HomeMy WebLinkAboutBLD93-0358 Final SFR - BLD Permit / Conditions - 10/15/1993 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 o- by Ribbons
date Or, 7- (,,-�3 by L(- J Gas Piping date b
Foundation Walls date by Set Up
date ` _. __7 by L INSULATION date by
BG/SLAB Insulation Floors Final
date -7 - 3 by r. .—J
FRAMING date U1f� g-Z(o- D by L�--� date by
Walls FIRE DEPT.
date r)I� - - 3 by `- date �r� date by
PLUMBING by OTHER
Groundwork , -Z Attic
date I( J b date OV' / .- 53 by �---�
D.W.V. WALLBOARD NAILING
date '6-20_ 3 by L J date by
Water Line FINAL INSPECTION
date 13-2_0- 5 by �� date by L date by
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MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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Permit No
MASON COUNTY �
NG PERMIT APPLICATION
►j A_
PLEASE PRIN 0
#1 Owner a Phone#
Site Address /'�' Fire District
City S t 9/4 s"01 Z ip �19_5_ s_
Directions to Job Site Zc 4)
,
� r
Z." 7- n nJ LL`9T
Owner Mailing Address G
City 1���.�.�:lZ St Zip
Lien/Title Holder
Address
City St Zip
#2 Contractor Name A Contractor Reg#pwim8� 7
Address 6 Expiration date
City St Zip Phone
#3 If septic is located on project site, include records .
Connect to Septic? Public Water Supply L� Well
(If residential, proof of potable water is required)
#4 Parcel No. 10� 3 30 -�/ -
Legal Description ��� �z Lei`,/
#5 Building Square Footage:
1st F1 Wf 2nd F1 'adc 3rd F1 Loft Basement
Deck_ #bedrooms 3 #bathrooms e9- Garage A44-- Carport'
Garage/Carport: Attached or Detached
Other
#6 Use of building S�`c r/�S Describe work /L1-1-w Av5,&_e .1i'o�'
#7 Type of Job: New o,- Add Alt Repair Demolition
Re-Roof Bulkhead Other
#8 MOBILE HOME INFORMATION
i
Model Year Make •M Xe'r
Length Width Serial,P
#Bedrooms #Ba ooms a of Heat
#9 Any water on or adja n t roperty: saltwater lake
river pond wetlan seasonal runoff
other
1
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 Scale:
Name of Fronting Street 11 Date:
APPLICANT TO DRAW SITE PLAN BELOW
o
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
i,
I
I
Plumbing Fixtures Fee Mechanical Fixtures
No. :2_Toilets Pr ry Heat Source (circle type)
.Bath Basins Elec eatpump/other
• Bath Tubs -,� 5�w Ce.�hi
Showers NO. FEE
-L-Hot Water Htr Furn
Laundry Washer Heat Pumps
Sinks 3 Vent Sys (Central)
Floor Drains 3 Vent Fans (Spot/Whole
Laundry Basins Boilers/Compressors
_ZDishwasher HP
Disposal Air Handling Unit
Urinals cfm.
Other Fire Protection Systems
Permit Basic Fee
TOTAL PLUMBING $
Other
Gas Outlets .Hookups
Wood/Pellet/Gas Stove
Other
Permit Basic Fee 14
TOTAL MECHANICAL $ 33
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 LAW 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. DEPARTMENT.
X OWNER X BY
DATE DATE
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: Tate:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond Hold
Approval
Planning:
moms
Environmental Health:
Building Plan Review:
Occupancy Group:_
Fire Marshal:
Other:
FEES
IlSpecial Conditions : II IlSite Inspection
II IlBuilding Permit �, 113(o Q
II I
11 Ilviolation Investigation Fee
II I
II II II Plan Check , II
II II 1 i 5fn:.k
II II II Plumbing Fee I $ ��
II II IlMechanical Fee 1 II
II II I
II II IlWoodstove Fee I II
II II I I �
II II IlBuilding State Fee II
IlBuilding Valuation: II II TOTAL I , 5