{p:{::}:j�. {{•F{,:%+M,%C.{,.::i�`:vva.:::}:v+•. .'::?Si.{{ x F u.::x�'`� ?�...6si: F�!-, v-�'>••�;€ } ..R..........:F::•:•.�j:::r{}vw;i. +`:.v:f:::::::::v:v::-::-:v Fit}: •.??:t-.vY`.•.:ti•••-.}kkx.XYA:rc:::.:v.{t......:..........v X`-}:.v fir}`:v:n...��::.k...�':-h::.�`v. ^ fill. ....... ...... ....:::::::x.xr.:xv....: .x......:.:F..xx:n::}::-:::•:�'-::::•:::.::y•F.•:.v:}.••::::v. .:::::::::x.,.:..............%.x.v!...Y:v:?.v:.r.;.n............x..1..�-'.....:.e. i'({��5�•'v�`r.-•.•+:•�tv. r Y r :...4 .F.v...k..v..{ .xd...........- .--...-- yr ••-v:::::-nv:w:::.v """.". xr?.G•:':L-rr-x\ r....v•.vv:r:.x.:.....:................ L..n..v.x..: v..v::xv.... ....... ...... ....v...........::}:-}...,}....}:4}}+- .. v::x: �.i:•i-•i:-}... ..N:}tv':-:iti....%...::• ..y... k�. v.{.... ::M�'•}!::.:::.r:r•::.: ..k.i...... :f..y:.v'n4 vx v : '• {-• •• �{ /l��{' (�� j�}�j-�!'r��'iv(�'�][L.//� f:•F... `{{;} .Yi.:V. ..�'..'.,:.-•-: IGiT•:'.�%FM� {j \ i 'M�•�!}7M'1,MI.• hR}% f �•':j• ra�. n h::.........................:v v-•vxv:_.::.i� . ; x,..::n.v.k.v Y4}iF:.::•O Y:r:rir .vv:f::1'v x-.d�.:. j. : �:rr. r yy�?}�.Wi'�•��• }�:•:::o;.•�""` .;�-` }r�:} ��,}�",_��i�.�L�fa�r.~:.: . '�: �r' .�[tFi:F.rv.'l.:�:-i��i.-;��:. .••~ j�lY; _ . ..: r •}:;}}}:-}....i}::-.-.v::-::t�::::�.... ........ n... - .. ..x. ............ r......��••T�i.•:.. ..:..�v:.v:::::.v.:v:::... ........:.......:n.:•.iv:•::r• ............................................{:.............................x.................. .n....................-::..........Xv:::::::.::::}:::...�}k.......:.v:::Yi:}.F?:T::::.:x}v:rrx;.v:::.... x'' ... ................... ..... .... ......... ..:x::•.r::::::::::::::.v:::::.::::::::-.v:- ::r::::.:v:::::::::::u:::::::::vv:.:v:::n r.:.iv:•i}}i}}:4:::?;�i}}:;::•}ti+• -;:ii}:•:,;.i rj}*K ............... ...•fv.}Y:::r.; r:;i+G:+?" 'vili?iv r s-riF :: ii:?::.. ��) /fir ��jr%/j /�(Jy/ �!/��yp yj�F� :S�fi x::}:r r;{f:Y;._:ii'�ii.:{-..,.:�,.•.v ` --'-•'r+:: C?•:{:}y.?•{.iiii:jT.R: ::1F� {:-':'•�{ '`�'.�:•il'v'IMM3Y :�V.li'.l4'�•�:l+�Y.G:::7}i: .I.f171t::Si:'i':'"i{xf'i? F. ?? i! _ _ S )p$};\••?r.,v,•k..{{.-.:..... •:i$:;.F}F. •.: ;.x hh:v:::xv.. K.`...v _ i:LiL:i•••'!::?i':?:i:::::::ijiii::::::iii:-is:{:::j<y'iy:::;::::::::::::i}ii::i::.:.'::.:'.'-: - � .}i'f.::-:�i:Ci.� ..:.. .:.:...{..:........ ..... ....:: .. -: - :-:•t:.��- :ii':��:::4:::.:::•::.::•:..•:..':;':•:'?:T:yi.•iiTT:ti}-.v::i:r}}::i}':-}iii::::{.�i:: ::. ' 5 TC? t' F �, � .. .:� : 1 ran.:�:w :::.:... : ....::<:...:.._::.::.: na£;� >u�tend�: �se.for the. hv�n reason. s....::.::=::> ::>> ::; = .........:...............................................:...::...........::::: :: ,:::::-::::.::::::::::::::g:::..::::::::::::::.:.::::: ._r:.::::::.:::::.....:..:::::::::. :::::r.......:......::.:::::::::::::..:::::::.::.::... :..:.:,.... ......... . .:.:.::::::.:::::::x:.:::::.:......:::,. REVIEWER'S SIGNATURE DATE 11:11 PDATAIAR CHI FEW I A7GRAD3.FIT Update:October 20,1995