HomeMy WebLinkAboutMIS92-00032 Cancelled Mobile Storage - MIS Permit / Conditions - 9/6/1994 MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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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 by date by
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MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
MASON COUNTY
BUILDING PERMIT APPLICATION
PLEASE PRINT
fU'e� — /b
#1 Phone# 4 2 7- f-/Z -t
Site Address 676 60 3 3 Ci ty S.L-,, Stk,4-Zip q1 s_r;c
Owner Address Xr -e Ci ty St Zip_
Li en/Ti Cl e Holder s
Address Ci ty St Zip
Describe Work 15.,-;9- Or k c w,
#2 Contractor Name Contractor Reg#
Address Expiration date
at ty St Zip Phone
#3 If septic is located on project site, include records.
Connect to Septic? 5,-s Public Water Supply 'tea Well ,y-
#4 Parcel No._'3 ;L 13 6
Legal Description_ 7'9 P
#5 Building Square Footage: (existing/proposed)
1st F1 / 2nd F1 / 3rd Fl / Loft /
Basement / Deck / Garage / Carport /
#bedrooms / #bathrooms /
Other sq ft /
#6 Use of building L;
#7 Tyne of Job: New Add Alt Repair Demolition
Plumbing Only Mechanical Only Woodstove Re-Roof
Bulkhead Other
#8 Plumbing Fixtures Mechanical Fixtures
No.—Toilets No. Fuel Types No. Air Handling Units
Bathtubs Furn < 10 OIL BTU <- 20000 cfm.
Showers Furs >- 100% BTU > 10000 cfm.
Bath basins Furs - Floor Other
Sinks Heat Pumps Evap Coolers
Dishwasher Vent Systems Hoods
Hot Water Htr Vent Fans Domes. Incin.
Laundry Washer Boilers/Compressors Comml. Incin.
Floor Drains 0-3 HP =ReloclRepair
Other 3-15 HP Gas Outlets
15-30 HP Woodstove
30-50 HP Other
50 + HP
#9 MOBILE HOME INFORMATION
Model Year! t s 7 Make 6r-y," 4 K°s Model I r3a ,l 1?
Length 4 s- Width ,10 Serial No. f-p.9 3o#s- ace3 L
#Bedrooms #Ba throoms 4k cv s
#10 Any water on or adjacent to property: saltwater 2&,- lakes
river -.!,P pond -4 e wetland seasonal runoff 'mot
o ther-7,.,�
Show foll-owing on the site plan Directions to Job site
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways
Water Lines Shorelines S'�ca �vb: - v� /,4 r�.�� 3— z rs,t d
Drainage Plan Topography -
Septic Systems Wells P—a-L
Proposed Improvements Easements 7, jeY14-0--
Name of Flanking Street
Name of Fronting Street
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Scale:
Date :
=APPLICANT TO DRAW TOPOGRAPHY PROFILE BELO
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2-7 jS
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,NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMIDENCED WITHIN 180 DAYS , OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK
IS COMMENCED
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY_ THAT I AM A CURRENTLY REGISTERED CONTRACTOR
CONTRACTORS REGISTRATION LAW RCW 18.27 , AND AM AWARE IN THE STATE OF WASHINGTON AND I AM AWARE OF THE
OF THE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH
THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
DEPARTMENT. DEPARTMENT.
X OWNER «i % c--C X BY
DATE L- 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: -
DEPART'M]TAL REVIEW
FOR OFFICE USE ONLY
Approved Cond Hold
Approval
Planning:
Environmental Health:
Building Plan Review:
Fire Marshall :
Other: