HomeMy WebLinkAboutBLD94-1779 Addition - BLD Permit / Conditions - 3/16/1995 MASON COUNTY
Mason County Bldg, III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
E3 !.a i L. [� 1 N G PERM I T FOR INSPECTIONS CALL. 427-9670
BETWEEN 5pm AND Elam 427--7262.
6L.D94-1779 PARCEL :322345000021 PLAT ;MAPLO DIV : BLKs LOT :
JOB ADDRESSs NE 13001 NORTH SHORE RD BELFAIR
OWNER : FRANK PRIT"CHARD 382-3630
CONTRACTOR : TAHIIYA BUILDERS 275-4573
LEGAL : MAIRONA MOININGSIDE RCN TRACTS TR 21 1 T.L. fS 14211 SK /49-
CLASS OF WORK . . sADD BEDR s 0 .BATH , 0 1YPf AMOUNT BY DATE RECUT TYPE AMOUNI BY DATE R�ECEIPP
TYPE OF USE . . . . :SF STORIES . . . . . . . s0 -
OCCUP . GROUP . . . s? BLDG . HEIGHT — : 0 .Oft fNff 11 51./6 KS 93/15195 1
TYPE OF CONST . . :7 FIREPLACES . . . . : 0 PRMT 1 50.11 KS /3116195 1
OCCUP . LOAD . . . . : 0 WOODSTOVES . .. . . : 0 Siff 1 4.56 KS 03115195 9
DWELL .IINITS . . . . ; 0 PARKING SPACES ; 0
INSPECTION AREA : i SHORELINE? . . . . :Y TOTALS 114.51 VALULAT1ONs 1
SETBACKS--------------�-- TOILETS . . . . . . . . . . s 0 FUEL TYPES---------- BOILERS/COMP---- MOBILE HOME---
FRONT . . . 0 .0ft BATH BASINS . . . . . . ; 0 s 0- 3 HP . s 0
REAR . . . . 0 .Oft BATH TUBS . . . . . . . . : 0 3-15 HP . : 0 MODEL :
S I DE ( t ) . 0 .Of t SHOWERS . . . . . . . . . . : 0 FURN < 100K BTU . 0 15-30 HP . : 0 --MAKE_ ..-_ ._ .-_
SIDE (2 ) . 0 .01t WATER HEATERS . . . . ; 0 FURN >-1O0K BTU : 0 30-50 HP . : 0
SHRL I NE . 0 . Oft CLOTHES WASHERS . . 0 FURN -- FLOOR _ . : 0 504- Hp . : 0 -YEAR-.-•-- - -
AREA --------------- -- KITCHEN SINKS . . . . : 0 HEAT PUMP . . . . . . s 0
LOT SIZE . . ; FLOOR DRAINS . . . . . . 0 VENT SYSTEMS . . . : 0 EVAP COOLERS ; 0 LENGTHS 0
BUILDING . . . : Osf DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 0 HOODS . . . . . . . ; 0 WIDTH . : 0
BASEMENT . . . : Osf LAUNDRY TRAYS s 0 DOMES . 1NC1N :0
DECKS . . . . . . : Osf DISHWASHERS . . . . . . : 0 AIR HANDLING UNITS- COMML . INCIN :O
GAR/CARPS? Osf GARB DISPOSALS . . . ; 0 10000 afm . : 0 REL.00/REPAIR : 0
AT/DT . s7 URINALS . . . . . . . . . . ; 0 ? 10000 atm . : 0 OTHER UNITS . ; 0
MISC PLM FIXTURES ; 0 GAS OUTLETS . s 0
PROJECT DESCRIPTION;AIDITION
PROJECT LOCATION;
THIS PERMIT BECOMES NULL AND VOID IF WORK 09 CONSTRUCTION, AVINOR12ED IS NOT CONNENCED NITHIN 180 DAYS, 01 If CONSTRUCTION OR WORK IS SISPENDED FOR A PERIOD
OF 181 SAYS AT ANY TINE AFTER RK iS COMM ACE#. EVIDfNCE',.Of JONTIIIIAT101 OF 141K IS A PROGRESS INSPECTION WITNIN THE 111 DAY PERIOI. FINAL INSPECTION MOST BE
APPROVED BEFORE BUILDING C OCCtl11ED.
