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Home My WebLink AboutMIS93-0352 Reroof - MIS Permit / Conditions - 7/13/1993 MASON COUNTY PERMIT Mason County Bldg. III 426 W. Cedar NULL & YOID BY EXPIRATIONDATE BY P.O. Box 186 Shelton, Washington 98584 �— 111ft A!rlll+i `+ � c t � �o� roc) W4 . MA l I frill NORIFI ONI Ati'-;Ut:" l',4-4000 4.'b--SSII rr1 INf+ : NOR1 H ONE AS;-JJC . I l- f: 1-1AL : It I If Sti's 1. iI L IZ i5 1#7Tg iI I f?0 A f 1. f-( I �� I I ON iii" Ppli,it 1. 1 10ChI10N - Huy 101 and Shelf-oti ';priligs roAd inr for :sign. PI{U,11 1 I Mli ! t I , y! l i1MWINI BY 01 11 1, f f I ! t �; t t t: �. �! . 5 N t {'ti H � / i •; i s :S 1 '.+�! ! t An fit,$ t.! f irtl I l AjS PW. r• 04111je COMP IANCF 10 AI IAC#if11 f.ONDI 1ION'1: 1 % REUU1RF0 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 PLUMBING date by 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 1 ) ri1 l IN ; 1 ptl,l,: 1 1 ?N ill , ! h;! f 1 iwl 1'i MENI '� ll i 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 Permit No. I YI BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT 'n �y #1 Owner fL._l nuua4I/YL(�,I Y-fs"fj �et4a�j Phone# /`q- 5660 Site Address I Z-CC)( Hwu 101 �J• C �1710-S.SII Fire District# City St K) Zip Directions to Job Site / ►file rnaekg ivy -- Owner Mailing Address 7 z City St�_Zip Lien/Title Holder Address Clty St Zip VJ(•. /y #2 eontr�stor Name Etiti /t Contractor Reg # Address 1 � '"� Expiration Date�/ / City St F io q, �q Phone # FS #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 �, I� sq. ft. / mot" #6 Use f building d eti�:5 Describe work #7 Type of Job: New Add Alt epai \ Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year Make Model Length Width Serial No. Y # 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 OtheN 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 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 i i 7,vy ivr APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each) No. Toilets CIRCLE FUEL TYPE: Gas, Electric, ath Basins Heatpump, Other Beth Tubs No. Units Fees Showers Furn BTU _Hot Water Htr _ Heatpumps _Laundry.Washer _ Vent�ystems _Sinks \ Spot Vent Fans Floor Drains, No. Boilers/Compressors _Laundry Basins. _ P y I _Dishwashi No. Air H n lin i r' Dispos _ cfm# _Urina 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 her '- Gas 6utlets 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 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 DEPARTMENT. DEPART NT. X OWNER X BY (fit DATE DATE FOR OFFICIAL USE ONLY:Accepted by: Date: -- - =--- DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: 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 Site Inspection Building State Fee Other Other Building Valuation: TOTAL FEE Show touowing on the aft plan . Plumbing FiMre=_33 each) F@g Mechanical Fixtures($6 each) v Dimensions Flood Zones ixisting Structures Fences Aructure Setbacks Driveways i S No._Toilets CIRCLE FUEL TYPE:Gas,Electric, Vater Lines Shorelines )rainage Plan Topography _Bath Basins Heatpump,Other >epbc Systems Wells _Bath Tubs NIL Uaft Fees 'roposed Improvements Easements Jame of Flanking Street indicate Directional by(N, S, E, W) _Showers _ Fum BTU Jame of FrontingStreet in relation to plot plan _Hot Water Htr _ Heatpumps .PPLICANT TO DRAW SITE PLAN BELOW Laundry Washer _ Vent Systems —Sinks _ Spot Vent Fans Floor Drains NIL _Laundry Basins _ HP _Dishwasher NL Air Handling Units _Disposal — /_ _Urinals rig, Fire Protection Systems —Oth — `— _ -—----- —� er — Auto.Fire Alarm Sys _D0 Fixed Fire Supp.Sys 50_00 - Permit Basic Fee 15_00 _ Auto Fire Spdnk Sys 25_00 TOTAL PLUMBING $ Ng. Qtbat Gas Outlets — yiv Woad,Gas,Pellet Stove NOTICE:THIS PERMIT BECOMES NULL AND VOID IF APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW 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- TOTAL MECHANICAL $ 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 MENNS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I RCW 18.27,AND AM AWARE OF THE MASON COUNTY AMAWAREOFTHEORDINANCEREGUIREMENTSREGU- 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. (911NER X BY DATE DATE FOR OFFICIAL USE ONLY:Accepted by: Date: Permit No. DEPARTMENTAL REVIEW MASON COUNTY FOR OFFICE USE ONLY BUILDING PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 427-9670/1-800-562-5628 APP� Card PLEASE PRINT AYPnarrl 81 Owner TifVeStMeiA QSSW kmYNALkt Phone# 7T?,T�)Qn Site Address I ZOO j OQ� 101 AJ Fie District• city StJdl�� Directions to Job She HQV IDI 5I1P I1TIC,p-S�t'101'�_. M IP m,ark'eJ'L 3 y Environmental Health: I, Owner Mailing Address City - FW-&'7 Zip Uen/Title Holder Address city st ZIP Building Plan Review F #2 BsaYa ,d.I, Jelor Name I�I� iryW uwOP�G�rnri � Hot• -umr 1 Contractor Rep A Address W Expiration Data__) / city St GI Fir Zip gRSR,91 Phone o Z/710—'S-5/ Occupancy Group: Type of Const: 03 n septic Is boated on project site,Induce records. Fire Marshal: Connect to Septic? Public Water Supply—Well Connect to Sewer System?—Name of System (If residential,proof of potable star is required) #4 ParcelNo.4- Lri�L1S.LL.11 Other Legal Description #5 Building Square Footage:(existinWpropoaed) 1st FI / 2nd Fl / Brd Fl / Low/ Basement / Deck / If bedrooms / #bathrooms Special Conditions: FEES Garage / Carport / (Circle:Attached or Detached?) Building Permit Other �:Rgm sq.It. / Plan Check #6 Use of building 4 WWIC.K� Desabe wort Plumbing Fee a 9Cn'e1nQt +h Mechanical Fee Wood/Gas/Pellet Stove #7 Type of Job:New Add Ait Repel Other Radon Monitor #8 MOBILEIMANUFACTURED HOME INFORMATION Violation Fee Model Year Make Model She Inspection Length Wdih Serial No. #Bedrooms #Bathrooms Type of Heat Building State Fee Purchase Price$ Other Jig Indicate by circling the applicable source if any water is on or adjacent to subject property: Oti»r River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other Buldirg Valuation: TOTAL FEE .J"