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BLD92-1566 MOBILE - BLD Permit / Conditions - 1/25/1993
i 0 xn JMM O O W '^ J ^ co ti Z co-� �m G r �J I X -i t h _ � U r: CONCRETE MECHANICAL Footings-Setback MOBILE HOME date date by Ribbons by Gas Piping Foundation Walls date � �r/ .2-3 �� b t date by date by Set Up t BG/SLAB Insulation INSULATION date ` by date by Floors Final FRAMING date by date by date by Walls FIRE DEPT. PLUMBING date by date by Groundwork Attic OTHER date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by u� - m X Z 4i Y•S flY "71� _- O s� to u� O O © O i C-0 � E33 •c rr Y. o s rt:n 3 k F- O Y•t- r Cfl - 9) rt 111 U) Y' Ci 01 - i rtc :5 om Sat p O C 3 :3 S O c- — rt { r ur I H-O -s rt 1 3 Z m O = O � � IIS ctS :3 rt 00 Y•S [-t fi 3 O k S C Z 0 O N 00 N O -h 0) - O -h 0 -S (� C C- p Ln 7 N O X rt CO � fII N °' Y• z rt-7 rt� :D o- S C f) -+ Eti rt O (D : O S C: Z (D Co _ p Q O Z W "O U3 - O 3 -s o - C _ -s F- � ° S � 5 � ° 3 � -'O H. -tt 3 �, 0 t3 � O � Q ti S II (D 'o 1.L ^ rt-A 3 0c) Q O Ui :1 00 {--• O 0- Q H. � :3 C M CSO [� Os . CET rt Y. -n a' Z f0 W r Permit No.BLD MASON COUNTY BUILDING PERMIT APPLICATION PLEASE PRINT #1 Owner LA - .3-U ArJ N I L3OU(� Phone# Site Address �e" City State GJ Zip Directions t Job Site `� Owner Mailing Address Cit State 7 Zip 9rJ Lien/Title Holder Address O' City . State t G Zip #2 Contractor Name ,rr, Contractor Reg # F� C 2Z 7 iP,1 _ Address Sl eO 6q7,4SW 44 RD Expiration Date City _S ��. J\Z State O)O'} Zip qqS Phone.. 4; -5ROZ 4 #3 If septic is located on project site, include records. Connect to Septic? Public Water Supply Well (If residential, p. of of potable water may be require" . ) #4 Parcel No. y - - Legal Description LG7` A9 S Y pt--9 D.,-'' /10 • ;?, LI,5 #5 Building Square Footage: (existing/proposed) 1st Fl 66 ` 1 ^ 2nd F1 3rd Fl /— Loft / Basement / Deck / #Bedrooms 3 / #Bathrooms ,') / Garage / Carport / (Circle: Attached or Detached?) Other sq f t / #6 Use of building Describe work #7 Type of Job: New Add Alt Repair Demolition Woodstove Re-roof Bulkhead Other #8 Mobile Home Information -� Model Year ;�Make D bERT H-AHOR Model Length (-do Width r�)L' R Serial No. CA—) #Bedrooms �3 #Bathrooms f Type of Heat a(-Pt t,ri c #9 Any water on or adjacent to property: Saltwater-�Lj River Pond Wetland Seasonal runoff Other I�t r Show following an th itn Lot Dimensions Flood Zones Existing Structures Structure Setbacks Fences Water Lines Driveways Drainage Plan Shorelines Septic System TOP°graphy Pro ased Wells P Improvements Easements Name of Flanking Street Name of Fronting Street Scales. Date APPLICANT TO DRAW SITE PLAN BELOW a APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures ($2.00 each) Fee: No. Boilers/Compressor Fees: No. Toilets 0-3 HP 6.00 Bath Basins 3-15 HP 6.00 Bath Tubs 15-30 HP 6.00 Showers 30-50 HP 6.00 Hot Water Htr 50 + HP 6.00 Laundry Washer Sinks No. Air Handling Unit Floor Drat s <= 10, 000 cfm. 7.50 Laundry Basin > 10, 000 cfm. 7.50 Dishwasher Disposal Other Urinals Evap Coolers Other ` Hoods Fire Suppression Permit Basic Fee 3. Domes. Incin. i TOTAL PLUMBING $ Comml. Incin. ! Reloc/Repair 6.00 Mechanical Fixtures Gas Outlets x 2.00 No. Fuel Types Woodstove separate Furn < 100R BTU 6.00 Other Furn >= 100K BTU 6.00 Furn - Floor 6.00 Permit Basic Fee 10.00 Heat Pumps 6.00 TOTAL MECHANICAL $ Vent System x 3 .00 Vent Fans x 3.00 NOTICE: THIS PERIUT: BECOMES NULL AND VOID IF WORK OR. CONSTRUCTION AUTHORIZED IS NOT COMMENCED'WITHIN 180 DAYS,, OR IF CONSTRUCTION. O&.-.WORR...IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180. DAYS AT ANYTIME AFTER.WORKis : .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 in contractors registration law RCW 18.27 , and am the State of Washington and I am aware of the aware of the Mason County Ordinance requirements for ordinance requirements regulating the work for which which this permit is issued and that all work done will the permit is issued and all work done will be in be in conformance therewith. No changes shall be conformance therewith. No changes shall be made made without ffm obtaining approval from the Building without first obtaining approval from the Building Departmenk! Department. X OWNE X BY OAT -_1_17 f,-5 ' DATE Return permit to: Department of General Services 426 W. Cedar Street/P.O. Box 186 Shelton, WA 98584 427-9670/1-800-562-5638 �J C� FOR OFFICIAL USE ONLY: Accepted by: p Date- �L> . DEPAPZMENTA,L REVIEW FOR OFFICE USE ONLY A"-.W C.-L Ewa Planning; Environmental Health: ' �i Building Plan Review: Occupancy Group: Fire Marshall: Other: a FEES Special Conditions: ^� ® Site inspection n � r Buildin C�5 Permit (� , � Violation Fee I Violation Investigation Fee Plan Check � � / II Plumbing Fee Mechanical Fee Woodstove Fee Building State Fee ✓� Building Valuation: TOTAL