HomeMy WebLinkAboutBLD94-1666 Cancelled Mobile Home - BLD Permit / Conditions - 5/17/1999 MASON COUNTY PERMIT
Mason County Bldg. III 426 W. Cedar NULL ,�8L--44V��O�ID BY EXPiRATiOis
P.O. Box 186 Shelton, Washington 98584 DATE � `�7— BY
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CONCRETE MECHANICAL MOBILE HOME Cj/'
Footings-Setback date by Ribbons v e - _
date by Gas Piping date I- - 55 by c
Foundation Walls date by Set Up
date by INSULATION date 1- 2 S- S by l J
BG/SLAB Insulation Floors Final
date by date by date 7—�cf 9J`' by T�
FRAMING Walls FIRE DEPT.
date by date by
PLUMBING date by 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
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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 INSULATION date by
BG/SLAB Insulation Final
Floors
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
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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
ate 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
Permit No.
MASON COUNTY 4
BUILDING PERMIT APPLICATION %9
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 �
PLEASE PRINT
#1 er �lf� /�i�Ul%� Phone# 2.2
ite Address /J��. 'ZJ L� 6�-� 13&zA4?le tfw �/ Fire District#
City St zip -
Directions to Job Site ne-)p
Owner Mailing Address U�—? ya PSG 17 L3CZ.�1'1�
City �� St�--_Zip
Lien/Title Holder
Address
Clty St Zip
#2 Contractor Name n 0/31c.f= UIL1C_ 5;��.4Cls�7 /,U Contractor Reg #,Moi3ic/,/S/11P
Address Z?O Expiration Date_lo
City St Zip Phone# 377�831
#3 If septic is located on project site, include records.
Connect to Septic?--X-Public Water Supply Well
Connect to Sewer System? Name of System /A, S 7A e--)D
(If reside ial, proof of potable water is required)
7
#4 arcel No. 3.�-0 - 5`y - tX�O
Legal Description — '�.e 74 ►8
#5 Building Square Footage: (existing/proposed)
1st FI / 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other sq.ft. /
#6 Use of building ,( �/l ,UC.C� Describe work
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year 7.S Make OOvA Model 6 J 9
Length_Width��Serial No.
# Bedrooms _# Bathrooms -;L _Type of Heat 6?&-r-7RiC-
Purchase Price $ 6�; o0o
#9 Indicate by circling the applicable source if any water is on or adjacent to subject property: �l
River Pond Creek Stream Wetland Lake Marsh 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 b S Indicate Directional
Name of Flanking Street y N, , E, W)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
i
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z
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
I
1
Plumbing Fixtures ($3 each Fee Mechanical Fixtures ($6 each)
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
_Bath Basins Heatpump, Other
"\Baat\th Tubs No.. UDija Fees
Showers Furn BTU
_Hot Watee - tr F atpumps
Laundry Wash /Vent Systems
Sinks Spot Vent Fans
_Floor Drains IN Boilers/Compressors
Laundry Basins HP
_Dishwasher No. Air Handling Units
_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 PLUMBIN Other
Gas Outlets
ood, 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 TOTAL MECHANICAL $
OF 180 DAYS AT ANY TIME AFTER WORK IS COM-
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 OBTA�NING APPROVAL;FROM THE BUILDING
THE BUILDING DEPARTMENT. DEPARTMENT.
X OWNER X BY
DATE DATE
FOR OFFICIAL USE ONLY:Accepted by: Date:
J
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY '
Approved Cond. Hold
Approval
Planning: ,Sf 41.,pe LC- 1%01 WS
Environmental Health:
Building Plan Review
Occupancy Group: Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit /00 c
Plan Check
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee - �—
Other 4/0
—
Other
Building Valuation: TOTAL FEE -