The URL can be used to link to this page

Home My WebLink AboutBLD93-0046 SIDING - BLD Permit / Conditions - 1/15/1993 OQ • o O (j) 0o � - c CN) � o n � O- O1 -i 00 Z m' C r O Orr CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date by 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 .;,. MASON COUNTY BUILDING PERMIT APPLICATION '?!EASE PRINT : #1, Ow er Phone# --I 7(. Si a Address ( N\ City � t,i e J St ti —Di ections to Job Site__ MLL ) ? z PAS c IA A,cE &O -r .__ - - t S i ► �� C CL1C�6�i` Ow er Mailing Address_ M.E . City St Zip Li /Title Holder * ES Address City S t Zip___ ___ #2 Cox tractor Name_- _Contractor Reg# Adc tessExpiration date /_/ _. Cirr St ZipPhone If 3eptic is located on project site, include records. Cot iect to Septic?__ Public Water Supply_____ Well____ (If residential, proof of potable water may be required) 4 Par el No. _Z03 Cam- 1490�i ! Le lecripticnTv- i a kf/z, SE N L-4 VJ of 1 #5 Bui ding S re Footage: (existing/proposed) 1st Fl 2nd Fl / 3rd Fl Loft Bas ment Deck / bedrooms / #bathrooms Gar ge Carport / (Circle: Attached or Detached?) 0th —_ a l%II ' sq #6 Use of building._ n- Describe work 4 #7 Type of Job: New Add Alt Repair Demolition Woc stave Re-Roof Bulkhead Other / MOBE E HMSrNFpRATtON Mode Year Make Model Leng h Width Serial No. "Bed ooms #Bathrooms Type of Heac Any 'ater on or adjacent to property: saltwater____ lake rive pond wetland_______ seasonal runcf: oche Show followiaq on the site plan -� Lot Dinensians Flood Zones Existingr'ictures Fences Structure Setbacks Driveways Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed T ravements Easements Name of �' nr Street Scale: Name ozg Street Date: APPLICANT TO .DRAW SITE PLAN BELOW — APPLICANT TO DRAW TOPOGRAPHY PROFILE BELL --, FOR OFFICE USE ONLY Approv,d Cond Motd Approval Plannin : Enviro arl Eealt : Buildin Plan Review: Occupancy Group: Fire Ma steal: L I Otter: FEES If special onditions: If iiSite Inspection ��J� 11 ii II (I I ►�' J 'I If If IlBuilding Permit I II If II If II II IIViolation Fee I II if it II I ---If If II IIViolation Investigation Fee II if II I II if If II Plan Check I II II II I `-- II II II II Plumbing Fee I II Il II I it If II IIMec:ianical Fee I II II 11 I I If 11 I1Woodstove Fee I II If 11 11— i -;f 11 IiBuilding Stace Fee I&J ) 11 I 11 II aluac on `' II II TOTAL I II ?luR1bi a »ixiures Fee t52 each) F - - -- roc No. Toilets Vent Systaits X 3 . 00 Bath Basins ______ Vent Fans X 3 . 00 i Bath Tubs _ No. Boilers/Compressors Showers 0-3 HP _ 6. 00 Hot Water Htr 3-15 HP 5 . 00 Laundry Washer 15-30 EP A_ S inks _________ 30-5 0. -i2_ Floor Drains 50 Laundry Basins No. Air Handling Unit Dishwasher <- 10000 cfm. 7.50 Disposal _ > 10000 cfm. _0 IIrinals Other Other Evap Coolers Hoods __ Permit Basic Fee 3 . 00 Fire Suppression TOTAL P1,MMING $• Domes . Incin. _____ Comml. Incin. Reloc/Repair 6.00 Mechanical Fixtures Gas Outlets X 2 . 00 No. Fuel Types Woodstove pa rate Furn < LOOK BTU 6 . 00 Other Furn >- LOOK BT ff 6 . 00 _ Furn - Floor 6.00 Permit Basic Fee _,0 . 00 Heat Pumps 6 . 00 TOTAL MECSANICAL $_ 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 ANYTD AFTER WORK IS COMMENCED• r'TTEP.c r.r"FT^.. :Ti';° CONTRACTORS AFFIDAVIT I CERTIFY THAT I AN EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT I AN A CURRENTLY REGISTERED CONTRACTOR CONTRACTORS REGISTRATION UW RCW 18.27 , AUG AM AWARE IN THE STATE OF WASHINGTON AND I AN AWARE OF THE OF THE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH ORDINANCE REQUIREMENTS REGULATING THE WORK FOR UNION 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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING OEPARTMENT. DEPARTMENT. X OWNER X SY _ DATE 1` i OAT_' Return permit to: Department of General Services 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800- 562 -5628 FOR OFFICIAL DSE ONLY: Accepted by: Data :