HomeMy WebLinkAboutBLD93-1158 Final Mobile Home - BLD Permit / Conditions - 11/2/1993 ..4
MASON COUNTY
Mason County Bldg.' 111 426 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 014 -ZL-Cj by L�
BG/SLAB Insulation Floors Final
date by date by date
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING Attic OTHER
Groundwork
date b 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
RO, 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 �7 oZ� 'i-3 byC.L_-,
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING Attic OTHER
Groundwork date by 5. D. Ci— —S
date b
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 �G, U
PLEASE PRINT �
#1 Owner .1 I A /J DA L)/e S Phone# 2 7:3-- Z
Site Address '/F7- fo Fire District#
City l s._A St W,4. . Zip
Directions to Job Site Afo T-E „Sh6 e ,,,fi icc d. -n./Z
o .v 9R 8 0 !.E F1-
T P R I 0 fir►'-G D, 5 1 G-AJ . 2e E 1,J0 4? ?-o L I aF!"-
Owner Mailing Address PC) 1811 1/
City "C! 1=a r k.'_. St 0-J/,
Lien/Title Holder 6 re etJ i 2 ri= F)11,4Af C4i- eo iZ l' ;w, : e? ( eAds zre/�..,1
Address__ n S �?�t�, sr, S4iTF 202 Vo Bo,C 32 io
Clty o-JA,1 , IAJA. 78041-:Z1 St U),4 . Zip `I8o6 3
31
#2 Contractor Name _n / �� y �� (e S io-n 1F c Contractor Reg# (7Q(!
Address 26 t3 `?Q `1 Expiration Date 7
City o 1-s`f" St l,U Zip Phone# .2 06 4/71� ?�-'7 W
#3 If septic is located on project site, include records.
Connect to Septic?-Pe 5 Public Water Supply X Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No. 1 2 3 n - %2 - 9 02 r
Legal Description Lo7- 3 S/'loP_i PIK,07 '-' Ig7A -30, ?23n/, R101w,Nl.
#5 Building Square Footage: (existing/proposed)
1st FI / 2nd FI / 3rd FI / Loft /
�- Basement / Deck / #bedrooms / #bathrooms /
'C� Garage / Carport / (Circle:Attached or Detached?)
Other sq.ft. /
#6 Use of building !C e-$ Describe work
S I--z4-J l- 00/(c
#7 Type of Job: New r Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year l , 4 Make('L1FrTAk)J;;Model l,!14l�P&I QP�f�,57+
Length t Width 6' .1" Serial No. L-L zUe-f Ull;LA - zl- Y-17,
#Bedrooms #Bathrooms 2 Type of Heat
Purchase Price$ �9 IUD
11
#9 Indicate by circling the applicable source if any water is on or adjacent to subject property: /iliq-
River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other
I
Show following on the site plan
F
nsions Flood Zones
Structures Fences
Setbacks Driveways
nes Shorelines
Plan Topography
ystems Wells 11f
Proposed Improvements Easements
Name of Flanking Street Indicate Directional by (N, S, E, W)
Name of Fronting Street in relation to plot plan
;bJA
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rLevb -
A PLICANT TO DRAW SITE PLA"ECO - -
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APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
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Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each
CIRCLE FUEL TYPE: Gas, Electric,
Bath Basins Heatpump, Other
Bath Tubs No. Units ,sU.�t Fees
_Showers I Furn 600 BTU
9 Hot Water Htr _ Heatpumps
Laundry Washer Vent Systems
% Sinks Spot Vent Fans
_Floor Drains 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 upp. Sys 50.00
Permit Basic Fee 15.00 _ Au Sprink Sys 25.00
TOTAL PLUMBING $ No. Other
Gas Outlets l
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 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
MEATS 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 APPROVA7;(.
THE BUILDING
THE BUILDING PARTMENT. DEPART ENT.
yX OWNER X BY
DATE .2 a � -I� DATE L43
FQ�t OEI*ICIAL 1JSE gNLY Accepted by' �::. `.�' ' Date �.� ,�
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: Na/& se-]Y cu S
�Y11MS
Environmental Health:
Building Plan Review
PN ST 4 t L Pt IL-
® -C
Occupancy Group :Try pe_of Cons#:
Fire Marshal:
Other:
Special Conditions: Ale r-og Dt�cig FEES
, P-4/V'S 610 3tr1f4J>16JC- OE Pe,0-49;;5 Building Permit
Plan Check
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee
Other
j Other
Building Valuation. '���b�� TOTAL FEE