HomeMy WebLinkAboutMIS94-00746 Foundation - MIS Permit / Conditions - 9/21/1994 MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
M 3E S C E L L— A N E O u S P E FZ M 3E T FOR INSPECTIONS CALL 427-9670
MIS94-0746 PARCEL : 321341390114 PLAT : DIV: ? BLK : ? LOT: ?
JOB ADDRESS : E 570 MIKKELSEN RD SHELTON
APPLICANT : EDWARD SMITH 427-2655
OWNER : EDWARD SMITH 427-2655
L E G A L : Tr. it of SW NE, TR 8 of SPt 784
PROJECT DESCRIPTION :
FOUNDATION ONLY
PROJECT LOCATION :
NORTH ON HWY 3 TO MASON LAKE TO LEFT TO MIKKELSEN ROAD RIGHT TO JOB SITE
PROJECT NOTES :
TYPE AMOUNT BY DATE RECEIPT
STFE $ 4 . 50 KS 09 /21/94 37244
FDNO $ 15 . 00 KS 09/21 /94 37244
TOTAL : 19 . 50 OWNER OR AGENT DATE
MIS_PRMT, rev: 0 4/0 1/9 2 COMPLIANCE TO ATTACHED CONDITIONS IS
REQUIRED
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
1!r-U SCE: L L ANE= 0IJ !3 P' 1- RM X X
HIS94-0746 I Al" 1, 1 3 ' 1 '.41 avN 1 1 4 11I A I
i11fa f,Il[►1tt L 670 NIKKELSEN RD SHEL.TOM
1?111'I 1 (7AN1 : FDWARD SMITH 427•-26515
00NE R r. FOWARD SMITH 427-26SS
IA'JiA1 : fir, It of $Y If, It 1 of S11 1114
FOUMPATION ONLY
@P11:11 r,] I.0f. ATt ()N -
NORTH ON HWY 3 TO MASON i_AKE TO LEFT TO N [KKE L St N ROAD RIGHT 10 .: OH SITF
f S'Iti�.11 �. I Null=
I
TYPF AMOUNT BY DATE RE t F If, i
I
II `FIFE. $ 4 1',0 K.`:; 09 /;' 1 11 ?44
141,
44 I . .
r0TAI IQ S0 OWNI fz fits' AIA NI f1AIF
#IS PEC. reL 11j1119 COMNI 7ANCF tO A'1'1"ACHF0 CONDITIONS IS
RFOITRE D
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date ,L ; (c�,-J by Gas Piping date b
Founda)ion Walls date by Set Up
date /( �Z by !Lt— 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 , {Jy �L— date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
4-L �-
i
I
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
Case No . : MIS94-0746
For : EDWARD SMITH
Page : 1
1 ) Proposed structure or any portion thereof greater than 30" in height from grade line ,
must maintain a minimum of 5 ' setback from all property lines , easements and right of
ways .
X
2 ) ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND UNIFORM BUILDING
CODE
x
ALL CONS RUCTION MUST MEET REQUIRED SETBACKS AS ESTABLISHED PER MASON COUNTY ORDINANCE
138-9 MASON COUNTY SHORELINE MASTER PROGRAM IF APPLICABLE .
