HomeMy WebLinkAboutMIS94-1003 Sign - MIS Permit / Conditions - 12/5/1994 MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
M .iL t�-. C. E t 1. A N t= Cl t l 4: F" t_- fi h1 1 i'
14IS94--1003 I iwi,k I c'N I ti I .,olo w,o I I A I
Iilli 11001,1 `. W /6;1# SHFI TON- 11AI I (1CK RO SHE ION
A1111I I VAN I AACKIF 6ROVF''S, 4J7 ?67:1
I)IJNV-R ! JACK11• 6ROVL.S 4 7 !h??
s IIW It 19 II R N JU f S 1#4 21
4 X 8 SIGN (POR1 AHI.F: )
7 IO 6 iMt.LFS WFtiL OF `;IfFI ION R16141 SIM- OF ROAD (NFXI I-I) 1-ciPRF`:tiO HAR )
1'Rk1,1k C i I�d[t I 1
1
1 I Y111 !,MOON I 10 [r!, r ;
....::.�.v Tom:-.......... ....-..: �::... _. ,. _... .. _...._:.....�
V)6+ HAr I
1
ivvLV
1 [t I AI
#Is RRNT. re: 0A 4i ;''I COMPI IANCt' TO AI FACtIf11 CONI1f I IONS IS
RF..Q(Il'17F1)
7
CL
v m w wm an d w o m o n
r
m � CD M mam � m ; mR. Z
am
z
Z o m m
CD o Z O W
m
to � tD
w Q
w y 0
o x
� I
C7 C7 C7 v v (7 U
K K K K K K
CL
w m11) � w 0 z w O w 3
mnm � momwm0NmCnm0
r W y w D ° D
Z O �' Z
m m z D
v r
j zz
z
z
1
q- c C7 or cr cr
am CL w v 3
m = mmmw m � � o W
m v 0
C O
3
m
a C7 Q
MASON COUNTY
Mason County Bldg, 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
J! 0 0 P 4--p Hie 0 H 0 ;I '0 ii,q
Cms(a No
f.-0 1,
a(Iv
11 POR fAH1 1. S I f,N 1 111 HU Hit I I IAH I I I VY 0 f 01JN f 1: IN
HAMA6f`; '; IHN 1 ', 10 OFMAIN Pf)klAtili
AI I api.I ew-d p I mw. f I - I, olpf I-r"d I,o b�, of-I - . tit ff,1, 1 (1c;f—'- I I -If 11111 if
Ca] I Od fnt Alld 1) 1 -till, 011`4) 1`10V Oil S.*.i 1 (1 . A I I p f,I>, i 141 1 1 N111 I f" f I t A I I o 4 Add 1 1.1
R p-I n(�-p e c n n f re e i (i t.h e,! amo i i n I f) f *3 s) , 0 0 (,or h o It r i at I I i fill Int I to r 11 f, , Il 'Aild
niff-'t ho 14'rAorl t)y (I6rI)Af-tIJI1PW, J1Fi,Ot 0) Mly flir I hill i 11!-, 1 1 i fill-, ht, i ill) 1.1 t i rfillwd or
(Itimli-4d
P11RfiItAN 1 1 0 1 49 1 1.1 N 1. F 0 R M Nil 1 1 It I N 6 1 Oil 1, 1 1 fIN it I I
IIAVF AITIMWO 'M A1104f �i I-1i 11'OV I (II H I N 1,11CH (i 1,fr. I I 1 1)N Ali I tit i'l Ill Y V I I Ii I I
/kNil t I ii-IHI I- I PliM I tit 1,, [1?1-t I M? ROAft I 0IN I I N(-, I I It I,R 0 P V I4 1 11, 1111"ON I IMN I 'i ill I I t 1 11 1 N(i
111- 11 A R I I,I f-,N 1 14 t 1)If I R U I It A I 1 11 1 ', NI- rnMPI I I I II I,Ii 1 41 111 r nl 1 1 1`4 VI 111P ewN
P V I N IL.I I I 10 N t I t , 1111ti1-fl 'IN IAA It IN I AH 1, 1 :(A tit I fit I I IIN I VOWN till f I I i 1 Ni, i flill Ill I I Ill
Al'i'-if `1`11 I1 I f ill IN I I?JCON I PA!:. I f1I, I A I li 1-11 11111 I AIIIH I (IN I 1 I I'l; 1W I if f."I 0111 1 11111
WiPL- 1 I 1.()N,, ,
i
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
MASON COUNTY
Mason County Bldg.. III 426 W, Cedar
P.O. Box 186 Shelton, Washington 98584
I
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date � by Gas Piping date b
Foundation Walls date b 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
Permit No.
MASON COUNTY Gx i
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT
#1 Owner Cf64 Phone#
Site Address Fire District#
City St lAle Zip
Directions to Job S' e
Owner Mailing Address laule
City St Zip
Lien/Title Holder
Address
City St Zip
#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)
#4 )�arcel No. O - /<A - ('-V'3 5 U
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. /
r ( /
#6 Us f buildin �\ D cribe work 1
#7 Type of Job: New _Add Alt Repair Other
#8 MOBILE/MANUFACTUR E INFORMATION
Model Year Make Model
Length Wi Serial No.
edrooms # Ba rooms Type of Heat
Purchase Price$
#9 Indicate by circling the applicable source 'f a y a r is on or adjacent to subject property:
River Pond Creek Stream Wetlandak 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
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
w
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each
No._Toilets CIRCLE FUEL TYPE: ; Electric,
Bath Basins Heatpump, Other
_Bath Tubs No. Fees
— hoovers Furn BTU
_Hot Writer Htr Heatpumps
Laundry WashLm,� 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 B is Fee 15.00 Auto Fire Sprink Sys 25.00
T AL PLUMBING $ No. h r
Gas utlets
Wood, s, 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
ME S OF A PROGRESS INSPECTION.
�GWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I ERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED
ENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I
CW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OFTHE ORDINANCE REQUIREMENTS REGU-
O DINANCE 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 OWNER X BY
DATE DATE
I
FOR OFFICIAL USE ONLY: Accepted by: Date:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: Z43
rt(z�9
Environmental Health:
Building Plan Review
Occupancy Group: At Type of Const:
Fire Marshal:
Other:
Special Conditions: o✓ `S FEES
� / / ` / Building Permit
( V -�
L2c.ti1 h eia 5 e Plan Check
—
N Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee 'r—
Other
Other
Building Valuation: ✓ O TOTAL FEE ����