HomeMy WebLinkAboutBLD93-01077 Final Mobile Home - BLD Permit / Conditions - 3/18/1994 MASON COUNTY y
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final /L.,/
date by date by date 1 3'J q 7�/2L
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING Attic OTHER
Groundwork date b S�5
date b y
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by dat L date by
I
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-Setback date by Ribbons
date by Gas Piping datecO- - 4 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 by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
Ub qlal
MASON COUNTY
426WBUIrLD Box
PERMIT I9APPLICATIO g< 19�3,v
PLEASE PRINT
/C
#1 Owner i /�/_ i 44 Phone# c: � 1 - �/S�F S
Site Address , Z h9 Z li'/7 Fire District#
City S,S/ELrot4 St Zips k3-&
Directions to Job Site W/./ 5&CI-76H- OUT 64-1"-//Y � 0 ,[y/ ms l !&6 412•
4 '6r 1" b H &fz, o N A ' DlZ ��z ff/ �� �•l� �',4H"SS.�L . ��(��v 2/CST
oA.r ato'e, GYrr,G 'Rb Ty�T
Owner Mailing Address 1r l 7o 71 L (Z 1,e 942
City S ! % d'e,U St—Zip
Lien/Title Holder
Address
Clty St zip
#2 Contractor Name-B156 Vo �PqQ! Cd'c/0�—' Contractor Reg #ateHo-m,kP
Address Expiration Date
City St Zip Phone# &2:L - o't4Y
#3 If septic is located on project site, include records.
Connect to Septic? �' Public Water Supply Well L
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No - 66'1 K 6
Legal Description /&-f K a Lai!� 4/nF is niy� kFCoz6/0 At, //6 Z �� />��rs v�6is /` -lz !3r r!!
RFGopwS of- ,4S ep Go-,,+err 4-#!5 ,xr--r#)v
#5 Building Square Footage: (existing/proposed)
1st FIB/�4- / I/.;-C) 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms___ _/ #bathrooms _/ Z
Garage / Carport / (Circle:Attached or Detached?)
Other sq.ft. /
#6 Use of building IY16 ty _Des)cribe work AQ4 " ULo
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year 3 Make 4_Model 4k4
Length G% c Width )-:5� Serial No.
# Bedrooms #_Bathrooms 2- Type of HeatjGf-�1r/?�L
Purchase Price$ 5 ,000
#9 Indicate b circling the applicable source if any water is on or adjacent to subject property:
Y 9 PP
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
dot
o
0
v �
Q
a
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
t�
D
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each)
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
Bath Basins Heatpump, Other
Bath Tubs No. Uni s Fees
Showers Furn BTU
Hot Water Htr _ Heatpumps
Laundry Washer _ Vey ystems
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 PLUMB G $ Ng 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-
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 EPARTMENT. DEPARTMENT.
X OWNE �u -�c X BY
DATE DATE
FOR OFFICIAL USE ONLY:Accepted by: D4F Date: (� G
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY '
Approved Cond. Hold
Approval
Planning: S f,V1 ii,"(AiM Side lkvd . e4)24 ,Ck 5
Environmental Health:
Building Plan Review /Yll:77-6 �E6�,
�L y `
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 ( .