HomeMy WebLinkAboutBLD92-1131 MOBILE - BLD Permit / Conditions - 10/1/1992 Z
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CONCRETE MECHANICAL MOBILE HOME
€=ootings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date FRAMING by date by date by
Walls FIRE DEPT.
date
PLUMBING by date by date OTHER
date by
by
Groundwork Attic
date by
p W WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
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Permit o.BLD
MASON COUNTY
BUILDING PERMIT APPLICATION
use Pnmr
(YlDaLt,
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#1 Owner V A La2r , , Phon # . -e, -
Site Address w
City
St —zip
Directions to Job Site N o n v ti
40 ( !
Owner Mailing Address 1
City t St
Ard A- zip
Lien/Title �
- Address
City-_.- f�:&=66w a St L- 4 -zip iss$Y
#2 Contractor Name
/ v ` `''/e.s G.rc l t i c: Contractor Reg# /-/4.uk
Address °/ 4l0Z f- y /0 Expiration date
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply_ ,_,—, Well-
(If residential, proof of potable water may be required)
#4 Parcel No. L/2 0
Legal Description. M) (-p r= 4r A),F
#5 Building Square Footage: (existing/Proposed)
1st Fl / 2nd Fl I 3rd Fl__. /
Loft �_
Baeemeat_____L_ Deck / #bedro m #ba cros
Garage- f Carport— /r (Circle: Attached or Detached?)
Other_ / I/X "7 0 sq ft my fle
#6 Ilse of building /1`/� r/ ,� Describe work �Z-0
,.
#7 Type of Job: New. Add. Alt, Repair. Demolition_
Woodstove. Re-Roof Bulkhead_,,,_,,, Other'„tom ', - ..
#8 moron ME INFol hrnr'rnrr
Model Year- � '"' oA Model
�_ Make _. � ��
Length_,,, ' Widths_ Serial No. k .
#Bedrooms,; , #Bathrooms
-�.... Type of Heat� M� _
#9 Any water on or adjacent to property: saltwater 1 e
river__
No. Toilets zaa
Vent Systems X 3 . 00
._Bath Basins Bath Tubs Vent Fans 3 .00
Showers No. Boilers/C ressors
Hot Water Ht_ 0-3 HP
—Laundry washer 3-15 HP �
Sinks 15-3 0 HP �2
Floor Drains -`- 30-50 Hp,
P
Laundry Has ins 5 0 + Hp
NO- Air
Dishwasher es Unit
Disposal <= 10000 afla. --7. So
.._...Urinals
_.,_..> 10000 cfm _
-Other Other
Evap Cooler _
Permit Basic Fee —Hoods
TOTAL PLUMBING $ 3 .00 —Fire Suppres sign
—Domes. Inc-4
CO 1. Inc'
Mechanical F1xtUrPs Reloc/Repai
Na Fuel Types Gas Outlets X 2 .00
Furn < 100K BTU ..._.Woodstove sep_ arate
—�-
Furn >• 10 0 K BTU 6.IQ `Other
_ ---...
Furn - Floor 6. 00_ Pe=mit Basic Fe ,n
.Heat 0
Pumps � TOTAL � �,y�,y,Q,Q,�
cz CAL
NOTICE: THIS PERMIT BECOMES NULL AND Vp
A=HORIZBD IS NOT COMMENCED IF WORK OR TRRIICTION
IS SUSPENDED OR ABANDONED FOR A� PERIOD 0p80 DAYS T NSTRU ON OR WORK
IS i® ANYTZM AFTER. wOR.K
OMSUS Aar►VT.T _,
AFF=V=
t CERTIFY THAT t AM EXE V FRM THE Rt4lUpen OF THE COMTRACTURS MIVRATTOM tAN Rol 1s.a t C>;RTTFY T I AN A �nT•Un. MO AN M ARE IM TRF OF YAf>ltMGTTJR MO t CONTRACTOR
n�(u PMIT is t °,o(+ '�au(RE OOK(rs fat uMLL K(aI ato(NAMa� ( T= , uTTlra °f TOE
TItEREYITH. iipT LL S Y( T BE moe HE PEAR is tSSIED AtO ALL yp�p( yOIdC fdt YN(a
Y(TMaIT FIRST aTAtNtMG APPROYAI, FROM C011 TRI�EYtTR, �p WILL sE IH
0� TIIE �ItLOttIR Y(THOYT f C7IAMCES SIIIILL dE MIIOE
aTAINING APPROVAL FNK THE oulLatUG
OVARTNEIIT.
