HomeMy WebLinkAboutBLD99-0600 shed - BLD Permit / Conditions - 7/22/1999 74
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CONCRETE ^7 0 AAA MECHANICAL MOBILE HOME
Footi s-Se kC date by Ribbons
date — 7 by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
dateteMI by date by date by
`., walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
GroundworkAttic
date date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date C7• ``! by �, _ date by
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PERMIT NO.: BLD (__
MASON COUNTY co
BUILDING PERMIT APPLICATION
426 W.Cedar/P.O.Box 186,Shelton,WA i 98584
Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482 269 Seattle 206 464-6968
APPLICAPY IN�O A ION CONTRACTOR INFORMATION
Owner k Q e/4 Contractor N' m
Mailin Mailing Addr ssCity State 4 Zip Code City State Zip Code
Phone Ot er Ph. / Ph.( Other Ph.( )
Lien/Title Holder /�70 Contractor R g. #
Address a 5' ;► A �G tvi CCU Expiration
vLr�uJ1C , S"4'
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic xisting Septic Connect to Sewer
y system Well Water System Name of
WaterSystem—"a
PARCEL INFORMATION-12 digit Ta Parcel No. / f, / do ire District
Legal Description C 6�
Site Address(Please includes eet name, str et numb r aQg city) i
Dir tion cp site G /c��J / na
i 4T cue '
Will timber be cut a d sold in parcel preparation? ( es/No) Rom f
Is your property within 200' of the following: Body of Water(Name)' �41SOA'^9 t 4 Saltwater
Lake River/Creek Pond Wetland Seasonal Ru off Stream opes or
Bluffs
TYPE OF JOB New Add Alt Repair Other Us of Building
Describe Work NC e G S A Q
No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st 9oor 2nd Floor
3rd Floor Loft Basement Deck Other sq. ft. H
Garage Attached Detached Carport Attach d Detached
MOBILE HOME INFORMATION-Make Model Model Year.
Length Width Serial No. No. f Bedrooms No. of Bathrooms
Type of Heat Purchase Price $ Replacement Unit ?(Yes No)
Installer Name Certifications No.
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WI HIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's be ialf,represents that the
information provided is accurate and grants employees of Mason County access to the above described property and s ructures for review and
inspection of this project. Acknowledgment of such is by signature below:
OWNER AFFIDAVIT-]certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I 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 per it is issued and all work
conformance therewit c ges shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without
appiroval. t first obtaining a proval.
X / Date X Date
FOR OFF CI L USE BEYOND THIS PPIIINT {._
Accepted b Date Submittal Amount Due `'EtJ. Rec�i t No. J�
P y P
DEPARTMENTAL R.E:'SEW. APP V pITNIED CONDITION C; pES
Building Department it
Occ Group Type Constr. �(wl /
Planning Department
Environmental Health Department
Public Works Department
j
Fire Marshal
Valuation $
FEES
„. .
Building Permit Fee �7 / S Site Inspection
Plan Review Fee -s UFC Plan Rev'ew Fee
Plumbing & Base Fee Public Works view Fee
Mechanical & Base Fee Other / ;� O
Wood/Gas/Pellet Stove Fee Other
Violation Fee Pre-Paid at Su ittal ( )
TOTAL FEES
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