HomeMy WebLinkAboutBLD92-0914 Cancelled Replace Mobile Home - BLD Permit / Conditions - 9/24/1999 MASON COUNTY
Mason County Bldg. 111 426 W. Cedar PERMIT 1�jy EXPIRATION
P.O. Box 186 Shelton, Washington 98584 t4UL & VOID UA)
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CO CRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up 0-7
date by INSULATION date //,7-9 by
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
D.W.V. WALLBOARD NAILING
date date by
Water Line by FINAL INSPECTION
date by date by date by
• MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
I .
MASON COUNTY Permit No.BLD
•
BUILDING PERMIT APPLICATION
PLEASE PRINT
#1 Owner
Phone#
Site Addres
City St Zip
Directions to Job S ' te
Owner Mailing Address doff a
City a rG�r.M. Lr,� St Zip 3
Lien/Title Holder
Address
City St Zip
#2 Contractor Name Contractor Reg#
Address
Expiration date_
City St Zip Phone
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply Well
(If residential, proof of potable water may be required)
#4 Parcel No. '
Legal Description
#5 Building Square Footage: (existing/proposed)
1st Fl 4 / 2nd F1 / 3rd F1 / Loft /
Basement / Deck / #bedrooms _ #bathrooms /
Garage / Carport / (Circle: Attached or Detached?)
Other sq ft /
#6 Use of building Describe work
#7 Type of Job: New Add Alt Repair Demolition
Woodstove Re-Roof Bulkhead Other < y
il `r tls„
#8 �Lh
N �^ 11.
Model Year Make Ci 76_T 10 h Model Z
Length /� Width Serial No.
#Bedrooms #Bathrooms' Type of Heat
#9 Any water on or adjacent to property: saltwater lake
river pond wetland 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 Scale:
Name of Fronting Street Date:
APPLICANT TO DRAW SITE PLAN BELOW
1
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELO
Plumbina Fixtures ($2 each) fag Gov
No. Toilets Vent Systems X 3 . 00
Bath Basins Vent Fans X 3 . 00
Bath Tubs No. Boilers/Compressors
Showers 0-3 HP 6 . 00
Hot Water Htr 3-15 HP - 6 . 00
Laundry Washer -3 0 HP 6 . 00
Sinks 30-50 HP
Floor Drains 50 + Hp 6 . 00
Laundry Basins —
o. Air Handling unit
Dishwasher <= 10000 cfm. 7 . 50
Disposal 10000 cfm. 7 . 50
—Urinals Other
Other EvaI7 Coolers
Hoods
Permit Basic Fee Fire Suppression
TOTAL PLUMBING $ Domes. Incin.
Comml . Incin.
Reloc/Repair 6 . 00
Mechanical Fixtures Gas Outlets X 2 .00
No. Fuel Types Woodstove serarate
Furn < 100K BTU 6 . 00 Other
Furs >- 100K BTU 6 . 00
Turn - 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 CONSTRIICTION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK
IS COMMENCED
OWNERS AFF=Vrr CMfrRA=RS AFF=V=
I CERTIFY THAT I AN EXEMPT FROM THE REaJIREMENTS OF THE I CERTIFY THAT I AN A CURRENTLY REGISTERED CONTRACTOR
COITRAC'TO= REGISTRATION LAY RCW 18.27 , AND AN AWARE IN THE STATE OF WASHINGTON AND I AN AWARE OF THE
OF THE MASON COUNTY ORDINANCE REaIIREMENTS 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 AUG ALL WORK DONE WILL BE IN
CONFORMANCE THEREWITH. NO CHANGES SMALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
WITMOIT FIRST OBTAINING APPROVAL FRON THE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
DEPARTMENT. DEPARTMENT.
X OWNER 2 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: Date:
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