HomeMy WebLinkAboutBLD93-1907 Deck - BLD Permit / Conditions - 9/20/1994 I
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 by Gas Piping date b
Foundation Walls date by Set Up
date by SULATION date by
BG/SLAB Insulation Floors Final
date by date date by
FRAMING Walls FIRE DEPT.
date by date by
PLUMBI G date by THER
Ground rk Attic
date by date by
D.W.V. WALLBOA D AILING
date by date V 1,4731 by
Water Line FINAL INSPECTION
date by date; _ ���_S�� by ( �/ date by
Zm • 1/lJ .
J
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
G
MASON COUNTY Permit No.
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT
#1 Owner Q�F�+Jq-Pi N -Phone# aa -asu i
Site Address NC J9 D W . T l 6 Ele Lk . P2-tj, Fire District#
city St Cv zip 4,F.I/
Directions to Job Site Co NU12Vtk IrRZt-( j6&L-f-At Q O to "OL6 &C-LF&/Z 141V-)1W APAUX
l o-c.tLem Tu e-w t e_E i hr .8e*p-c-p�=K eD no DCwa-nd T!GE/Z Lk r z4k, 4g i �T
QiatT ols) To -ricap. kisslou Lt< Pi>• Tar ITT L..aa Q/U 7-/6EN- Lk P.b. 6o
-P g l AeLEsS ,4PR� � rct • BL tc l�(�tL.f�Ox ant c&Fi-3' ol<P- tiRker T
Owner Mailing Address es E t1•� Pr66 UC -roll Or-
City St Zip
Lien/Title Holder
Address
City St Zip
#2 Contractor Name S t=L - 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
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No. JA 30s - -�2 1 - nnoiAQ
Legal Description GOV• LOT a TOWN S41 P .73 V6> 1e-A QQ=, 1 W.M.
#5 Building Square Footage: (existing/proposed)
1 st FI 2nd FI / 3rd FI / Loft /
Basement / Deck / /3qq #bedrooms 3 / #bathrooms /
Garage / ort / (Circle:Attached or Detached?)
Other sq. ft. /
#6 Use of buildi CL° Describe work
#7 Type of Job: Ne Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make Model
Length (o(�,, Width '/D"Serial No.
# Bedrooms- # Bathrooms_Type of Heat ELEc*rej C�
Purchase Price$
#9 Indicate by circling the applicable source if any water' on or adjacent to subject property:
River Pond Creek Stream Wetland ake arsh Saltwater 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 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
I
_Bath Tubs No. Units Fees
Showers Furn BTU
_Hot Water Htr _ Heatpumps
_Laundry Washer Vent Systems
_Sinks _ _ Spot Vent Fans
_Floor Drains No.. Boilers/Compressors
_Laundry Basins HP
_Dishwasher No. Air Handling
_Disposal cfm#
_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
i
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
j I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED
I` 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-
I ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED
I 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 BUIL EPARTMENT. DEPARTMENT.
` r
I
X OWNE� X BY
DATE DATE
i
FOR OFFICIAL USE ONLY: Accepted by: J Date:���G
L
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
�?z
Environmental Health:
I
Building Plan Review
Occupancy Group: Type of Const:
Fire Marshal:
Other:
FEES
Special Conditions:
Building Permit
Plan Check
Plumbing Fee
Mechanical Fee
I�
Wood/Gas/Pellet Stove I
Radon Monitor
i
Violation Fee
Site Inspection
Building State Fee
Other
Other
Building Valuation: TOTAL FEE
I
S { j ,^la�
Cal
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IV
67
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