HomeMy WebLinkAboutBLD92-01371 Final SFR - BLD Permit / Conditions - 9/28/1993 MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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CONCR MECHANICAL S MOBILE HOME
Footing etback date_%'d: _./_� 73 by t-r Ribbons
datey-,22-C?3 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 - '3 by -� date by
Walls FIRE DEPT.
date ::. (- "y 3 by i ._.J date t- y b date by
Attic
PLUMBING _ OTHER
Groundwork date I - 2 b "T 1-�
date b � y
D.W.V. WALLBOARD NAILIN
date &V� rl- 3 by date � ��PbY PIS
Water Line FINAL INSPECTION
date L::7� 7 by by 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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PLEASE PRINT
#1 Owner/(/L�'AM � � /-/L-tiv AAA f �- Phone# �
Site Address Ziz& /oo
City A'-7r= n- A St 144 Zip
Directions to Job Site AAd 4 77-:
Owner Mailing Address '&- dl n E� d
Cit - St a A- Zip a
Lien/Title Holder C P c--
Address
City St Zip
#2 Contractor Name E Contractor Reg#
Address Expiration date
City St Zip Phone
#3 If septic is located on project site, include records.
Connect to Septic? �f— _ Public Water Supply= Well
(If residential, proof of potable water may be required)
#4 Parcel No. A V/ - -�-/ - 60° :�'" 3
Legal Description Qi�-A,&4-5 C°e V Or ✓ S
#5 Building Square Footage: (existing/proposed)
1st Fl — / /JL Yk 2nd Fl _- / 3rd Fl — / Loft /
Basement / � Deck y / #bedrooms�tta
_ bathrooms
Garage Carport �/ (Circle- che r Detached?)
Other sq ft /
#6 Use of buildin Describe work jt,��'W (0/u C/
#7 Type of Job: New -- A,dd Alt Repair Demolition
Woodstove Re-Roof Bulkhead Other
#8 MOBILE HOME INFORMATION C)
Model Year Make Model
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
��o
Lot Dimensions Flood Zones
EX4 sting Structures Fences
Stricture Setbacks Driveways
wa
ter ter 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 BELO
t
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELO
a
No. Toilets Fee
Vent Svste_*ns X 3 . 00
Bath Basins Vent Fans X 3 . 00 �- 71
Bath Tubs
showers No. Boilers/Compressors
' 0-3 HP
Hot Water Htr 3 -3 HP - -Q
Laundry Washer Sinks 15-30 HP
/
Floor Drains 30-50 HP
00
Laundry Basins 50 + Hp 6 . 00
No. Air Handling Unit �
f Dishwasher <= 10000 cfm.
Disposal S _
—urinals
> 10000 cfm. ?5�
Other
Evap Coolers
Hoods
Permit Basic Fee 3 . 00_ Fire Suppression _
TOTAL PLUMBING $ �1 Domes . Incin.
COmml. Incin.
Mechanical Fixtures Reloc/Repair 6. 00
Gas Outlets X 2 . 00 _
No. Fuel Types Woodstove
Furs < 100K BTU �Barate
--��-
Furn >= 100K BTU 6 . OQ Other
Furn - Floor 6_00 Permit Basic Fee
10. 00
Heat Pumps
6 . 00 TOTAL MECHANICAL $
F
: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK
ENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AF`TZR WORK
MENCED
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE
CONTRACTORS REGISTRATION LAW RCW 18.27 AND AM AWARE I CERTIFY I AM A CURRENTLY REGISTERED CONTRACTOR
OF THE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH IN THE STATE
OF WASHINGTON AND I AM AWARE OF THE
ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH
THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN
THE PERMIT (S ISSUED ANO ALL WORK DONE WILL BE !N
CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDINGBE MADE
DEPARTMENT. WITHOUT CONFORMANCE STH ER OBTAINING APPRQVAL GFROM HTHE BUILDING
N1
1 4i /�i E�IIiWC�Q lJ t/G DEPARTMENT.
X OWNER X BY
DATE I/- a - y Z
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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