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MIS93-0660 Cancelled Foundation - MIS Permit / Conditions - 9/24/1994
MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 1111Y)3-0660 F'rif;t: i : I 2,i 3W:,,'0"01WA PI A i tit I NE: 71 HARPOON DR (iF I FAIR ,IUNF EOGi m tj38--Y2$H 011F0 k JUNF FIMEN H:3� i.ce4! PERMIT t_3 I,1 ItAkIs GIVE $EY 5 ttlY• tW I tt $011 o1 #1-0 EiY EXPIRATION $ VOID FOUNDAI ION ONLY E~X .ISIIN6 MOHtEF DATE fir:„ its I ! ? "N ' ter t A 1 R 10 NOR I H !1HORF: 10 SANDHttA 10 L AN.sON t;t VI). R 1 68 1 ON I ONt ON IJAHPOI I i Mtn !'Fdl 041 1f C0Kk IANCf- fO At [AC11FH CONDII IONS CV itF"(j111 RI'11 I f � 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 date by date by MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 • MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 f I w' )Jill i lit- lit �, 1 i 1 ,�."IR"11 I ,� I il' i ti!-.• Jill', i •.IN�. i 1, r [ it ..1:•{,:t rt i l Permit No. MASON COUNTY / O LDING PERMIT APPLICATION ��0 4 W. a ar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 w PLEASE PRINTI C T L O 1 \,n 1 " #1 tL Phone# 9 3 R- 77200 H&QArs ,c At , M7 n I HWWrl e'• Fire District# .� City X6 d;deli 2 St (A)A Zip C185ZS Directions to Job Site - A F P-fQ tI To IUo prtf g Sfr z- la S/4wd hl.L L _7�; A�!4/L5vv ZGv Owner Mailing Address ��. -��%�- t. Wo.J City f' ; �'d�o/L L-c�t,Cl , Qi Sl3 35— St (-�' Zip Lien/Title Holder (-Xi f!5��-�'?"P�v tug �Q �. '54u"-A S Address Clty / St Zip 1)� #2 Contractor Name 140,&V I. n. ,�S�c�r�u-� � ?��- / ontractor Reg#�;EG��a2�o£l✓7 Address 4//54 G 7` iAJ W Expiration Date/ City G. 6 L LU , St k A Zip%33 S Phone# .ZG S-Gc�a3 #3 If septic is located on project site, include records. Connect to Septic?_- Public Water Supply Well Connect to Sewer System? Name of System (If residential, proof of potable water is required) #4 Parcel kq : "' "- Legal Description /6KAC)5 -nVV-- /)r u #5 Building Square Footage: (existing/proposed) ��l i Ste+ItSL 1st FI / 2nd FI / 3rd FI JJ / Loft / Basement / Deck / #bedrooms / #bathrooms / Garage / Carport / (Circle:Attached or Detached?) 1 Other sq.ft. .Z$_/�O Po t-t4, •r c/YM ©n l�/ #6 Use of building Describe work wa�o✓ � #7 Type of Job: New Add Alt Repair Other �.'o, Q VR #8 MOBILE/MANUFACT, D HOME INFORMATION Model Year Mak Model Length) Width �462 Serial No. # Bedrooms zZ # Bathrooms Type of Heat Purchase Price $ [Jok� #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 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, E, W) in relation to plot plan Name of Fronting Street APPLICANT TO DRAW SITE PLAN BELOW ,2D U tj 01 I APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW �' dx� Plumbing Fixtures ($3 eachj Fee 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 PPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT. i X OWNER X BY �+ c, DATE DATE ICJ i 7'—/3 FOR OFFICIAL USE ONLY: Accepted by: �✓ / 'ti -- Date: C'/� i DEPARTMENTAL REVIEW FOR OFFICE USE ONLY - Approved Cond Hold Approval Planning: Environmental Health: Building Plan Review fZ-kw oti Occupancy Group: --� ype of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee •S� Other Other Building Valuation: TOTAL FEE �- ��