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Home My WebLink AboutMIS93-0389 Reroof - MIS Permit / Conditions - 7/26/1993 MASON COUNTY PERMIT NULL VOID BY EXPIRATION Mason County Bldg. III 426 W. Cedar DATE BY P.O. Box 186 Shelton, Washington 98584 M :I. So E. 1. EAIMV CUU 1J, 11 . 4t 10 1_ r[ Iil}f fllttl};; . . . . . . . . . . . . . . . hPI,I f i mN I NO►t 114 ONF. I NVI I Mt- N I A';tilli: SHNN tit 441.i NORTH ONk INVHS tME N I AS';OC _ /!)9 �-N000 I I tiff) it 1 10 sits 1, 11 1 17 is I111e PIO)-ti- ; I IA t.k 11, } I (IN I r t:r).I I I } } t,t fi, 1 r f)r•1 HWY 101 AND %HFt_ ION SPRINGS RD INtERS1 C I ION I il!i !} 1 Ntt I F I y 1'1 hMOON 1 14Y Oft I i t ; I'r RIt �I0 N 0 i 1119 MI . le ! 114,'')1 {q' COMNI l ANCt I U A l l ACIII-Ct CON11 1 I I ON`; I Rt_QUIRI t) a I CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date by 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 MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 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 b date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by o +- fb % vedh- a+ " bde io Cch ��VelBc� Lc.✓ CNwt R. r71iy1G �t� — c II I I I I Permit No.a/i MASON COUNTY BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 Owner N Phone# �75q -5000 Site Address ZO C( Hw� IC A kI y Fire District# City St IA)HZip Directions to Job Site J S i Owner Mailing Address City Fw- Y-n �Z- St Zip Lien/Title Holder Address Clty St Zip #2 fir Name L"IaYLA10 e. 1 p51Q� Tl.• VVI�,Ir1c7� �Contractor Reg# Address I rn I f k4 0 3 Expiration Date City St 6 /A. Zip qMy Phone# z #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. - - � Legal Description #5 Building Square Footage: (existing/proposed) 1st FI / 2nd FI / 3rd FI / Loft / Basement / Deck / #bedrooms / #bathrooms / Garage / Carport / (Circle: Attached or Detached?) Other_ sq.ft. / #6 Use of building Describe work #7 Type of Job: New Add Alt Repair O1 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 Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences A i Structure Setbacks Driveways !v 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 . 5� Q16 I n 1� _i APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW i DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: Building Plan Review 7�6 Occupancy Group: Type of Const: Fire Marshal: , Other: Special Conditions: FEES Building Permit L4 Q — Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other Other Building Valuation: TOTAL FEE , Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each) No._Toilets CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins Heatpump, Other _Bath Tubs No. uDila Fees _Showers Furn BTU _Hot Water Htr Heatpumps _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. 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 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. X O NER X BY DATE DATE - - FOR OFFICIAL USE ONLY: Accepted by: Date: