HomeMy WebLinkAboutBLD94-0893 Replace SFR - BLD Permit / Conditions - 8/17/1994 MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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A
CONCRETE MECHANI AL MOBILE HOME
Footings-Setback date >t -- by Ribbons
date 5,f L t e—��� by Gas Pip' g date b
Foundation Walls (, date b Set Up
date by INSULATION ?e-e_ i�.s r,, date by
BG/SLAB.Insulation `� Floor Final
date c date by date by
FRAMING Walls FIRE DEPT.
date S by date by date by
PLUMBING OTHER
Groundwork Attic
date by dat by
D.W. WALLBOARD NAILING J
date V ! — ! date by
Water Line FINAL INSPECTION
date f by date /Q-_ /r "l j by �� date by
Pro 4 1, n c na -/ nc . the ;^ f�,',, -��. 4 c
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MASON COUNTY
Mason County Bldg, 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
N H L D 9 4--0 8 9
F 14 Of A N D V14 R UN`;F N
it 1 1 t y is tint he 1 nrl fis'.1cl rad P-(I c t:I I o! d v,t-.r i al 0 n r) # tfitt aquat i e. -tv, i
of Lhi-t, r)rc)-jef I-, Rc
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Appl'oved per site- plan
The tise . hAnd 1 .1 nq and €,to r ei it P ha't a r flow; (11A te r ia I v f:I 111111JAI) 1 9 41)d 170(116W;I.,i bj
1,1 t1iji,d s in execsof 10 oat I fm( i "; nnf A i d W I I t I If 0 �)1)11 t 4)N,1 a I (I Mm 4)n Comity
Fire MarshAl , ,ke
rbposecj, tv I-1c,tut-o. or any pot, r i on v 1-1 o j,e(,. t t1 r�A P r, t1ji,11 tj foo i if I I I' f r om t a(I e, I i n 0
fn ts s malnt.min a of J.vi i,m t im o k f,r mn A p r o It*�t t, o -,-t tt m 4-1 t (I r i- h to of
X
h,
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 date by
PLUMBING Attic by OTHER
Groundwcrk
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
CENTERLINE OF 66 COUNTY ROAD ROW
10
LOT NUMBERS
48.92'
NORTH SHORE ROAD D
___ -______ ----------------
DRIVEWAY 1 EASEMENT
Ale—
- EXISTING DISPOSAL
DRY WELL(1984)
I
r'c I ' •" I � HousE
EXISTING 11 GAL.TWO
TANK(C�T 98TIC
4)
?Ii iz
� � I
' 16
PROPOSED t•
MOBILE HOUSE f 144.fi3'
HOME154.
�J A
40 u
9 i
BOAT /
HOUSE
i o
/ LOT 10
i/
BOAT I'a
HOUSE
LOT 11
// Q
LOT
LOT 13 + ir Q
50.01'
SITE PLAN
0 5 10 20 40
GRAPHIC SCALE
NOTES ELEVATIONS BASED ON TIDE APPORX. Z
FOR MEAN LOWER LOW WATER DATUM w w NORTH
w
LINE EGL=EXISTING GRADE LINE w r ROAD
h o:EASEMT
w a
u Z 04
an
¢ a
EXISTING NEW HOUSE EGL
BOATHOUSE -
LOT PR❑FILE
SCALE, 1'=40'
PROFILE TAKEN AT EAST SIDE OF BOATHOUSE EXTENDED.
WASHINGTON <j� 3 �/� y�-
STATE Buildin Record WSEO Contract# 91�i'!nt B
CODE
MOGPAM For Site-Built Residential Buildings Heated by Electric Resistance or Heat Pumps
= CLASSIFICATION — --
(please check one) (please check one)
New Building El Addition over 500 sq. ft. Single Family ❑Duplex
Jurisdiction: / _4A Spy/ ❑Multifamily ❑Zero Lot Line Home
❑Planned Unit+Development
please check one: ❑ City County Permit#
Fi le I D #(if different from Permit#)
. ...
lICTCI f
A. Site Information B. Owner Information
Address illy /a 90/ 1VO rth 0ho,-e, Owner owner at time of construction receives utility payment)
,Qn /20 r) CIA-,s ye�n s ejo
City / Zip _ Company
Assessor's roperty Tax# (or attach legal escription): Address / D/ 1-1h Shute f2
AJad,-orc, Mo rr��'. s�cl� loch Tr . io`t Citystate(,)A Zi 5 6'u
Utility Servicing Electric /�L)/�.3 Phone �O 3
C. If Single Family, Zero Lot Line or D. Duplex E.If Multifamily(R-1)
Planned Unit Development First Duplex Unit s .ft. Total#/Bld s.
