HomeMy WebLinkAboutBLD93-0599 Deck - BLD Permit / Conditions - 5/27/1993 r ^'
MASON COUNTY
Mason County Bldg. III 426 W. Cedar PERMIT
P.O. Box 186 Shelton, Washington 98584 NULL 8 VO ID BY EXPIRATION
DATE 11 BY �LW
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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 FRAMING by date by date by
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. 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 by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
i
it
I I
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
PLEASE PRINT A�
#1 Owner (XOA471r12 g J F-Anl glLK5 Phone# 978' �S7y
Site Address_' A0 Fire District # G
Cityu/1//or✓ StGaAe'AJ4& GA/ Zip 5�T522
Directions to Job Site _U_1 Z M L
t d,t
cX1
W( I'J
Owner Mailing Addre •a• 0X 5S/ 1is -i-h Si +e2
City "I%llew St W,45A 1x4701AI Zip `�6Sy2
Lien/Title Holder p-c e, ;,,i
Address S MrrRo o- /7,-4 ,KC--. Ag, BoX 20330
City_OK/�tAOMA C, St Ok 40MA Zip 73�
#2 Contractor Name -N-V'5_ekf Contractor Reg#
Address Expira date
City St Zip Phot�
#3 If septic is located on project site, inclu re
Connect to Septic? Public Water Supp� d
3r 1
(If residential, proof of potable water is requ�i d� VL
F,Q
#4 Parcel No. 322.s 2 - W- 6)J/6)
Legal Descriptio g-f 13/oc.K 1-/ Grr�✓ fVrboi ,�
u N/DW C Ty R� /►2 wc�/�A/a/i7 i o.� To uwia�
#5 Building Square Footage:
1st F1 2nd F1 3rd F1 Loft Basement
Deck LG fr#bedrooms #bathrooms Garage Carport
Garage/Carport: Attached or Detached
Other
#6 Use of building �L � Describe work rn"La/'_
#7 Type of Job: New _ Add Alt Repair Demolition
Re-Roof Bulkhead Other
#8 MOBILE HOME INFORMATION
Model Year Make�n ( Model
Length Width 8�erial No.
#Bedrooms #Bathrooms Type of Heat
#9 Any water on or adjacency property: saltwater lake
r rive pond 1 t �nd seasonal runoff
other
f
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 Scale:
Name of Fronting Street Date:
APPLICANT TO DRAW SITE PLAN BELOW
i
y
`v
� Sr JP'
t
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
N
X s TIM TY� 1/..�.�-p, Ts�-
FrOpPsed d4cK
Plumbing Fixtures Fee Mechanical Fixtures
-No. Toilets Primary Heat Source (circle type)
Bath Basins Elect/heatpump/other
Bath Tubs
Showers NO. FEE
Hot Water Htr Furn
Laundry Washer Heat Pumps
Sinks Vent Sys (Central)
Floor Drains Vent Fans (Spot/Whole)
Laundry Basins Boilers/Compressors
Dishwasher Hp
Disposal Air Handling Unit
Urinals cfm.
Other Fire Protection Systems
Permit Basic Fee
TOTAL PLUMBING $
Other
Gas Outlets .Hookups
Wood/Pellet/Gas Stove
Other
Permit Basic Fee
TOTAL MECHANICAL $
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK
IS COMMENCED
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT 1 AM A CURRENTLY REGISTERED CONTRACTOR
CONTRACTORS REGISTRATION LAW RCW 18.27 , AND AM AWARE IN THE STATE OF WASHINGTON AND I AM AWARE OF THE
OF THE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH
THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
DEPARTMENT. DEPARTMENT.
X OWNER X BY
DATE — — 3 DATE
Return permit to: Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, IPA 98584 427-9670/1-800-562-5628
FOR OFFICIAL USE ONLY: Accepted by: Date: