HomeMy WebLinkAboutBLD93-0551 Cancelled SFR Addition - BLD Permit / Conditions - 6/11/1993 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 OV— by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date L�4 q— j— by date by date by
FRAMING Gti- Walls Gly/ FIRE DEPT.
date —<2 by L �-✓ date —,3p.- \ by c.J date by
PLUMBING OTHER
Groundwork Attic
date b date — s- 4/3 by t.�✓
D.W.V. WALLBOARD NAILING
date by
date /Zj - `/- %3 by
Water Line FINAL INSPECTION
date by date 5 73 by date by
/ IJ Ct
z• ex el C�f 4,D e--) 1
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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j 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 I
date by date by date by
MASON COUNTY
Mason County Bldg, III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
L i I M,..,P 1: IL... Ell :1. R'4 N;:'ii INI J.: ....1.. F O R INSPECTIONS C A L L 4 2 7—9 6 7 0
BETWEEN 5pm AND Sam 427-7262
BLD93-0551 PARCEL : 123094190071 PLAT : DIV : "? BLK : ? LOT : ?
JOB ADDRESS : NE 3520 OLD BELFAIR HWY BELFAIR
OWNER : HOPE 6IERKE 275-0988
CONTRACTOR :
LEGAL : Tr 1—A of NE SE, W of liver
CLASS OF WORK NEW BEOR : 0 . BATH : 0 TYPE AMOUNT BY DATE RECEIPT TYPE AMOUNT BY DATE RECEIPT
TYPE OF USE . . . . : SF STORIES . . . . . . . : 0
OCCUP . GROUP . . . : ? BLDG . HEIGHT . . : 0 . 0t IPRMT $ 80.00 KS 66/11193 3 29 16
TYPE OF CONST . . : ? FIREPLACES . . . . : 0 P L C K $ 31.50 KS 16/11/93 3 29 16
OCCUP . LOAD . . . . : 0 WOODSTOVES . . . . : 0 S T F E $ 4.50 KS 16/11/93 32916
DWELL . UNITS . . . . : 0 PARKING SPACES : 0 IIEHFE $ 0,08 KS 16/11/93 3 29 16
INSPECTION AREA : 1 SHORELINE ?. . . . : N L (TOTAL 116.11 VALULATION: 8136I
SETBACKS-------------- TOILETS . . . . . . . . . . : 0 FUEL TYPES---------- BOILERS /COMP---- MOBILE HOME--
FRONT . . . E 50 . Bft BATH BASINS . . . . . . : 0 : ? 0-3 HP . : 0
REAR . . . .W 5 . Oft BATH TUBS . . . . . . . . : 0 3-15 HP . : 0 MODEL : ?
SIDE ( 1 ) . N 5 . Oft SHOWERS . . . . . . . . . . : 0 FURN < 100K BTU : 0 15-30 HP . : 0 —MAKE------
SIDE ( 2 ) . S 5 . 0ft WATER HEATERS . . . . . 0 FURN )=100K BTU : 0 30-50 HP . : 0 ?
SHRLINE . ? O . Bft CLOTHES WASHERS . . : 0 FURN — FLOOR . . . : 0 50+ HP . : 0 —YEAR------
AREA ---------------- KITCHEN SINKS . . . . : 0 HEAT PUMP . . . . . . : 0 ?
LOT SIZE . . : ? FLOOR DRAINS . . . . . : 0 VENT SYSTEMS . . . : 0 EVAP COOLERS : 0 LENGTH : 0
BUILDING . . . : 208sf DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 0 HOODS . . . . . . . : 0 WIDTH . : 0
BASEMENT . . . : 0sf LAUNDRY TRAYS . . . . : 0 DOMES . INCIN : O —SERIAL#----
DECKS . . . . . . : Osf DISHWASHERS . . . . . . : 0 AIR HANDLING UNITS-- COMML . INCIN : O
GAR /CARP : ? Osf GARB DISPOSALS . . . : 0 <= 10000 cfm . : 0 RELOC /REPAIR : 0 .
AT/DT . : ? URINALS . . . . . . . . . . : 0 10000 ctm . : 0 OTHER UNITS . : 0
MISC PLM FIXTURES : 0 GAS OUTLETS . : 0
PROJECT 0ESCRIPTI0M:RESI0ENTIAL ADDITION
PROJECT 0 CATI0N:FR0M BELFAIR, NORTH ON 0 L 0 BELFAIR H W Y TO BEAR CREEK STORE TURN IN PARKIN6 LOT HOUSE OM RIGHT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 181 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED FOR A PERIOD
OF 181 DAYS AT ANY TIME AFTER WORK IS COMMENCED. EVIDENCE OF CONTINUATION OF WORK IS A PROGRESS INSPECTION WITHIN THE 181 DAY PERIOD. FINAL INSPECTION MUST BE
APPROVED BEFORE BUILDING CAN BE OCCUPIED.
��OWNER OR AfiENT: x'l DATE. (%
BLO_PRMT, rev: 13 1/91 COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED
I
MASON COUNTY
Mason County Bldg, III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
F:a Y::::: IFS: Iwo ::k::: ...p.... C]:: C.:0 W"'H N:)l ::L ..N.. .:IF: i(.:N
Case No . : BLD93-0551
For : HOPE I GIERKE
Page : 1
1 ) The use , handling and storage of hazardous materials or flammable and combustible
liquids in excess f 10 gallons is not allowed without the approval of the Mason County
Fi M r hal .
X
2 ) A L CONSTRUCTION UST MEET OR EXCEED ALL LOCAL CODES AND UBC
REQ RE N T S/
X �,
Permit No.
W
� MASON C M OUNTY BUII�DING PERIT APPLICATION �q
PLEASE PRINT
#1 owner H U PE I G/E A.K E Phone# 7�7 — (
Site Address 3.52O NE tXD /.3,CC/`A1k HVVYFire District # 2.
City O'Eu:A►m St W'4. Zip 989' Z 9
Directions to Job Site r&OM 131fL A41 & , /VWE TH ON O Z-0
a4L.E4M, Ml W lY TO /3CZ&A Gam. S1209,6 TU2Al IN,
84&IUN4 4.0 T HU05L 0A/ /Z,/G147-
Owner Mailing Address S-IM&
City St Zip
Lien/Title Holder /UGN6
Address
City St Zip
#2 Contractor Name /VONI6 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 is required)
#4 Parcel No. 'a 2 3 d q - ) - e1
Legal Description / t II&I SE 9, T Z,3 N I VV
VV,Ni. inn 4s jO N C O U Ar Y
#5 Building Square Footage:
1st F1 Z O 8 2nd F1 3rd F1 Loft Basement
Deck #bedrooms #bathrooms Garage Carport
Garage/Carport: Attached or Detached
other S To&A e.rz — M Ii1_-? i,. a,-.)m
#6 Use of building $ 7-0n-14LF ` Describe work
#7 Type of Job: New Add Alt Repair Demolition
Re-Roof Bulkhead Other
#8 MOBILE HOME INFORMATION
Model Year Make Model
Length Width Serial No.
#Bedrooms #Bathrooms Type of Heat
#9 Any water on or adjace t t property: saltwater lake
river pond and seasonal runoff
other
T
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: = ADO
Name of Fronting Street Date: �� 16�
APPLICANT TO DRAW SITE PLAN BELOW
III
Y
,3E 1 1
009 T -)3eCA O
i
�
�O� �� Iy S�lul•.
to , �
0001,
e.
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOLEI
i
SJ C��
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_.�ns 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 $
I 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. LL DEPARTMENT.
X OWNER X BY
DATE i} — al 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:
Environmental Health: -(/
i L/, Li* . r-.T
Building Plan Review:
Occupancy Group:
Fire Marshal:
Other:
FEES
IlSpecial Conditions: 11 11site Inspection I II
11 11 H 'I
11 it IlBuilding Permit
it II I� $--�-II
Il II llviolation Fee I II
11 II 1i it
II 11 llviolation Investigation Fee 1 II
I1 11 11 Plan Check 1 <p II
II II I' l 3l- 'I
II 11 Il Plumbing Fee I II
II 11 1� � it
11 II 11Mechanical Fee 1 11
11 11Woodstove Fee 1 II
11 I 1
(( 11 IlBuilding State Fee 1 1
I
�lBuilding Valuation: 3 TOTAL
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