HomeMy WebLinkAboutBLD93-00074 Cancelled Garage - BLD Permit / Conditions - 11/26/1997 MASON COUNTY
PERMIT
Mason County Bldg. 111 426 W. Cedar WILL A VOID BY EXPIRATION
P.0, Box 186 Shelton, Washington 98584
DATE By
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CON.;RETE 1M,VVO MECHANICAL MOBILE HOME
F date by Ribbons
date n �� by Gas Piping date b
Foundation Walls date by Set Up
date 1 by INSULATION date by
BG/SLAB Insu atio
date �— Floors Final
FRAMING by date by date by
Walls FIRE DEPT.
date by C` 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
1
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
II
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Permit No.BLD
MASON COUNTY
BUILDING PERMIT APPLICATION �D3
PLEASE PRINT
#1 Owner re 30 Phone# 2 7- S 3 `f 8
Site Address
City s��/7'0�. v -St 4/ Zip_ 9� k S-9 4-
Directions to Job Site /�✓�,7� „�. - ,<< / � T� L ,� , ,�
f2d, ot, Qt , L ,E L ' /
'12,_ ' // d1
or /
wo�� /^ G S f' nL. Uo�l/r,onr
L- t. 6-
04 'tom A,
Owner Mailing Address E 1n6 13& lifl �jz--z
City ,S 4 f/roa St WOL Zip q Fr.5-Crq-
Lien/Title Holder A
Address
City St Zip
#2 Contractor Name —/04c Pe.S-0(-F,. C Contractor Reg#ffo .ue ec �203NY`
Address L�8' /7 FFoXr,,,;1 0,-. lI/E Expiration date 12 /2S- / 93
City_ StU4 Zip 91-s-/ Phone 4-9J -1/ 96
43 If septic is located on project site, include records. rA
Connect to Septic? Public Water Supply We 1
(If residential, proof of potable water may be required)
#4 Parcel No. 3 2-/ 2 7 - S3 - 00 // 5—
Legal Description a_k e k a),v_ Z'
#5 Building Square Footage: (existing/proposed)
1st Fl / 2nd Fl / 3rd Fl / Loft /
Basement Deck / #bedrooms _ #bathrooms__
Garage IF747 Carport / (Circle: Attached or Detached?)
Other sq ft /
#6 U e of building_ ro 4P Rau.- - o ro o e Describe work Co+ -r _. �
r ra o s, o
#7 Type of Job: New-X— Add Alt Repair Demolition
Wcodstove Re-Roof Bulkhead Other
#S MOBILE HOME INFORMATION �41
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
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 1
Name of Flanking Street Scale:
Name of Fronting Street" Date: JoH - 22 , 9ga
APPLICANT TO DRAW SITE PLAN BELOW--
12
Lake
4 Lp*„j
I Q
a �
y;j
Propos t, 00
6-21
T4h�
� VNAPryfO .a 4�•I �O -. _ .
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELO
00
DEPARTMENTAL RE'V1EW
FOR OFFICE USE ONLY
' Approved Cond Hold
Approval
Planning:
Environmental Health:
Building Plan Review:
77- !3
Occupancy Group: A4-L
Fire Marshall :
Other:
FEES
IlSpecial Conditions: II Ilsite Inspection I II
II II 1 I
11 11 IlBuilding Permit
II II I' I ce7 i1
II 11 llviolation Fee 1 11
it 11 H i III
II 11 11violation Investigation Fee I II
II it I 1
II 11 Ij Plan Check I A60� II
II II I' it
II 11 II Pluming Fee I II
II 11 I I
II 11 11Mechanical Fee I II
II II I
II 11 IlWaodstove Fee I II
II II 1i i ��, I
11 11 IlBuilding State Fee I q II
IlBuilding Valuation: Az 11 11 TOTAL I II
I
lumoing r'ixtures ($2 each) � Fee
No. Toilets Vent Systems X 3 . 00
Bath Basins Vent Fans X 3 . 00
Bath Tubs No. Boilers/Compressors
Showers
0-3 HP . 00
Hot Wate
r Htr
3-15 HP 6 . 00
Laundry Washer 15-30 HP 6_00
Sinks 30-50 HP 6 . 00
Floor Drains 50 + HP 6 . 00
Laundry Basins No. Air Handling Unit
Dishwasher <= 10000 cfm. 7 . 50
Disposal > 10000 cfm. 7 . 50
Urinals Other
Other Evap Coolers
Hoods
Permit Basic Fee 3 . 00 Fire Suppression
TOTAL PLUbSBING $ Domes . Incin.
Comml . Incin.
Reloc/Repair 6 . 00
Mechanical Fixtures ��� Gas Outlets X 2 . 00
No. Fuel Types Woodstove separate
Furs < 100R BTU 6_00 Other
Furn >= 100K BTU 600
Furn - Floor 6 . 00 Permit Basic Fee 10 - 00
Heat Pumps 6. 00 TOTAL MECHANICAL $
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK
IS COMMENCED
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR
CONTRACTORS REGISTRATION LAY RCW 18.27 , AMD AM AWARE IN THE STATE OF WISHINGTON AND I AM 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 AIMING 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:LIF2� /MTh