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HomeMy WebLinkAboutBLD93-1008 Final Mobile Home - BLD Permit / Conditions - 1/19/1994 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 Ill 1,D 193 1008 1 3 It jJ1-Oil I YME . . . . . . t MNHtf, RRAItY 4,lfi3-0.0i/ I If (lills I I 11talck 4 !0,4.(! Ito is 1111thl IV 1711� :t tit 1,141 k I I A it It A I il!Y If A I i Ii I I f 11,1 E 1 Y i' A A 0 0 A I f-, '7M f U P.I t.F.I p I tit, I N 4 I iltq f1tt1 +, tEiif•1 I ! Ili+iist 104 wO VAI.11101110111! 4M0 V 6 Its 1r i it I kq I if! I fill t 1 1 1 Pl< MIMI I I Itom1 it I 1"JI f, c9 III IJ m fit .: F I I I '1(1;00 I it I., I 1 Pvl. bit t9 i i i if 1111 1 1 Ile H 10i IF is I i tit 44 1 1-41 VS lit it t I twl,, I 1411 1 1 1 l I Ni, v" I" 1 11 t 1 ills 1 11111! I f j I it I it Ill t ld 1 is 1;t)j1I1 J'j f4 1 k I Al 0 r-I I 1 1 r4l, !il'i I j t Ittlipi I I Wi I H 0 1 1 h G A k I tkRP I 111" (11 1 its lit if I i I - I lit. 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WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O, Box 186 Shelton, Washington 98584 A tj•! a r' t N j 1141 k w $ !1 W A I! 14 .. .� it I?ft 1.1 t�1 i :iil ,},• 1 ! r,f�,., f1�•1 ,y { i r,l,:,...� I : ! ?. It��+! i i I 1 i it•, ow i i •• i�1�vt ii, 1 0, 1 11 11!turn :, I two, ! IN 1 1 til i, i0 1 HN ' f "UM Kin 1 1 i11 No t ""j d t { "jt "in t 11 i 1 1 1 Nil Itt; `4 on I 'I'.. { it i'ti{1mkl r. •, IM lllp4!t,i ,1 I p "V i Iri I! Ir.! !i! I! t'li t 1 i IiLy vt'• ; ,, }!, i 1 ti i NI s `•t I . i I;I lyhllf i.'t I HI 1 t Is"M I di - 1 i+1 1 1 "h 1.00" 1 I•:!1M I ! "h I "I h' :Itt'i !. 1 i t't(+""" a nil" 1 t win 11 {! t 0,; p11 PAL iM1 HI K; "IfIvIn Ilin , I01 HI I Omni i iI It no Wt I " t MI I fpd+! I "n iVd'p'i nI { i t-'t i PI'•I' I i tlj+! 1 1 1. . PAAI I! ON 11 1 N I nit! I 1 !fi I 'll I "A l "N 1 i ohm VII I I I! I i �5 :t ,. -. i �. t11l p+l I. r'I.SI;:j � i'itl I i!i,. r fl I ? '. I If I !.),, 1 (111i!I:! , t!!`•1 i !, I i'!; i p11', i f! I, i 1:. t it i ,t, t!! ,-,t i �ti :i i , 1, I, I illt ! �I {.:1 . ! :,rl ��': ,i t : is ! >:1 .I 11: , : .I?.. i !! .. ,. it t.i It I 11, :! j - •Y i t ! f f :i t ! t I f ? i �, it ,!i i'tI i t .;(,I : i. t 'ti• - III'1 ! ! ! !i It , :itt., ! t11 Permit No, V1 -/60� MASON COUNTY BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT 01 Owner Phone# �-X QLU-n1�8 Site Address Fire District# City �p\�nn St WC." zip. r Directions to Job Site L,� Li" c-�Ck nan-k e �\��- o ra (1kd-Q �� Pica Owner Mailing Addynn ess jc, ':Q C�Q ��� City h� I :6 C , St (.�o�.. zip Lien/Title Holder Address CZV A-k�-- Clty St Zip #2 Contractor Name Ol-t=c<< a p I LtT to Contractor Reg# Address Expiration Date City St Zip Phone# #3 If septic is located on p✓rject site, include records. Connect to Septic? Public Water Supply ✓ Well Connect to Sewer System? Name of System L LL Y—Y d21 e i'� (If residential, proof of potable water is required) #4 Parcel N �- - Legal Description #5 Building Square Footage: (existing/proposed) 1 st FI $5h / 1,9�_2nd FI / 3rd FI / Loft / Basement /��A / NI+ Deck / #bedrooms_ / 4 #bathrooms_L/ 15 Garage/I Carport / (Circle:Attached or Detached?) Other sq. ft. / #6 Use of building Describ work #7 Type of Job: New—Add All Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year /9 y3 Make��`�`�-i-Model A/4-766 N Length &Q/ Width gVel Serial No. # Bedrooms 4 # Bathrooms Type of Heat Ekejr�C urn Purchase Price $�6Q[) t9 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 1 I i APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbina Fixtures ($3 each Fee Mechanical Fixtures ($6 each) No. Toilets CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins Heatpump, Other Bath Tubs No, Uni a Fees Showers rn BTU _Hot Water Htr _ He tpumps _Laundry Washer Vent Systems _Sinks Spot Ver Fans Floor Drains No. Boilers/Compressors _Laundry Basins HP Dishwasher No. Air H n lin ni _Disposal _ cfm# Urinals No. Fire Protection Systems _Other Auto. Fire Alarm Sys 50.00 _ Fixed ire Supp. Sys 50.00 Permit Basic Fee 15.00 _ Auto Fire Sprink Sys 25.00 TOTAL PLUMBING $ No. h r Ga Outlets W od, 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 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 OFTHE 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 OWNER e X BY DATE DATE FOR OFFICIAL USE ONLY:Accepted by: pe _ Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: rn "I Environmental Health: Building Plan Review fi 1 Z-'t Occupancy Group: Type of Const: Fire Marshal: II 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