HomeMy WebLinkAboutBLD94-1275 Cancelled Addition of Storage to Park Model - BLD Permit / Conditions - 11/16/1992 Co O ?b— -v s ``ljjl • .
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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 Attic OTHER
Groundwork 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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!� Pe=i t No. 4
WASON Comm
j - BUILDING PERMIT APPLICATION
PLEASE PRINT C'l C%
_hone# "&:F5e
AT-te Address_ E 132. 0 Lc-a-, oad
City St �-
Directions to Job Site
i
owner Mailing Address .O. �-
City /&,, L Stnz, Zip n S�..')
Lien/Title Solder
Address
City St
Zip__
#2 Contractor Name Contractor Reg#
Address Expiration date
y St Zip _Phone
#3 If septic is located on project site, include records.
Connect to Septic?,__ Public Water Supply__ Well_
(If residential, proof of potable crater may be required)
#4 ce1
Leg31 Description _ Cp 'f /"�o— /�C'�trTi✓�- Lp�4 Cl� p/� A`x'�v�:
Build1 m Square#5
. q exist�q �
1st Fl1�b / Znd Fl 3rd F1. / Loft /
Basement / Deck 1 #bedroa ___,_ *bathrooms_
Garage [0 2 Caxport Ci�4 rcle: Attached or Detached?)
" �' sq tt
#6 Use of buildin
� Describe wvrlt
#7 Type of Job: New_ _ ; Alt Repair,_, Demolitioa
Woodstove Re-Roof Bulkhead_ other
#8
Model Year,•,_,_ Make Model
Length Width
-----.r._ __.____ Serial. Nv.
#Bedrooms. #Bathrooms , Type of Heat
#9 Any water on or adjacent to property: saltwater lake_
river. pond wetland_ seasonal runoff_,
other
Show following on this site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
L
ptic Systems Wells
Proposed Improvements Easements
e of Flanking Street Scale:
Name of Fronting Street Date:
PLICANT TO DRAW SITE PLAN HELD
PLICANT To DRAW TopoGRA,pay pROFILB HEL
-a g as =; -ures ($2 each) gee
Nv•_Toilecs Vent Systems X 3 . 00
_.,,Bach Basins
--- ,Veal Farts X 3 .0()
_,Hach Tubs No boilers/------ CamPre=sors
,Showers 0-3 HP _
_,Hoc Racer Htr
L ..1 Washer 15-30 HP �
—Sizks rtke
- -- 30-50 _;Lp
—�oor D Huss S0 + Hp �,_
--- undz y ins No. air Handling Dom.t
Dishwasher _<= 100aa cfm. 7, 10
,Disposal ,_, 10000 c1m.
_,_.Ur:.aals Other —7. 5Q-
, Other --- Hip Coolers
_Hoods _—
Pe=it Basic Fee 1 .00_ _gam Supnressioa _
TOTAL PLDMBIl+1G $ —Domes. Ines.
Comma . Intro.
Mec-hanT cal FtelQc/Repair
NO. Fuel Types _
_ _ Fixtttr�4 Gas Outlets X 2.00
Woodstove seyarare
_Pura < IOOK BTU �_ Other
F`urm �= 10 0 R BTU �_
____Fttr=t - Floor 6. 00 Permit Basic Fee 10.00
._Heat Pumfls 6.00 TOTAL WSC*.3Aarl=
19 CB: T=s PERMIT BECOMBs NULL AND V0m IF wDRR OR CORSTRu=m
A==P-IZHD IS NOT CO1�2�14 D W-L= ISO DAYS, OR IF CONSTRUCTION OR WORE
IS S=Pmmm OR ABANDONED FM A PERIOD OF 180 DAYS AT ANYTME AFTER, WOVX
IS
OIIi�S AyF=V= AVrJ=Vrr
i CI'.MFT n"T t AM GOMr FM THE J=tn FR+ M Or TM t C MFT TEAT t MI A CR[RBMT RMStTM CaVrRACM
COMACMRS REatstce MM LAW Rear ia.V , AN AN MM 9 is TRH suit of 1M=I M M AMo t Aw AMg of TM
Of TIN + = CCITT MIM UM "wtR1g1Em fa( NII4 CIOtRRMCt{ REOttRBIBtrS REQRtiATtMC THE �[ jolt IAItCR
TIIts OXWOWANX cs c M[ Ago TNO Ant,M 91A of RE g TIE PWIT cs tsattM Am ALL wrc oat WILL gg cn
T�ELI MI. Mq CRAMIF SRAM fE MRtM; MFORONX TRtRS M. 00 MOM MS 9M L RE MAOE
ftaRAtMtMG A OVAL fRQI T1IE Blttlatll6 . UrnO tr F%IW MAINNG APPROVAL FM THE euttagma
f;479
00%RtNW.
