HomeMy WebLinkAboutBLD92-1107 REROOF - BLD Permit / Conditions - 9/18/1992 OD
(>
(D pp
O Cl
� CQ
Q N
on
cD
�o Q
000
C �
Oo
z
c
to
a
o
Z
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 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
Pe=it Nc .3-LZ
MASON COUNT':
BUILDING PERMIT APPLICATION
PLEASE PRINT
#I Owner 4, l�ys C l= >� Phan #
Site Address U UjccdL /c'
City =L` St
Dir ons to Job Site /�Y S 6 hl TL a <�i NC
�,
Owner Mailing Address ,P
Cit - &,7-e A St Zip
Lien/Title Holder
Address
City �— St Zip
#2 Contractor Name ORR/.S /9a Q Contractor Reg#
Address Expiration date 1 /
City St Zip Phone
#3 If septic is located on project site, ' clude records.
Connect to Septic? Public Water upply Well
(If residential, proof of potable water may be required)
#4 Parcel No.�f; �
Legal Description
#5 Building Square Footage: (existing/proposed)
1st F1 / 2nd Fl / 3rd FL Loft /
Basement / Deck ' / #bedr oms,1_ #bathrooms_
Garage / Carport / (Circle: Attached or Detached?)
Other sq ft
#6 Use of building De cribe work
#7 Type of Job: New Alt Repair Demolition
Woodstove Re-Roof Bulkhead Other
#8 MOBILE HOME INFORMATION
Model Year Make Model
Length_ Width Serial No.
#Bedrooms #Bathrooms Type of Heat
#9 Any water on or adjacent to property: altwater_ lake
river pond wetland_ seasonal runoff
other
F
following oa the sate playimensions Flood Zonesing Structures Fences
Structure Setbacks Driveways
water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements
Name of Flanking Street Scale:
Name of Fronting Street Date:
APPLICANT TO DRAW SIT, PLAN BELOW
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW:
? ,.nbinQ ixturgs ($2 each) Fee -on
No Toilets Vent sv3t:eMs :� 3 . 00
Bath Basins vent Fans X 3 . 00
Bath Tubs No. Boilers/Compressors
Showers 0-3 HP 6 . 00
?act Water Kt:* 3-15 HP 5. 00
Laundry Washer 15-30 HP 6 . 00
Sinks 30-50 HP 6 . 00
Floor Drains 50 + HP 5 . 00
Laundry Basins N . Air Handling Unit
Dishwasher <- 10000 cfm. 7 . 50
Disposal > 10000 cfm. 7 . 50
Urinals Other
Other Evap Coolers
Hoods
Permit Basic Fee 3 . 00 Fire Suppression
TOTAL PLUMBING $ Domes. Incin.
Comml . Incin.
Reloc/Repair 6 . 00
Mechanical Fixtures Gas Outlets X 2.00
No. Fuel Types Woodstove gegarate
Furn < 100K BTU 6. 00 Other
Furs >a 100K BTU 6 . 00
Furs - Floor 6. 00 Permit Basic Fee 10 . 00
Heat Pumps 6. 00 TOTAL MECHANICAL
NOTICE: THIS PERMIT BECOMES NULL, AND VOM IF WORE OR CONSTRUCTION-
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 18 DAYS AT ANY71M AFTER WORK
IS COMMENCED
oWNMZS AFF=VIT CON= =P-S AFFmnvrr
I CERTIFY THAT I AN EXE14PT FROM THE REQUIREMENTS OF THE I CERTi THAT 1 AN A CURRENTLY REGISTERED CONTRACTOR
CONTRACTORS REGISTRATION LAW RCW ia.ZT , AND AN AWARE IN THE STATE OF WASHINGTON ANO I AN AWARE OF THE
Of THE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH ORDINAN REQUIREMENTS REGULATING THE WORK FOR WHICH
THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN THE IT IS ISSUED AND ALL WORK OONE WILL BE IN
CONFORMANCE THEREWITH. NO CHANGES SHALL BE MAOE MMFORNANQ THEREWITH. NO CHANGES SHALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
DEPARTMENT. DEPAR T.
x ownil a BY _
DATE DATE
Return Permit to: De artment of General SeYvices
P P
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
FOR OFFICIAL USE ONLY: Accepted by: Date:
DEPARTNMINTAL REVIEW
FOR OFFIC'S IISE ONLY
—'T
Approved Cond Moid
Approval
Planning:
Environmental Health:
Building Plan Review:
Occupancy Group:
Fire Marshall:
Other:
((Special Conditions: FEED
I( 11Site Inspection --- --�
( 11 IlBuilding Permit
II
11 ((violation Fee ( II
i( II I I
ll it IlViolation Investigation Feel ((
II II I I
Il 11 IlPlan Check ( u
11 I
Il 11 II Plumbing Fee
11 IF—
II 1I IlMechanical Fee ( (�
II Il I I
Il 11 Ilwoodstove Fee I q
I( (1 I (
1 11 IlBuiiding State Fee ( Il
IIHui lding valuation: Il Il TOTAL I If
L'—_