HomeMy WebLinkAboutBLD93-1427 Final Mobile Home and Desks - BLD Permit / Conditions - 1/28/1994 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
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date by Gas Piping dater /�—�'5.3 b ..J
Foundation Walls date by Set Up
date by INSULATION date r: D by
BG/SLAB Insulation Final
Floors )
date by date by date -:2 - I by L -✓
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING Attic OTHER
Groundwork
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 COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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Permit No.
• MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT
#1 Owner-F�Tom" m 0 ileGvhk E— V CI G f4 Phone#(o�oG 2 -A76` 301V O
Site Address K E 1 1A0 Ao b k b R . • Fire District# a
City - L E 14 St Zip �5a
Directions to Job Site o? a-o 3o,
5 �
Owner Mailing Address _ y 41
City E L�A i R St Zip�S�
Lien/Title Holder ►-}
Address
Clty St Zip
#2 Contractor Name T 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
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No.1,2 3 1 - .5"/ - 0 DO 9-�Z,
Legal Description
r21J5 Cc:, 1)�i l� y L 0 /
#5 Buildin Square Footage: (existing/proposed)
1 st FI / 2nd FI / 3rg FI / Loft /
U Basement / Deck / 3(oO #bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other Mn r sq. ft. gD
#6 Use of bui ' /-/D Describe work t� )r.Q
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year/ 9'3 MakeJ- Model 67/er) O,*KS
Length Width /41 " Serial No. '�(a q y�o
# Bedrooms #Bathrooms_Type of Heat C4 CC%/e l C
Purchase Price$ off/, rJa
#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
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 Indicate Directional by (N, S, E, W)
Name of Flanking Street
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
t�
�raYes� �
- -- V,67
s 7
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
�s
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each)
No._Toilets CIRCLE FUEL TYPE: Gas, Electric,
Bath Basins Heatpump, Other
,Bath Tubs No. Units Fees
Stidwers Furn TU
_Hot Wat' Htr _ ZHeatpum_Laundry Was r Sinks
_Floor Drains �.� o Boilers/Compressors
_Laundry Basins HP
_Dishwasher VL4� Air Handling
_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 PLU, ING $ No. r
Gas Out
Wood, Gas, Pe 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.
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD
OF 180 DAYS AT ANY TIME AFTER WORK IS COM- TOTAL MECHANICAL $
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.
X OWNER �� X BY
DATE % 9 DATE
FOR OFFICIAL USE ONLY:Accepted by Dater
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
A proved Cond. Hold
Approval
Planning: ��� 4�n
IY 1
Environmental Health:
3
Building Plan Review,--1 N ST ALj- pE2 M i:'G- C'S
l�
Occupancy Group:nLQ51 L Type of Const:
Fire Marshal:
Other:
Special Conditions: o /4-NS post A FEES
QeC1'S Z_14 T r7"o ,c4E 13i-4 Building Permit
2R� CS 3 6 , Plan Check
2 1¢-
Pe Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee
Other
Other
Building Valuation: TOTAL FEE ��