HomeMy WebLinkAboutBLD93-1887 Final SFR and Garage - BLD Permit / Conditions - 12/20/1993 rll�- ,3 6Z S(,P -I- L — Permit No.
�LA-�q - MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT
#1 Owner -StS IZZ11 -Aq fYLO1.1 t] Phone# q'2+� O► p
Site Address IB 101 Wt L LnPA 9-0At� Fire District# S
City 5►44EL'Tb6 St 1, iq Zip `t 8684
Directions to Job Site A(.orrF, (-A `re, stoeE . L.T S'Sne-E, L..T AT T,&&2R LAUZ
-DP.tVB - PIT oy tF.t.A9ZsgbeE; OIt - t_.T c ►.1 t?Ael- ZZ- - t,T 60 LjJtt1.DPA
V.oAo. rnmp6a. of LP,1tuoFA VbArD 4- W►t•LOPA YLA4.6,
Owner Mailing Address SW 6ftQ44ffZ LA]de e Q8
City SitEm St Zip 98S84-
Lien/Title Holder S A&1e.
Address
City St Zip
#2 Contractor Name Zee" ?AYMOOD Contractor Reg#
Address Expiration Date
City St Zip Phone#
#3 If septic is located on project site, include records.
Connect to Septic? ✓Public Water Supply Well ✓
Connect to Sewer System? Name of System "Ti Li SEg LA".5 L.,scrz.
(If residential, proof of potable water is required)
#4 Parcel No. 7=11 - S 1 - oo►
Legal Description "rf uaML^V-E , DW q LOT 15 4
#5 Building Square Footage: (existing/proposed)
1st FI / 1 I D L� 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms- _/ #bathrooms /
Garage / q zA Carport / (Circ<2995Mbr Detached?)
Other sq.ft. /
#6 Use of building Describe work
#7 Type of Job: New `� Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make
Length Width Serial No.
#Bedrooms #Bathrooms Type of Heat
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 Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements Indicate Directional b N, S, E, W)
Name of Flanking Street y
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
LAT
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
t/ Approval
Planning: VVI 4M S 1(�0 I/A PCI
Environmental Health: �,QJ' f 3 worfv - daStay-\ r14O
Building Plan Review
Occupancy Group, Type of Const• r
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit
Plan Check IG 50
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee 5
Other
Other
Building Valuation: TOTAL FEE
Plumbing Fixtures ($3 eachl f Pg Mechanical Fixtures ($6 each)
(_pnc nano-5 t t P E e.G o o D
No.2"Toilets CIRCLE FUEL TYPE: GaSEED
-Bath Basins Heatpump, Other
_Bath Tubs No. ILWIa Fees
Showers 3 _ Furn BTU
Hot Water Htr _ Heatpumps
Laundry Washer _ Vent Systems
1 Sinks 3 Spot Vent Fans 1 V
_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�:: ND� Other
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
i
THE BUILDING DEPARTMENT. DEPARTMENT.
X OWNER X BY
DATE I6-1e'lb a3 DATE
F{ t t~31 FICkI USE ONLY Acceptedy bats
2 Z
A4
3:1
77
al Z,
z A. OA
7r
ICU
WR
CA
D
c
7 z 3�
vow Z Z 2
'77
C7
Aft OR
-pr ;p-
140 Im am
WV4&
So. ab 4
go
-0 IND -0SN
(>
D
OL
CA
7n
z Z to
S
ors Zm
X 39
Im
CONCRETE MECHANICAL MOBILE HOME
Fggkngs-Seback data 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
/ Walls FIRE DEFT.
data Z 9" data �—I— by date by
IPL NABING OAR
Groundwork Attic
date by date by
D.W.V. WALLBOARD NAILING Poo
date t `L? by date by
Water U dFIIN1eAL 7F date by date /9
by
— -w-
f4kc-k I l Y 9 naft Mt!. e I
Slimy-e�,,l l
>
'r V < X Z 0
'7t 2 3)0 n
3>
32,
rr
!r
rr
T, C cn
r- cn
X. 0
z 8!
cn Z
X :z Z
OL 0
U' 3); CZ
14 — 7
7t Z
co
=r (>
100-
00
01
7-
z a
I
rt z cz
t z
rr,
Y " J a a,
T if s x
Z v x cn
OL
' Z x
.a. N N
.T - D
z is n { -c
T T Z Z
ly
VK
I � y
° z
1 T \V_ T
vo
cn ND
ODQ
U �
OD
` T
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback ert"' ¢ ``4 A
date _ s*x Y. s Nou r_ date by Ribbons
�— by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date FRAMING by date by date by
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