HomeMy WebLinkAboutMIS93-00773 Final Foundation - MIS Permit / Conditions - 3/4/1994 P , MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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CONCRETE MECHANICAL MOBILE HOME
Footings-Se ck date by Ribbons
�date' /� !� by Gas Piping date b
Foundati 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 b date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date 3_!lC_ 9'� by date by
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MASON COUNTY
Mason County Bldg, 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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MASON COUNTY
Mason County Bldg, III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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Permit No.
MASON COUNTY
BUILDIIVG 'PERMIT APPLICATION \�
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628l�'��
PLEASE PRINT Q�
#1 Owner Q A W h n f,l U1 Phone#
Site Address E /9 1 .S7-0"6-b&iA2 PL-Aa Fire District#
City I Z'LYoN St 0 A. zip
Directions to Job Site N a P--f o N a4 ek Lr1i ro 3'B+jSow R.
Owner Mailing Address 3 l 3 C S O b N R D.
City o L— )n* A 'a 4 r 6-,m_G St Zip
Lien/Title Holder No nJ
Address
Clty St Zip
#2 Contractor Name 1M L U.s cv N S TV LT l ON ,T NG Contractor Reg # -M ILLS C 10f VT-
Address 3 1 3 o Soy IV-4 A-6 Expiration Date y / 1 2 / 9 N
City 0" 'Mr;a 10 St WA ._Zip 4 T Sb 6 Phone# L) q 1 .7 0'- .�.
#3 If septic is located on project site, include records.
Connect to Septic? 4R-S Public Water Supply Well_ S
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No.? 2 1 37-3z- - 9 o u l
Legal Description
#5 Building Square Footage: (existing/proposed) \
W
1st FI 1 6 2-0/ 2nd FI / d FI / Loft /
Basement / Deck #bedrooms / _#bathrooms
Garage yTH / Carpo (Circle: Attached o Detached?)
Other sq. ft.
#6 Use of building R iEt !O i�vT$ xtEIW NotinF Describe work C00Xr .ALT
nUi
#7 Type of Job: New K Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMA \I
Model Year Make Mo el
Length Width Serial
# Bedrooms #Bathrooms T rofHeat
Purchase Price$
#9 Indicate by circling the applicable source if any wat n r) a nt to subject property:
River Pond Creek Stream Wetland Lake Mars Salttva er 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
Q9
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
1
1
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each)
No. 2-Toilets CIRCLE FUEL TYPE: Gas, Electric,
2 Bath Basins Heatpump, Other
2 Bath Tubs No. Units Fees
Showers 2, Furn BTU
Hot Water Htr / _ Heatpumps
Laundry Washer Vent Systems
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 1 Auto. Fire Alarm Sys 50.06
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 to)14:1olt"' X BY 6 Oalb
DATE /" Z F—f 3 DATE -2T 3
FOR OFFICIAL USE ONLY: Accepted by: `� 1, Dater 1 ��
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: rn
Environmental Health: j1QJiaK� Sc�D M- p?lw1�- 31ccC �1�
Hk4i
Building Plan Review
(BLS -
Occupancy Group:►-3 /M_ Type of Const: S
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit 7'5
Plan Check III
Plumbing Fee ys
Mechanical Fee
Wood/Gas/Pellet Stove ,59 °
Radon Monitor ,00
Violation Fee
Site Inspection
Building State Fee .�
Other
Other
Building Valuation: 73 TOTAL FEE s
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