HomeMy WebLinkAboutBLD94-01493 Final Garage - BLD Permit / Conditions - 2/6/1995 del --
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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
Attic
Groundwork date by
date by WALLBOARD NAILING
D.W.V. date by
date by
Water Line FINAL INSPECTION
date by date _ by L ✓� date by
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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
FRAMING date by date by
date b Walls FIRE DEPT.
y date date b
PLUMBING by OTHER y
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
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�,- Permit No.
MASON COUNTY n �� pt te✓*,se e r*,-L( l"A-�
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton,WA 98584 427-9670/1-800-562-562F(43
PLEASE PRINT .t
#1 Owner ep 1�1 W�i 71-\ Phone# c -7S " (oft e
Address>c. aa� 3 P4"Cl� 1�Oc� _Fire District# �
City Be e-�x.- st e zip Q�szB
Directions to Job Site
'SPe 14-t-E-i4CPW cl
Owner Mailing Address Z 5-re-
city ke A)A t van � St Zip �O 37
Lien/Title Holder
Address
Clty St Zip
yd
7 f
#2 Contractor Name rl1 Contractor Reg#T6tANCPFW9 L T*
Address {G 5 Expiration Dates/_36 / �✓r
City f rl yJ"ejo Q( St &I 1�- Zip 4`6 17 Phone#
#3 If septic is located on project site, include records.
Connect to Septic? `�Public Water Supply-4—Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required) q
Legal Description
#5 Building Square Footage: (existing/proposed)
1st FI 2nd FI / 3ra FI /�Loft/ c
Basement / D4eck ] #bedrooms / #bathroomsGarage /r3�o�a (Circle:Attache r Detached.Other q.ft. /
#6 Use of building �P 4S4-c 11P d eay2/4 Describe work �'D�s><e�
#7 Type of Job: New _Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make Model
Length Width Serial No.
#Bedrooms #Bathrooms Type of Heat
Purchase Price$
L
#9 Indicate by circling the applicable source if any water is on or ad'acent to subject property:
River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other A-�(?a ck &AJ A,
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
Name of Flanking Street Indicate Directional by (N, S, E, 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 eachl EDg Mechanical Fixtures ($6 each)
I
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
Bath Basins Heatpump, Other
Bath Tubs Units Fees
Showers _ Furn BTU
Hot Water Htr _ Heatpumps
_Laundry Washer _ Vent Systems
Sinks _ Spot Vent Fans
Floor Drains Ng,, Boi(gjs/ omoressots
_Laundry Basins _ HP
Dishwasher Ng, Air Handling Units
_Disposal _ cfm#
_Urinals NgL Fire Protection Systems
_Other _ Auto. Fire Alarm Sys 50.00
Fixed Fire Supp. Sys 50.00
i
Permit Basic Fee 15.00 _ Auto Fire Sprink Sys 25•00
TOTAL PLUMBING $ Ng� 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 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 CHAN ES SHALL BE MADE WITHOUT
MADE WITHOUT FIRST OBTAINING AP P VAL FROM FIRST OBTAINING AP ROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. DEPART T.
X OWNERP� X BY U
DATE
DATE —q l
:
::::.:.:!:o;;;.;:.;::<!..;;;;:::.......:::.!.;;:.•,;`:.............:. ...:.. ..:.......:.......».:...s,.:xt:w:'.:`:i'O:C"toa.;;m:::':i::5::is:;:.;;;;:.n».;;.;;:::.;::.;::.;;;;;:::.;::;:..>::::::.:.i;;:.;:..;:.;::::i:::::.::..;;;:!.;::%:.::ic;:::..;::::::<:;::.:::.::.::::::.....
y M." y�
DEPARTMENTAL REVIEW `
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
Environmental Health:
Building Plan Review
Occupancy Group: Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit �3
Plan Check 5-z
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee
Other
6� Other
Building Valuation: /W 3z-0 TOTAL FEE 42-2
� HOME OF
Town&Country
Suite B s 16521 Highway 99•Lynnwood,WA 98037-3161
POST FRAME BUILDINGS Everett(206)258-4171 Puyallup(206)840-9552
_ Administrative Headquarters(206)743-1555 i
�— aysoHaF FAX(206)742-1691 Toll Free 1-800-824-9552 !1
Contractor's Lic.#TOWNCPF099LT
Quality:Our Future Depends On lt.-
PLl,EEASE CHECK: Site Plan
[HProperty dimensions Wseptic and drainfield C�ccess to proposed building
([�� xlsting buildings Q,Sewer lines of size
Proposed building Setbacks of proposed and lev ss t of property
❑Easements ,existing buildings odies of water
CYMain road with name ❑Floorplan
Job name:
Job Site Address:
Legal Description 54M _`t'u&-`IVyk'�_Mf�kl�. � �tN 3R g r 4
-- 'fi4 Parte� No' 12332- �n � tt�c�pq�
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Owner has verified and approved the location of accessories,orientation of the building to the no d verifies tha terns specified in paragraph
B of the contract are shown on this drawing and vice versa. Customer signature: