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HomeMy WebLinkAboutBLD93-00167 Cancelled Carport - BLD Permit / Conditions - 10/29/1991 MASON COUNTY PEAMIT Mason County Bldg, III 426 W. Cedar NULL V ID BY EXPiRATION P,O, Box 186 Shelton, Washington 98584 DATE BY M•A %.N p 1. N_b M t^'d A: w U �' i� d�' h+f 1 1 OLD93-4 III P[Itr .t I i. 1 2 /', W0.1011 I'l It 1 , L 10,1' 1 1 MI I l'i 1+01,1-�t ', E 412 Ot DE I YMt . . . 101 NNi- I i ON tt14N1 MAR.lott I f WFNfill-H 44'b---61->tvta 1 I10 1 Fait I it, AWNt R t S t:(IN iRAC 1 014 I&kf 1.I1floRt / JIM III 16 f191St NN 11M N IIIPI nN fill 01 iPl + ttP1 nNn�iNi �'• ! ,til kill t 1 Y14V Qp ll ,f- . . A f- 01 I. lif' tit W1 - IIi. I i,ti i L) tt I i f .-IIIJ , ! 1 I1 1 1,1 It t ltt.t ISi' l ntllt . 4) i,it.tllit : ! iiA�i ', {9 � If: t. (IL.i1 1 1 ifN i 1 ,+ 1 ►li t. ! Id+, I't + i yr 1 i :`1',FI t: i 1ON ftl<I A li++;:t 1 1i.41 { li'AI Hoff ')AIIIIAi1!.r . I tti1N I A I I litt`. t -'; 4� is i11' et It /Ili l i.4! 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WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by � � /� D . Permit NO.BLD BUILDING orr coox�r�r PERMIT APPLICATION PLEASE PRINT #1 Owner Phone# Site Address City St Directions to Job Site14, ,77 Zips•-�A-sL- 172 Owner Mailing Address City ���hP/ St Lien/Title Holder Zip Addressmp City St P S Contracto #2 Contractor Name '�iS4�gAL SE VNIC Address Expiration date / City 3—�� -St—zip Phone / #3 If septic is locaton p oc �ct te � 9 wi� records. Connect to Septic. Public Water Supply Well (If residential, proof of potable water may be required) #4 Parcel No. Legal Description�LC � Q1rn0 na r r #5 Building Square Footage: (existing/proposed) 1st Fl / 2nd Fl_ / 3rd Fl_ / Basement_ / Loft_ / tiara e Deck_ / #bedrooms_ / #bathrooms__ / g / Carport (Circle: Attached or Detached?) Other Z X sq ft / #6 Use of building G�2 ,©®�f Describe work i #7 Type of Job: Newt_ Add Alt Repair Demolition Woodstove Re-Roof Bulkhead Other #8 MOBILE HOME INFORMATION Model r Make Model Length Width Serial No . #Bedrooms #Bathrooms Type of Heat � #9 Any water on or adjacent to property: saltwater river nd lake wetland seasonal runoff other i 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 Scale: Name of Fronting Street Date: APPLICANT TO DRAW SITE PLAN BELOW c9 c) 5`D APPLICANT TO DRAW TOPOGRAPHY PROFILE BELO Plumbing Fixtures ($3 each) Fee Fee i No. _ Toilets Vent Systems X 6.00 Bath Basins Vent Fans X 6.00 Bath Tubs No. Boilers/Compressors Showers HP .00 Hot Water Htr Laundry Washer Sinks No. Air Handling Unit Floor Drains cfm. Laundry Basins Dishwasher No. Fire Protection Systems Disposal Urinals Other Permit Basic Fee 5 . 00 No. Other TOTAL PLUMBING Gas Outlets X 6. 00 Woodstove, Pellet 25 . 00 Mechanical Fixtures Other No. Fuel Types Furn BTU . 00 Permit Basic Fee 15 .00 TOTAL MECHANICAL $ Heat ,Pumps . 00 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 LAW RCW 18.27 , AND AM AWARE IN THE STATE OF WASHINGTON 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 OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. DEPARTMENT. i 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 i I I DEPARTMENTAL REV]LEW FOR OFFICE USSIONLY , Approved Cond Hold Approval Planning: Environmental Health: =n;gReview: cy Group: shal: Other: ------------- --------------- IlSpecial Conditions: FEES II II IlSite Inspection I II 11 II I 1 II ii IlBuilding Permit II II IlViolation Fee I II II II I I II 1I Ilviolation Investigation Fee I 1I II II lI II IlPlan Check II II Plumbing Fee I II II II I I II II I1Mechanical Fee I II 11 IlWoodstove Fee I 1 11 I II I 11 1113uilding State Fee (Building Valuation: I 1 - I � II- R M ni r TOTAL FEE I i� //11 ,