HomeMy WebLinkAboutBLD92-1268 Mobile Home - BLD Permit / Conditions - 12/2/1997 MASON COUNTY
PERMIT
Mason County Bldg. III 426 W. Cedar NULL & VOID BY EXPIRATION
RO. Box 186 Shelton, Washington 98584 DATE BY
R 1:1 1 d 4, 1_N 1.{ 1 i tilt 1 q
t
t3l_t)92—I?61H I'1t1 l I I >.i-i0o:, i 0000H
1,Ik iltt#,r , iN1 81 CAPTAI" K IDO. . . C 1 101 1 AIN
Ctt 1flt I< t t f`,A P ( 0HN I R1K I 1 ON 1:1) A 11- 6 i,*,4
{it,- (aWNF O 1 ', CON 11?a1I'IOR,
! i t A I 01110S tAYt ply 4 Nil. 101: 8 14 44$41 Mk Is#
t ,
it i.t�1 1i§.Itl� - _ ItJ� l ii '. .. Il ;i'? Ri .�r id{ �'{J`s flit; a is f k '� •t :� {•Pp}f i.; :p I r:
I YI I 1tI t1:;I mH `j I Lth I t t <>
I
ilf, 1 I f ?`'�-E' I (l�. t 4i t'allf t h# It11 i�'r{q
I t
`it t lli i i AI I t I Vl ( i
1 Iq I I` 1 I tltt o? 1 ea I �!tiisl I ! Ptl !I AIItItlsltt?1
•t;
I'9
t_ipt i 1 {It v1 t "< ! 1t! �n
'� i k1� et1 It I t P•tI t;
lt1 'f I (`t t ,,ttF: Ii� ?'h f•I': d`) '�'I' �+ { i I t Irl': ti! . '-�ItSI �{ti} � I; ,. t.v } 1 f'A,i !
iil! I ! ii i Id( I t. I in I kfF i rdts t ittl,µ
t ..,I` 1vil. h; € _ ,.?•_. ( I ritill;ti,'/ t ts., �' t� r,ttt�{ � t I�It I ti ; i-. . ;tit
Itl, , h;�, �r)•=, ! I1 � ' fi'.fV"=iii t_f eil t �irsl'd?:t I I'��. !)i'.4 ! 4 rrl+ik`kl 1 C'ft ` t1 �, I t��: ,{
iP,it. l!_ a,1•:I' 4 <: I t,11I i 1t ! ',I'tl lIttl
r1 I .1•I= I tl1< I I1Ri �. vt l �?,�,�+t�± � i ,n �� t�, t sft I{ tln� i �;
f1 I ':t 4 I m I I ., i tl1•'1:
I'110,111i Qt'athtpIlON:N{IIIIII HAN•,.
RRliJFI`I titt;ATI I'm�N{iAIH��910R1 kIf 1i :.rNItttfAlf iAiti kI it >AN1111ItI f4 IIFI IIN IAkolm IA?t It tI I)$ I_A1-16111 t11111
Ilii'a I'IhN1I ktiOf oil II ANFI VttIli I I, it i,(10" fiill I16A AV1110liI IIt I HAI II)MON( llt 4iiIt10 1 k 0 PA'i sif: II tEthfi11t11o$ Itp 14it
Ot IMA bfi;'ti Al NN IINE A6TIR U0I! I`; t.11AI C'10 fV10f"If tit I'1)0f AIAIIitI ttl� 4itkt I`+ +i FRttahf�:�, I0';I'I-rlIit0 WIINCN 1Hf !aa it A'; I'f#±I+tlg ftNAl t0'41°ftli44 i!'t ;t A,
APpkilvI1 0 1 F 0 0 f HIf11410 rA `sii Otrill RI10
OUNI.R 11F RGI a I� t t.', \. a •1..� I`A t
IIIIt PBNI . rev: C<; i{ 41
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback X date by Ribbons
date -2— ,!�-- z by Gas Piping date b
Foundation Walls date by Set Up
date __ by INSULATION date by
BG/SLA@ Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
d date by
ate by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
a•acar7 vat �.U Ui�a Z
BUILDING PERMIT APPLICATION ,
PLEASE PRINTNa�z UIT A6
���
#1 Owner Ospp CG�j V 0 � •Phone#
Site Address
City '£(_F/n St U-X H Zip
Direr,tions to Job Site `i (Zc PON) rCtm AEL
t i (>J i- CI J 2\ j
C
A) CAQ1f)T�J V VD (3n o Li i C)k) BHT—
Owner Mailing Address V OI.J
City � VC St Zip cfK�l
Lien/Title Holder KD QCk JWQ C-L-W CO. 1J
Address _ 9^�-
City St Zip
#2 Contractor Name Ow Com- Q�t Contractor Reg# e[JACC /36 DQ
Address 3 3 Expiration date
City StZip c Phone
#3 If septic is located on project site, include rec rds.