Total Conditioned Floor Area s .ft. Second Duplex Unit s .ft. Total#/Units
A. Primary Space Heat Type B. Secondary Space Heat Type C. Water Heat Type
(check one) (check all that apply) (check one)
❑ Electric Baseboard ❑ None Electric
Electric Wall Heater � Wood ❑ Gas
❑ Electric Furnace ❑ Electric Baseboard ❑ Other(specify below)
❑ Electric Heat Pump ❑ Other(specify below)
❑ Other
WSEC Compliance Method For Heat Pump Only: ��11��
Prescriptive Path Built to the Electric Date of Permit Application � —� o�v
❑ Component Performance Requirements of WSEC? Date Building �Permit Issued — /
Date of Insulation Inspection
ElSystem Analysis ❑ Yes ElNo (If yes, Date of Final Inspection AD / — �5
utility may offer incentive.)
I hereby certify that this building or addition has been inspected for the measures required
by the 1991 Washington State Energy Code(WSEC), that it is in substantial compliance with
the WSEC, and tha the WSEC checklist for this building is on file.
Si ure of Building Official or Authorized Representative Date
■ Building Department:Return white copy to Kathleen Skaar,Washington State Energy Office,P.O.Box 43165,Olympia,WA 98504-3165.
■ Owner or Building Deparment: Forward canary copy to the servicing electric utility to trigger WSEC compliance payment.
■ Building Department: Retain pink copy for jurisdiction's building file.
WSEO#94-015 2-94
Permit No.
• MASON COUNTY
BUILDING PERMIT APPLICATION
PLEASE PRINT J_�'� hC
#1 Owner Phone#
*i-fse Address 12901c NO ORE RD, Fire District #
city 13EL.VAIK St WA Zip -1 52.8
Directions to Job Site 12.9 MtusS WEST of 5a-FAw, ON
g0RTPSNORE ROAD (WATER 'SIDE)-
Owner Mailing Address R I AND F. GNR15T�iJ5EN.
City SREMECZTow St VJA Zip IB512-Zo5¢
Lien/Title Holder � /A
Address
City St Zip
#2 ntractor Name Contractor Reg#
Address Expiration date
amity _ St Zip Phone
#3 If septic is located on project site, include records .
Connect to Septic?U `Ct6 Public Water Supply_ Well K0
(If residential, proof of potable water is required)
#4 Parcel No. 3Z234 - SO - 00012
Legal Description MAVVoNA MDW1WG5IDE BEAW TRACTS ,TR, 12.* 7-L-
#5 Building Square Footage: -7&
1st Fl '192 2nd Fl 3rd F1 Loft - Basement
\p10 Deck L� #bedrooms 2 #bathroomsIy? Garage — Carport
Garage/Carport: Attached or Detached
Other
#6 Use of building 9SS1DiWCF-- CSUMMF-& Describe work 1,1r--W cor15TRUCT1W
-M REPLACE EXIS - iV46 C-ASW, (W0tJ- EyP^t4 lo►4)
#7 Type of Job: New ✓ Add — Alt Repair Demolition dF r-%674)
Re-Roof Bulkhead Other
#8 MOBILE HOME INFORMATION QA ►�il� q U
J L!�
Model Year Make Model
Length Width Serial No. U Ut U i`V4
#Bedrooms #Bathrooms Type of Heat ERViCES
GENLKIM-
#9 Any water on or adjacent to property: saltwater ✓ lake —
river - pond wetland — 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 Scale:
Name of Fronting Street Date:
—APPLICANT TO DRAW SITE PLAN BELOW
—APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
P-Lambinct Fixtures Fee Mechanical Fixtures
No. I Toilets � Primary Heat Source (c;rcte type)
2 Bath Basins ("`Elect heatpump/other
Bath Tubs 7
-- Showers NO. FEE
Hot Water Htr —Furn
Laundry Washer —Heat Pumps
Sinks --"Vent Sys (Central)
Floor Drains �f� 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
_LIood 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 I 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 '_JdAl X BY
DATE DATE
Return permit to: Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
FOR OFFICIAL 'USE ONLY: Accepted by: Date:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond Hold
Approval
Planning: 14y rCtw S:;W— 421C y\
�7
Environmental Health:
Building Plan Review: mi1nt iYp CT Kruk c� .vc, , �t
Occupancy Group R----'5 11�
Fire Marshal:
Other:
FEES L7C
11special Conditions: II 11Site Inspection I 1I
itVILY14
II II IlBuilding Permit
II II I I
II II Ilviolation Fee I II
II II I' 'I
II II 11violation Investigation Fee I 11
II II 1
II 11 IlPlan Check
II II
II II Il Plumbing Fee
II I II I �j2_ II
II II 11Mechanical Fee I II
II II I iI
II II IlWoodstove Fee
II 11 II
II II IlBuilding State Fee
IL 'I II it
IlBuilding Valuation: ,� 11 11 TOTAL I pu II