T. OliiQfiR ,�
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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 USE ONLY: Accented by: Dat_:
P Y • •
• Dimensions Flood • •
esi
• • StructuresFences
SetbackslExisti
water Lines Shorelines
Drainage Plan Topography
Septic - rr - Wells
,Proposed Improvements - - u - •
ts
Name of Flanking
of • • • . StreetS'
__MEN ME M MMMEEMM
MMMEII MIEEM rIJ MNEWHI l"MMINIME MEEM
low
Ili:�.;�i/®■Si�L�■i.l�lS��i�i!►�►!���®�E!��!�i�
1
I i i
I _
DEPAR'T:NVIENTAL REVIEW
FOR OFFICE Usm cmmY
Approved Cond Mold
Approval
Plaaaing: �1r�►Ykr,+,�i �' �� I i°.( � .,�,,a Ce,��h
VT
Eaviroamental 8ealth:
Building as Review:
Occupancy Group:_
Fire Marshall:
Other:
FEES
((special Conditions: 11 IlSite Inspection ( II
11
II IlBuilding Permit 1 (�
-q 11 llviolation Fee 1
I II
II 11 11violation Investigation Fee ( p
q Il I
11 II Plan Check
I! HERAL
II !
11 11 II Plumbing Fee ( 1!
11
11 11 IlMechanical Fee i II
II 11 Ilwoodstove Fee ( Il
II II I I
11 11 IlBuiiding St#te.Fee 1 II
((Building valuation: 1
�� _� II II TOTAL I !I
NAME ON PERMIT Ltl fir l P (Lna-/)'JLi,ITE OF PEP,`�1'T
1
PERMIT NUMBER 6L 1 TYPE OF HEAT Cl'
Washington State Energy Code\Ventilation and Indoor Air Quality Code
SET-UP INSPECTION CHECKLIST FOR MODULAR HOUSING
Note: l W 17
This checklist is not comprehensive:other code requirements may apply. This checklist can be
used by local by building departments for modular homes built to the 1991 Washington State
Energy Code (WSEC) and inspected in the factory by the Washington State Department of Labor
and Industries (L&I).
Ground Cover:6 mil, black
Ventilation:Ventilation in crawlspace must be a minimum of one square foot of fr e
ventilation area (without louvers)per three hundred square feet of
crawlspace area, or a passive radon vent pipie must be installed. Nate: UBC
regulations may require more ventilation.
Pipe Insulation:Cold and hot pipes insulated to R-3 in unconditioned areas.
Floor Insulation:No damaged or missing insulation; if floor insulation is done on site,
R-value installed is consistent with NLEA form
Ducts: Where appropriate,crossover ducts are properly joined,sealed,and supp
Duct insulation is in place and in good condition. If duct insulation is
installed on site, insulation value shall be R-8,or according to NLEA form
Marriage Line: Sections are properly aligned,and sealed or gasketed with approp Fate
materials (a non-porous material,such as a foam sill seal) to limit
infiltration.
Attic: Check for batts moved and not replaced during set-up. Loose fill insulation is of
uniform depth. Baffles displaced during set-up or transit are properly reins ed.
Doors. Check doors to ensure that they close and latch properly.
Notice to Local Enforcement Agency Form(NLEA): 7.be NLEA has been reviewed and
the items listed have been inspected.
12/17/91