HomeMy WebLinkAboutBLD94-01169 Final Garage - BLD Permit / Conditions - 9/30/1994 "Y Pe � � � V
MASON COUNTY Qy� \�' � , .
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BUILDING PERMIT APPLICATION (;�
426 W. Cedar/P.O. Box 186,Shelton,WA 98584 427-9670/1-800-562-56�NERAL SERVICES
PLEASE PRINT ter- /
#1 Owner V o6 n t FA11)C&s; �e nil P& Phone# 9, 6 917L 7 V 5/
Site Address /1), Ft. 151 k(,FA 111 AI A A)Q ft R L Fire District#
City B F- L FA I(� St t_zip
Directions to Job Site F4e0A4 STDCK ✓k1ATKl%i I N P&L FA R GO W F5T CA) 300 A&0Q
:1, AA1 LIVE `T'LAAI\) aIGN T ON TO .5A&Jd t4ILL Q'i D . CrO rO7-Y& 'i-010 QF 7-8k
l+IL-L, PAST- 1-bt* -ScHoeL ANh NC-W CHi4RCH <ATt40QQ A80 rr l%m1L*-5 r URN
FIEF?` oN 8rKMfit MNIJO(t RU, TftE Ftpstr co� Toi LJ�IF( ES /tA 1nJk
Owner Mailing Address Pc e)c 26A Q O. :S "0"5rE
City R E L Fib I R St WA . Zip �?. 8 5,
Lien/Title Holder K k 1/COR P 1AQ /GAG EE I N C .
Address P.D, &OX 1(5l q
City TA C 0,A4A LIA . St t J A Zip98Y11-39 q
#2 Contractor Name A)S CO_/_) , /ABC•Contractor Reg# (0- y
Address Lf 19 0 COS/ A IF CIA L Sft Expiration Dated/___6T-
City SA L RM St OR- zip 17JJ& Phone# t-8W-3y Y-28 y3
#3 If septic is located on project site, include records.
Connect to Septic? AO Public Water Supply 1U2 Well d
Connect to Sewer System? IUD Name of System
(If residential, proof of potable water is required)
OF 5/40k ` NO , 450 [AQDI TORS F(i& 353�a�
#4 Parcel No. MD3_- _-'76R 92
Legal Description sNORr P(-AT' OF A P6R1'ION OF /201-el- 112ESZ- QUA7-UR Or -LHE
RgoNo 1EA67�-�SQU�A-T ` F SECrIeA) 30, T0wN5H1P Z3 N0# T7-Hl
#5 Building Square Footage: xistingTproo�et1) `
1st FI / f y y Q 2nd FI 7----- 3rd FI -f Loft T---
Basement Deck #bedrooms #bathrooms --7"
Garage / 1410 Carport ---t—" (Circle:Attached r Detached.
Other sq.ft. ---i—""
j
#6 Use of building GA(Z A G E Describe work
i
#7 Type of Job: New _Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFO ATION
Model Year M e odeI
Length idth erial No.
#Bedrooms #Bath ms Ty a of Heat
Purchase rice$
b
I #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 `
m
{ 4'
i Show foil r2g on the site plan
Lot Dimensions ~ Flood Zones
xstin, , gctur ! 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
1 5Du"r N �
I)CeTH ( pectop-R-N SE PTI c-
S U.A P
PLAAA P
Q
� 3
titou 10 D FAZ
3 .bRA,u F i E D
NEW 3o ic�f8
1. &AfZAG R-
�o�s�
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
HO(AGE A PPDX
Aeouf T4
CANAL
f{eFT0 X
G-ARA G E
100' A1300k ?"iqrp-
CANAL
Plumbing Fixtures ($3 each) Egg Mechanical Fixtures ($6 each)
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
_Bath Basins Heatpump, Other
Bath Tubs No. JLni Fees
Sh ers Furn BTU
_Hot Wate tr _ Heatpumps
_Laundry Wash _ Vent Systems
_Sinks _ Spot Vent Fans
_Floor Drains Ng,,, Boilers/Compressors
_Laundry Basins _ HP
_Dishwasher No. Air Handling Units
_Disposal _ cfm#
_Urinals Ng,, 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 $ Other
Gas Outlets
W d, 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. j
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 CHANGES SHALL BE MADE WITHOUT
MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILWGDRTMENT. DEPARTMENT.
X OWNERX BY
DATE I DATE
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DEPARTMENTAL REVIEW
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FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: 1"
Environmental Health:
Building Plan Review
cD� -
Occupancy Group: Type of Const: —
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit
Plan Check Sy.sV
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building St e F �� s
Other
Other
Building Valuation: / 7 2 J--a "¢ TOTAL FEE 4ftz���� 1
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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
aRAMING by date by date by
Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic 0
date b L
date by h c7+e
D.W.V. WALLBOARD NAILING lv J� y
date by date by
Water Line FINAL INSPECTION
date by date OK c7_3 y 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
aRAMING by date by date by
Walls FIRE DEPT.
date PLUMBING by date by date by
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