HomeMy WebLinkAboutMIS93-00461 Cancelled Foundation - MIS Permit / Conditions - 2/13/1994 MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
MAS93-04611 1 3 P. 1001 1 f�1, A I
U 101/ MIKKEt.St- N R0
A JJ-I I i A N I 1VRkY SMITH 41'!b--, 3jh0
111,1141-b? TERRY SMIIH 4 3 4!0
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Front town. take Hwy 3 north to Mn,ioti I :the Or im-ti i pit.. cp) to mikkelspil "Ofid.
Lt-#rn right:.
. Follow Mikketsevi Road -)/TO injit,! t.t) I()#-k . tfike 11ol-l" fouh . (it) ;1/110 mile to propol-tv
corner . I.urn right (10 :'*Oft. t.0 driveway cite lett. ,
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Nil, pimf - 00#111i! COMPi # ANC U 10 AvIACHFD CoMm I ION% Is
RUQUIRED
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M = S C C iL L t+1 E 01J S P M Z T i0k fN&PECTIONS CALL 427-967
MIS93-0461 PARCEL : 321352290011 PLAT : C11.V.? BLK : ? LOT: ?
. JOB ADD1 EqS : E 1012 MIKKELSEN RD SHELTON
APPLICANT .: TERRY SMITH 426-3950
OWNLR : TERRY SMITH 426-3950
LEGAL : V12 ME NU NH
Foundation Only
PROJECT LOCATION :
From town, take Hwy 3 north to Mason Lake Dr . Turn Left, go up Mason Lake to Mikkelsen Road,
turn right. Follow Mikkelsen Road 9/10 mild to fork , take left: fork , Go 2/10 mile to property
corner . Turn right go 200ft. to driveway on left.
PROJECT NOTE"',
TYPE AMOUNT BY DATE RECEIPT
FONO In . 00 CPH 08/11 /93 336:1 /
TOTAL : 15 . 00 OWNER ON nhl ri OATS
NIS PRNT, rev: 14/0192 COMPLIANCE TO ATTACKED CONDITIONS IS
REQUIRED
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MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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GaSe No . : MIS93-046.1
For : TERRY SMITH
Page : 1
1. ) PURSUANT TO 1991 UNIFORM BU11.DING COOT , t:[: 1 70N 05 (C ) AND `3I C F ION r t '> , A1- 1. Sf 11::;; R P 11 '5T
HAVE APPROVED NUMBERS 01i ADDkt.:.;Sl. S 1'i'<OVII)i_u J.id U c H to 1'01 1 rill ;'s:; I U ict Pl. ltiliVLY V1 _�1L L.E
AND LEGIBLE FROM THE STREET OR ROAD f7kON1111(i I'lih PF:Opk Y . M ti: Ur•! C 0 U N Y i:,lJl:LDfNG
DEPARTMENT RFQUTRF; THAT TH] S BE COM1%1.1:=`I F I) 1'kl OR TO CAI. I I Nt FO!t t'sP:!',' ',.11 F 111S1) GI 10NS . A
RE-:INSPECTION FEE , BASED ON RATES TN TP,E;I F Cll` TIIL_ i < 9 ;1NT1'[ll;ll I;Uf. l_ritNG C:UFJ WILL BE
ASSEiSSE1) 1F OWNER/CONTRACTOR "I I S l U F'05.�1" lll)lif;!'';S UN 1 l l k1 Uk 1 0 (iEt;llll"..':"I :1 N(,
INSPECTIONS .
X__. a.`._l__ _.......___............_....____.
ALL. CONSTRUCTION MUST MEI-T OF? CXCL-Cli "ILL l.Ot,AI.. CODIi_ ; ANO UN tF'[.11 11 I:U 1:L01NCODE
t�
ALL CONSTRUCTION MUST MEET REOU.TRED SETBACKS AS F!!FABL".T".IIFO K-1,' MA'-ON COUNFY nDrNANCE
138--9� AND MASON COUNTY SIIORELINE. MOS11 1( hftUtiliRPl LI i11'F'l. t [:lit 1.t:
X- r�.IF THE FOUNDA'I-JON IS PLACED IN VIOLl1 TION Of� ANY NA,'-';ON C[i11N I Y t;l t,lll. ;'� t :f0i11 11 W.f. LL oL THE
0WNERS LIABILITY 10 REMOVE '..ATO CONSTRIJC'I'jON Af IIII.. OWNI, lc l. Xpi !:.;1 t!`•IIi ltl liti 0 fJ] 1111N
THE: TIME. S P E CIF1 ;. 1) 13Y iii : Pit)I1_UlNG Of--l'ICfAL
X
X
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons / 2
date by Gas Piping date 25[ > 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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Permit No.
MASON COUNTY �ADWm �S L
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT
#1 Owners S (ln'��1r� A— ��ro ZC�aj:�,MPhone# 4�,b—
Site Address E_ . ft 1O\"a �(V _� Q 152 r'� 26 Fire District# _S
City 0 1 AC)n St zip q
Directions to Job Site �®�i�
Owner Mailing Address '�. a l +n � 1&)2= —+
City Sh'��Y, St t A Zip
Lien/Title Holder CtX.JV1*- cQ S d�OL)&-
Address
Clty St zip
#2 Contractor Name Q � A-& / �J,�d er Contractor Reg#
Address 7 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 Nose- .ate - C` \
Legal Description—Eq 1- A C:,C N E- K v�, N W . �E
#5 Building Square Footage: (existing/proposed)
1 st FI / 2nd FI / 3rd FI / Loft /
Basement / Deck / j0' #bedrooms / #bathrooms /
Garage / Carport /_ (Circle:Attached or Detached?)
Other sq.ft. /
#6 Use of building — otjriJ'r"t I U' Describe work Pour
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year 1Qg 3 Make��zf t Model-V-rxk t n e-nc2,.
Length 1-\y , Width a'S, Serial No. QGq O 1
#Bedrooms _#Bathrooms _Type of Heat
Purchase Price$ : ' - ' l \q.5
#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 Dim ions 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
3 3 o �---
0r
o
ti Q
F9s1
----------------
APP ANT TO DRAW TOPOGRAPHY PROFILE BELOW
l
Plumbing Fixtures ($3 eachl Fq2 Mechanical Fixtures ( 6 each)
No._Toilets CIRCLE FUEL TYPE: Gas, Electric,
_Bath Basins Heatpump, Other
�11bs---.-___1__---___._ No. Units Fees
Showers Furn BTU
_Hot Water Htr _ Heatpumps
_Laundry Washer Vent Systems
Sinks Vent Fans
Floor Drains N B iters/Co Dressors
_Laundry Basins HP
Dishwasher N it H n linUnits
_Disposal fm#
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 $
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 FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. DEPARTMENT.
X OWNER X BY
DATE �- I�I - �t =< DATE
�T
FOR OFFICIAL USE ONLY: Accepted by: Date: z
DEPARTMENTAL REVIEW
' FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: h,
Environmental Health:
Building Plan Review- _�undcX01 01 L, n e)i r3,1 �y
Iry s-t--4cL- Pet lyr& Spce.S
Occupancy GroupynoRiLC Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit
Plan Check
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee
Other
Other
Building Valuation: TOTAL FEE