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HomeMy WebLinkAboutBLD93-0866 Remodel - BLD Permit / Conditions - 6/10/1993 * Permit No. MASQN CO lWY BUILDING PERMITAPPLIC N pt0. 426 W. Cedar/P.O. Box 186, Shelton,WA 98584 427-967Q/1-WO-562-5628 � 1D" PLEASE PRINT #1 Owner Phone# 'a--7 Site Address 2 Fite DIftict Z City -,�! Sty Zip ' g$S'` ' - —�'� Directions to Job_She 1-6 U 3 *4-0 lCe N lle=az' bye j Owner Mailing Address PO 50 x 12 8 City B-e I :Y St Zip ig' Lien/Title Holder Na f tom a 6 a nr fe v,C 3•yQv�.oy Address F city e-V -Lv ,.( St uhm Zip $3 /n i #2 Contractor Name © W N Contractor Reg# Address S Q v►1 Q Expiration Date / / `i City SQ vr• St Zip Phone# i E #3 If septic is located on project site, include records. Connect to Septic? I Public Water Supply We IIII EConnect to Sewer System?��Name of System G�-�a'r Wad"'/ Wa sjne S Ys (If residential,proof of potable water is required) t #4 Parcel No.,I�L5 a- _ y 3 D U t O Legal Description- 7-&- 16 047 #5 Building Square Footage: (existing/proposed) 1st FI / 2nd FIB/ 3rd FI / Loft / Basement / Deck / #bedrooms / #bathrooms / Garage / Carport / (Circle:Attached or Detached?) Other sq.ft. / ��r'b r RvN,noolcil #6 Use of building "um 9 Describe work_1� --- 4�1' S rtA k-►e GEC' -jo CO :N fito li-Ale Coo #7 Type of Job: New Add Alt Repair (/� Other #8 MOBIL%eaake ED HOME INFORMATION Model Model Length Serial No. #BedrBathrooms Type of Heat Purcha #9 Indicate by circling the appl' le source 'rf any water is on or adjacent to subject property: River Pond Creek Stream band Lake Marsh Saltwater Seasonal Runoff Other Show fol hV on the lte plate , Lot Dimensions FJdW.Aones. Existing Structures "Fences Structure Setbacks Driveways Water Lines Shorelines Drainage Plan Topography Septic Systems _ Wells Proposed Improvnts,- Easements Name of Flanking Street Indicehlbi6ctional by ( k S. E9 Name of Fronting Street in relation to ptot plant APPLICANT TO DRAW SITE PLAN BELOW APPUCANT TO DRAW TOPOGRAP14y ngoFJLE BELOW_. _ Plumbing Fixtures(S3 each) F 'MechS I iiitures(1;6 each) Idea Z- .75 1 .&'� 13TA- No._Toilets CIRCLE FUEL TYPE:. Electric, _Bath Basins Heatpump, Other 14Pipv/l 1A _Bath Tubs Ng.. Unk Eem ��r•l Showers Fum BTU _Hot Water Htr _ Heatpumps _Laundry Washer _ Vent Systems _Sinks _ Spot Vent Fans _Floor Drains Ng., Boilers/Compressors _Laundry Basins _ HP _Dishwasher Ng,, Air Handling Units _Disposal _ cfm# Urinals - NgL Fire Protection Bj/stems _Other _ Auto.Fire Alarm Sys 50.00 r _ Fixed Fire Supp. Sys 50.00 Permit Basic Fee 15•� Auto Fire Sprink Sys 25.00 i TOTAL PLUMBING $ Ng. Qthel _ Gas Outlets Wood,Gas, Pellet Stove NOTICE:THIS PERMIT BECOMES NULL AND VOID IF WORK ORtONS?RUC ION AUTHORIZED lS NOT COM- MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 15.00 WORK IS SUSPENDED OR All IANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME,-AFTER WORK 19 COM- TOTAL MECHANICAL $ MENCED�-PfIIOOF OF CATION OF WORK IS BY MEANS 60 A PROS INSPECTION. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY-THAT1 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 AMAWAREOFTHEORDINANCEREQUIREMENTSREGU- ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH iHEPER'MITTSISSUED MIT IS ISSUED AND THAT ALL WORK DOME WILLBE IN AND,ALL WORK-DONE WILL BE--iN WNF.ORMANCf CONFORMANCE THEREWITH.NO CHANGES SHALL BE THEREWITH.NO CHANGES.SHALL.BE164ADE WITHOUT !WADE WITHOUT,.FIRST_ N OBTAINING A ROVAL ROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDI EPAR DEPARTMENT. Th'�, T X O NER (Vw� X BY - DATE ? -1/c7- 93 DATE DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved COW. Hold Appro W Planning: Environmental Health:, Building Plan Review Occupancy Group: Type of Con& Fire Marshal: f� Q56 4�ko D1 - 5 r Other: Special Conditions: FEES Building Permit Plan Check Plumbing Fee Mechanical Fee Wood/G�WPellet Stave Radon Monitor Violation Fee Site Inspection M Building State Fee ` Other Other Building Valuation: L TOTAL FEE i m � a rRc m 25 i A —_ m Ado 0 mo Imm OD CIL O ? r x c+ /A A f � rn � I 1 � I r � � D / 3 ' f x C-P I O A n �fR m 0 m S Dr Tq �, ` mD RSV T :c 40* ow Af 77 77, CJ) S Z S �s S -T S ISS Ss S 0 OD < Ong a. 09 aw 40 z y 7r AW are= r qw 4w IV 4b 'o =t IS 13L Im o z -z" 30 as LNSL -"w rw S S is as lcl CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date by Foundation Walls date by Set Lip ' dam by INSULATION date by BGISLAB Insulation Flom Final date by date by date by FRAMM Wells FIRE DEPT. date �- 7'7 by LPLUmem1—) dateby Attic OTHER date work dada by date byW D.W.V. date by dale by water Line FMALINSPECVM date by date by date by P-N — Jl V1 ee--4 i c� / An i n 3