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Home My WebLink AboutBLD94-00374 Final SFR - BLD Permit / Conditions - 9/8/1995 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 t I A 1 trill a I n 9 4 -0 3 7 11 V A Ir 1 4 1 > 1 z 'K 10 0 0; , r 1 A I I AV 1 0 A"H AhhPi , E Hit D( DE LYN[ RU SHEIMN "Iml I IFNNO JOHNSYDN 634- 9141 ' "WIPWIM , BRUCE Gil LEF ?N4 -7bb/ V "& tot It 13 I's loW It 17tv Itt 11"vy poll "I HIN f 1 P F ANDON! 01 RAII 111 , IPT 111101 ARM! W 0II M II.ifi I PRNI I Sh 14 1 n 10404 4§ �111H IN of 1 1 1 P, V I hi V Imm 1 R I* in 14;14/14 u � I N kA IS 140Y 0 1 ;imW, I Il"", Gi 11i11. I Iml go n jqpq!Qj 4, 1, F4 W1404 ill P 1 -0 Act A k I I to 14 002104 41, 1111Hi hb: to valol.A11014, 011, I RAI I PK -10 0 1 lll:!'! 1 00? 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PHAN RIN11fl amin pill Im PoAn lArr 1 (mill to in qp or on ku, 111011 UFF UP tillf U11114 1`11111ARPHI"t F6 JAPATO "il 100411MA 1 t CAM;At Alh 1101 loop AND VIINAINHIO PDAP 1 bAy Pt I A 60 109011) Iff APPRAVvil Iff-uh buflpiAn CAN Rt 01(upffil 0 ll Wilk worR A CONCRETE MECHANICAL �. � `� MOBILE HOME Footings-Setback date by L, Ribbons date by Gas Piping date b Foundation Wall f date by Set Up date " �, (,--_-,by' 't � 1 � INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date 'i— i �•l�*, ` \ by �� _� date by PLUMBING date by OTHER Attic Groundwork date_ date - IIWq4q �Z,' WALLBOARDNAILINGb �� O D.W.V. t b�( date by date -1 .�I- by Water Line t FINAL INSPECTION date 4 E �. �� by b` date t ate by /VO E- CC-Ti?-4 c AL 51 6 Al ZP OFF �4 vEDra, It- r � 11 -A -AA-J_j�� g±Af 44T�—Lz:�oe'd IF I ( ►.1M# 1_ (HN(.k IU AI IA1_r1k1) 1(IN UII IUN'-i LS KLQU IkLU MASON COUNTY Mason County Bldg. III 426 W. Cedar F.O. Box 186 Shelton, Washington 98584 --- - - ------------------------------------- MASON COUNTY Mason County Bldg, III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 I I II I SWTAATE GTON ENERW BuildingRecord WSEOContract# s,-19 i i e CODE PROGRAM For Site-Built Residential Buildings Heated by Electric Resistance or Heat Pumps ....... .... :<::::.:::<: (please check one) (please check one) New Building ❑Addition over 500 sq. ft. ingle Family ❑ Duplex Jurisdiction: /,4AtSCA1 [:] Multifamily ❑Zero Lot Line Home ❑ Planned Unit Development + please check one: L✓ City County Permit# qq — o, �Fyill.e�}I D# (if different from Permit#) + A. Site Information B. Owner Information Address Owner own rat time ofconstru ion receives utiW payment) Len/I n City 6- 11n Zip Company Assessor's Property Tax# or attach legal 4escn tion Address 5- aU e' �e�✓� e 5 L ZJ city State&Azipv� Servicing Electric Utility fiu,6, " Phone ) J3� - .� / 715L qS' C. If Single Family,Zero Lot Line or D. Duplex E.If Multifamily(R-1) Planned Unit Development L First Duplex Unit s .ft. Total#/Bld s. Total Conditioned Floor Area s . ft. Second Duplex Unit s .ft. Total #/Units A. Primary Space Heat Type B. Secondary Space Heat Type C. Water Heat Type (check one) (check all that apply) (check one) ❑ Electric Baseboard None Electric JBJ Electric Wall Heater ❑ Wood ❑ Gas El Electric Furnace ❑ Electric Baseboard ElOther(specify below) ❑ Electric Heat Pump ❑ Other (specify below) ❑ Other WSEC Compliance Method For Heat Pump Only: ❑ Prescriptive Path Built to the Electric Date of Permit Application -��- ❑ Component Performance Requirements of WSEC? Date Buildin Permit Issued � If es, Date of Insulation Inspection System Analysis ❑ Yes ❑ No ( Y Date of Final Inspection 9 - 8 utility may offer incentive.) I hereby certify that this building or addition has been inspected for the measures required by the 1991 Washington State Energy Code(WSEC), that it is in substantial compliance with the WSEC, and at the WSEC checklist for this building is on file. 6 4f - v� — Si a re of Building Official or Authorized Representative Date ■ Building Department:Return white copy to Gail Burris,Washington State Energy Office, P.O.Box 43165,Olympia,WA 98504-3165. ■ Owner or Building Deparment: Forward canary copy to the servicing electric utility to trigger WSEC compliance payment. ■ Building Department: Retain pink copy for jurisdiction's building file. WSEO#94-015 5-95 ' � Permit No. MASON COUNTY • BUILDING PERMIT-APPLICATION �� 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 Owner /1 e ST' Phone# QJ�Q 4 ' q)4-1 Site Address E 1 Fire District# ,5 City 19 he_L+o� 0— St Zip �8�" 34 Directions to Job Site MO Se ri 4 A n^JIZ �-� �— ce ;" -:) v ' r� ;l 0c1 ko Cc�L j�t:a� Oe 04 C) 1z Owner Mailing Address 5 7L96 U N A Pa C-o,oa_ City et StC L Zip 95 9101�- 7ZQs Lien/Title Holder JuA Address Clty St Zip #2 Contractor Name 6 ,1 Q r Contractor Reg # &1 LL SC 4)7/*'18 Address fD 9-C?4 eoanl rA,4 1.4-1 Expiration Date 7 City ( St Zip g d1 Phone# '7S6 7 #3 If septic is located o project site, include pti records. Connect to Sec? Public Water Supply Well Connect to Sewer System? Name of System (If residential, proof of potable water is required) #4 Parcel No. Zj-z: -'s14 - ��u3 Legal Description 1ID= 1 -3D 11/ .5 COL ke #5 Building Square Footage: (existing/proposed) 1 st FI /1 Z.0 / 2nd FI / 3rd FI / Loft / Basements/RC OJ Fiu j,4 Deck 0 #bedrooms _/ #bathrooms •2. / Garage /4x 24/ Q_Carport / (Circle:Attached or Detached?) Other sq. ft. / #6 Use of building Ke 5 1 A Q h L Describe work #7 Type of Job: New L--" Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year ake Model Length Wi h Serial No. # Bedrooms B hrooms Type of Heat Purchase Price $ #9 Indicate by circling the applicable so if any water' adjacent subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater 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 Indicate Directional by (N, S, E, W) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW — J APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Sc z 1 Plumbing Fixtures ($3 each) Mechanical Fixtures ( G each) No3lToilets CIRCLE FUEL TYPE: Gas, lectric, 3 A Bath Basins Heatpump, Other --o-kk U.N ► 3 Bath Tubs 13AI- ut NoUnitsFees .+ewers Furn BTU / Hot Water Htr Heatpumps LLaundry Washer _ Vent Systems Sinks Spot Vent Fans t Floor Drains 2 No.. Boilers/Compressors Laundry Basins J 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 00 TOTAL PLUMBING $ �� . 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 00 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 OWNER X BYa DATE DATE :> FOR OFFICIAL USE ONLY: Accepted by: Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold t Approval Planning: inb�d )C/COL CA'1 Tl6 C'f L_C i Environmental Health: Building Plan Review y r� Occupancy Group: - /99- Type of Const: ��- Fire Marshal: Other: Special Conditions— FEES Building Permit aT,1QPo R— Plan Check Plumbing Fee -,tf` o Mechanical Fee 00 Wood/Gas/Pellet Stove Radon Monitor (o Violation Fee Site Inspection Building State Fee Other Other 50 Building Valuation: 7() ,5-/ 2 TOTAL FEE o� Al on _ b. 'DK `I w I Y