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Home My WebLink AboutBLD93-00868 Cancelled Garage - BLD Permit / Conditions - 9/24/1999 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 !,!'ik Is tit ',141 1 1014 PERMIT iflAr4l I., Jollfill (3AMsK.111. EXPIRATION NULL & V01[) By E DATE T?qj BY ;,I tit I Ill, ;it I i0ii it r'i i It i! ki I, l', I I I 1 1 1 14 1, 1 i4if I t it I Iti I iA I 1 i I I?1; I 1 1 6 it P4i81(f IOCAIIAO W11904 lAtf HWY I lit t [Of :t $A)og IltlAil J(, kVfRitRj 10 lipl�t lift Ili f0h 19 1 S Pf R I I I oft 11NIS poll ii N It V it 10 f W01 14 1 to, I filif 1 160 AIJIM11F.I it I, I', N F!I I 01"IN(I 11 Ill hil" 19 q 1i A lip I i lit i I lip it k. u it "it Of loil hfiyti Al All 1141 Aflf'R Viij.1 0 CONAtmQ0 FVIDf,g'rf Al 110fiPlIAM4 lit lohifil f`; A PRr)i,Pl tillfil ill 141* 14 1 0 NAi P 1:P 14 It 11A It rev; u1j, 101 C 0 14 It'L I A N L U' t0 AI IAt.Hf.tt C 6 N 111 1 IV N) I!:i RE QU I RE tj r- CONCRETE MECHANICAL MOBILE HOME 4�ootings-Setback date by Ribbons date ?-1--1 7 -R 3 by Gas Piping date b Foundation Walls date by Set Up " date by INSULATION date by BG/SLAB Insulation Floors Final date FRAMING by date by date by 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 MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 ��t ,.iiq �.tij ! ! r;If i i7;'1 ,'ri ; .. °� "• 4 �! ft. �i +di•' �1 �1 � t yI itI ,:tilm i Permit Noy_og5 'O oW MASON COUNTY BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 Owner ��" ..1 �/ Phone# Site Address e- D0, Fire District# City C L,,.• To.✓ Sty Zip `37s 4' Directions to Job Site �/2,4 ;,��le .( ,4-/e e Nwv -3 Z-a' 'X JCQ 'c-& •.4-1A se'. 2_d Owner Mailing Address �► e City St Zip Lien/Title Holder Address City St Zip #2 Contractor Name��, ,e d 444 s7 Contractor Reg#lo3,w_/AwCzo;Z& Address R a : w Expiration Date__ /_,I _/_ct. ' city �,v St was Zip Phone# � 7- / 1�03 #3 If septic is located on project site, include records. Connect to Septic?_&40_Public Water Supply �%, Well Connect to Sewer System?_,44p__Name of System (If residential, proof of potable water is required) #4 Parcel No. 3 R /3 y - Legal Description RA; � � A< �/�c /� % #5 Building Square Footage: (existin ro 0 1st FI / 2nd FI / 3rd FI / Loft / Basement / Deck / #bedrooms / #bathrooms / Garage_,I;:��/ Carport / (Circle:Attached or Detached?) Other sq. ft. / #6 Use of building Describe work L ' C #7 Type of Job: New 2 Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year Ma Model Length Serial No. Wi # Bedrooms # athrooms Type of Heat Purchase Price$ #9 Indicate by circling the applicable source if any water is on or adjacent to subject pro e River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal T�"Iher 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 i� r� �r J �j � J• y � APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbina Fixtures ($3 eachl Fee Mechanical Fixtures ($6 each) No. Toilets CIRCLE FUEL TYPE: Gas, Electric, Bath Basins Heatpump, Other Bath Tubs No. Units 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 No. Air Handling Units Disposal cfm# Urinals No. Fire Protection Systems Other _ Auto. 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- 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 VRAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. NT. X OWNER (� DATE �—"��`-7 FOR OFFICIAL USE ONLY: Accepted by: LC' Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: iI I Wl Building Plan Review Occupancy GroupWL:: Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit "Z.Ob Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee s Other Other Building Valuation: TOTAL FEE MASON COUNTY PERMIT NO..20 as 1 PLUMBING/MECHANICAL PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 Shelton (360)427-9670•Belfair(360)275-4467•Elma(360)482-5269 On the web www.co.mason.wa.us APPLIC NT INFORMAT ON CONTRACTOR INfZRMATION Owner -LD I Company Name f/p-- 1A 624 d es Mailin ddres I V Mailing Address City State I I I A Zip Code q 2)5EL City State Zip Code Phone a/)n_2_5 E_f 5FZ_-Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. # Exp. E mail address E Mail Address Drivers Lic.# DOB I Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION- 12 Digit Parcel No. Fire District Legal Description Site Address(Please include street name, street number and city) - Directions to site Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New Add Alt Repair Other Use of Building Location of Fixtures/Units- 1 st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric—LPG—Natural Gas_Heat Pump_ Toilets Type of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs Heatpumps Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kithen Sinks Wood/Gas/ elletStov 1 _-La.00 Dishwasher Kitchen Exh Hosebibs Dryer Vent Other Other Base Fee Base Fee 28.S0 TOTAL PLUMBING TOTAL MECHANICAL OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information proviffFF urate and grants employees of Mason County access to the above described property and structure for review and inspection. PROO INUATIO WORJLIS,BY MEANS OF A PROGRESS INSPECTION. Date: wner Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYONQ THIS POINT Accepted b Planning Pd Ck# Date 10 1 IZIW I I Bld Pd Receipt No. DEPARTM NTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group—Type Constr. Planning Department Environmental Health Department FEES Plumbing& Base Fee Site Inspection Mechanical & Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES