HomeMy WebLinkAboutMIS93-00308 Mobile Home Runners - MIS Permit / Conditions - 12/25/1993 i
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
Nis19 —N:i4ft3 1'f1k0,1- t. s, t J!, t4YNI 1'I AI I A[It 0
it+tl �1tlil ( L 1*ON
tiNy{ .34 16
t�tNtCt 4 Hitt 155 IS 19i41 /I 1211
PhIl,ltI I ill `,Lf< 11, 1luN :
NUH 1 1_F HOMC RUNNERS 0141 Y
t'fmll11,' I t !1CNIl "N .
TAKE 1ST R PAST LIMERICK '..if ORE ON DAR [MOOR S1AY i Al Y(lint t;l 1111) GO 10 0ARN:,HY 4iO R it)
HAI.HR16GAN IST 1. (CORNER 01. HAI.HR1166AN & ANWIS C I j
# rlf RMIIIIiJI 1 `i I1i iflllt' t �
1
j
eI I I I N I le ,1 1 ri i,,1 td l 11 Jti !
M15 PkM1, ;?v 4+1�n11,� t.11NP1 t ANCE 10 A 11 ACHED t.C►NDI i 1ONfi V7
141:4111.RFD
V
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback - �� date by Ribbons
date /v L@ - .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 Attic OTHER
Groundwork date b
date by y
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
J
MASON COUNTY
-- Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
1 ;+ 1 111:`;11AN i 1 tl I + I HN I i At M MU I 1 0 1 Nw + 11U1 ,i +- I ! "N
11AVI_ ilPPINO i " NUNNI I;`, III' Allitl-I 11.�,i ! ( +t`..' 11't ti 11`I "III it
11NU i 1 " I H1 1 Fk"N 1111 , 1 41 1 1 111; I:"Ho i MIN I I Nt, 1111 1 k 110 r 1 , q::1 ,,Ifd + ts"W I `; HH
OF VAk I MI N I Wt PH 1 1=1 1 Hh I 10 15 hi + 0hp 1 1 1 1 11 1'I. I ow 1 0 1 "1 1 ± An 1 w Jto 1 . i 1 1 1 Hn
!'1 I NIPV 1. I 1 ON 1 I. I . Hl'+`.I I+ Ithl wh 11 1 N I nk! 1 :0 +,I 1 "1 1 14 1 "N 1 ! ,1Po 011 1 1 " I NK I in-
A .f ", i1 1 1' Ii11N1 1 i I I,N 11aAf 1 Ills i f'( I 1 1 I i11' Hri "N , I i I !tin 1 ii 1 i tlltl i I
t (II i + ON" I k111 f I ON PH" f ill I I ON 1 t 1 1 0 N1, i f III H1 11111! ;(1;;+ It" 1 1 "1 hl t;t11 1 1111141
K +1trl
. .
11,1 IIN'. i I<1 j I I I N NH4 I Mi 1 i h.i "0 1 ri i+ .1 1 VAt I.`, n4 1 1 AM I 11! Ic
!t tI l N �.Ui1PJ Ii �fit+kl I I lal 1tt14 I1 k {'l=t+rte:'fSf"r I 1 t+l'Ii 11.1.
iI`�1H3 I 11 I I+h11 .I1114 t I t 10 111 IN V101 61 11iN III nNr 1'1ri` "N + I ""I t6t I "M . I I wll I OF IH
1)f. m k" I. 1AH1111 'i f11 h1movi hIII I "N" Ihilt 1
I IIi I imp, 4P i 1 f I I 11 IG If I III Ho 11 i' 1 "K III V I I I
Per o
MASON COUNTY
ING PERMIT APPLICATION rni5� 3
IQL
4
26 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT
#1 Owner j l7m D2 Phone# giff
Site Address E Fire District# .5
City o5 St I<-3'4 Zip5�
Directions to Job Site 7vf KBE LL Das ( DAP lW66P— '
6 Lfc 0 C u D o rn.5,bur/ 4
Left Cum v
Owner Mailing Address 1 l�
City St �4 )kZip
Lien/Title Holder 5gn qp
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
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No. '��' - 5 3 -w1
Legal Description Lc U f'11ert D1 J Q" L
#5 Building Square Footage: (existing/proposed)
1st FI / 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other ,sgq.ft. /
#6 Use of building �/� Describe work
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Jqq S Make Model
Length Width o;) Se lal No.
#Bedrooms — #Bathrooms Type of H at 6
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 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
g
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
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
Showers Furn BTU
_Hot Water Htr _ Heatpumps
_Laundry Washer _ Vent Systems
_Sinks �' Spot Vent Fans %
Floor Drains j / . B it r / m r
_Laundry B ins
Dishwas er Air H n lin
_Dispo al _ cfm#
Uri als No. Fire Protection Systems
ther Auto. Fire Alarm Sys 50.00
Fixed ire Supp. Sys 50.00
Permit Basic Fee 15.00 Auto ire Sprink Sys 25.00
TOTAL PLUMBING $ No. r
as 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 ermit Basic Fee 15.00
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD TOTAL MECHANICAL $
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.
X OWNE X BY
DATE DATE
FOR OFFICIAL USE ONLY: Accepted by: Date:
J
DEPARTMENTAL REVIEW '
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
Environmental Health:
Building Plan Review
Occupancy Group: Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit
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