HomeMy WebLinkAboutMIS99-00173 Pre-Inspection - MIS Permit / Conditions - 4/12/1999 77
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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
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
;ire `TT{ 'f Z 42-�-
FORM MUST BE COMPLETED IN INK S
PLEASE PRESS HARD
�32q Z1 ON C
- / I PERMIT NO.:�
"� SOUNTY MIS
MISCELLANEOUS PERMIT APPLICATION
426 W.Cedar/P.O.Box 186,Shelton,WA 98584
Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968
APPLICA T INFORMATION CONTRACTOR INFORMATION
Owner o, 0, +4 C�, Contractor Name Q"7k a Ito s. l" k
Mailing Address 3 5 95 '5) w !fl Mailing Address PO t3a 1710
City ka l*W*_kd> State W Zip dode 965575 City kke Ae-, State W Zip Code 9652O
Phone(3&o ) 977-5a900ther Ph.( Ph. 3( 6o Other Ph.(�
Lien/Title Holder Nv -.Y Contractor Reg. #
Address Expirations/��
PARCEL INFORMATION-12 digit Tax Parcel No. O 40 /27/ T 2 3 w
Legal Description Se o-�, Z-7 - 2 3 �. 4 Site Address(include street name and city !o
Directions to site: Mt.•c� S• c rn-I
C S..
Will timber be cut and sold in parcel preparation? (Yes/No)
Is your property within 200' of the following: Body of Water(Name) Saltwater
Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or
Bluffs
TYPE OF JOB New Add Alt Repair Other Use of Building
Describe proposed construction
SHORELINE PROJECTS New Replacement Repair Expansion
Bulkhead Material (concrete, rock, wood, etc.) Length Height
A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF PERMIT.
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the
information provided is accurate and grants employees of Mason County access to the above described property and structures for review and
inspection of this project. Acknowledgment of such is by signature below:
OWNER AFFIDAVIT-I certify that I am exempt from the requirements of CONTRACTOR'S AFFIDAVIT-]certify that I am currently registered as a
the Contractor Registration Law RCW 18.27 and am aware of the contractor in the State of Washington and that I am aware of the
ordinance requirements for which this permit is issued and that all work ordinance requirements regulating the work for which this permit is issued
will be done in conformance therewith. No changes shall be made without and all work shall be done in conformance therewith. No changes shall
first obtaining approval. be de withoutrr first
''obtaining approval. c1
X Date W LAJ Date
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date 1 —/J_?S bmittal Amount Due Receipt No. l
DEPARTMENTAL REVIEW APPROVED DENIED CONDITION CODES
Building Department
Occ Grp Type of Const.
Planning Department
Environmental Health Department
Public Works Department
Fire Marshal
Valuation $
FEES
Building Permit Fee Site Inspection
Plan Review Fee Other
UFC Plan Review Fee Other
Violation Fee Pre-Paid at Submittal ( )
fx�,a}���"4> �. j } '� �• wk fi3 .� TOTAL FEES
> ♦ ik fr<o� }ar fS. `S^^^., Jt:•>r+`�NF '�,k C x
��.x�� +. --
. I+'?`',� ...-. ww. :N S > r.�. .''+y",'ix'�'.n'fi}" x •ram..•.....:.
s
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
Mason county Bldg.111426 W.cedar
P.O.Box 186 Shelton,Washtngton 98SU
(UM 427-9670
BUILDING PARKS&RECREATION FAIR/CONVENTION CENTER ADMINISTRATION
M 1 Q 196
TO: 4awa �nlc- 0 -
RE: Permit Number ## rvlt5c�5- o(AS -¢ ( (Ln9L-4- 0`1?J
m rS 9y- My � Otd Iaczd e C(U-01 �f
To Whom It May Concern, erI -)ove
During a recent review of our files, it was determined that your permit
may.meet one of the following criteria:
1 . Permit is expired and needs to be renewed or have a final inspection
2. Due to the type of your permit and scope of work it is possible that
the work has been completed and it needs to be inspected to close
the permit
or
3. The permit is ready to expire and needs to be inspected or an
extension needs to be requested.
Permits are valid for 180 days from the date of issue to the inspection
date and remain valid for 180 days between each required inspection.
If our records are inaccurate and you have had a final inspection, please
send a copy of the signed off permit to this office so that we can update our
cards. If you have not had a final inspection and your permit is expired or will
expire within 30 days, please_ contact this office for a final inspection, update
inspection or extension prior to M' //_/96 to avoid renewal fees.
All permits which are expired or due to expire within the next 30 days will
become null and void if contact is not made with our office.
If you should have any questions regarding permit validity or the purpose
of this notification, please contact the building department for clarification.
Sincerely,
3
Building Department
cc: Property File