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MIS92-0064 Mobile Storage - MIS Permit / Conditions - 8/6/1992
T � • = MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 1- 1.... 14 ri i:- tl lJ ' t> Ul tt I" I i i i. i rd ! i ; :;t 1! ►t>f io MI`i9 NH6� ! 1Owl 1 i f't1 IIpd1 1 ttl p ! '! 1 ri ) IM 1111I1, . . . . . . . . . . . . . { ! 1 1!1 ! I ONY I A`.i STO ;t4j i; IONY f"AS';IO i11i1-MYS MA1101 I IM too #11° IV to) 4-11 I1tils AIJ 14081Lt FORAGIF PI RMII :IX I Y DAY f Xt1IRA1ION - CAN B1= l X I1.140t O PK(1,1{ 1 I 1 ti+ it1 IIIN FROM MCURL AVY ROAD 10 Wt;. S 1 014 !, Ill S'TRFF I . 1 AK F A I F F 1 A I POP 1 I OWNS NO S I"RF t- I . GO UP 1 HE III 1 IP PINE STRUF1 . I AV,F. A i I I I AND 1:11 OW ROAD AROONII 10 '.PHIIt;I %TRuf 1 . IAKI 11R`.ii DRIVEWAY 10 THE It I6H I . N}tri,lf i. I 14 11 �I i � r nitutlyd I t t I l 1 1 I t + ! ! I j 1 ! tI1S_NNNi. rpv� 11,li1`?1 C_ 004PI IAN(:I 10 A ( IAII-Hf1) t-'ItN0IIIONS 1�i RFUU CRf:U — ------_�.—--------------------------- 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 I I MASON COUNTY Mason County Bldg, III 426 W. Cedar P,O, Box 186 Shelton, Washington 98584 t /' 1 �' I II; , 1 , el 1..,1 r-i', ' .,ill .r+ r. s 1•! ;!., :1, i ,.!: r I r i 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 PLUMBING date by OTHER Groundwork Attic date by date by WALLBOARD NAILING D.W.V. date by date by Water Line FINAL INSPECTION date by date by date by li i i J Permit No.BLD + MASON CODNTY ")'I.LS Q"r ee&1` BUILDING PERMIT APPLICATION 7 PLEASE PRINT #1 Owner -To—N\/ P r7�i o Phone# Site Address &LK 1 y Lots 9 to City ON j0r3 St WA - `Zip 9 592 Directions to Job Sitefkaon MCr ay /gyp west o� STN sr ,AKe e�'tL sFT i�Ort *p63f4.se,+J sue, go .o +i.#- h'11 to DiA si 7AKe a Lehi an tbHOW 2oc� an",d fo SPrhC2 sT �aKe- /s r lN;rE wA�! +c fh e ►2;e ht. Owner Mailing Address 'Po- 60>< 62 City (AN i©N St W 87 Zip 99.S99- Lien/Title Holder same- As AjocvE 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 (If residential, proof of potable water may be required) #4 Parcel No. 3�)-32 - 52 - 1 ?oo? Legal DescriptionuNjo,4g&AY-S Hu0-600- C,,VO U O-4A. Arld 4LK /9L,fs 9cv✓d/0 al/cys T #5 Building Square Footage: (existing/proposed) 1st Fl / 2nd Fl / 3rd FI / Loft / Basement / Deck / #bedrooms #bathrooms_L_ Garage / Carport / (Circle: Attached or Detached?) Other sq ft / #6 Use of building Describe work #7 Type of Job: New Add Alt Repair Demolition Woodstove Re-Roof Bulkhead Other #8 MOBILE HOME INFORMATION Model Year t 9?q Make C,HAM�,-d�l Model —7A- mh AeK Length 6/o FT Width ! F-r Serial No . _99&D10 897oo #Bedrooms ?"?Bathrooms 1 Type of Heat ELEC721C #9 Any water on or adjacent to property: saltwater lake r-ver pond wecland seasonal rurof= ot:�er Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Driveways Water Lines Shorelines Drainage P1ar. Topography Septic Systems Wells Propcsed�vements Easements Name of- _ ``�nq�gtreet Scale: Name of Fronting Street Date: APPLICANT TO DRAW SITE PLAN BELOW 1 f i - ,w 1 APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW lu bina ($2 Fixtures each? Hop - moo No - Toilets Vent Systems X 3 . 00 Bath Basins Vent Fans X 3 . 00 Bath Tubs No. Boilers/Compressors Showers 0-3 HP 5 . 00 Hot Water Htr 3 -15 HP 6 . 00 Laundry Washer 15-30 HP � Sinks 30-50-Hp 0 Floor Drains 50 + gp 6. 00 Laundry Basins No . Air Handling Unit Dishwasher <= 10000 cfm. 7. 30 Disposal > 10000 cfm. 7.50 Urinals Other Other Evap Coolers Hoods Permit Basic Fee 3 . 00 Fire Suppression TOTAL PLIIMBING $ Domes . Incin. Comml . Incin. Reloc/Repair 6 . 00 Mechanical Fixtures Gas Outlets X 2 . 00 No . Fuel Types Wcodstove separate Furn < 100K BTU 6 . 00 Other Furn >a 100K BTU 6 . 00 Fury - Floor 6 . 00 Permit Basic Fee 10 . 00 Heat Punms 6 . 00 TOTAL MZC3ANICAL $ NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMM_ZNCFD WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSP=ED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTE.�t WORK IS COMMENCED OWNERS AFFIDAVrr CONTRACTORS AFF=kvZT I CERTIFY THAT I AM EXEMPT FROM THE REOUIREMENTS OF THE I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR CONTRACTORS REGISTRATION LAW RCW 18.27 , AND AM AWARE IN THE STATE OF UASHINGTON AND I AM AWARE OF THE OF THE MASON COUNTY ORDINANCE REOUIREMENTS FOR WHICH ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL 3E IN THE PERMIT IS ISSUED AND ALL WORK OOME WILL BE IN CONFORMANCE THEREWITH, NO CHANGES SMALL BE MACE CONFORMANCE THEREWITH. NO CHANGES SMALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. ,J \� DEPARTMENT. X OWNER�4ni/ / d7G�� X BY DATE r At49 9 OAin Retu^ perait to : Depar=ent of General Services 426 W. Cedar/P .O. Box 186, Shelton, WA 98584 427 -9670/1-800 - 562 - 5628 FOR OFFICIAZ. USE ONLY: Accepted by: Dace : DEPAR1iV1E2qTAL REVIEW FOR OFFICE USB miMY Approved Cond Hold Approval Planning: Environmental Eealth: Building Plan Review: Occupancy Group.-- Fire Marshal: Other: FEES IlSpecial —Conditions : (1 Ilsite Inspection I II II 11 1! ' I! 11 IlBuilding Permit ,l I( I II II II I 1 11 I1Violation Fee I II II Il I. '1 II II (!Violation Investigation Fee I II I! II I 1 I! II II Plan Check I! II I! I it II II 11Plumbing Fee II I II II II I 1 (I 11 IIMec:ianical Fee I 11 II II I 1 II II IlWoodstove Fee I 11 II II I I I� 11 IlBuilding State Fee I II valuaczon: II II TOT�c.,I II