X
IF TI �7FOUNDATION IS PLACED IN VIOLATION OF ANY MASON COUNTY REGULATION , IT WILL BE THE
OWNERS LIABILITY TO REMOVE SAID CONSTRUCTION AT THE OWNERS EXPENSE AND TO DO SO WITHIN
THE TI ECIFIED BY THE BUILDING OFFICIAL
X
X
I
J
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P,O. Box 186 Shelton, Washington 98584
iNt I i.a°111 11,'11 1 1 i1N M I 1 ; ; Pit t T +11; 1 .xi 1 I I AI 1 i i+t AI 1.111I 111411 11N 1 1 It 11 1-fH I i I111d+,
e"
A 1 I. +:(:)N 1 R+1C i t ON (411', 1 M1, t. 1 Rt UH I Rt 11 ',t I HA( Kai A F `" f Af-"I 1 IIE 1" 1,1: ti m1'4 N 1'(11IN ( y 11F,1� 1 (vitl
1 eti J MA',ttN i 1)11NT 1 i11)IJ 1. 1 NI MA1 I k PRfll7{dAM 11 f%ITI I A I f
t
I F TAIL I oIINi.+AI I-ON I t'1 ACF- II I N V J 0 t A I [+7N 01' A N f P1A', N 1 C11IN 1 Y let
istil A l l I1N .. I I b.IJ I t bI l iI
0WNF R', I.J All I I 1 I Y 1'0 Rl- MOV1- `,A 1 0 +'+)idc;'f POV I I ON A I I lit M4N1 1; 1 +.I'f WO ANO 10 1111 `;Ii IJI1-ti f f.+
T IIF T 1 MXf 'I; is T I 1 f 11 0 Y f It F: 8 0 1 1 I 1.1 N 6 0 T 1: I(' 1 A 1._
k .
CONCRETE •J 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
MIS
MASON COUNTY
MISCELLANEOUS PERMIT APPLICATION ��`��•��
426 W. Cedar/P.O. Box 186, Shelton, WA 98584. 427-9670
PLEASE PRINT
#1 Owner Phone# ��oS� Fire District#____
CWA
ddress E .570 CIIA.ICC.��.U�-� xtcl City �Ti�jit/ � 1A)4.�
ail Address �f'S� /,C�,C/--Z;! / o .
City St Zip g _
Applicant 5,q/7-P Phone# 'y27— !
Applicant Address E-Z Syr✓
City _�,�`�.� �� _ St Zip
Directions to Site: 'Aft.72q Off/ 77T-�vi 7'0 � T- ��� ,o _
ap, czz
Parcel No. � � lj?h - a /
g /
Leal
# Description ��T ''•� a�/r�ieT_ ,�i¢�^. # ��f�8
#3 Indicate by circling the applicable source if any water is on or adjacent to the property site:
saltwater lake river creek stream pond wetland seasonal runoff marsh other
#4 Project Start Date R!!54 P Project Completion Date
#5 Use of Buildiing /�ce-1 n, /®,Q.�-trO� Describe proposed construction /-off,
�Szl 1 U4 Jj LG—
*Depending upon the type of permit,a floor plan and plot plan may be required.
'This permit is valid for 180 days from the date of issuance.
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED CON-
MENTS OF THE CONTRACTORS REGISTRATION LAW TRACTOR IN THE STATE OF WASHINGTON AND I AM
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AWARE OF THE ORDINANCE REQUIREMENTS REGULAT-
ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT ING THE WORK FOR WHICH THE PERMIT IS ISSUED AND
IS ISSUED AND THAT ALL WORK DONE WILL BE IN CON- ALL WORK DONE WILL BE IN CONFORMANCE THERE-
FORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITH. NO CHANGES SHALL BE MADE WITHOUT FIRST
WITHOUT FIRST BTAININGAPPRO ROMTHEBUILD- OBTAINING APPROVAL F M THE BUILDING DEPART-
ING DE1 ARTrqT. MENT.
X OWNET
f� X BY ' L
)ATE �4� �/ — �� DATE
Show following on the site plan ' .►
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Wells
Water Lines Shorelines
Drainage Plan Easements
Septic Systems Name of Fronting Street Indicate directional by
Proposed Improvements Name of Flanking Street N, S, E, W etc.
PLOT PLAN AREA
FOR OFFICIAL USE ONLY:Accepted by: Date:
DEPARTMENTAL REVIEW
FOR OFFICIAL USE ONLY
Planning
APP COND APP HOLD
Building 56-� k jE04�Z UJLf-
bow
Fire Marshal
Other
Special Conditions Fees
Permit Fee $
Plan Check
Other
Other
State Building Fee
TOTAL DUE $