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HomeMy WebLinkAboutBLD93-1846 Mobile Home Caretaker - BLD Permit / Conditions - 5/24/1994 Permit No. MASON COUNTY BUILDING PERMIT APPLICATION �- 426 W.Cedar/P.O. Box 186,Shelton,WA 98584 427-9670/1-800-562-5628 10( , PLEASE PRINT #1 Owner Phone# .:2 Site Address - Ev�alot rn # City St�Zip eftq p. Directions to Job Sft _=� AA AF.vd 49C -T/id.✓ .eigg yY­ fig 7Vio 0 !rs/O.CT ry/LG Owner Mailing Address �,�l? SvticSET �D City St Zip 9'FS�F.4 Uen/Tdle Holder o c/E 0,rA A 5 0-LA­ k Q N Address City St Zip #2 Contractor Name t'EL Contractor Reg# Address Expiration Date City St Zip Phone# #3 If septic is located on project site, include records. Connect to Septic?--,k-Public Water Supply Well Connect to Sewer System? Name of System - 4i4.CT ©F 7-gw (If residential, proof of potable water is required) #4 Parcel -c��rl 00 0't O I/ Legal Description t2-c i ? -7 .i Al .P. 4 w I' a� Q1✓. #5 Building Square Footage: (existing/proposed) 1 1 st FI 25!!Y� 2nd FI / 3rd FI / Loft / Deck / #bedrooms / #bathrooms / Garage / Carport / (Circle:Attached or Detached?) Other sq.ft. / #6 Use of building ( ( \��n 'S-� ` �.�9 Describe work [4_F�-f1ti� #7 Type of Job: New ✓ Add Alt Repair Other #8 MOBI . URED H ME INF I L IA tIOU Model Year Length 'Width- rial No. ? #Bedrooms-#Bathrooms Z Type of Heat EAee �vecEv Purchase Price$ #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other Show following on the site plan Lot Dimensions Flood Zones Existing-Structures Fences Structure Setbocks Driveways Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed Improvements Easements Indicate Directional N, S; f, Name of Tanking Street by E W) Name of Fronting Street iR re atkYn to piotplact APPLICANT TO DRAW SITE PLAN BELOW CA/0? MoBitE �f � R W1 � APPLICANTT15 DRA*'I?0POGRAf44Y PR�ILE-BELOW Y a Plumbing Fixtures„($3 each) g Mec?ianical'P'Mures ($6 each) No. 7- Toilets CIRCLE FUEL TYPE: G Electric, Z Bath Basins �_ Heatpump, Other -Bath Tubs N Units Fees —Sho6e4' i ; — Furn BTU Hot Water Htr — Heatpumps —Laundry Washer — Vent Systems /Sinks 3 Spot Vent Fans —Floor brain$, Boilers7Comnrgssors / Laundry Basins 3 HP _Dishwasher NIL Air Handling Units _Disposal — cfm# a —Urinals Ng, Fire Protection Systems _Other — Auto. Fire Alarm Sys 50.00 _ Fixed Fire Supp. Sys 50.00 Permit Basic Fee 15A0 — Auto Fire Sprink Sys 25.00 TOTAL PLUMBING $_ NQ. Mar _ Gas Outlets O - Wood,Gas, Pellet Stove ,Fiit� - NOTICE:-THO PERIIiIIIIIII-BECOMES NUILL AND-VOID IF WORIC OR CONSTRUCTION 11UTHt>iR ED I>3 NOT COIIII- MENCED W"1P$0 DAYS,OR IF CONSTRUCTIONOR Permit Basic Fee 15.00 WORK I$ D OR A8FI3R ADD TOTAL MECHANICAL $ OF 18Q i YS /rT ANY TNI�-AFTER-1AlORIK-0 COCA- MENCE 00011 11NtlfkTit OF-WORK f3 BY £'I"IDt11... OWNERS AFFaDAVIT CONTRACTORS AFFtDAVIT 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 WASMNGTON AND I RCW 1827,AND AM AWARE OF THE MASON COUNTY AMAWAREOFTHE ORDINANCE REQUIREMENTS REGU- ORDINANCE REQUIREMENTS FOR WHICH THIS'PER- LATING THE WORK FOR WHICH THE PERMITtS ISSUED MIT IS ISSUED AND THAT ALL WORK DOWWILL 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 _ AR . _. NT. DEPARTMENT. X OWNER X BY ATE — DATE : .L�v.: 11111111111 .:j:. :;did,_::Z,Y.,•:;f , DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved ' coed. HoW AWmW Planning: - tip Environmen alth: aw Building Plan Review "Ac.z-%. 1ro{j' Occupancy Group: 2 3 m° ype of Const: S-N Fire Marshal: j Other: Special Conditions: FEES Building Permit Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection �s Building State Fee Other Other Building Valuation: TOTAL FEE ,rj a :°: ,'� e . n;ID to �, m e CD '° a°' r+. R.. WD W WrM W WW MM -q H 0 0 -IO -I A O W r v r o 3► rna COS xMMrn .� W Z � A � A � r Z xA H -i xao3s03s D WM0 V AM -� 3► W .� a W H -I `I, AM i rrnmxzo -o or- crnaMcn x a I H to 3 a to I H 7i rn r fl 'O cn t- m+ 0 a $a t o�a+reo M M v p • rnHH j ZNF� to A p p rn A £ x ap r �„ r, O e .� • Z z N ( rn v v ( -4 C -t o a) -I Z rn A w a s ,�.� • '� 0 rn ( . . . . i H Z r aA -n 31. O rn to 00 G may+. .� o •� 'V ( N rn to z I OH0 Ax C r xx to ►. H •.. _ ( 1 z -I 30 00 to £ •• .• .. .. M H to O z C rn O a � O 70 rn x M . . . 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