HomeMy WebLinkAboutBLD94-00734 Final SFR and Garage - BLD Permit / Conditions - 12/9/1994 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-Se ack date i (t by Ribbons
date La-- Gas Piping Set U b
Foundation Walls date by p
date 0 I<_ INSULATION date by
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls t— V,� FIRE DEPT.
date _ by date by date by
PLUMBING OTHER
Attic c�A
Groundwork date 0 IL 2_- PU�
!- b�
date b
D.W.V. WALLBOARD� NAILING �Q�_ S 6
date by Water Li FINAL INSPECTION
date by date 2 `L L 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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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
or�
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 nl
PLEASE PRINT `CJ
#1 00ner Phone
ite Address E. �.°�\ P, LN�Q r�� Fire District# _�
City
st\nIA zip Q85R�1
��.�,\�, �
Directions to Job Site -
�cC\
Owner Mailing Address 1 -
City St,nl B Zip
CM
Lien/Title Holder
Address
St _Zip
City
#2 Contractor Name F�p,�- �cY� ,c-��p S% 1 W C Contractor Reg
Address IL Expiration
City St W A Zip Phone#
#3 If septic is located on project site, include records. cvm, cM[QLk-Y\LfA V: UUJ ,j
Connect to Septic?�Public Water Supply_Well 1
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No. _ '�.\�Q - %--?, _-D-CM-0
Legal Description 1s *a�\
#5 Building Square Footage: (existing roposed
list FI cA 04 / 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms _/ #bathrooms —/
Garage . 04�/ Carport / (Circle:Attached or Detached?)
Other sq.ft. /
#6 Use of building Describe work
#7 Type of Job: New _ Add Alt Repair Other D
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make Model
Length Width Serial No. O 0
# Bedrooms # Bathrooms Type of Heat �� t
Purchase Price$
#9 Indicate by circling the applicable source if any water is on or adjacent to subject provPttlh
River Pond Cree Stream Wetland Lake Marsh Saltwater Seasonal Runoer
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
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
olde �
-- 17► g
Plumbing Fixtures ($3$3 eaQ_h Fee Mechanical Fixtures ($6 each)
No. Toilets CIRCLE FUEL TYPE: Ga Electric,
Bath Basins 3 Heatpump, Other UJa
Bath Tubs :5 N_Q. Units �
�Showers3L Furn BTU
Hot Water Htr 'J{ Heatpumps
Laundry Washer J _ Vent Systems
I Sinks . Spot Vent Fans ��-
Floor Drains No.. Boilers/Compressors
_Laundry Basins HP
Dishwasher No. Air Handling Units
_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 PLUMBING $ No. Other
Gas 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 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 DEPARTMENT. DEP�TMENT.
X OWNER X BY j� ", , �«
DATE DATE
FOR OFFICIAL USE ONLY: Accepted by: Date:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: n 1Lr
W1 s j l r, ves oAac 3 a Z l�
� 6vckn.N dW VcLtin 46 } I C( 11 ifw
Environmental Health:
Building Plan Review j'T)u- - frYl��i�`_ S -Cpfe,�.1t" —,IFCt�
Occupancy Group: Type of Const:l96=.+
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit sy�
Plan Checkmu.sT p,4Y Avtw �ro`< /ol-CID
Plumbing Fee 30( 00
Mechanical Fee 627,0
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee lj
Other
00 Other
Building Valuation: TOTAL FEE