HomeMy WebLinkAboutMIS94-0880 Sign - MIS Permit / Conditions - 11/2/1994 MASON COUNTY
NilMason County Bldg. III 426 W. Cedar
P,O, Box 186 Shelton, Washington 98584
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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
I
-----------------------
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O, Box 186 Shelton, Washington 98584
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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
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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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
—) R@N0TN [
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� /a8(3 4-prr, ADJ)lT7o�j Permit No.
LM MASON COUNTY
0rT 17 S4 BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
P T
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V
#1 w r ill L1 , ILL Y21 Pone#
e Address 4tjo Fire District
City St _Zip
Direc ons to ob Site
c —
ti�
Owner Mailing Address
City St Zip
Lien/Title Holder
Address
Clty St Zip
#2 Contractor Name l.C. ' A Add T> Contractor Reg #
Address W - 7 3 I S�fA�Ta.. "A l a e n-!,C 0 Expiration Date
City -5,76 —rL%Gti L4 St Zip 9 S-S k phone# �/e2G 959�
#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 rcel No. / - /7 -
Legal Description L(�� Ly
#5 Building Square Footage: existi 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 E 5 �i114 f2f�� l Describe work w
/O' I.16NTED cA8 NE-r UL AKROOZ ROOF MOU&111-6D
#7 Type of Job: 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
� r
Sho:v 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 Indicate Directional by (N, S, E, W)
Name of Flanking Street in relation to plot plan
Name of Fronting Street
APPLICANT TO DRAW SITE PLAN BELOW
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Plumbing Fixtures ($3 each Fee Mechanical Fixtures ($6 each)
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
Bath Basins Heatpump, Other
Bath Tubs No. UaL 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
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 BUI RTMENT. DEPAR NT.
X OWNER X BY
DATE AD DATE 0 -1 7-
4
FOR OFFICIAL USE ONLY:Accepted by: Date:
DEPARTMENTA6 REVIEW '
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: c
III
Environmental Health:
Building Plan Review
Occupancy Group: -f— Type of Const: IV
Fire Marshal:
�0
Other:
Special Conditions: FEES
Building Permit
Plan Check
q0CID
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee IV w
Other
Other
Building Valuation: TOTAL FEE
SOMASON COUNTY
DEPARTMENT of GENERAL SERVICES
Mason County Bldg.IA 426 W.Cedar
P.O.Box 186 Shelton,Washington 98SU
MM427-9670
BUILDING PARKS&RECREATION FAIR/CONVENTION CENTER ADMINISTRATION
To: Ph U
5J/LL I D rn I
RE: Permit Number # C7q- L�
To Whom It May Concern;
During a recent review of our files, it was determined that your permit
may meet one of the following criteria:
1 . Permit is expired and needs to be renewed or have a final inspection
2. Due to the type of your permit and scope of work it is possible that
the work has been completed and it needs to be inspected to close
the permit
or
3. The permit is ready to expire and needs to be inspected or an
extension needs to be requested.
Permits are valid for 180 days from the date of issue to the inspection
date and remain valid for 180 days between each required inspection.
If our records are inaccurate and you have had a final inspection, please
send a copy of the signed off permit to this office so that we can update our
cards. If you have not had a final inspection and your permit is expired or will
expire within 30 days, please_ contact this office for a final inspection, update
inspection or extension prior to ()--I _/_0Q?_/96 to avoid renewal fees.
All permits which are expired or due to expire within the next 30 days will
become null and void if contact is not made with our office.
If you should have any questions regarding permit validity or the purpose
of this notification, please contact the building department for clarification.
Sincerely,,
C�r vW S
Building Department