HomeMy WebLinkAboutBLD92-00403 SFR - BLD Application - 5/2/1992 BUILDING PERMIT APPLICATION Z-b+W
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W.CEDAR/P.O.BOX 186 SHELTON,WASHINGTON 98SU
427-9670 DATE ISSUED
I / 6 V& PERMIT NO.
OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE
db Z S
DIRECTIONS 1
TO JOB SITE N (� C"j �� d (- J "
PARCEL LEGAL //�� q
NUMBER 3Z Q 75-(�I£L' DESCR. Lars A a
NAME MAIL ADDRESS CITY&STATE ZIP PHONE LICENSE NM
CONTRACTOR N&R CO %Tale l r
USE OF
BUILDING �5
CLASS OF W ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE E
WORK & 1 0 I L l7 W S
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE L93ZSgFt STORIES Z- SHORELINE❑ CONDITIONING.
BASEMENT SgFt BEDROOMS _ PRIMARY RESk THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS SgFt BATHROOMS { SEASONAL RES.❑ COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
CARPORT- 49- SgFt FIREPLACE IS CARPORT/GARAGE
GARAGE_419' SgFt ATTACHED❑DETACHED❑
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM THE BUIL ING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
XOWNER DATE Z _ ��- X-14 DATE 2-'-I2
FOR OFFICE U E ONLY
DEPARTMENT YES
PPRQVENo DEPARTMENT YES No
BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE MARSHAL BUILDING PERMIT
D.O.T. I I BUILDING I PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
�, JT SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
i STATE BUILDING FEE
APPLICATION ACCEPTED BY PLANS CHECK SY APPROVED FOR ISSUANCE PERMIT VALIDATION
TOTAL
BY CASH CK MO
KASON COUNTY
BUILDING PERMIT APPLICATION
PLEASE PRINT
#1 Owner N► .. Phone2_7=Q„�2 ,
Si to Address—_„E /=:9...,., t_8h. Ci M—SA 1 cA,,...�_._._St�zip?'Rrb S' Y
Owner Address;,i. s. /a hk Ci tYSbc�� _St&&Zip 9 gs�
Lien/Title Holder ,Ai+tE
Address City St._.,_Zip—
Describe Work �c-�w�srec�cT�e��_ - C uJ,w,,,,, )0sA-7
#2 Contractor Xame,'-VALE LW rt-[- Contractor Reg#
Address ration date /
City St zlp Phone yO(I - q 7 in r
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply Well
#4 Parcel No. O - 04 L 7R -A 6C- -�S J.
Legal Description t k 121 r5F 5u /.r'V el-7 `l
#5 Building Square Footage: (exlstd=71proposed)
1st FZ AM/'7I6 2nd FZ gft l4/6 3rd F2 �. Loft /
.Basement _ / Deck ___ Z_4;= Garage / Catport ,1
#bedrooms / 4(Z,i# #bathrooats ZLQ 3
Other sq f t /
#6 Use of building
#7 rae of sjQ, : Vew_,A_ Add 'Al t Repair_ Demolition
Plumbing Only,,,,, Mechanical acay�, Woodstove Re-Roof
Bulkhead_ Other
#8 P, na Fixtures McChaai cal,,Fixtures
No Toilets No. Fuel Types No. Air Uarmdling Units
Bathtubs Furn < 1008 BTU <• 10000 cfm.
Showers Furs >= 100K BTU _„_> 10000 cfm.
Bath basins Furs - Floor Other
Sinks —Heat Pumps _,-,-Evsp Cool ers
Dishwasher —Vent Systems ,Hoods
)Ho t Wa ter Htr Vent Fans —Domes. mein.
Laundry Washer Boilers/Compressors Comml. Incin.
I Floor Drains 0-3 HP Reloc/Repair
_Other 3-15 HP Gas Outlets
15-3 0 HP _.,,,Woods tone
30-50 -HP Other
50 + HP
G a d aT tt.l c�(( l/en�o r`s
#9 MOBILE9= 'Q$►j��
Model Year.. Make Model
Length_ Width - Serial No.
#Bedrooms. #Bathrooms
#10 Any water on or adjacent to property: sal twa ter. lake
river pond_ wetland seasonal runoff
other.
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHT49 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 AN EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT I AN A CURRENTLY REGISTERED CONTRACTOR
CONTRACTORS REGISTRATION LAY RCY 18.27 , AND AN AWARE IN THE STATE OF WISHINGTON AND I AN NAME 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 SMALL BE MADE COMFORNANCE THEREWITN. NO CNANGES SHALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM TIE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
DEPARTMENT. DEPARTMENT.
X OWNER A& Z BY
DATE DATE
Return permit to: Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
FOR OFFICrar. IISR ONLY: `-Accepted by: Date:
DEPAR�'1VIENTA�., 1tEV7EW
FOR OFFICE USS (mmy
Approved CwW Hold
Approval
Planning
Irwr+■r.-■1. Irrr r rl. Irrrr��
.■�I■.� I■�■rarir Irr�..
elrr.l�.11l.r-rr■����i■�.rr1 urrrl I ■ I -■uar .11. r ■1■. r.rri-r+�rr�.-Irrr�
.rr.Iwl■-lo....r■rr�..�.■I.I.ri irrli�Iri- r r. �■.�.■I�.rr.1 �.1■I-.r
lnvixonmental 8eallth:
.■ �rrarrlr ■ ■
II■r.Yi�■.Yr1Y■■I�.� I rrr��r� .
rllra 1 ■ �.■■��. ... ��
Building Plan Aev►iea:
�-.�■r1..lIIlA1-I■..�I�.�L..�rr ���
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�r..�l I ��Il.l.r I 1 ■rrrl■..r.11.r�lr■ r - �� I I
Fire Marshall:
,.rr.
i
Other:
I
MASON COUNTY :.
DEPARTMENT of GENERAL SERVICES
Mason County Bldg.III 426 W.Cedar
P.O.Box 186 Shelton,Washington 98584
(206)427-%70
BUILDING PARKS&RECREATION FAIR/CONVENTION CENTER ADMINISTRATION
April 2, 1993
Jody Lund
221 S. 12th
Shelton, WA 98584 �
RE Building Permit
Dear Jody Lund
Your building permit was put on HOLD by the Environmental Health
Department over four months ago. Our department's policy is to
hold the permit for a four month period before the permit will be
filed in legal pending resubmission from the applicant. Please
indicate your intentions, and mail this form back to our
department.
I will be in within the next two weeks to take
action on my permit.
I wish to cancel my permit.
If our department does not hear from you within two weeks of the
date of this letter, it will be assumed that you wish to cancel
your building permit.
If you have any questions regarding the above information, please
feel free to contact our department at 427-9670 or 1-800-562-5628.
Sincerely,
Mark Tompkins
Environmental Health Specialist
MASON COUNTY
DEPARTMENT of HEALTH SERVICES
Mason County Bldg.111 426 w.Cedar
P.O.Box 186 Shelton,Washington 98584
(206)427-9670- Beltair.275-4467
Seattle:464-6968 -Other: 1-800-562-5628
environmental health personal health water quality
MEMORANDUM
DATE: G f,5
TO:To��
FROM: f laA
RE: ,,; �� �e�M;� PARCEL # 3a{ 30 --7 5- o o t a'o
Your building permit Onot be processed, by Environmental Health until the
following items are completed and turned in.
Application for determination of Water Adequacy.
(Approved sewage system it a d desi�r,.
0 If existing septic system then complete set of septic records including as-
built.
❑ Complete and accurate plot plan.
PLUMBING & MECHANICAL PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W.CEDARIP.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY a STATE ZIP PHONE
L 1 jb Z S w . 8 4 2- - 1
DIRECTIONS
TO JOB SITE TOP ff ILL rj
LEGAL
DESCR. P -_43 1 30 -75- 0 01 $D Lurs A 8 c of 7 15-
CONTRACTOR NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
JVANR La 2-1 JAMA�714r,_1 18's-46 I .
USE OF
kCS I �E_0T1 A L-
BUILDIDING
PLUMBING FIXTURES MECHANICAL FIXTURES
NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE OF FIXTURE FEE
WATER CLOSETS FORCED-AIR/GRAVITY TYPE FURNACE 6.00.
BASINS FLOOR I SUSPENDED FURNACE 6.00
BATH TUBS Z- BOILER/COMPRESSOR 6.00
SHOWERS 'L REPAIR/ALTERATION 6.00
WATER HEATERS REFRIGERATION COMPRESSOR SYSTEM 6.00
AUTO.WASHER Z.r AIR HANDLING UNITS 7.50
SINKS HEAT-PUMPS 6.00
FLOOR DRAINS EACH GAS PIPING SYS.2.00 PER OUTLET
DRINKING FOUNTAINS VENT.FAN SYS.3.00 PER UNIT
LAUNDRY TRAYS Z FIRE SUPPRESSION 5.00
CONNECT TO CITY SEWER WOOD FURNACE 5.00
DISH WASHER
DISPOSAL
URINALS
PERMIT BASIC FEE , 3.00 PERMIT BASIC FEE 10.00
TOTAL TOTAL
SPECIAL CONDITIONS: 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 ANY TIME AFTER WORK IS
COMMENCED.
OWNERS AFFIDAVIT:1 CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF CONTRACTORS AFFIDAVIT: I CERTIFY THAT I AM A CURRENTLY REGISTERED
THE CONTRACT OR REGISTRATION LAW RIM 18.27,AND AM AWARE OF THE MASON CONTRACTOR IN THE STATE OF WASHINGTON AND I AM AWARE OF THE ORDINANCE
COUNTY ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL REQUIREMENTS REGULATING THE WORK FOR WHICH THIS PERMIT IS ISSUED AND ALL
WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
WITHOUT FIRST?qAININ9 APPROVAL DVM TH BUILDING DEPARTMENT. p WITHOUT FIRSWOOVAL FROM THE BUILDING DEPARTMENT.
XOWNER DATE �- 1 Z- XBY DATE
FOR OFFICE US ONLY
APPLICATION ACCEPTED BY PLANS CHECK BY BUILDING GROUP APPROVED FOR ISSUANCE PERMIT VALIDATION
BY CASH CK MO
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Site, Plot Plan, Bldg., Sewage, Water,and Shoreline Planning are
reviewed by one or all of the Permit Center Units for compliance
with code requirements which cover the following items :
• Setback= related to proper tyOnes, easements, rood rights-of-„ray,
parking, levees,dikes and bulkheads.
• SWIdinq separation.
• A review of substandard lots.
• Percent of lot coverage.
• Shoreline.P CANNING • Parking.
• Property accesess.
• Addressing
• IE.P.A.
H
E P • Setbacks from property lines, well,water lines, surface water,
buildings and banks.
q • Eneroachn+ent Of sewage system by building,paving,etc.
. � � . Eseessive slope. .
• "lability of public sewer.
T • Sewage system installation in fill.
H • Sewage system adequacy, proper size,proper performance.
• Properly certified well.
0 C
• Z+Pa'ation behrean buildings and betneen bwWings and
Property Mee Is deternaae fkt protection rega;rments.
B U L I�� is so• a 6r
awl orientation of buildings for solar Osarnptions
•rgy code.
• Man review.
• Auiwir I inspection.
213srComposition Shingles
IS*Felt Underlay 24" Shakes
1/2" COX P. 1. 32/ 16 /a ,` / 30* Felt Interweave
Engineered Trusses 24" O.C. // ��i IXG Skip Sheathing 10" O.C.
. 2 I ,f 2X10 K F T2 2a* O.C.
4; Slope
r.
Vented Blocking
2X8 M.F.st2 24" Q C_ '
R.38 Insutdtion
4 X 10 Headers 06 F. 1
106 Min. ar"Orwah1: +rorto)
T' Malts,Etc.
+r,
M
2 X 10 IB" O.C.(M.F.e2) 303 Plywood Siding
IS Felt
2X4 Pressure Treated Plot Rise 2 X 6 Studs 24" O.C.
w/1/2 A. Botts 6' O.C. Type R•19 Insulation
2Xt0 t6 O.C. 1/2" Gw9
•19 Insulation
rll��rls, GARAGE 6" Finish
It SIP �• la"Mir.
6 wall 4 b&l. 1R 8..,� .a " 12 Grade
a"f �.,.M 4 Rebar ''••
. 18" O.C. Mort.8 Vert. I11
#4 Rebar 4"
2ea. in Foodng�s `'�" = ?: 'N s + s' s �4 + + 6•
of Z N /4►
s
.=PICAL /GROSS SECTION
Seale 1/2"s 1►O"
2' Above my Cant. w/In 16 6" .
[ --'—Root kct.
Call.
16
aiding
..�,._...........,...__....._. d_o"
Fin. FI.
.ode FF=
TYPICAL ELEVATION
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