HomeMy WebLinkAboutMIS92-0155 Final Woodstove - MIS Permit / Conditions - 1/26/1993 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 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 INSPECTIO
date by date �� by date by
Permit No.BLD
MASON COUNTY
BUILDING PERMIT APPLICATION .(YI (5q6? -0(��.'L
PLEASE PRINT r% l � l!C� r��/ �i
Owner Phone \6
Site Address e r P Ed 4kA 1
City State t
Directions to. Job Site 1:'i"`tn _. Kunr'-14
Owner Mailing Address NZ44
City -State fA _Zip ,_ '
Lien/Title Holder
Address
City State . zip
#2 Contractor Name Contractor Reg #
Address _.ExTiration Date
City State 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. )
Parcel No. 2_3 2.
Legal Description TtZ Ito -me-
#5 Building Square Footage: (existing/proposed)
ist Fl 2nd Fl— —3 rd Fl —Loft
Basement -Deck #Bedrooms —#Bathrooms
Garage —Carport. (Circler Attached or Detached?)
Other sq ft
#6 Tie, of building Describe work AG
#7 Type of J0 J New Add Alt Repair Demolition
Woodstove. 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 adjacent to property: Saltwater Lake River
Pond wetland Seasonal runoff Other
Show'.foTlowin a on the
Lot Di
mensions'.
en S1.ons'
1"ood'Zo nes
Existing---.:
tin ��S t rn cture s�.
g. 33
. . •Fences.
Structure.:Setbacks Driveways:.
Water Lines
Shoreline ..
Drainage Plan T
oPo9raPhy
Septic System Wells.
- Proposed Improvements Easements
Name of Flanking Street "
Name of Fronting Street Scale:.
ate .,
APPLICANT TO DRAW SITE PLAN BELOW .
i
I
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
i
i
I
Plumbing Fixtures ($2.00 each) Fee: No. Boilers/Compressor Fe\9
No. Toilets
0-3 HP 0
Bath Basins 3-13 HP \
6.00
Bath Tubs 15-30 HP 6.00
Showers 30-50 HP 6:00
Hot Water Htr 50 + HP 6.00
Laundry Washer
.Sinks No. Air Handling Unit
Floor Drains <= 10, 000 cfm. 7_50
Laundry Basins > 10, 000 cfm. 7.50
Dishwasher
Disposal Other
Urinals
Evap Coolers
_Other,- Hoods
Fire Suppression
Permit Basic Fee 3.00 Domes. Incin.
TOTAL PLUMBING $ Comml. Incin.
Reloc/Repair 6.00
Mechanical Fixtures Gas Outlets x 2.00
No. Fuel Types Woodstove separate
Furn < 100K BTU 6.00 Other
Furn >= 100K BTU 6.00
Furs - Floor 6.00 Permit Basic Fee 10.00
Heat Pumps 6.00 TOTAL MECHANICAL $
Vent System x 3.00
Vent Fans x 3.00
NOTICE: THIS PERMIT: . BECCMES N= AND= VOID IF *ORK. OR. CONSTR13CTION
ADTHORIZED IS NOT COMbMNCED WITHIN 180- DAYS; OR IF CONSTRUCTIOW,OR;,WORIC,.IS.
SUSPMMED OR ABANDONED FOR..A PERIOD OF 180..DAYS AT ANT' TIME AF.TEB.WORK:".3S"
OWNERS AFFIDAVIT - = CONTRACTORS AFFIDAVIT
I certify that I am exempt from the requirements of the I certify that I am a currently registered contractor in
contractors registration law RCW 18.27 , and- am the State of Washington and I am aware of the
aware of the Mason County Ordinance requirements for ordinance requirements regulating the work for which
which this permit is issued and that all work done will the permit is issued and all work done will be in
be in conformance therewith. No changes shall be conformance therewith. No changes shall be made
ade without first obtaining approval from the Building without first obtaining approval from the Building
epartment. Q2 1 Department.
r3
X BY
DATE: 15,- I DATE
Return permit to: Department of General Services 426 W. Cedar Street/P.O. Box 186
Shelton, WA 98584 427-9670/1-800-562-5638
FOR OFFICIAL USE ONLY: Accepted by: Date:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
An—" C-L xw
Awed
Planning:
Environmental Health:
Building Plan Review:
Occupancy Group:
Fire Marshall•
Other:
FEES
Special Conditions:. ;
Site Inspection �
Building Permit
Violation Fee
Violation Investigation Fee-_
Plan Check
Plumbing Fee
Mechanical Fee
Woodstove Fee
Building State Fee
Building Valuation:
TOTAL