HomeMy WebLinkAboutBLD93-00055 Final Mobile Home - BLD Permit / Conditions - 5/3/1993 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,5-5-9 bZ4 Gas Piping date b
Foundation Walls date by Set Up 4C
date by INSULATION date �7�%-�3 by
BG/SLAB Insulation Floors Final
date by date by date 5- s-4-2-5 by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date b 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
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ALL SANDY COVFP.?lINII'AUrA S MIN/IN RATING. V
sr, NO VEHICULAR TRAFF"' ON SEPTIC SYSTEM!.
610--� CURTAIN DRAIN NerREQUIRED AT THIS TIME.
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LATERALS TO FOLLOW CONTOUR OF SLOPE.
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REMOVE NO TOPSOIL DURING SITE rRFr.
a OWNER TO PLANT GRASS OVER SYSTEM
AND MAINTAIN GROWTH.
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Permit Nc.BLD
MASON COMJTY
BUILDING PERMIT APPLICATION � s
Q�
PLEASE PRINT
#1 Owner L4A/y,Z\fPhone#
Site Address N 1101 14,4 Yak
City A4,1 vA St VIA - -dip j�s�fsk�
Directions to Job Site�3/=L,=.,��.,Z _ Nnr2.—,(r i 77")
l-llz AL01 -rAL-1,, f A Y1j (Z ap
Owner Mailing Address 1 Q VJ�i�r��
City
Lien/Title Holder
Address
City St Zip_
#2 Contractor Name hao,,' ,L Hcv r, ZnL�;s L,i d'nntractor Regtt�D13T(.e45 1ILi�i�/
Address Sox z2. sr Expiration date IV
Cit S t-LaAZip qk--. Phone 3 77 , 8-,3 C Z
#3 If septic is located on project site, include records .
Connect to Septic? y,_� Public Water Supply_ Well
(If residential, proof of potable water may be required)
#4 Parcel No. 3 2.Z 1 Z-SQ '-C Q Z p� /fjL %/+H✓,�,a �2 �.2 T,z•4c s YEy_5 $,'//
Legal Description Po�2r; � r„= S c_ )Z 1 Z1J �a�r 3uJ �4yx-y40- y'�L71rp
#5 Building Square Footage: (existing/proposed)
ist F11a1sv11.L_ 2nd Fl �_ 3rd Fl / Loft /
Basement / Deck / #bedrooms #bathrooms_
Garage / Carport / (Circle: Attached or Detached?)
Other sq ft /
#6 Use of building Describe work s`�e�i— LAIQ
"n(,a) <;
#7 Type of Job: New Add Alt Repair Demolition
Woodstove Re-Roof Bulkhead Other
#8 MOBILE HOME INFORMATION
Model Year J-3 Make Model Gfi<,g�vc�U�
Length G,Ei Width Z( _ Serial No.
#eedrocros�_ 'r$BdC�+* ;;,:;_ Ty-;e of Heat
149 Any Water on or adjaron-- ca urar3�ity: Sair4acer lake
river pond wetland seasonal runcr:=
other JJ)Q _
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan 'Tzzography
Septic Systems Wells
Proposed T rovements Easements
Name o ? inq• Street Scale:
Name of Frotting Street Date:
APPLICANT TO DRAW SITE PLAN BELO
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
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($2 each) Fee
- - -- goo
No. Toilets Vent Sys ems X 3 . 00
Bath Basins Vent Fans X 3 . 00
Bath Tubs No. Boilers/Compressors
Showers 0-3 HP 6 . 00
Hot Water Htr 3 -15 HP 6 . 00
Laundry Washer 15-30 HP 9 . 00
—Sinks 3 0-5 0_ap
Floor Drains 50 +. HP 6 . 00
. 00
Laundry Basins No. Air Handling Unit
Dishwasher <= 10000 cfm. 7. 50
Disposal > 10000 cfm. 7 . 50
Urinals Other
Other Evap Coolers
Hoods
Permit Basic Fee 3 . 00 Fire Suppression
TOTAL PLUMBING $ Domes . Incin.
Comml . Incin.
Reloc/Repair 6 . 00
Mechanical Fixtures Gas Outlets X 2 . 00
No. Fuel Types Woodstove separate
Furn < 100R BTU 6 . 00 Other
Furn >a 100K BTU 6 . 00
Fern - Floor 6 . 00 Permit Basic Fee 10 . 00
Heat Pumps 6 . 00 TOTAL MECZ-ANICAL $
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 ANY'?'I'`�Ii E AFTER WORK
IS COMMENCED
OWNERS AFFIDAVI': 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 RC%J 18.27 , ANO 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 OONE WILL BE IN
CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE 3UILOING WITHOUT FIRST OBTAINING APPROVAL FROM THE SUILOING
OEPARTMENT. OEPARTMENT.
X OWNER X 9Y ��2✓�� t Yam✓�j � �
0A, DAT r
Retur^ permit to : Deoar=ent of General Services
426 W. Cedar/P .O. Box 186 , Shelton, WA 98584 427 -9670/1- 800 - 562 - 5623
FOR OFFICIAL USE ONLY: Acceoced by: 6. 1 Date : /-/l
ULFAKI TEW
FOR OFFICE USE ONLY
i Approved Cond Notd
Approvsl
Planning: Y
Environmental Health: �er s.o a4,7f- let a A �t
LmT
Building Plan Review:
Occupancy Group:
Fire Marshal:
Other:
FEES
IlSpecial Conditions: II IlSite Inspection I II
II II I I
II II IlBuilding Permit I �
II I
II II IlViolation Fee I II
II II If
II If II IlViolation Investigation Fee I II
II I
II II II Plan Check I
II I II
II II I. ;I
II II II Plumbing Fee I II
II 11 I
II II IlMechanical Fee I II
II it I I
II 11 II Wands t ove Fee
II 11 I 1
I` 11 IlBuilding State Fee k5c) II
I If
IIBui di=g valuation: it II
L , TOTS 1
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