HomeMy WebLinkAboutBLD2000-00147 Final Change of Use-Woodshop to Apt - BLD Permit / Conditions - 5/9/2000 CL
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j CONCAETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbon
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 FIRED PT.
date by date by date i 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 S_ �'_ by date by
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PERMIT NO.: BLCeR
6►SbOW 7
MASON COUNTY 2 ItP
BUILDING 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
APPLICANT INFORMATION CONTRACTOR INFORMA ION
Owner k -'r Contractor Name
Mailing Address Mailing Address
City I State Zip Code City State Zip Code
Phone( ) Other Ph.( ) Ph.( ) Other Ph.L
Lien/Title Holder Contractor Reg. #
Address Expiration
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer
System Name of Sewer System Well W 'ter System Name of
Water System
PARCEL INFORMATION-12 digit Tax Parcel No. 12= /, _/ Fire District
Legal Description
Site Address(Please include street name, street number and city)
Directions to site
Will timber be cut and sold in parcel preparation? (Yes/No) Q
Is your property within 200' of the following: Body of Water (Name) Saltwater
Lake River/Creek Pond Wetland Seasonal Runoff Str am Slopes or
Bluffs
TYPE OF JOB New Add Alt `.Repair Other Use of Building o '
Describe Work
No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor'-7 " nd Floor .
3rd Floor Loft Basement Deck Other sq. ft.
Garage Attached Detached Carport Attached Detach( d
MOBILE HOME INFORMATION-Make Mode! odel Year
Length Width _Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price $ " t;: Replacemen Unit ?(Yes/No)
Installer Name Certification No.
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTIONVUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AF ER THE WORK IS COMMENCED.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent cm owner's behalf,represents that the
information provided is accurate and grants employees of Mason County access to the above described r roperty 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 the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance 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 will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance there ith. No changes shall be made without
approvaj. first obtaining approval.
X x' A e X Date
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date- / Submittal Amount Due ` ` ` r Receipt No.
#DEPARTMENTAL REVIEW APPROVED ;DENIE0 CO DITJON CODES
Building Department M13
Occ Group 3L Type Constr. SN' 3 I5 )Cc?U
Planning Department
Environmental Health Department
Public Works Department
1
Fire Marshal
Valuation $ ( a
.. ....-_.._...._... __ _ _. .. ......... _..... ....... ..
CMES.
Building Permit Fee S Site Inspection u QO
Plan Review Feed ,r UFC Plan Review Fee
Plumbing & Base Fee 60,00 Public Works Review Fee
Mechanical & Base Fee 6 1,o Other
Wood/Gas/Pellet Stove Fee Other j
Violation Fee Z y 5 Pre-Paid at Submittal ( c j �5 )
TOTALFEES /
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PERMIT NO.:
MASON COUNTY
PLUMBING/MECHANICAL 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 64-6968
APPLICANT INFORMATION CONTRACTOR INFORMA ION
Owner Contractor Name
Mailing Address Mailing Address
City State Zip Code City St e Zip Code
Phone( Other Ph.(___) Ph. O her Ph.(_�
Lien/Title Holder Contractor Reg. #
Address Expiration
SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect t Sewer System Name of
ewer System
PARCEL INFORMATION-12 digit Tax Parcel No. / / { Fire District
Legal Description
Site Address(Please include street name, street number and city)
Directions to site
Is your property within 200' of the following: Body of Water (Name) Saltwater
Lake River/Creek Pond Wetland Seasonal Runoff Str am Slopes or
Bluffs
TYPE OF JOB New Add Alt Repair Other Use of Building
Location of Fixtures/Units 1st Floor 2nd Floor Basement Garage Closet
PLUMBING FIXTURES(Show Number of each) 7rna
CAL UNITS uel Type: Electric
Type of Fixture No. of Fixtures Fees Natural Gas Heatpump
Toilets nit o. of Units Fees
Bath Basins
Bath Tubs ps
Showers 35.4° Vent Fans 5�
Water Heater Propane Tank
Laundry Wsher Gas Outlets 5.50
Sinks Wood/Gas/Pellet Stove
Dishwasher Direct Vent? �-'3 5U
Other �,,� Other l,50
Other Other
Base Fee �)O.O0 Base Fee J a. 0
TOTAL PLUMBING -Q.t7C> TOTAL MECHANICAL
'�(5.scv
A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE PE OF FIXTURE/UNIT.
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR.F
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AF ER 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 roperty 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 the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance 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 will be done in requirements regulating the work f r which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance they with. No changes shall be made without
approval. first obtaining approval.
)( Date X Date
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date Submittal Amount Due Receipt No.
RENIEf3 >...
< EPART(t+EE1UT4E REview q TROVEf�. G.,NDi It31V GOfJ S
Building Department
Occ Grou T e Constr.
Planning Department
Other
Other
E
...........................
Per Fee Site Inspection
Plan Review Fee UFC Plan Review Fee
Plumbing&Base Fee Other
Mechanical&Base Fee Other
Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal )
Violation Fee TOTAL FEES