HomeMy WebLinkAboutBLD92-1142 Woodstove - BLD Permit / Conditions - 9/23/1992 MASON COUNTY
—� Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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APPROVED OffO.R.t RitI1DiN5 'CAM BE OLtVR1rb
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date by
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
PLUMBING Attic by OTHER
Groundwork
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by dates by date by
TyS,62c
• ?SASCN �^uIINT'T
BLILDD G PERMIT APPLICATION
PLEASE PRINT
C4
#1 Owner Phoae#
Site Address �s
City St
ip
Directions to Job Site ire
Owner Mailing Address
City St Zip
Lien/Title Holder
Address
Ci ty S t Zip
#2 Contractor Name Contractor Reg# Z�'C` ' -Pr'1/L
Address Expiration date 6
City ,�( �► �1 Sf Zip Phone �` �r L>
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply_ Well
(If residential, proof of potable crater may be required)
#4 Parcel No... "� j^� �j 20 2-`� - SO - Cl O !L2
Legal Description
#5 Building Square Faotage: (existing/proposed)
1st FI / 2nd QI / 3rd FI / Loft /
Basement / Deck / #bedrooms _ #bathrooms_,
Garage / Carport / (Circle: Attached or Detached?)
Other sq ft /
#6 Use of building Describe work j&j� �rsr' .
#7 Type of Job: New Add Alt Repairer Demolition
Woodstcve— N�- Re-Roof Bulkhead Other
#8 BILE HOME INFO M=ON
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
Vent .Svstems x. 3 _-
3at 3as,ns 'lent _ azs X
Bat: -T,,=s No . Boilers/Compressors
Showers 0-3 P 6 . 00_
icc Wacer ar 3 -15 HP
_6 .J 0
Laundr-r Washer 15-3 0 3P
—Sinks 30-50 HP 5 . 00
Floor Drains 50 + Hp
5 . 00
L.aund--1 Basins No. Air Handling IIni t
Dishwasher
<- 10000 cfm. 7 . 50
Disposal > 10000 cfm. 7 . 50
IIrinals Other
Other rvap Coolers _
Hoods
Permit Basic Fee 3 . 00 Fire Suppression
TOTAL PLUMBING $ Domes. Incin.
Comml. Incin.
Reloc/Repair 6 . 00
Mechanical FiYtu-ems Gas Outlets X 2 .00
No . Fuel Types Woodstove separate
Fur= < 100R BTU 6 . 00 Other
Fu='a >- 10 O K BTU 6 . 00
Fur= - Floor 6 . 00 Permit Basic Fee 10 . 00
Heat Pumps 6. 00 TOTAL XECHAN CAL $
NOTICE: THIS PST BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
A=CRZ= IS NOT COMMEN= WI THIN 180 DAYS, OR IF CONSTRUCTION OR WORK
IS SUSPEM= OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTF.,R WCR_K
IS COMMENC=
awNEits AF?'=V'Z CONTRACTCRs AFP=vrr
I CERTIFY THAT I AN EXElIPT FROM THE REOUIRg"TS OF THE .I CERTIFY THAT I AN A CURRENTLY REGISTERED CONTRACnX
CONTRACTORS REGISTRATION LAW RCN 18.27 , AND AN AWARE IN THE STATE OF WASHINGTON AID I AN AWARE Of THE
OF THE MASON COUNTY ORO I NANICE REGII I RE?HENTS FOR WHICH OD I NANCE RM I RBOMS REGULATING THE WORK FOR WHICH
THIS PERMIT is ISSUED AND THAT ALL WORK DONE WILL BE IN THE PERMIT IS ISSUED AND ALL WORK GONE WILL B[ IN
CONFORJNANCE THEREWITH. NO CHANGES SNAIL BE MADE CINNfH>RIIANCE THEREWITH. NQ CHANGES SHALL SE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING Al OEP FROM THE BUILDING
IUHTlfEHT. OEPARTNENT.
X OWNER Z BY
WHYS .�
Return permit to: Department of General Services
426 DP. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
FOR OFFICES,, USE ONLY: Accented by: Date:
1
-show' following on the site plan
Lot Dimensions Mood Zones
Existing _`�7t--uctures Fences
Struc;:ure Sethacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements
Name of Flanking Street Scale:
Name of Fronting Street Date:
PLICANT TO DRAW SITE PLAN BELO
PLICA= TO DRAW TOPOGRAPHY PROFILE BELO
D EPARTNILEN T.0 RE VIE W
FOR OFFICE USS ONLY -
�Aoot ovaa 'Car«y Hold
Approval
i
P1an.:::g:
Environmental Health:
Building Plan Review:
Occupancy Group :
Fire Marshall :
at-her:
llsnecial conditions: 11 Ilsite Inspection I II
II II L' ----;1
II II llBuilding Permit I Il
11 11 IlViolatian Fee ( II
(I 11 IlViolatian Investigation .Fee I II
(I II I
li 11 II Plan check it
11 II I� I it
II 11 11 Plumbing Fee 1!
it II i. I II
II 11 IIMec�ical Fee f ;1
II Il i. I II
II l
II II Ilwocdstave Fee I II
Imo— 11 IlBuilding State- Fee I II
1lHuilding Valuation: II II IOZ'AL I lI
LL-- �