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Home My WebLink AboutBLD95-1178 - BLD Permit / Conditions - 9/18/1995 :77 > z > > Z) Z 7� Z z ;z z z z ZE 1E 7:7 -7 < n i > -4 f Jii Z z rn x z -rl > 0 C) z --71 > X 00 s � S !Sz � S -,:4 s -s s s s ol :3 CO > < Z z Z :C!l z '37 "It 7L z Ol100- 000 OD z Z _ - > zz S S nS S- CONCRETE MECHANICAL MOBILE HOME Footings-Setback date /67- by ,J ° Ribbons dat by Gas Piping date b Founilation Walls� date by Set Up dat —�_ r y by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING FIRE DEPT. date to d 'q5- by Walls date date by �O- ��" by s%? PLUMBING OTHER Groundwork Attic date by date b D.W.V. WALLBOARD NAILING , date l0 30-9-5— by date , .30" 9 si by G• Water Line FINAL INSPECTION date (j 30 -15 by _,q,44eAr date / .r by. date by 1°'Z 6 �S_ 5 "T z tv 7 -4,::, try T tD, 7, try OD ol :5 zr Z 00 ;4 ND :37 (> M 7--, 7 (D 100- :D 71 op -t Ol OD X�h =7 2 4 Z� hq��) L Permit No. MASO N TY �`► , �bS BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 ner Phone# ite Address Fire District# City St _Zip-q& Directions to Job Site AJ rmi I ri I M 5A0CM6 c Owner Mailing Address A-in C—r t'4L i� -- City St Zip Lien/Title Holder Address City St Zip #2 Contractor Name ��ic - e�eole- COtQ s 7- Contractor Reg# 1)16k r-.o-1 r Address <S� � � b'4- Expiration Date /( / / /- city G. e St eAfA _Zip Phone# 42L:'- #3 If septic is located on project site, include records. Connect to Septic?_,�5_Public Water Supply Well Connect to Sewer System? Name of System (If residential, proof of potable water is required) #� arce No. 2- gal Description , #5 Building Square Fpotage: (existing/proposed) 1 st FI WO/ - 2 n d FI / 3rd FI / Loft / Basement / Deck / #bedrooms / #bathrooms / Garage / Carport / (Circle:Attached or Detached?) Other sq.ft. / #6 Use of building 0,P,JC'f_ Describe work #7 Type of Job: New Add)_Alt Repair tea# a ,. #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year Make Model AUG 10 19% Length Width Serial No. # Bedrooms # Bathrooms Type of Heat 9 � Purchase Price $ i!-A[-T �" 3, i #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Driveways �V Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed Improvements Easements Name of Flanking Street Indicate Directional by (N, S, E, W) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW ram° f. APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW i Plumbing Fixtures ($3 eachl Fee Mechanical Fixtures ($6 each) No. Toilets CIRCLE FUEL TYPE: Gas, Electric, —Bath Basins Hea pump, Other i _Bath Tubs No. Units Fees Showers Furn BTU i —Hot Water Htr Heatpumps k Laundry Washer — Vent Systems I I _Sinks Spot Vent Fans Floor Drains No. Boilers/Compressors P - i Laundry Basins — HP f Dishwasher No. Air Handling Units Disposal cfm# Urinals No. Fire Protection Systems Other Auto. Fire Alarm Sys 50 00 Fixed Fire Supp. Sys 50.00 Permit Basic Fee 15.00 Auto Fire Sprink Sys 25.00 TOTAL PLUMBING $ . Other Gas Outlets Wood, Gas, Pellet Stove NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COM- — MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 15.00 WORK IS SUSPENDED OR ABANDONED FOR A PERIOD TOTAL MECHANICAL $ OF 180 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OF THE ORDINANCE REQUIREMENTS REGU- ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE CONFORMANCE THEREWITH. NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER X BY DATE DATE FOR OFFICIAL USE ONLY:Accepted by: Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: ��(n 8/1b Environmental Health: 'i 1 Building Plan Review 1 i Occupancy Group: Type of Const: Fire Marshal: i� 1 I Other: I Special Conditions: FEES Building Permit a Plan Check Plumbing Fee {' Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other Other Building Valuation: TOTAL FEE