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HomeMy WebLinkAboutBLD93-0619 Final Shed - BLD Permit / Conditions - 9/14/1993 � R o b Permit No&0q, 0V( 1 �' ' MASON COUNTY BUILDING PERMIT APPLICATION PLEASE PRINT .} #1 Owner ffi/i C G Us�i�rl� J724,,7/GU Phone# 7 Sa 33 Site Addre�s ►1 df31 wet , - ��zai��cxt Fire District # City Door or' St /� lvb Zip a< Directions to Job Site ID,`v fo ��j�� SyaQ T�>�C cLF- 0-c 0 A 5AE Owner Mailing Address City St Zip Lien/Title Holder S"a'wc Address City St 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? A a Public Water Supply Well (If residential, proof of potable water is required) #4 Parcel No. Legal Description .Z,,7 /c�/�t"'�� 5 .Sy��9S�C 9 7� �5/�'.r �� /l/� ns� qZ/ #5 Building Square Footage: 1st F1 2nd Fl 3rd F1 Loft Basement Deck #bedrooms #bathrooms Garage=--;4 Carport Garage/Ca ort: Attached or Detached Other #6 Use of building ��rfi �z�r Describe work #7 Type of Job: New �f Add Alt Repair Demolition Re-Roof Bulkhead Other #S MOBILE HOME INFORMATION Model Year Make Model Length Width Serial No. #Bedrooms #Bathrooms Type of Heat #9 Any water on or adjacent to property: saltwater lake river pond wetland 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 Name of Flanking Street Scale: Name of Fronting Street Date: O Orr✓ APPLICANT TO DRAW SITE PLAN BELOW-- 0 6"ND b'' /JAW A, i I t � f I -1 t� APPLICANT TO DRAW TOPOGRAPHY PROFILE BELO Plumbing Fixtures Fee Mechanical Fixtures No. Toilets Primary Heat Source (Circle type) Bath Basins Elect/heatpump/other Bath Tubs Showers �- Hot Water Htr Furn Laundry Washer Heat Pumps Sinks Vent Sys (Central) Floor Drains Vent Fans (Spot/Whole) Laundry Basins Boilers/Compressors Dishwasher HP Disposal Air Handling Unit Urinals cfm. 0 t h e r Fire Protection Systems Permit Basic Fee TOTAL PLUMBING $ Other Gas Outlets.Hookups Wood/Pellet/Gas Stove Other Permit Basic Fee TOTAL MECHANICAL $ NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT i AM A CURRENTLY REGISTERED CONTRACTOR CONTRACTORS REGISTRATION LAW RCW 18.27 , AND AM AWARE IN THE STATE OF WASHINGTON AND i AM AWARE OF THE OF THE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER X BY DATE DATE Return permit to: Department of General Services 426 W. Cedar/P.O. Box 186, Shelton, IPA 98584 427-9670/1-800-562-5628 FOR 0t8tCIL 'QSg ONLY; AcepteY« <I:at .. DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond Hold Approval Planning: Environmental Health: No c-,.a Qk11 l << r Building Plan Review: Occupancy Group: Fire Marshal: Other: FEES IlSpecial Conditions: I1 1lsite Inspection I 11 11 H II J II IlBuilding Permit I II II II I'. —�I 11 11 Violation Fee II II I I 11 11 11Violation Investigation Fee 1 II II 11 1 iI II 11 I Plan Check 11 I 11 II Plumbing Fee I II II 11 1' 'i II 11 11Mechanical Fee 1 11 II 11 1 1 11 11 11Woodstove Fee 1 11 II 11 1' 'I II 11 IlBuilding State Fee I •S �( 11Building Valuation: - © 11 11 TOTA'� II m o r 75 r � ^ o cf) x o ° � z � = C Q N z D °CC• CQ C - - O (� CD 10 Q_ 00 CYI Q 00 .p x CONCRETE �� MECHANICAL MOBILE HOME Footings Setb k ( �<� date by Ribbons V ,/) date '� by M / L �— 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 dat� �� C ��' date by