HomeMy WebLinkAboutBLD94-00018 Final SFR - BLD Permit / Conditions - 10/5/1994 MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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CONIPCIANCE TO RITACHkO CONDITION% K srt n"I Pf v,
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date /g- by J Ribbons
date _',-3 I- f,/ by L Gas Piping date b
Foundation Walls date by Set Up
date ' -?/- ;V by INSULATION date by
BG/SLAB Insulation Floors Final
date by date % 3 n S�/ by c _J date by
FRAMING Walls FIRE DEPT.
date 5-L S by Z date b
PLUMBING date S- �'�i�/ by L ✓ OTHER Y
Groundwork Attic
date b date cj -�3D- %� by �
D.W.V. WALLBOARD NAILING
date _ _ 5 c by t ,J date vx byL��✓
Water Line FINAL INSPECTION
date _ c�_ c�c/ by `J date _ S _S by l date by
e o� s ns 8 3f >/ _ /"�C-X
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MASON COUNTY
1 Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
RLeR 3 —
D 5 4�' Permit No.
�G �bc� MASON COUNTY
J
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT
#1 Owner U ap Phone# �(O 4Z7--'5qO
Site Address ki/. r L - Fire District#
City St Zip
Directions to Job Site 14w, T /
/ !
Owner Mailing Address 1 l
City 1'C.r'I� St Zip
Lien/Title Holder L-<�!c rn +�
Address
Clty St Zip
#2 Contractor Name 4-L 60a KL Contractor Reg #RLd04J 12-7A417
Address Expiration Date
City St Zip Phone#
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply Well
Connect to Sewer System? Name of System1le-
(If residential, proof of potable water is required)
#4 Parcel NoJ a331
Legal Description v Lot 44
#5 Building Square Footage: (existing/proposed)
1st FI / 26 2nd FI / 3rd FI / Loft /
Basement �d/4r Deck / #bedrooms� ��#bathrooms
Garage / �� ) Carport / (Circle:49tiached-or Detached?)
Other sq. ft. /
#6 Use of building Re5 Describe work
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFOR ON
Model Year Make Model
Length Widt Serial No.
# Bedrooms #Bathrooms Type of Heat
Purchase Price $
#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 O/A
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)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Plumbing Fixtures ($3 eac!21 Fee Mechanical Fixtures ($6 each
No. 2 Toilets CIRCLE FUEL TYPE: Ga Electric
Bath Basins Heatpump, Other
�-Vath Tubs �— No. Units Fees
Showers Furn BTU
Hot Water Htr _ Heatpumps
Laundry Washer _ Vent Systems
Sinks 3 4 Spot Vent Fans
_Floor Drains No. Boilers/Compressors
_Laundry Basins HP
1 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 $4Z 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 $1_
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 OF THE 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 APPROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. DEPARTMENT.
i
X OWNER OI d /' X BY � ® � Ll ��
DATE / 1 DATE J A N 0 7 1994
- - - 114
/
FOR OFFICIAL USE ONLY: Accepted by: `� ' C H
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
Environmental Health:
Building Plan Review (D c
Occupancy Group: Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit 3 (a,
Plan Check '56,
Plumbing Fee �a
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor .(fb
Violation Fee
Site Inspection
Building State Fee _r�
Other.
Other
Building Valuation: TOTAL FEE 56 _s