x t3Y
RAZE
Ret= pe"d t to: Department of General Semites
426 w. Cedar/P.O. eeac 186, Shelton, wA 98s84 427-9670/1-800-562-5628
FOR OFFTC-AL IISZ MLY: Accepted by: Dace:
DEPARTMENTAL REVIEW
FOB OFFICE U= CmT
PPrewd sand Nola
+poroval
P laaafnq:
Eaviroamental 8ea1,the
B Jq,Pl 8e "�g0r; �
Occupancy Group-
Fire Marshall:
Other:
Ilspecial. Conditions:
II Ilsite Inspecti
II on
! I II
II �
II IlBuilding Permit I
II a Ilviclation Fee I !I
I
II n Iloiolati= Investigation Fee I (�
Il II I I
II II II Plan Check I
It ii ! I
If . _ _ II Plumbing Fee I !I
II
II II IIMechanical Fee I
II If I. � II
II IIWOadstove Fee ( 1
11 If ! I
_ II Ueuilding Stace.Fee I (I
IlHuilding valuacion: II If TOTALI II
MASON COUNTY Permit No.BLD
�
. BUILDING PERMIT APPLICATION
PLaSE PRINT �(� O' l�
#1 Owner IZAI/61L %4 az <_ Phone#
Site Address _ �. ��[� 6egg-
city elwlo>' St 14/4 Zip l,'.S
Directions to Job Site
Owner Mailing Address----
City--AY/ ,d St _ Zip r�s 5 2
Lien/Title Holder lsz.,,�el4s la e/�
Address P4
City Gl!/i: St /NtI Zip
#2 Contractor Name Contractor Reg#
Address Expiration date_
City St Zip Phone
#3 If septic is located on project site, include records.
Connect to Septic? ye5_ Public Water Supply Well
(If residential, proof of potable water may be required)
#4 Parcel No. 5�;. 3.a
Legal Description ?>s T -3a 10li a r
As
#5 Building Square FootageL—(tt��3rd
roposed)
1st F1� _ 2nd Fl Fl / Loft /
Basement / Deck / #bedrooms _ #bathrooms_
Garage / Carport / (Circle: Attached or Detached?)
Other sq ftde C
/
�ct�!��•�C�
#6 Use ofbuilding � � � ��°/eD ribe work _
�/4 '� a
J t3w� `t-
#7 Type of Job: New �L- Add Alt Repair Demolition
Woodstove Re-Roof Bulkhead Other
#8 MOBILE HOME INFORMA_ ION �► /�
Model Year / Make 6fr1u i�'�� Model K. ►".�V�[.� V)Uc�d L
Length= Width/--I- Serial No. &r 3YG.1 5
#Bedrooms / #Bathrooms Type of Heat 6,4 5
#9 Any water on or adjacent to property: saltwater lake
river pond wetland seasonal runoff
other J-Ng"
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 SiAiLking Street - Scale:
Name of Fronting Street Date:
APPLICANT TO DRAW SITE PLAN BELO
APPLICANT TO DRAW TOpOGRApgy PROFILE BELOW
Plumbing Fixtures ($2 each) Egg Fee
No.—LToilets Vent Systems X 3 . 00
Bath Basins Xe
X 3 .00
Bath Tubs ompr sors
_L veers 6 . 00
Hot ter Htr S . OQ
Laundry Sher Sinks �0
Floor Drains �0
Laundry Basins iaq Unit
Dishwasher <= 10000 cfm. 7. 50_
Disposal 10000 cfm. 7. 50
_Urinals Other
Other Evap Coolers
HOods
Permit Basic Fee Fire Suppression
TOTAL PLUMBING owes. Incin.
Co Incin.
Reloc air 6 . 00
Mechanical Fixtu Gas Outle X 2.00
No. Fuel Type Woodstove separate
Furn < OR BTU 6.00 Other
100K BTU 6.00
Floor 6.00 Permit Basic Fee
Heat Pumps 6.00 TOTAL IO;CSAAICAL $
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRIICTION•
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTnE AFTER WORK
IS COMMENCED
OWNERS AFFIDAVIT COP'I'RAGTORs AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY TNAT I AM A CURREMnT REGISTERED CONTRACTOR
CONTRACTOR$ REGISTRATION LAY RCY 18.27 , AM AM AWRE IN THE STATE OF YASMINGTON AND I AN AWARE OF THE
OF THE MASON COUNTY ORDINANCE REOUINOWITS FOR YNICN ORDINANCE REQUMMEHTS REGULATING THE WORK FOR YNICH
TUIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN T1NI PERMIT IS ISSUED AM ALL WORK DONE WILL BE IN
CONFORMANCE TNENEWITN. NO CHANGES SMALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SMALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
DEPARTMENT. , DEPARTMENT.
OWNER Z BY
DATE DATE
Return permit to: Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-900-562-5628
FOR OFFICIAL USE ONLY: Accepted by: Date:
DEPARTNITMAL REVIEW
FOR OFFICE US73 ONLY
Approved Coed Nold
Approval
Planning:
Environmental Health: �O
B ld g Plan Review:
72i
Occupancy Group:
Fire Marshall:
Other:
IlSpecial conditions: I g3ite Inspection
it II �I
II II gBuilding Permit ` I II
II II I� 'I
II II gviolation Fee I g
II
�� II ------
Violation Investigation Fee i II
II it N l
II II gPlan check
If II n l
If
If gPlumbing Fee I g
II n
II II IlMechanical Fee I II
II II N 1 A
Il II IlWoodstcve Fee I II
II II 1 i
I Il gBuilding State Fee I - II
'} if----- 4 1 dbfibl
liBuilding Valuation: TOTALI
L i IL