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Home My WebLink AboutBLD93-1577 - BLD Permit / Conditions - 10/18/1993 I _ ,, NN o ° 00 O of z o � O C 10 Q 0 � cyl � r CON BETE_ MECHANICAL MOBILE HOME Footings etback r� tt _ date by Ribbons date :Y 7 Gas Piping date b Foun ion date by Set Up date C by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING �p ,� FIRE DEPT. date f6 7 47.E I�� dates by date by PLUMBINGOTHER Groundwork Attic � date byn� �"iC1r 70 date by date V o� by WALLBOARD NAILING r,7�fQ17�C'► date by / Water Line FINAL INSPECTION date g by date ,9, by date by 40 OQ O x ^ O00 O ol z Q � z --� 10Q 000 Ol 00 MASON COUNTY - �5 BUILDING PERMIT APPLICATI sEP o t993 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-8(6_L5At SERVICES PLEASE PRINT #1 Owner Kirk Petersen Phone# 206-426-3082 Site Address w Dnyf on Trai 1 s Dr Fire District# City Shelton, Washington St Zip 98584 Directions to Job Site Denton Trails , ton of hi 11 turn left second lot on right Next door to Neals Owner Mailing Address Kirk Petersen , W. 6651 Shelton f a'c1ock Rd. City Shelton Washington 98584 St Zip Lien/Title Holder Kirk Petersen Address W. 6651 Shelton Matlock Rd. City Shelton Washington 98584 St Zip #2 Contractor Name PETERSEN CONSTRUCTION COMPANY Contractor Reg# PFTFRC:C:1 65R8 Address W 6651 Shelton Matlock Rd Expiration Date_12 / 1 7 /9_ City Shelton Washington St Zip 98584 Phone # ?.Dh-4?.h-3C_82 #3 If septic is located on project site, include records. Connect to Septic?___X__Public Water Supply_X_Well Connect to Sewer System? Name of System (If residential, proof of potable water is required) #4 Parcel No.\/ 2 8 - 7 8 q Legal Description VaAc 2 : Algid ' or s fi n . 5 6 T /l�c� ' of 50n t5/100 i►2 I FS-� #5 Building Square Footage: (existing/proposed) o- 1 st FI 9 n 42 / 2nd FI / 3rd FI / Loft / Basement / Deck 1 50 / #bedrooms 3 / #bathrooms 9. Garage 5 7 2. / Carport / (Circle:Attached or Detached?) Other sq. ft. / #6 Use of building single family resi dencP Describe work Npw C;nngtriirti nn #7 Type of Job: New New Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year Make Model Length Width Serial No. #Bedrooms # Bathrooms Type of Heat Purchase Price$ #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 none Show following on the site plan i Lot Dimensions Flood Zones Existing Structures Fences E �� Structure Setbacks Driveways Water Lines Shorelines Drainage Plan Topography Septic Systems Wells s Proposed Improvements Easements Indicate Directional b N, S, E, W) Name of Flanking Street y Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW i 1 �I �I 1 1 h SI d6G rvrP I I�V SET8�4cfZ s_� i s,t� M W Dr- +ox ray 15 U ,ve C'A� dutF� APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW F7Ir vV.t- r �Fo�sG 3 Ls voOTt Z� 5 ' 1�4 , Vt C-W RoaQ � 0 a3d r of- Plumbing Fixtures ($3 each) FQ& Mechanical Fixtures ($6 each) No. Toilets CIRCLE FUEL TYPE: Gas, Electric, Bath Basins Heatpump, Other heat pump 2 Bath Tubs No. Uni s Fees 1Showers _ Furn BTU 1Hot Water Htr I Heatpumps 1 Laundry Washer 1 Vent Systems Sinks / 4 Spot Vent Fans Floor Drains No. Boilers/Compressors '114 1 Laundry Basins HP (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 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 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 DEPA TMEN�. DEPARTMENT. X OWNER 4._ X BY r . DATE _�C C DATE : -- - _ C3 FOR OFFICIAL USE ONLY:Accepted by: ! Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: Vei .G f e f A' Building Plan Review 4> � Occupancy Group: Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit Plan Check r Plumbing Fee Mechanical Fee t Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee .� Other Other Building Valuation: TOTAL FEE ?, 93-0445 Sure= GQOd CzIItS HC -C�n TE : DOUG HALL ?LCNr: 427-9601 S- A=:DF...ESS = DAYTON TRAILS ACC-- - 1-T=:.C`+G ,D c?.SS: P.-O. BOX 357 SHELTON, WA. 98584 3U=LI)E PETERSON CONST. 426-7205 A.:::: 12- SS: W. 6651 SHELTON MATLOCK RD. t=e a=c'''_ad`=ess to be e == and ca--:' heated bc:ae_ lcca - .�� c,:P- G^CD c arc_ ._cL caa__s _ - v C_ T:' i?C^e aL'S' 2 IIS - -"- ..�.iTG �7as::iIIC ^vn _ i S - e=gv Ccde, attachecJw =� n ccm=" _a=ce w_ actsu_ =eat loss a-d Lcag Te--- Suee_ Gccd Cent; addend'.:m/s:eci=_cations . - C u de=stand t=at � IIs�ectic= :v r_ -- ict sta is =ec'�i=ed at = o the �c?_cw_mc s`aces : `-- eac- ?=_c= co=c==_ce 2__c= tJ iIIst=?1` IIc e tte=ic= insul . .e_Cw C=ade has a-me c wa'_?S = ram-., da.'^.aD _=CC= t e is ==amed roc. is IIs aIId all g�e �c_=-gc w --IIg, teleucoLe aIId ?^� cab?e a x - - ns a_e sea_edj . - = COVe=_ '` -- -- su-at_Cn a d Va_o= =qta `e= bL- _g. . X V final ins^ec�_cn - all ccrz=onem�s _=S-al_ed. X Cte= AS NEEDED. ccTE:m lecec-�_- ins�eeby cu_ Sine= GcccCents De^a= enC of : the IIILS=�bec :t is L'z _St t-at the 1 e cc Su e= G�cd Cents Deca=�reIIt is to be aoti=iec at 426-0777 C= -Q��- -- =e _s e - S:s�. 7 , , nct less than ' 3 hcu o= =e�ua c i c`_c s . `` =s :_= tc CoL'IItV =L'__`C `L C_l_�=CDT _CtLt- GCOdT Ce-tS CeCII� _C3tiCC b� masc- LOnc Te=I^ ,'-tee- G�:CCJC�CtS -�C_�_ r_OIIr�% Ve-=--as COm-oliaIICe ;:�t yt e en v =_`c= _ s a--da=_sad oz! -g c--- - - Ne_t=e= c e no= �..; ecn wa==ant_v, exc_ -essed or iaz e i - anv e �_-ogees ;sake a=v - t-`tio__ C , n gam CO the Gene=al wCrzraIIS`�' a �C_ - ---- C- Le =e5_C?_Ce CL ti - consu,�apt_c=- e I, ; the uvc =s_c_Ld, u=derstaad that i` the hqe is buy th_s ag_ e...ea-, `fie attached s-CeC___cat_oLs, de =, �_t acco_d_mg to addeadu3, and is ce_ti_ied by -' t-_led chec�Clists, and t e DiSt=ict re�=esentative that T will be eligible tJ receive Te. show or_ 'IC*_-_-_ a`- ,.„� Lent _... Svc incent_ve �av-aent(s) is the a Lcun-ac.___ wo_ks ee�_ - 4 I further understand that it is my responsibility to be aware and adhere to the Long Term Super Good Cents s-ecificatioas. Only upon verified comr_ letioa by the oa—site iaspecthons listed in this agreement of all the attached criteria by the Mason County Public Utility District No. 3 Long Terra Super Good Cents representative, will the house be certifiedp as a Suer Good Cents home. Signed: :omeowner aul.Ldez Laze Date r ecera� l or 5oc-a! Sec,=jzy r eaera_ ID,ID# or 60cla.L -__ity Representative TONI HERMANSEN tzli.ty Representative (print) SEPTEMBER 29 , 1993 ate Homeowner conservation incentives may be paid directly to homeowner o= applied as a credit Onyour utility account. The builder may receive incen�ive paymen� it agreed to by homeowner at time of const�--ucti.on and the homeowner signs the Washingt Assignment For . on State Energy Code Sncentive MASON COUNTY . BUILDING 111 426 W. C DAR SHELTON, WASHINGTO 98584 (206) 427-9670 CORRECTIO NO - ICE Job Location This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items listed below must be corrected to gain code compliance 4'Alino You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Cfor re-inspection when corrections are made before continuing 'Make corrections, it ms ill be checked on next inspection U OK to 1'i�l5u��i Department +e 12 �171;!;F Inspector 7/7� -N($ NOT REMOV ItHIS TAG