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BLD97-1250 RES - BLD Permit / Conditions - 12/16/1997
77 7, Y, :Z Z Z ti 4 x 00 ol C/) 71 cn al 100- 00 00 fw Sz CONCRE4E MECHANICAL ��''� � MOBILE HOME Footings-Setback date ,_ �- �f by0 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 FIRE DEPT. date -to 48 by dateWalls by date by PLUMBING OTHER Groundwork Attic'T2or>f iP- i� r"` .+-u� c�rc.. date by date 2—i 3 `i by .. � D.W.V. WALLBOARD NAILINGNO /3A5;6".0, :57W j Y /?cxyK date . "�� �! by date,j-.;`1$ by 1-4giLi�' Water Line FINAL INSPECTION "A r-7A)i i60 date by date f, _ by date by /2 Z :c -7 71 > 7J > 7r= B —Z IT 00 ol D cf) 77 —12 Sn N) 10 Q- 00 00 -r"-z 71 7n ON C) x 00 ol 00 -0 QOl OD Permit No. MASON COUNTY BUILDING PERMIT APPLICATION lcA�/ b 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 -,Owner �J Q iz L3 E )=A � rC KS Phone#(3) as /-f Z 8 8 Q ,N\Site Address '1`1( K LA, 5 cZa T 771 �� Fire District# 1�o City ���-1 tE 1-'7D A..) St Wf, -Zip - Directions to Job Site �. ��'�(ro«' Az-g_poo2 i Q 4� CAR 1A/ 33171- La AV i�?t►11� ;SST LL'-P-i lb LOSIV C4P Vt t<4GC -zAzaa r+-'t- To Owner Mailing Address City v St wk Zip 9 79717f- Lien/Title Holder '- �� t L S Address 2 S0 7 City c-7-0 01_� St Wyk Zip 17 #2 Contractor Name �i IZECe LOPS �m#Js �L LC 1 M� Contractor Reg#CT4W-L�01gQQP Address 4--- l Z-$ S Ec-T Expiration Date 1 l / t / 97 City '51-I - TVA) St_Ja Zip S� Phone#0(a426•119 y #3 If septic is located on project site, include records. Connect to Septic? ✓ Public Water Supply ✓ Well Conn to Sewer System? Name of System (If. sidential, proof of potable water is required) Q, 12 OUSE_' °� fb U #4 `'�`I?arcel No. Lf�� - Sy - ©D©�2 .�+�'� l3 Lo'Legal Description r5 12. ,e,..� i3 L�'rvr�a.� �r t-�CC� \ r_>3 VoL.cc-1E 1.0 ©c L-6'-f-5 as s 97Ewa RTC Cco2,)5 mr- $1Al"so4-) C0c4sjTy, WA #5 Building Squarefootage: (existing/proposed) 1 st FI- 0 - /% ZOo 2nd FI ►�-� /A 3rd FI Loft_ Basement--U-f 11 ZO O Deck / #bedrooms —O- / Z #bathrooms -O-/ Garage - O- / 3td Carport K) / (Circle:Attached or<etache ) Other J`Au►�Q sq. ft. -0- / ZA 22 #6 Use of buildi Describe work #7 Type of Job: New__\Z_Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year Make Model Length lr Serial No. #Bedrooms # Bathrooms Type of Heat Purchase Price $ #9 Indicate b%�S( i g the applicable source if any water is on or adjacent to subject property: River Pon C eek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other Show following on the site plan F Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Driveways 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 I-c,4 iz t o i '75 -7S, Sca,l� 3 ` I 'F SO.un4 eve e Jk ©,a wolk �dca°IZ�` x I � _ N a 5ervloe5 Kokes APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW l V� Plumbing Fixtures ($3.35 each Fee Mechanical Fixtures ($6.75 each) No. 2. Toilets ~l CIRCLE FUEL TYPE: Gas Electri ` eat um Other ._, `Bath Basins 4 1 � p p 1 Bath Tubs No. Units Fees v�Showers Furn BTU (c _ °? Hot Water Htr Heatpumps t -R 1 _Laundry Washer 4 Vent Systems _Sinks flU�,e Spot Vent Fans-� Floor Drains No. Boilers/Compressors •-V-Laundry Basins — HP ~- Dishwasher No. Air Handling Units -0-Disposal — cfm# -0-Urinals No. Fire Protection Systems - Other Auto. Fire Alarm Sys 50.00 Fixed Fire Supp. Sys 50.00 Permit Basic Fee 16.75 _ Auto Fire Sprink Sys 35.00 TOTAL PLUMBING $ j�7� No. Other _ Gas Outlets Qr (`Woo,/'Gas, Pellet Stove rl(- "-- 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 16.75 WORK IS SUSPENDED OR ABANDONED FOR A PERIOD Z5 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 OFTHE ORDINANCE REQUIREMENTS REGU- ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING' HE WORK FOR WHICH THE PERMIT IS ISSUED MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND AL WORK DONE WILL BE IN CONFORMANCE CONFORMANCE THEREWITH. NO CHANGES SHALL BE THEREV fITH. NO CHANGES SHALL BE MADE WITHOUT MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST C BTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT.Ae X OWNER X BY ,— DATE DATE ` OFFICIAL USE ONLY: Accepted by: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold TEC Approval Planning: ��"'b-v� G,t� . I�-C.r✓4� , Cj,��- bI�i1 Environmental Health: Building Plan Review L crf- s /L —(!—Q1 R..f,;cTrZ Ad b f�n)v� .`V� dC tw.4�o► Z e C 2t sot Gis]L Li .,/a. r Ova In.acn,1-c St4Ae r Occupancy Group: _ Type of Const: v �1 Fire Marshal: Other: Special Conditions: FEES Building Permit 1 lZoo -46= S, 2 00 Plan Check 25-7 Zr Cog+ zzs - 1f4 10 3so Plumbing Fee oa Bs�i- 17.00- 15.50 A96= Mechanical Fee Wood/Gas/Pellet Stove �6 00 Radon Monitor Violation Fee Site Inspection Building State Fee 5, Other Other , Building Valuation: LT:O:T�ALFEE�� f � ��