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HomeMy WebLinkAboutMIS95-0664 ReRoof - MIS Permit / Conditions - 8/30/1995 MASON COUNTY Mason County Bldg, III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 , i'VI 1 C. f= I...._ L A N F Cl>U fc:� PERM I FOR INSPECTIONS CAL I.. 42 7-9670 MI S95-0664 PARCEL_ : 123294200030 PL..�+ i D i V : BLK : !.01 : JOB ADDRF SS . . . APPL. I CANT i GEORGE WFRDOLL 275--38313 OWNLR : GE:ORGE WFRDOL 1 275-3838 PERM �*4 LEGAI TO 3 OF NIP 3E PROJECT DESCR 1 PT I ON �{0. REROOF O PEE PROJECT t_OCA F I ON TWO DH I VEWAYS ON R 1 GNT SIDE HW/Y 300 PROJECT NOTES TYPE AMOUNT BY DATE 171 CEO ! 1'1 STFE 1 4 .50 KS 08/30l95 796 RER€' 25 .00 KS 08/30/9 5 796 r". ,t ^OWNER OR AGENT DATE MIS_ ONT, rev, /4111l42 l 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 I J {-Y9,5'0/ 64 Permit No. -A* 0`7'T G MASON COUNTY vss�-` , BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 Owner h 9 C.--- 60 r- C-ld Phone# ' 5 3 _ Site Address / ,/Ul Fire District# �- city 1/ St W 1� Zip �2 Directions to Job Site �' l v a d '� / )1 Owner Mailing Address J `- City St Zip Lien/Title Holder 01 V Address City / d / r-' St Zip #2 Contractor Name ��c f 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) a3� o©o36 #4 Parcel No. - Legal Description �' �) (� S' ,::::- #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 Describe work #7 Type of Job: New Add Alt Repair Other #8 MOBILE/MANUF CTURED HOME INFORMATION Model Year Make Model Length Wi h Serial No. # Bedrooms Bathrooms Type of Heat Purchase Pri e$ #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: 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 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 / d i y APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plums ing Fixtures ($3 each) Fee Mechanical Fixtures 6 each No. Toilets CIRCLE FUEL TYPE: Gas, Electric, Bath Basins Heatpump, Other_ 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 Handlina Unita _Disposal _ cfm# Urinals No. Fire Protection Systems Other _ Auto. Fire Alarm Sys 50.00 Fixed Fire 113upp. Sys 50.00 Permit Basic Fee 15.00 _ Auto Fire Spirink Sys 25.00 TOTAL PLUMBING $ No. Other Gas Outlets 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- 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 OBTAINING APPROVAL FROM THE BUILDING THE BUILDING D ARTMENT. D DEPARTMENT. X OWNER mod" X BY DATE DATE FOR OFFICIAL USE ONLY: Accepted by: Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: I Building Plan Review Occupancy Group: Type of Const: Fire Marshal: I Other: Special Conditions: FEES Building Permit 2S 0-0- Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other Other Building Valuation: TOTAL FEE S