HomeMy WebLinkAboutBLD92-0210 PRE-INSPECT - BLD Inspections - 4/29/1992 4� x
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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 by
E DEPT.
date by date by
PLUMBING Attic OTHER
Groundwork date by
date by WALLBOARD NAILING
D.W.V. date by
date by FINAL INSPECTION
Water Line
date by date by date by
BUILDING PERMIT APPLICATION LDRa — c 1 c1
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
L t�t P RMIT NO.
A E MAILADDRESS CITY&STAT ZIP PHONE
OWNER j A ' S' ( y < </ '7
DIRECTIONS ✓ j=sQ i)-t C /f� çaI
TO JOB SITE '3 do /tnt to d ® u t LAI iQç7Z4T 9 ' 2cc" ry ,QI .- it ≤ -h (s'ii be%,,4th ?O7
RCEL ✓ j LEGAL ?ou,vs�. ��a Ne2R `/u1 `� r Ma3oP ( carriP n�h ter rf
NUMBER S `4/3Q DESCR. ,
NAME MAILADDRESS CITY TATE LIC NSENO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASS OF EW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK
DESCRIBE
`c IV c - ..
WORK _ �``- ► �e ccr - � � - ç-
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED 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
TOTAL SQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERS AFFIDAVI CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM E EMPT 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 WHI H 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 THE EWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FR M THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
fr
X OWNER DATE X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES N9
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING LAI WH'ECK----..._,--
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHO ELIRE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED B PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
TOTAL
BY CASH CK MO
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i3ONCRETE 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.
I date by date b date by
PLUMBING y 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