HomeMy WebLinkAboutBLD93-00744 Cancelled Decks - BLD Permit / Conditions - 11/19/1997 PER
MASON COUNTY NULL 8 VOID BY E TION IT X RA
Mason County Bldg. III 426 W. Cedar DATE 1L`1'�BY
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
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
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APPROVED
Q n`P MASON BULL IN11 WSPECTOR 1
CHANGES SUBJECT TO A►PitOVAI
6' DATE
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QO, 92
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 ��Q 0
PLEASE PRINT
#1 Owner V I Phone#
Site Address 1 0 1 E E b b LLS C--+' Fire District#
City —'.)116 L A St Zip
Directions to Job Site -
a* V Y b
Owner Mailing Address
St _Zip
City D
Lien/Title Holder
Address
City St Zip
#2 Contractor Name —Contractor Reg#
Address Expiration Date
City St Zip Phone#
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No. 3,5?a?- -6�--
Legal Description u i m ar 1 &t
#5 Building Square Footage: (existing/proposed)
1st FI / 2nd FI / 3rd FI / Loft /
Basement / DecQx/ / #bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
ti Other sq.ft. /
ti j�
#6 Use of building `✓e0-b I Describe work o9�e
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION --`
Model Year Makes e
Length Width ------Serial No.
#Bedrooms #Bathrooms Type of Heat
Pur a Price $
#9 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
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each)
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
_Bath Basins Heatpump, Other
_Bath Tubs No. Units F
Showers Furn BTU
_Hot Water Htr Heatpumps
_Laundry Washer Vent Systems
_Sinks _ Spot Vent Fans
Floor Drains No. Boilers/Compressors
/ha
s HP ;
N� Air Handling Units cfm#
No.. Fir Pr i m Auto. Fire larm Sys 50.00
Fixed Fir Supp. Sys 50.00
15.00 Auto Fire Sprink Sys 25.00
TOTAL PLUMBING $ No. Other
Gas Outlets
Wood, Gas, Pellet Stove
NOTICE: THIS PERMIT 1137-: AND VOID IF
WORK OR CONSTRUCTION ION AU1 HUI L—L-, 'S NOT COM-
MENCED WITHIN 180 DAYS OR IF CONST RUCTION 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 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 OWNE ` BY
DATE 11.5 3 DATE
FOR OFFICIAL USE ONLY: Accepted by: f`- Date �—�
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
�S
Environmental Health:
Building Plan Review Rob
Occupancy Group: Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit (ft)
Plan Check S
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee [ ,
Other
7
Other
Building Valuation: TOTAL FEE �j