The URL can be used to link to this page

Home My WebLink AboutBLD92-0417 MOBILE - BLD Permit / Conditions - 5/26/1992 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SE /ICES 426 W.CEDAR/P.O.BOX 186 SHELTON,WASHI GTON 98584 427 9670 DATE ISSUED PERMIT NO. I[L Z o�f � ZIP PHONE CITY STATE •--0 MAIL ADDRESS NAME �. . ay s4f� OWNER --a0 r'�I'V I V W )0 w �W.e.�-�w�i c� DIRECTIONS (,�� j1' UV-C C., N 1L ® J +9�- t C S o� 7'b TO JOB SITE DfS 1i�n1 wi T r T4_tLi CIF x7" r ?�+ ?t�/L�'` to 'i3 P dF rE1✓t.l +�- y s� i r ,lti v ®s�sAc— s ✓ / U 1-(0;S ice.- T@. `I`� O �=17- '7 LEGAL _ ,,,,� I � PARCEL _ DESCR. T %R PEE LICENSE NO. NUMBER NAME MAIL AD CITY&STATE ZIP DRESS CONTRACTOR USE OF Lk r,3,L £s7ALT`ERATIO�N c BUILDING 5�NMOVE REMOVE CLASS OF NEW )< ADDITION �REPA WORK ✓ DESCRIBE �Tn �' 157 AcL wt 6TCF x", (Pt SET WORK ' SI~PVT c_ S S��/K r,.iSTAI.Cr r i T�F VeA0 r a- L,,A mx PQ w r �- P rfa vF NOTICE NUMBER OF: PLEASE INDICATE: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR AREA: J T .�.SgFt CONDITIONING. li RESIDENCE STORIES SHORELINE 0 B PRIMARY RE9A THIS PERMIT BEC MES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED SUSPENDED OR IS NOT OR WORK IS BASEMENT S qFt EDROOMS I A IN 180 DAYS, OR IF PERIOD OF 80 DAYS CORNY TIME AFTER WORKNSTUCTION is COMMENCED. DECKS �—SgFt BATHROOMS 01 SEASONAL RES.ID ABANDONED FO CARPORT 1 I q0? SgFt FIREPLACE IS CARPORT/GARAGE GARAGE ATTACHED❑DETACHED)k SgFt �SET STIR l CONTRACTC FIS AFFIDAVIT OWNERS AFFIDAVIT R W CH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN RE OF THE MASON COUNTY ORDINANCE WASHINGOTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTSOF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE REGISTRATION LAW RCW 18.27, AND AM AW SUED AND THAT ALL WORK DONE WILL BE WORK ING REQUIREMENTS FOR WHICH THIS PER IN CONFORMANCE THfyREW1T O CHAN ES SHALL BE MADE WITHOUT FIRST CONFORMANCE ROVAL F O THE BUILDING DEPARTMENT. NGES HALL BE MADE WITHOUT FIRST OBTAIN OBTAINING APPRO O E BUILDING D ¢ARTMENT. DATE X OWNER DATE XBY FOR OFFICE USE I. NLY APP vED BUILDING VALUATION APPROVED DEPARTMENT YES NO FEE DEPARTMENT YES No PUBLIC WORKS HEALTH FIRE MARSHAL BUILDING PERMIT PLANNING BUILDIN PLAN CHECK D.O.T. BUILDING GROUP PRE-INSPECTION � �/' SP LCONDITIONS SHORELINE ~ it WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION TOTAL CASH K MO BY MASON COUNTY A BUILDING R E RMIT APPLICATION PLEASE PRINT Via - LKI 3 #1 Owner 304^'1 `�'pf F_ Phone# `f "-00 F33 Site Address + � ��;<r .ter` Ci ty s c 1 c'€`o.-' St Owner Address t' - ;z city � St`�°A Zip Lien Title Holder ws�•� << Address Ci ty St Zip Describe Work Ct4L4, >& 7 C U25- #2 Contractor Name Contractor Reg# Address ;Expiration date / / City St--Zip-.-Phone #3 If septic is located on project site, include records. Connect to Septic? Public Water Spply Well #4 Parcel No. -�-y '7- -�7 Legal Description (Jo 4 d- 2 t"7 Te-3 9 #5 Building Square Footage: (existing/propo �d) 1st F1 2nd F1 / 3rd F1 Loft / Basement / Deck / Garage / Carport / #bedrooms / #bathrooms / Other sq ft / #6 Use of building #7 Type of Job:, New Add Alt Repair Demolition Plumbing Only Mechanical Only Woodstove Re-Roof Bulkhead Other #8 Plumbing Fixtures Mechanical Fixtur No. Toi 1 ets No. Fuel Types No. Air Handling Units Bathtubs Furn < ZOOM BTU <= 10000 cfm. Showers Furn >- 100K BTU > 10000 cfm. Bath basins Furn - Floor Other Sinks Hea t Pumps Evap Coolers Dishwasher Vent Systems Hoods Hot Water Htr Vent Fans Domes. Incin. Laundry Washer Boilers/Compressors Comml . Incin. Floor Drains 0-3 HP Reloc/Repair Other 3-15 HP Gas Outlets I5-30 HP Woodstove 30-50 HP Other 50 + HP #9 MOBILE HOME INFORMATION Model Year Make Model Length Width Serial No. #Bedrooms #Bathrooms #10 Any water on or adjacent to property: sal twa ter lake river pond wetland easonal runoff other ��i■%mimi■uii�■iiiiiii�■iu■iiiii mp�i■iiim■niii�iiiiiiiii�iii�ii�i ��■��■�O�■fin■■��■■■��■�■��■q�■ ■��■�■■■��■n■■■■��■■■��■■fin■ �■tiro■��■■�■■■��■■��■■■■�■��■ ■■�■■■■■��■��■Ott■■■■�■��■�� ■■�■��■u��■��■fin■��■�n�n��■ Show following on the site plan Directions to job site 'Lot Dimensions ••• Zones, �Existing Structures Fences Lines •. Shorelines= I Septic!'Drainage Plan Topography Improvements Easements Name of • • Street of • • Street I I I ■■■■■■■■■■■■■■■■■■■■■■■■■IIOE■■■■OMEN■■■■ 1 NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD`OF 190 DAYS AT ANYTIME AFTER WORK IS COMMENCED OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR CONTRACTORS REGISTRATION LAN RCW 18.27 , AND AM AWARE IN THE STATE OF WASHINGTON AND I AM AWARE OF THE OF THE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH THIS PERMIT IS ISSUED ANO THAT ALL WORK DONE WILL BE IN THE PERMIT IS ISSUED ANO ALL WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER X BY DATE DATE Return permit to: Department of General Services 436 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 FOR OFFICIAL USE ONLY: Accepted by: ✓'f `t 'ar_ , Date: (�7 f. d DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond Hold Approval Planning: Environmental Health: Building Plan Review: Fire Marshall: J i Other: 1 MASON COUNTY DEPARTMENT of GL'NERAL SERVICES Courthouse Annex I + r -_& W. Cedar P.O. Box 186 Shelton, Washington 98584 (206) 427-9670 building environmental health maintenance landfill parks&recreation it/convention center planning sewer&water June 3, 1992 John R. Tupper P.O. Box 24 Shelton, WA 98584 W. Tupper, Your Building Permit for the mobile home is currently being processed, however we cannot include the storage shed and carport/shop. I need for you to fill out the enclosed forms and include two sets of plans for eac structure. If you have any questions please feel free to contact me at 427-9670 extension 352. Sincerely, C � Desi King Building Department Clerk i IS T r 7 /-S