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HomeMy WebLinkAboutMIS97-0733 FNDTN - MIS Permit / Conditions - 11/20/1997 OQ p a D x n co J O O Q` Z cn n ° p O � = C z Q -� on w � � C- CONCRETE MECHANICAL r— MOBILE HOME Footings-Setback oic irez G• am"✓ -'�'� 'Sdate by Ribbons date "�S '�! 7 by t- Gas Piping date b Foundate dati riW `� 7 date by Set Up by INSULATION date by BG/SLAB Insulation Floors Final date by date b date by y FRAMING Walls FIRE DEPT. date by date b PLUMBING date by OTHER y Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date j �cJ� by, �i date by it � � � � ,� CJ) 0 00 - - ol :3 Z cn N) 10 Q. Can OD 2 :L 77 0 a co ol00 z D :)7 cn 00 100- C) cyl OD Permit No.M,r5`t"7'b7 MASON COUNTY BUILDING PERMIT APPLICATION 6� 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 Owner J f2r t h V.7k-rF rC KS Phone# 3 Z - 8 S 4 4 Site Address4, = o K L_t' S'TrZC-ET Fire District#� City St�.1& zip�l-� Directions to Job Site t ?t ATro 13 sz'Rt 7` Owner Mailing Address C�_ 4�p�c 2,SC)'- City ,v St Wk Zip 'q 797z-t Lien/Title Holder '- _v-' A-'3 [ 2 t c-c S Address 3ov_ S-O City St Zip #2 Contractor Name�L�'Cp l��fC�- GtykYS 1 2,�C T Mc-1 Contractor Reg#GWSLc*o94Q(k Address i-9 2AB HAYS E r=� Expiration Date I 1 / t 10 / City StW a Zi Phone#(3,C.0) 426-)13Z14j #3 If septic is located on project site, include records. Connect to Septic? ✓ Public Water Supply ✓ Well Connect to Sewer System? Name of System (If residential, proof of potable water is required) #4 Parcel No. L[Zook- S7c> - ©DO 12 Legal /Description Low � Po,.7vr�a,J qrC _t a� ks r-'FR1 ; e'A rr R�rc OQ �F DJ o L_tt-tG 1,0 OC ?LA-mI t�aG1S q 77 4.z R�� i2CCo21�S ©� �'f $Dv [0tt#JT'f/ WA #5 Building Square Footage: (existing/proposed) 1st FI - 0 - / 1,Z.00 2nd FI /A 3rd FI / 4 Loft 2.2.5 Basement -O-- /J Z.O O Deck / #bedrooms --O- / 2. #bathrooms_Q-l Garage - O- / 38 Carport ►.) /A (Circle:Attached or< etache ) Other jgu•-i[a sq. ft. --Q / 22 #6 Use of building � L_ Describe work MC ht-6 CT-A,Q2446 E * 5_ c c.t.7 AJ #7 Type of Job: New _Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year N Make Model Length i Serial No. # Bedrooms # Bathrooms Type of Heat Purchase Price$ #9 Indicate b c ViC the applicable source if any water is on or adjacent to subject property: River Pon k Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Driveways I" 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 ��f 1z Boa `r3 `75 Scu.I� �A So.uH4 � O �ouSP tifro " O Teie Ekc. _ a -- SPry ceg KLA 5 reef APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW J�� k I Plumbing Fixtures ($3.35 each) Fee Mechanical Fixtures ($6.75 each) No. 2 Toilets CIRCLE FUEL TYPE: Gas Electri 2 Bath Basins =eatpi,um:p)Other 1 Bath Tubs No. Units Fees (Showers _ Furn BTU i Hot Water Htr 1 Heatpumps 1 Laundry Washer L Vent Systems kSinks (o Spot Vent Fans 'L Floor Drains No. Boilers/Compressors _-[V-Laundry Basins _ HP 1. Dishwasher No. Air Handling Units 70-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 $ No. Other Gas Outlets W�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 16.75 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 1 AM EXEMPT FROM THE REQUIRE- I CERTIF THAT I AM A CURRENTLY REGISTERED MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRA TOR IN THE STATE OF WASHINGTON AND I RCW 18.27, AND AM AWARE OF THE MASON COUNTY AMAWA OFTHE ORDINANCE REQUIREMENTS REGU- ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING TI IE 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 THEREWI H. 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 IEICIAL USE 0NLY:Accepted DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: i Environmental Health: i i d a ! Building Plan Review mid ,kou;� rr,.��..i ESA � zo ti Occupancy Group: Type of Const_zj:N Fire Marshal: 1 Other: Special Conditions: FEES Building Permit f �' Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection i Building State Fee Other Other Building Valuation: TOTAL FEES