HomeMy WebLinkAboutBLD96-0221 PATIO COVER - BLD Permit / Conditions - 4/12/1996 17; >
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by 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 Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by _ date by date by
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Permit No.
Q��D 9�aOzZ�
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT
#1 .Ow pier /29 t .A aeL- l ACR—a / Phone# 99
ite Address tE , y C tir r _1S, Fire District# //
City S h 1'j'ON St f t)ri Zip 2R1:8`/
Directions to Job Site yico- ME Vllew To Wallace 49 art Wa�llac2 BLrd. �-o
ShelT.� Springs tar Ge /ell' en S1►e�Toi.Sorinoc Rd io .ems/o.+.� la.c�RcL Ga rahTe� ?s>o.,o2
flake 9.4 To Cherry AX, Tur,u rt�hl' ;A7 o GAe rr,r PX i ur.c-) 1 e f-T oni o Cherry cT 4'77 e�s
4T%% 64 ce. ev+ I efT -
Owner Mailing Address /Wrchael- (' + 7hregjf
City .S e.IT&$% St t.L y, Zip Y 8s 841
Lien/Title Holder mast. ST, e ftpL Gr 4
Address
City O St w a, zip 48Sa y
#2 Contractor Name Contractor Reg #
Address Expiration Date
City St Zip Phone#
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#regal el No. U 01 R - 3Y - DDOD N
Description 407' y Cjxcrr�/_ 1104. q OP PUTS A?, 32 S3
#5 Building Square Footage: (existing/proposed)
/ 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms- _/ #bathrooms /•,d /
Garage / Carport / (Circle: Attached or Detached?)
sq. ft. /
#6 Use of building Describe work
h
#7 Type of Job: New Add ,l Alt Repair r
,,
JI
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make Model ® 0 4 1996
Length Width Serial No.
# Bedrooms #Bathrooms Type of Heat
Purchase Price$ 91-P-A
#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
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements l i Indicate Directional b , S, ,
Name of Flanking Street by E W)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
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APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
P
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each)
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
Bath Basins Heatpump, Other
Bath Tubs No. Units Fees
Showers Furn' BTU
Hot Water Htr eatpumps
_Laundry Washer ' Vent Systems
Sinks Spot Vent Fans
Floor Drains No. Boilers/Compressors
_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 $ No- h r
Gas utlets
Wood, G 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 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 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 OF THE 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 DEPARTMENT. DEPARTMENT.
XOWNER���� XBY
DATE R ' 2 - RCS DATE
FC1R OFFICIAL USE ONLY:Accepted by: Date:
c ' -
i
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: �4AO , SQ-11,,Ws
Environmental Health:
tA
Building Plan Review
Occupancy Group: Type of Const: >:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit
Plan Check
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
,SA@4Rspe49f4en ,
Building State Fee
Other
Other
Building Valuation: !. -� TOTAL FEE �,