HomeMy WebLinkAboutMIS92-0105 Replace Sign - COM Permit / Conditions - 9/30/1992 MASON COUNTY
Mason County Bldg. III 426 W, Cedar
P.O. Box 186 Shelton, Washington 98584
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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BUILDING PERMIT A-PPLICATION
PLEASE PRIHt
#1 Owner Phone# ,�75 - 2&5
Site Address ME. _1\ QLD -z3e1 P air-- \w�)
city �Pl�''9iT $t (A Zip 1''9JZk
Directions to Job Site -A b..e C0!\n A r
Owner Mailing Address
City St W Zip
Lien/Title Folder POAS-kk r\ c-e QAddress
City St Zip
#2 Contractor Name -AWW Vim,'/e tr c ServI'
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 may be required)
#4 Parcel No. 127 3 -29 -4IZ- COc3 io
Legal Description 'T
#5 Building Square Footage: (existing/proposed)
1st PI / 2nd ?I / 3 rd ?1 / Lof t /
Basement / Deck / #bedrooms #batbrooms�_
Garage 1
/ r+..r.'�—,L'�+t / (C�+':.1 Attached :r a^�etac.uCd?
Other sq ft /
#b Use of building Describe work Z Z
#7 Type of Job: New Add Alt Repair Demolition
Woodstove_ Re-Roof Bulkhead Other S ,cjtn
#8 MOBILE HOME INFORMATION
Model Year Make Model
Length_____ Width Ser-al NO.
#Bedrooms #Bathrooms Type of Heat
#9 Any water on or adjacent to property: saltwater lake
river pond wetland seasonal runoff
32
-NC :_r.eCS - --
vent systans X 3 . 00
Sat h 3as-.ems vent ?qS X 3 . 0 0
at Tins No. Boilers/Compressors
Sh wers 0-3 U 6 . 00_
Hot aver Htr 3 -15 HP
Launder washer 15-30 3P �
Sinks 30-50 HP '� 5 . 00
Floor Ora 50 + HF 5 . 00
Lawn ' -_
dry Has No. Air Ha ndl g Uni t
Dishwasher <- 100 cfm. 7 . 50
Disposal 00 cfm. 7 . 50
Urinals � ��.
Svap Coolers
Hoods
Permit Basic Fee 3 . 00 Fire Suppression
TOTAL PLUMBING $ Domes . Incin. _
Comml. Incin.
Mechani cal Fixtuz-�s f:
` Reloc/Repair 6 . 00
M Gas Outlets X 2 .00
No . Fuel Types �� odstove a Leo rat
Furn < 10 BTU 6 . 00 Other
711= > 10OK BTTJ 6. 00
Floor 6 . 00 Permit Basit-Fee 10 . 00
at Pu=s 6. 00 TOTAL MEC.DXIC;LL $
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTROCTION•
AUTHORI= IS NOT COMMEIvCED WIT= 180 DAYS, OR IF CONSTRU=ON OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT AW=.fE AFTER WORK
IS COMMENN=
OWNSRS AFFmavrr coz 'Rac:oRs ar�mAvrr
I CERTIFY THAT I AN EXEMPT FROM THE REMIRElQTS OF THE .I CERTIFY THAT I AN A CURRENTLY REGISTERED CONTRACTOR
CONTRACTORS REGISTRATION UAW RCSI 18.27 AND AN AWE IN THE STATE OF WASHINGTON AND I AN AWARE OF THE
Of THE 'HISON COUNTY ORDIMANCE REQUIREMENTS FOR WNICH ORDINANCE RECUIREMEHTS REGULATING THE WORK FOR WNICH
THIS PERMIT IS ISSUED ANO THAT ALL WORK OOME WILL SE IN THE PERMIT IS ISSUED AND ALL WORK OOME WILL BE IN
CONFORMANCE THEREWITH. MG C]RANGES SMALL SE WE CONFORMANCE THEREWITH. 40 CMANGES SHALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOlT FIRST OBTAINING APPROVAL FROM THE BUILDING
OEPARTMEHT. DEPARTMENT.
X ( WNHR ` I A a BY
CA= CIATE
Return Per= t to : Depart=ent of General Services
426 W_ Cedar/P.O. Box 186, Shelton, PEA 98584 427-9670/1-800-562-5628
FOR OF?ICIAL tTSE ONLY: Accepted bv: Date:
Show following on the site plan
Lac Dimensions Flood Zonesj
Existing St=actures Fences
Struc:::re Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements
Name of Flanking Street Scale:
Name of Fronting Street Date:
PLICBNT TO DRAW SITE PLAN BELO
f� I
PLICANT To DRAW TOPOGRAPHY PROFILE BELO
k
1
DEP=ARTMENT A-L REVIIEW
FOR OFFICE IIS3 ONLY
Aaor°vea Coed Hold
Awroval
P'_aQuiag:
Environmental Health:
Building Plan Review:
I.
Occupancy Group :
Fire Marshall :
at-her:
S
Ijspecial Conditions : II IISite Inspection I II
-
Ij II IlBuilding Pe=it
II Violation Fee I Ij
II
it IlViolat;an Investigation Fee ( II
II I j
II II II Plan Check
Ij II I
II II IIPlumbing Fee I
II it I. i II
It II IIMechanical Fee ,I
II II i. I II
Il Il IlWoodstove Fee I II
II I I
I
II IlBuilding State.Fee
I I l
IIHu='-ding valuation: 4LI
Il II TOTALI �(