HomeMy WebLinkAboutBLD93-1721 Final Deck - BLD Permit / Conditions - 11/22/1993 MASON COUNTY
Mason County Bldg. III 426 W. Cedar
RO. Box 186 Shelton, Washington 98584
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OWNER
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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 Final
Floors
date by date by date by
FRAMING Walls FIRE DEPT.
date by date b date by
y
PLUMBING Attic OTHER
Groundwork
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
. F►NwLidD o N Jim 22- 42 L W
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Sir. ��0 43- rasa Fon� leo�r�ecat��i$�.
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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i CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING Attic OTHER
Groundwork
date b date by
WALLBOARD NAILING
D.W.V. date by
date by FINAL INSPECTION
Water Line
date by date by date by
I
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Permit No.
g Lim
MASON COUNTY
Ul DING PERMIT APPLICATION
N O V 5 4261$/.Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
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PLEASE PRINT
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#1 fv:A�� s7��"� � - /�S Phone# �?OG) 27� 0/6?,
Site Address ? (f_h)1J601< Fire District#
City 73FL i--A)d 1. St ),,1/4 Zip Zq6?,q
Directions to Job Site /Jo, 4 .aeLr yi/2 -7-'0 (fkeCK
�"'Pad n fD 0('Y'R G1 r n J n "X >R l"O LZ '4;7
Owner Mailing Address ISO 1__1y15_zL �3
City 0��r'o IV, St Zip
Lien/Title Holder
Address
Clty St Zip
#2 Contractor Name �GV1Y? G�OInI ���' "JAY . Contractor Reg#
Address Expiration Date
City St Zip Phone#
#3 If septic is loba\ted on project site, include cords.
Connect to Septic? Public Water Supply Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)\
#4 Parcel No. 1Z.330 - 32 - 90 5
Legal Description
#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-buildifg )ECI< Fo/C- `n')OL)LLr Pan-re- - Describe work /q ALL ✓l
�v' X 241 -noZ CF
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/ NUFACTURED HOM INFORMATION �� 2
Model Year Make Model
co
Length Width Seria o.
#Bedrooms # Bathrooms Type of Heat Q
Purchase Price$\ n w
#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 /J�)/J C_-
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, >Er W)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PI AN�ELOW
— — -- - -----
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C'evU „ ''LL„ � — ---- - - -- �o fl)
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APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
I
Plum,bing Fixtures ($3 each) Fgg 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 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 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
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 CHANGES SHALL BE MADE WITHOUT
MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING D
E DEPARTMENT.
J
X OWNER X BY
DATE _&JcslC ,I '?S DATE
.:. . .. ....
FC3R O1"ICIAL USA ONLY i4Cce ted b Date
p
DEPARTMENTAL REVIEW n��:�� YF' OG
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: J I 1)01) �v✓I e�- �:. ?���,�,� I c�, - 11 _s� v-)
Environmental Health:
Building Plan Review
Occupancy Group: De-IL Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit ?,CID
Plan Check 1s,
OD
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee
Other
Other
Building Valuation: TOTAL FEE 5