HomeMy WebLinkAboutMIS93-0044 Final Woodstove - MIS Permit / Conditions - 3/9/1993 MASON COUNTY
Mason County Bldg. III 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 by
BG/SLAB Insulation Floors Final
date FRAMING by date by date by
Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION-:dC
date by date_p_y ; by date by
i
DEPARTMENTAL REVIEW Permit No
- C
�LS /
FOR OFFICE USE ONLY MASON COUNTY
BUILDING PERMIT APPLICATION
�..L PLEASE PRINT 1 /� ,�C+� — LD.
Planning: J-�
441 Owner Pr�1 Rl�lc 17• ����G� Phone# Ca��� �5 Cor53�'
Site Address K E :a1 5akoct,v-<
City C3 �z-\F►��fZ State Wow Zip 9'55:A
Environmental Health:
Directions to Job Site WZst o SK,,f RI-4 Right ON SA*( 4;1� ROAD
Ltd Grp U%C�,c,-j L►aKu 6LVd R1 hf ON Sc.hoo�Nee, Lcr
� e
5 Gl�u c r� P L.ra c:� . lst ►w,.:s:� c,� (rz�-� .
Owner Mailing Address WE 5L�.00Nze_ PLrac-z
Building Plan Review: City '6z-k q w'rz State ('6o' Zip
Lien/Title Holder_ KQ`f C:o�p MmK+�aqr� 7Ep c
Address P 0 130rc 35SN
Occupancy Group: City PC"Lk 4_xNck State CR Zip lgao,3 - 3596
Fire Marshall: #2 Contractor Name Contractor Reg #
Address h" I""4_'o- vi P 0 �C'X t1t,0* I Expiration Date
City Q av��kc�� Stated" Zip`1'661'SL14S Phon X�( a75 -915`�
Other: #3 If septic is located on project site, include records.
Connect to Septic? Cz.' Public Water Supply Well
(If residential, proof of potable water may be required. )
FEES #4 Parcel No. LOt(5)a-'+ e'W5 co-je- Afo.S nc 'idlw- i't Pint +k0_Xe;F
U Cl lAM0. 7 c{` al.Ats c s 113 -0b [
Special Conditions: ; a�_ f
Site Inspection
#5 Building Square Footage: (existing/proposed)
-Building Permit 1st Fl 1 3 A ' / 2nd Fl / 3rd Fl / Loft /
Basement / Deck 'i-"^s / #Bedrooms 3 / #Bathrooms :;t- /
Violation Fee Garage / Carport Lfo� / (Circle: Attached or 'Detached?
Other sq ft__ /
Violation Investigation Fee
#6 Use of building R-�� c� Describe work
Plan Check
#7 Type of Job: New Add Alt Repair Demolition
Plumbing Fee
oodstove Re-roof Bulkhead Other
Mechanical Fee ' #8 Mobile Home Information
Model Year � Make Model ,)(,A
Woodstove Fee Length P- Width N A Serial No. A
#Bedrooms N pl #Bathrooms ti Type of Heat
Buildin State Fee � �
Building Valuation: I i #9 Any ter on or ad acent to property: S it water ti' Lake H A River
TOTAL Pond Wetland�Seasonal runoff K A Other IJ QNC-
Show folTnwinQ on Plumbinc Fixtures ($2.00 each) Fee No.
Boilers/Compressor Fees:
No. Toilets Lot Dimensions Flood'Zones i 0-3 HP �Op
[[Existing Structures Bath Basins
Structure Setbacks Fences , 3-15 HP 6.
Driveways Bath Tubs 00
water Lines Shorelines 15-30 HP 6.00
Drainage Plan Showers
We Hot Water Htr
Wells Septic System Topography 6.00
ProposedImprovements
_ wa Basements _ 30-50 HP 50 + Hp
Name of Flanking Street Laundry Washer 6-00
Name of Fronting Street [Dattcale: Sinks
No. Air Handling Unit
e: ' Floor Drains
Laundry Basins <= 10, 000 cfm. 7.50
APPLICANT TO DRAW SITE PLAN BELOW. > 10, 000 cfm.
Dishwasher 7.50
Disposal Other
Urinals
Other EvaP Coolers
Hoods --
Permit Basic Fee Fire Suppression
3.00 Domes. Incin.
TOTAL PLUMBING $
Comml. Incin.
Reloc/Repair 6.00
Mechanical Fix ��reg
Gas Outlets x 2.00
No Fuel Types
Furn < 100K BTU CK' Woodstove
separate
6.00 Other
Furn >= 100K BTU 6.00
Furn - Floor 6.00 Permit Basic Fee
Heat Pumps 6.00 10.00
TOTAL MECHANICAL $
Vent System x 3.00
Vent Fans x 3.00
NOTICE: THIS PERMIT' BECMMS xUU AND APPLICANT TO DRAW TOPOGRApHy PROFILE BELOW AUTHORIZED IS NOT COMME2TCSVOID IF WORK N
OR. CONSTRUCTION
SUSPENDED 180 DAYS,., OR IF CONSTRUCTION 0 TRUCTIO
SUSPENDED OR ABANDONED FOR.:]► PERIOD WORK IS
OF 180 DAYS AT ANY TIME AFTER wORK: IS
COMMENCED.
OWNERS AFFIDAVrr CONTRACTORS AFFIDAVIT
I certify that I am exempt from the requirements of the I certify that I am a currently registered contractor in
contractors registration law RCW 18.27 , and am the State of Washington and I am aware of the
aware of the Mason County Ordinance requirements for ordinance requirements regulating the work for which
which this permit is issued and that all work done will the permit is issued and all work done will be in
be in conformance therewith. No changes shall be conformance therewith. No changes shall be made
made without first obtaining approval from the Building without first obtaining g a PProval from the Building
Department.
X OWNE -�
DATE: / Z. 7-7-� X DATE
Return permit to: Department of General Services 426 W.
Cedar Street/P.O. Box 186
Shelton, WA 98584 427-9670/1-800-562-5638
FOR OFFICIAL USE ONLY: Accepted by:
Date