HomeMy WebLinkAboutMIS92-00066 Cancelled Kobile Home Storage Only - MIS Permit / Conditions - 8/11/1992 MASON COUNTY
Mason County Bldg. 111 426 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 by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date b 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 COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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MASON COIINTY Permit No.BLD
BUILDING PERMIT APPLICATION
PLEASE PRINT "f
#1 Owner Z2- E, Phone# C 200 27 !O y6 U
Site Addr s kJ
City r St Zip
Directions to Job Site
Owner Mailin Address
City '; r St Zip � J'2
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)
0(!�n
#4 Parcel No. 13--3 - -
Legal Description 1�" -^�-fze' L i cr
#5 Buildin S are Footage: (existing/proposed)
ist Fl 2nd Fl / 3rd Fl / Loft /
Basement / Deck / #bedrooms _ #bathrooms_L_
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 5�CA4�
#8 MOBILE HOME INFORMATION
Model Year'. Make Model
Lengthl 0 Width _ Serial No.
#Bedrooms_ #Bathrooms_ Type of Heat ��C
#9 Any water on or adjacent to propL-rty. 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 Froi�ting Street Date:
APPLICANT TO DRAW SITE PLAN BELO
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELO
l
Plumbing Fixtures ($2 each) Fee Fee
` No. Toilecs Vent Systems X 3 . 00
Bath Basins Vent Fans X 3 . 00
Bath Tubs No. Boilers/Compressors
Showers 0-3 HP
. 00
Hot Water Htr 3-15 HP 5 . 00
Laundry Washer 15-30 HP 6 . 00
_
Sinks 30-50 HP
Floor Drains 50 + HP
Laundry Basins No. Air Handling Unit
Dishwasher <- 10000 cfm. 7 . 50
Disposal > 10000 7 . 50
—Urinals Other
Other r%mo Coolers
Hoods
Permit Basic Fee 3 . 00 Fire Suppression
TOTAL PLMMING $ Domes. Incin.
Comml . Incin.
Reloc/Repair _ 6 • 00
Mechanical Fixtures Gas Outlets X 2.00
No. Fuel Types Woodstove separate
Furs < 100K BTU 6. 00 Other
Furs >- 100K BTU 6. 00
Furn - Floor 6. 00 Permit Basic Fee 10 . 00
Heat Pumps 6. 00 TOTAL HEMANICAL $
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRU=ON-
ADTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTII E AFTER WORK
IS COMMENCED
OWNERS AFF=VTr CONTP-I=RS AFF=Vrr
I CERTIFY THAT I AN EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT I AN A amRENTLT REGISTERED CONTRACTOR
CONTRACTORS REGISTRATION LAW RCW 18.Z7 , AND AM AWARE IN THE STATE OF WASHINGTON AND I AN 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 DONE WILL BE IN THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
CONFORMANCE THEREWITH. NO CHANGES SHALL BE 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 x 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:
DEPARTMENTAL REVIEW
FOR OFFICE IIS8 ONLY ,
Approved Cond Hold
Approval
Planning:
Environmental Health:
Building Plan Review:
Occupancy Group:
Fire Marshall:
Other:
FEES
llSpecial Conditions : II 11Site Inspection I Il
II Il I
11 II IlBuilding Permit 1 Il
it II IlViolation Fee I II
II II i I
II II IlViolation Investigation Fee I it
it II I I
II it 11 Plan Check I II
II II I
II II II Plumbing Fee I II
Il II I I
II 11 11Mechanical Fee I II
II II I I
it II IlWoodstove Fee 1 II
Il II I I
II 11 IlBuilding State Fee I II
113u4lding Valuation: 11 11 TOTAL,I II