rr
OWNER OR AGEMI.s c c_ t' `-'� _ DATE:
6L 1_tIMI, rev; 03131191 \`� COMPL i ANCE TO ATTACHED CONDITIONS IS REQUIRED
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date q-I •- 5 S by C Gas Piping date b
Foundation Walls date by Set Up
date L1_ by 1 INSULATION date by
BG/SLAB Insulation Floors -Z 9— s S Final
date by date b date by
FRAMIN y
Walls np ��5 CG icn e:4 FIRE DEPT.
date / by date by . J date by
PLUM NG OTHER
Groundwork Attic
date b date 6 -� � — SS by
D.W.V. WALLBOARD NAILING no � 15P
date by dataCl,fle-0 by �J
Water Line FINAL INSPECTION
date by datejby date by
II
?• J� � Gil GW icy cc//c C.S. IS 2 2- X Z p
• �rOL)t i L �- S/' O�C G ec �C c- 4cn-y- i n V cCn.eoin .-•
ire
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
PE RM I T 0 00 r D I T I t7tVy;
Case No . : BLD94-1779
For ; FRANK Phi I TCNARD
Rage : 1
4
1.) The prop. sed project must be consistent with all applicable potir� ie}s and other,
provisi� s he Shoreline Management Art , its rules, and the Mason County Shoreline
Master / roc
LLLL
+.. _ 2 ) Approved pet- site-plan . X
Approved per Declaration "ova cTom na on approved by Mason County 1 / 13/ 95 ..
i
3 ) Applicant should note: that in the event one of the two resl+.lences Is removed from this
property^ a shoreline substanl I regl opment permit will be required for accessory living
quarters ( or an a justmentftio he property line could be performed) . Minor additions to
the res Vdences ,-i permit"b l e Ory i d i ng all other code requirements are met .
CONCPETE 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 PLUMBING by date by date by
Attic OTHER
Groundwork
date by 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 y
BUILDING PERMIT APPLICATION �;� � yr
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1 800 562 5628 �
PLEASE PRINT
#1 ner I-t-aL k 2 Phone# 30 -;L �-�? S— Z `i 7
ite Address A] 9 1 b 6 1 � f. s -e Fire District# g
City i�Q C t� St .)c,— Zip qW15 2g
Directions to Job Site
Owner Mailing Address �0"O ( (f/t C olek-S f fV 13--f
City si&Ltuzcr- St Zip Q 10
Lien/Title Holder
Address p� p
Clty St Zip
----� (,l � 2�f3
#2 Contractor Me -�U 2 Contractor Reg# rA tt y B f�
Address s-0 Expiration Date
City St Jk,16— Zip Qf o 2F 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 Parcel No. Z Z3 - So - Gob I �
Legal Description
#5 Building Square Footage: (existing/proposed)
1 st FI C U� /2(ob 2 n d FI 11 3rd FI / Loft /
Basement :;�.lp 0 pl O Deck / #bedrooms / #bathrooms /
Garage / Carport / (Circle: Attached or Detached?)
Other sq.ft. /
#6 Use of building V aCl-ri 6--n Describe work t2
#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. ' cent to subject property:
River Pond Creek Stream Wetland Lake Mars Saltwater asonal 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
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. UDila Fees
owers Furn BTU
_Hot ater Htr _ Heatpumps
Laun Washer Vent Systems
_Sinks Spot Vent Fans
_Floor Drains No.. Boilers/Compressors
_Laundry Basins _ HP
_Dishwasher No.. Air Handling Units
_Disposal _ cfm#
I
_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- 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
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 BUILDING DEPARTMENT. DEPAFT1VaENT.
X OWNER X BY G
DATE DATE
FOR OFFICIAL USE ONLY:Accepted by; ' -z� Date: ��
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: ID3
Environmental Health:
Building Plan Review �DLLSL� MA Jz /1,2Al"WALL
Occupancy Group'-5 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 �Y
Other
Other
Building Valuation: TOTAL FEE