Connect to Septic? Public Water Supply_ Well
(If residential, proof of potable water may be required)
#4 Parcel No.1 "Ao - J( now
Legal Description LOT 5Z (Tv q 4 os Cc�
#5 Building Square Footage: (existing/proposed) h
1st Fl / 2nd Fl / 3rd Fl / Loft /
Basement / Deck / #bedrooms_ #bathrooms_
Garage / Carport -• / (Circle: Attached or Detached?)
Other sq ft /
#6 Use of building_ I J-' 1-On- Describe work
#7 Type of Job: New Add Alt Repair Demolition
Woodstove Re-Roof Bulkhead Other
#8 MOBILE N
Model Year Make G)tA C Model
Length Width 9 Serial No. iin9L4
#Bedrooms _ #Bathrooms
Type of Heat _ (�
#9 Any water on or adjacent to property:0sal twat er lake
river pond wetland seasonal runoff
other
Lot Dimensions Flood Zones
Existing Strictures Fences
Stricture Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements
Name of Flanking Street Scale:
Name of Fronting Street Date: Q
APPLICANT TO DRAW SITE PLAN BELO
Rzoposo
OCR i�c�
Q S T
o�
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELO
Ste.
i
F'on
No. Toilets y Vent Systems X 3 . 00
Bath Basins Vent Fans X 3 . 00
Bath Tubs
—_. No. Boilers/Compressors
l Showers 0-3 HP 6 . 00
L Hot Water Htr 3-15 HP
00
=Laundry Washer 15-30 HP 6 . 00
Sinks
30-50 HP 6 . 00
Floor Drains 50 + HP s o�
Laundry Basins No. Air Handling Unit
Dishwasher <- 10000 cfm. 7 . 50
Disposal > 10000 cfm. 7 . 50
Urinals Other
Other Evap Coolers
Hoods
Permit Basic Fee 3 . 00 Fire Suppression _
TOTAL PLUMBING $ Domes. Incin.
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 >a 100K BTU 6 . 00
Furn - Floor 6 . 00 Permit Basic Fee 10 . 00
Heat Pumps 6_00 TOTAL MECHANICAL $
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK
IS COMMENCED
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR
CONTRACTORS REGISTRATION LAN RCW 18.27 AND AM AWARE IN THE STATE OF WASHINGTON AND I AM AWARE OF THE
OF THE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH
THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
DEPARTMENT. /,1 T DEPARTMENT.
X OWNERIIs,�( CW�1 ' W'J��.
D / X BY - �,a
ATE • ,�.;
DATEaj
Return permit to: Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
FOR OFFICIAL USE ONLY: Accepted by: Date:
Approved Cond Hold
Approval
7 Planning:
Environmental Health: YIJ
Building Plan Review:
1 o V
Occupancy Group:_,
Fire Marshall:
Other:
FEES
IlSpec: II IISite Inspection I II
II
II II IlBuilding Permit I
II 1 I
II II IlViolation Fee I II
II II II ;I
II II Ilviolation Investigation Fee I II
II II I; —�---;I
II I ilPlan Check I I II
I H ')
II II II Plumbing Fee I II
II II II 'I
II II IlMechanical Fee I II
II H
II IlWoodstove Fee I II
II II 'I
II IlBuilding State Fee
'I G
IlBuilding valuation: �4 11 11 TOTAL I 75 11