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HomeMy WebLinkAboutMIS92-00119 Final Woodstove - MIS Permit / Conditions - 10/30/1992 MASON COUNTY e9n Couni-y Bldg, 111 426 W. Cedar r) n s ox 186 Shelton, Washington 98584 A 14 1. 1 1 ,4"0 0 0 0'10 P I 1, 1 IONY 4IINNIN610N 4 1-1 IONY OUNNIN610N 4 1 1 /j MOM Riff It j# is 44M It 1146 vamp a f-. a d(11 k e fy s house t' ,,, cream colored witAs dark brown Y "y 14, 00 1 1 fl 1 0/ t ", 1 0 0 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 i G �L by /JI C/� date by (D-Z7-q 2. )1 o 1 L N A L. ( ,Q :FA, ry ©*J 1k 0t i �v�Lu v v r�tuv111 fit'YLll�ti 11V1V PLEASE PRINT #1 Owneri hone# Site Address I�P/1C _ ,�'► City h 'e ry St I z 9 Y-1- Zip_ Directions to Job Site l , 0 Owner Mailing Address iYY — City St Zip Lien/Title Holder Address 1-200 ` CitySt LAtj !� #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 (If residential, proof of potable water may be required) #4 Parcel No. L __3L( Legal Description #5 Building Square Footage: (existing/proposed) 1st Fl / 2nd F1 / 3rd Fl / Loft / Basement / Deck ' / #bedrooms_ #bathrooms_ Garage Carport / (Circle: Attached or Detached?) Other sq ft / #6 Use of building � �7�— Describe work #7 Type of Job: New. Add Alt Repair Demolition Woodstove v Re-Roof Bulkhead Other #8 MOBILE HOME INFORMATION Model Year Make Model Length Width Serial No. #Bedrooms #Bathrooms Type of Heat #9 Any water on or adjacent to property: saltwater lake river pond wetland seasonal runoff other J 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 Scale: Nance of Fronting Street Date: =APPLICANT TO DRAW SITE PLAN BELO ,APPLICANT TO DRAW TOPOGRAPHY PROFILE BELO i I i I i LVO. TOl1ets Bath Basins vent SVste_^Is X Bath Tubs vent Fans X 3 . 00 _ Showers No. Boilers/Compressors Hot Water H t r 0-3 HP ---L-OQ Laundry Washer 3 -15 HP _ 6 00 Sinks 15-30 HP Floor Drains 30-50 HP Laundry Basins 50 + Hp _ No. Air Handling Unit 6 . 00 Dishwasher Disposal — <= 10000 cfm. Urinals > 10000 cfm. _ Other Other Evap Coolers Permit Basic Fee 00 Hoods TOTAL PLUMBING --�----- Fire Suppression $ Domes . Incin. COmml. Incin. Mechanical Fixtures Reloc/Repair _Q.0 No. Fuel Types Gas Outlets X 2.00 Furn < 100K BTU 6. 00 Woodstove segarate - -Furn >= 100K BTU 6 . 00 Other Furs - Floor 6 . 00 Permit Basic Fee Heat Pumps - . 00 _10 . 00 TOTAL MECHANICAL $ NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AF"I'ER WORK IS COMMENCED OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTQRS REGISTRATION LAW RCW 18.Z7 AND AM AWARE I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR OF THE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH IN THE STATE OF VASHINGTON AND I All AWARE OF THE THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH THE PERMIT IS ISSUED ANO ALL CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE ARK DONE WILL BE IN BUILDING CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BU DEPARTMENT. WITHOUT FIRST DEPARTMENT. OBTAINING APPROVAL FROM THE BUILDING X OWNER BY DATE DATE Return permit to: Department of General Services 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562 -5628 FOR OFFICIAL USE ONLY: Accepted by: Date: Approved Cond Hold Approval Planning: - 1 I I i Environmental Health: Building Plan Review: Occupancy Group: Fire Marshall: Other: FEES Ilspecial Conditions: 11 Ilsite Inspection ( (( 11 11 Ii �( 11 11 IlBuilding Permit ( (( 11 11 11 Violation Fee I II 11 11 Ii 11 11 Violation Investigation Fee I 11 II 11 1! 'I II 11 IlPlan Check I II II I ,i 11 11 II Plumbing Fee I it 11 11 1! �( 1) 11 11Mechanical Fee 1 II II 11 Ii i II it Ilwoodstove Fee 11 1` - 'I II 11 IlBuilding State Fee I 11 liBuilding Valuation: 11 11 TOTALI �, I IL I I � / I