HomeMy WebLinkAboutBLD92-1250 Mobile Home - BLD Permit / Conditions - 4/24/1993 MASON COUNTY •�y. � ��,�� x+r<� .�x���r w . �.
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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 1
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
date by date by date by
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MASON COU=
BUILDING PERMIT APPLICATION
PLEASE PRINT
#1 Owner Phone# -
Si to Address i z e_,. fa l r_- St�Z1p
Owner Addres ' v S /�
"L
Lien/Ti tle Holder _
Address `'C4y St Zip
Describe Work
#2 Contractor Name Contractor Reg#
Address Expiration date_
City St Zip Phone
#3 If septic is locate on project site, include records.
Connect to Sep ti r:? _ Publ c Eater Supply j,P_ we?1
#4 Parcel No._/:z 3 3 Ca /
Legal Description _3P_Q 'Y1'r r'nl 0/LI Slan fo 3
#5 Building Square Footage: (exist_�=g/proposed)
Ist FZ / 2nd F1 / 3rd FI / Loft /
,ch Basement / Deck / Garage / Ca-rport /
✓J #bedrooms / #ba throoms /
�j Other sq f t_�—
#6 Use of building
#7 Tyne of Job: New Add Al t Repair Demolition
Plumbing Only Mechanical Only Woodstove Re-Roof
Bulkhead Other
#8 Pl umbinQ Fixtures mechanical Fixtures
No. Toilets No. Fuel Types No. Air Handling Units
Bathtubs Furs < LOOK BTU <- 10000 cfm.
Showers Furn >- LOOK BTU > 10000 cfm.
Ba th basins Fur*± - Floor Other
c ^-ks Heat Puzps map Coolers
Dishwasher Vent Systems Hoods
Hot Water Htr Vent Fans —Domes. Incin.
Laundry Washer Boilers/Compressors Comml . Inc-in.
Floor Drains 0-3 HP Reloc/Repair
Other 3-15 HP Gas Outlets
15-30 HP Woodstove
30-50 HP Other
50 + RP
Ir L MOB ZNFORMATION ��
Model Year Make Model
Length Widths S rial No.
#Bedrooms_ "Ba t.hrooms
uZ 0 Any water on or adjacent to property: sal cwa cer lake
river pond wetland seasonal ranof=
other
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,NOTMC.E: TEIS PERMIT BECOMI_S NLLi ALND VOID IF WORK OR CONSTRUCTiON
AUMHORIZED IS NOT COMMENCED WITH.-IN 180 DAYS , OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR ABANDONED FOR A ?ERTOD OF 180 DAYS AT ANYTI= AFTER WORK
IS COMMA^ED
OWNERS AFF:DAVIT CONTRACTORS AF F IDAv: -
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT I AM A CURREN-TLY 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 0ONE WILL BE IN THE PERMIT IS ISSUED AND ALL WORK DONE WILL SE IN
CONFORMANCE THEREWITH. NO CHANGES SHALL SE 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
T BY
�� DATE
Ret'.>.-Tn pe_nmit to: Depart-.�.prt Qf f,c.�nryI _C
426 W. Cedar/P.O. Box. 186, Shelton, WA 9 5 427-9670/1-800-562 -5628
FOR. OFFTCTAL USE ONLY: Accepted byr Datez;� �.:
DEP-A-R-TMENTAL REVIEW
FOR OFFICE USE ONLY
NERAI. SERVICES. Approved czw� HaIC
Approval
Planning: �]`
Envir0zmeata1 Heal
I
Building Plan Review:
Fire Marshall :
Other :
I