HomeMy WebLinkAboutBLD94-00430 Decks - BLD Permit / Conditions - 11/5/1997 MASON COUNTY PERMIT
Mason County Bldg. 111 426 W. Cedar NULL & VOID BY EXPIRATION
P.O. Box 186 Shelton, Washington 98584 DATE -4 -9�7 BY
V$ 11-91, L., t' �1. 04 11%,";
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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 INSPECTION
date by date by date by
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MASON COUNTY
Mason County Bldg. III 426 W. Cedar
F.O. Box 186 Shelton, Washington 98584
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rod iy this cIppartmn" t prior to any 1 !{! { it"r in4per ri ('ll,.; boinq pArlorrd
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HAVE fti{'F'I?!J`•JED NUMf;FRS OR A01JRF93Fq PROVIDED Q •...;ucw A {.;01 c 1 f OH An in Hy PI h I of ,I, V l `: I HI is
ANO LEGIBLE{•IBLI=. FROM M THE ','fR i'. l nR FtfiAW 1 k0N I rNG THE i•f({. PP R i 'r hli5`,NN LuoNly 1•s{11 1 it I410
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Code, the UnifnrW IHI dinq Code and /or Moon i_.ituniv i''G;t111 ) Fttion" {IY"WI
he approved by Masnn rounty prior to ronshruckjonX
i t'1.)}:!_, CFiUI:.T ):C!N PROCESS To BE F If LI{ Cn1?1:}-,F`, l V IA AS EQF {)1) 11•'F l.t pi 0 Wrs` ON r {.{UPI F`I HU i 1 0 fNti
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MASON COUNTY
Mason County Bldg. III 426 W. Cedar
PD. Box.,1.86.Shelton,.Washington .98584
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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 Indicate Directional b N S E
Name of Flanking Street y , , , W)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
Sc q L E Ia�1�?Wu�l I b r 0r1
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MUST MEET ALL CURRENT
VAINI.NUTON STATES CONS
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S e�s WASON BUILDING NSPECTOR
CHANGES SUBJECT TO APPROVAL
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APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
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MASON COUNTY BUILDING DEPARTMENT .
DECK CONSTRUCTION
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Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
PLEASE PRINT
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
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#1 Owner r�l J rS file-1 Phone# 2 0 G 27 — G68`�
Site Add zp<i 4 --3, 2L Z Fire District#
City --13 E L F)q 16L .. St 10A . Zip
Directions to Job Site 1'5 cm aRetrA/rc ti a (NQ/179 SA %U&) 9T AT yd?iLo,J _Q/<
T % QytJ S L CgreveL Qo / 40 /M E _Lc D4/U e, F
o nJ 4o 1V E / / l /76 M a
Owner Mailing Address ho 86 y I I
City F_ 1_F i2 St cOA . Zip 9442A
Lien/Title Holder _7i ref .T� PGA
Address F16 156,L 11
City Z.EzFAig- St WA Zip 98.52P,
#2 Contractor Name ;VC- -j,eLd o Contractor Reg#JZSF/>;t 223DO
Address '-F-In 06-� 1 l Expiration Date 6 3 / 2l7 / 640
City Q.i 2 WA- • St LOA Zip 9/V, 52-Q Phone# 2�,oG ?7 7 d 6A L/
#3 If septic is located on project site, include records.
Connect to Septic?_ _Public Water Supply . Well 7�
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No._/23 Z D - 3 ' - oo266
Legal Description T2 2G oh �,n, Lor 3 .
#5 Building Square Footage: (existing/proposed)
1st FI / 2nd FI / 3rd FI / Loft /
Basement / Deck /11#bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other sq.ft. /
#6 Use of building l 10F iA� Describe work cPur L,( FQvti�
4NJ qgAcK 2EG KS
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year 77 Make ! k Model i liJ�d r:
Length J- O' Width Serial No.
#Bedrooms #Bathrooms 2 Type of Heat
Purchase Price$ �J ,6 U)o
#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 Indicate Directional by (N, S, E, W)
Name of Flanking Street
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
�`�
Sc.A LE ���f�oy� `'� = ib� Itl
6 _
r
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
_Bath Tubs No. Uni s 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 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 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- TOTAL MECHANICAL $
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 OFTHE 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 C ES SHALL BE MADE WITHOUT
MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST 01 NIN P OV7TH71LDING
THE BUILDING DEPARTMENT. DEPARTMENT.X OWNER X BY � j c)
DATE DATE ,5
Ft71�Of"�COIAL t1SF ONLY Aec�pted by Date
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
Environmental Health: n%oW6W, 'Jo G
Building Plan Review
Occupancy Group: Vn - I Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit
Plan Check
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee
Other
++ �7 �> Other
'e Building Valuation: 1 l � TOTAL FEE ®o