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HomeMy WebLinkAboutBLD94-01618 Cancelled Addition to Deck - BLD Permit / Conditions - 2/10/1999 MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 I..31 M 1 N 1J, 1 1JI i� 1 ' I i1 1M1 1 A I tit, : 14 I I I I IIIv 1 i11 I 417-4610 tt!- 1 1-11 1 I'd ',f,1,1 t+Nl1 r;: 1n 4;11 -I V 6 2 t31 l?y4— iEi1R E'ttl-'t 1 1 1• 1 ' ;I,:(i?4lHfi''4 Iml F 120 K I 1 MARNOCK Rt) `iff l CON PERMIT Y rI.E II i ItRE0 1IE*.ifNJSS C..! 7 '+ti ( �r.. •:�t� K.� �� III-4 1 f-:w III, Rif Hill CO"1i I R111' I I ON 'I.'t, 1 46ti NULL 141F I11I11(f S 11 19 CS 4IMS 11 Ila _fD j 111 1 „i l:Ill;at t Isl , vi I;t+ l ) �i RF IYP( 11001N1 NY DAII 0:4 (P1 !ti'FF tNfttlNi Ni I)AIF 1f110 1 I`{"I II( I I'-.} '";f 1 1 11 j: E t '� - bf —_^ar•�+e�snsr-�.-error.vr-��evv-+,na.._+a:rr� _•.�:-r_ -:tz-^<=^--=e-:.a�.�r.-r.���-�'c:-S:�ss---=v,. � fit,1.Hp (-,(<till 1 ,i ;1'1 if, I I'Itl l II� i ) F+1 I N PICK 1 1. 1.y t '� litl�,lv1 ti; ! IliIh,i44 4lr ! 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Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT Z 1 ese n ► ss #1 caner ` Phone# 27 Addr ss r W Fire District# `�1City StZip Directiops to Job Site _ 00 Owner Mailing Address WAI city S l zip Lien/Title Holder W Address city St nn —� #2 Contractor Name /�c.�� �c� �� � �h� Contr eg#�( kL C966 IEF Address Pd 4,bw. Expiration City 5& St t,/A- _Zip Phone# #3 If septic is located on project site, include records. Connect to Septic? Dom—Public Water Supply Well Connect to Sewer System? Name of System (if residential, proof of potable water is required) Ala 7 5y C0064 S19 #4 Parcel No. _- 90 - C Legal Description 0e.44 s' l-o #5 Building Square Footage: (existing/proposed) 1st FI / 2nd FI / 3rd FI / Loft / Basement / vl #bedrooms / #bathrooms / Garage / f (Circle:Attached or Detached?) Other sq. ft. / # e of uildi g Describe work/7'fi(�`' 1111 . c '� Or #7 Type of Job: New`4 Add Alt Repair Other P _ #8 MOBILE/MANUFACTURE , ME INFORMATION Model Year M a keet Model Length r2_Width ;?Z. F Seri .[Ac G6o"b�54 ' sj # Bedrooms 3 # Bathro -'?-_Type of Heat Ple�ri�� Purchase Price$ 14S #9 Indicate by circling the applicable source if any water is on or jacent to RtihiectDroperty: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoft)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 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 p n ac S �v` 1_ � ��•� ( l�ro�GS G' �A Stu.-t 1 V APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Pau i Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each) No._Toilets CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins Heatpump, Other _Bath Tubs No. Uni Fees _Showers Furn BTU _Hot Water Htr _ Heatpumps _Laundry Washer Vent Systems _Sinks _ Spot Vent Fans _Floor Drains No.. Boilers/Compressors _Laundry Basins HP _Dishwasher Air Handling Units _Disposal cfm# _Urinals No. Fire Protection Systems _Other uto. 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 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 lJ X BY � DATE Gam- I DATE FOR OFFICIAL USE ONLY:Accepted by: pate: i DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: MIA Environmental Health: a,u Jor Building Plan Review Occupancy Group: 41 Type of Const: r` . Fire Marshal: Other: Special Conditions: FEES Building Permit (,(p� Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other Other Building Valuation: `7�� TOTAL FEE a 7