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Home My WebLink AboutMIS97-0312 REROOF - MIS Permit / Conditions - 5/29/1997 Z Z m 0 co OD 0 0- Z :Y ,< + 00 n 4: Q ® cn :)7 0, 0 D (D 10 00 Ol 00 CONCRETE MECHANICAL MOBILE HOME Footings-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 by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING Attic OTHER Groundwork date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by OD ol N) 10 Q- 00 C;l 00 T -c I ® Q _ o r t o V 11Jfff 0�0� o Cl) z cn � Q OD i 1 MIS 0031 a MASON COUNTY MISCELLANEOUS PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584. 427-9670 PLEASE PRINT #1 Owner a� G'urt T-lti UJ b o'& z. Phone �_9 (40 _Fire District# Site Address g q© City Mail Address [ N = StL City StW IP Zip_ i Applicant Phone# Applicant Address City St Zip Directions to Site: r t r o rT f f Of #2 Parcel No. 4 2 d l a- - 0 - O OO C) Legal Description e =S o Tr a cT o� #3 Indicate by circling the applicable source if any water is on or adjacent to the property site: saltwater lake river creek stream pond wetland seasonal runoff marsh other #4 Project Start Date (9 `j'`�� Project Completion Date #5 Use of BuildiingG', n D�cribe proposed construction 'Depending upon the type of permit,a floor plan and plot plan may be required. 'This permit is valid for 180 days from the date of issuance. OWNERS AFFIDAVIT CONTRAC ORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY HAT I AM A CURRENTLY REGISTERED CON- MENTS OF THE CONTRACTORS REGISTRATION LAW TRACTOR'' N THE STATE OF WASHINGTON AND I AM RCW 18.27, AND AM AWARE OF THE MASON COUNTY AWARE O THE ORDINANCE REQUIREMENTS REGULAT- ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT ING THE WORK FOR WHICH THE PERMIT IS ISSUED AND IS ISSUED AND THAT ALL WORK DONE WILL BE IN CON- ALL WORK DONE WILL BE IN CONFORMANCE THERE- FORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITH. NO CHANGES SHALL BE MADE WITHOUT FIRST WITHOUT FIRSTOBTAINING APPROVAL FROM THE BUILD- OBTAINING APPROVAL FROM THE BUILDING DEPART- ING DEPARTMENT. MENT. X OWNER X BY DATE DATE i Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Wells Water Lines Shorelines Drainage Plan Easements Septic Systems Name of Fronting Street Indicate directional by Proposed Improvements Name of Flanking Street N, S, E, W etc. PLOT PLAN AREA i i CQa QF'FICIAL USE ONLY:Accep#ed by: D DEPARTMENTAL REVIEW FOR OFFICIAL USE ONLY Planning APP COND APP HOLD Building Fire Marshal Other Special Conditions Fees Permit Fee $ Plan Check Other Other State Building Fee TOTAL DUE $