HomeMy WebLinkAboutBLD94-00063 Cancelled Mobile Home - BLD Permit / Conditions - 10/8/1997 MASON COUNTY PERMIT
NULL OID BY EXPIRATION
Mason County Bldg. 111 426 W. Cedar DATE BY
P.O, Box 186 Shelton, Washington 98584
RLD94 -0063 PAR(,Et - 12331lF-,1000/3 Pt Ai" - HE.PI 0
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JUDY MOORE ( 20111027S-31-111. 7
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1/10 N 1 R F IIJ f R I'll)
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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 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 COUNTY
Mason County Bldg. III 426 W. Cedar
\ P.O. Box 186 Shelton, Washington 98584
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4*,9�'� 0`,-D(2>3 Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 Ol
�D ✓
PLEASE PRINT no
#1 Owner �/!/� D - Phone# 3��
Site Address / Fire District#
City eol�� St zip
Directions to Job Sites T So cJ Td �= o o
a �✓ 7
Owner Mailing Address Or 'eby
City t� St zip f� l
Lien/Title Holder �. /5� -- er /e
Address
Clty E-7` .f�I' StZ',Zip 98C
#2 Contractor Name Z_; 6 Contractor Reg#
Address Expiration Date
City St Zip Phone#
#3 If septic is located on project site, include records.
Connect to Septic. �Z Public Water Supply��Well
Connect to Sewer S stem? Name of Systkm
(If residential, proof of potable water is required)
#4 Parcel No. AfZ,bs cj-
Legal Description .<c,T 7? 1XV °
#5 Building Square Footage: (existing/proposed)
1st FI r-?R 71a 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other / sq.ft. /
#6 Use of building ��%QG71L'4Z —Describe work
#7\v Type of Job: New Add Alt Repair Other
#8` MOBILE/MANUFACTURED HOME�/ INF99MATION� �
Model Year MakeG� OV8de' 1 �
Length 1�o Width2$Serial No.
#Bedrooms # Bathrooms Type of Heat E1 C_—
Purchase Price$
#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
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
71 o
:3 Gr
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
t t
Plumbing Fixtures ($3 eachl Fee Mechanical Fixtures ($6 each)
No. Toilets CIRCLE, FUEL TYPE: Gas, Electric,
—134th Basins Heatpump, Other
Ba Tubs No. n' Fees
—Sho rs Furry BTU
—Hot W�er Htr Heatpymps
Laundry Washer Vent Systems
—Sinks Spot Ven�Fans
—Floor Drains No. Boilers/Compressors
_Laundry Basins HP
_Dishwasher No. Air Handling
Disposal _ cfm#
Urinals / No. Fire Protection Sat
—Other Auto. Fire Alarm Sy� 50.00
Fixed Fire Supv. Sys, 50.00
Permit",
asic Fee 15.00 — Auto Fire Sp
nk Sys 25.00
T(DTAL PLUMBING $ No. Othe�tlets
Gas
W od, Gas, Pellet Stove
;1
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
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 DEPA ME DEPARTMENT.
--
X OWNER � � X BY
DATE C DATE
I
FOR OFFICIAL USE ONLY:Accepted by: Date: �, !�.
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: W A I s E� c A J CCS� U IBC K
�qv0VV\, C,I I I. I► � �l
Environmental Health: U»
r
Building Plan Review 1{/f4 P C S Wjq C 2- ,S- S'D IHN Nlbi V 1A)
Occupancy Group: Type of Const: -W
Fire Marshal:
Other:
Special Conditions: /I719NN F/3C'Lrrc CO r(0,V C FEES
-7-o 6 e In e&- o^1 uNpist rzr Building Permit
Go t � / !VG% 'elAc c E)N Plan Check
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee
Other
Other
Building Valuation: TOTAL FEE