The URL can be used to link to this page

Home My WebLink AboutBLD92-00117 Cancelled Mobile Home - BLD Application - 2/23/2000 BUILDING PERMIT APPLICATION °�� • MASON COUNTY DEPARTMENT of GENERAL SERVICES 426 W. CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. OWNER N E MAIL ADDRESS CITY BSTATE ZIP PHONE ze-Mqw wd FW-k L7 =5170,6 DIRECTIONS TO JOB SITE PARCEL LEGAL _ NUMBER a�� 75(j DESCR. s�= IL T Z C/J CONTRACTOR NAME MAIL ADDRESS' CITY&STATE ZIP PHONE LICENSE NO. USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE WORK X S (� AREA: NUMBER OF: PLEASE INDICATE: NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR RESIDENCE'5 Y_7 SgFt STORIES SHORELINE❑ CONDITIONING. BASEMENT SgFt BEDROOMS PRIMARY RES.0 THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT DECKS SgFt BATHROOMS SEASONAL RES.❑ COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. CARPORT SgFt FIREPLACE IS CARPORT/GARAGE GARAGE SgFt ATTACHED U DETACHED❑ OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. XOWNER - DATE t /� /�� X BY DATE FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATIONAc YES NO YES NO c HEALTH PUBLIC WORKS FEE PLANNING FIRE MARSHAL BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP �� PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION TOTAL q.lq'q -Z IBY CASH CK MO PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES 426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. OWNER NAME MAILADDRESS CITY BSTATE ZIP PHONE DIRECTIONS TO JOB SITE LEGAL DESCR. CONTRACTOR NAME ) �^` MAIL ADDRESS CITY BSTATE LICENSE NO. ZIP PHONE USE OF BUILDING L v tyG, PLUMBING FIXTURES MECHANICAL FIXTURES NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE OF FIXTURE FEE WATER CLOSETS FORCED-AIR I GRAVITY TYPE FURNACE 6.00 BASINS FLOOR/SUSPENDED FURNACE 6.00 BATH TUBS BOILER/COMPRESSOR 6.00 SHOWERS REPAIR/ALTERATION 6.00 WATER HEATERS REFRIGERATION COMPRESSOR SYSTEM 6.00 AUTO.WASHER AIR HANDLING UNITS 7.50 SINKS HEAT-PUMPS 6.00 FLOOR DRAINS EACH GAS PIPING SYS.2.00 PER OUTLET DRINKING FOUNTAINS VENT.FAN SYS.3.00 PER UNIT LAUNDRY TRAYS FIRE SUPPRESSION 5.00 CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISH WASHER plo Y 4OD CA DISPOSAL URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL TOTAL SPECIAL CONDITIONS: 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 TIME AFTER WORK IS COMMENCED. OWNERS AFFIDAVIT: I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF CONTRACTORS AFFIDAVIT: I CERTIFY THAT I AM A CURRENTLY REGISTERED THE CONTRACT OR REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON CONTRACTOR IN THE STATE OF WASHINGTON AND I AM AWARE OF THE ORDINANCE COUNTY ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL REQUIREMENTS REGULATING THE WORK FOR WHICH THIS PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST O AINING AgpROVA FROM THE BUILDING DEPARTMENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. X OWNER DATE qhy/2-9- X BY DATE FOR OFFICE USE ONLY APPLICATION ACCEPTED BY PLANS CHECK BY BUILDING GROUP APPROVED FOR ISSUANCE PERMIT VALIDATION APPLICATION ACCEPTED BY PLANS CHECK BY 7 BY CASH CK MO • BUILDING PERMIT PLOT PLAN MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. Box 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. NAME MAIL ADDRESS CITY&STATE ZIP PHONE OWNER _ _ C s= DIRECTIONS TO JOB SITE PARCEL LEGAL C I NUMBER DESCR. Indicate below: O Property lines and dimensions. O Easements and roads. O Septic, drainfield and reserve area, or sewer. O Septic tank and drainfield setback distances from foundations. O Location of proposed construction on property. 0 O Building & septic system setback distances from all property lines& easements. Indicate North O Well and water line. In Circle O Saltwater, lakes, rivers, streams, wetlands, drainage. O Attach copy of septic system"as built" or septic permit approval. O Indicate topography profile o perty and structure on reverse side. 0 ao I/We certify that the proposed construction will conform to the dim 'ons��n above an that no changes will be made without first obtaining approval. •IY 7 SIGNATU E OF OWNER(S)OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE q--11 y / ,22—_ TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE MASON COUNTY DEPARTMENT of GENERAL SERVICES Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 (206) 427-9670 building environmental health maintenance landfill parks&recreation fair/convention center planning sewer&water April 17, 1992 Philip L. Barber NE 901 Tahuya River Tahuya, WA 98588 Mr. Barber, Due to recent changes in the Mason County area the Health Department is requiring an Application For Determination of Adequacy be filled out and turned in with each new residential permit. Please fill out the enclosed form and return to our office as soon as possible. If you will be using a private well, it will have to be drilled and tested prior to the building permit being issued. If you are on a community water system the system manager must sign the bottom of the form. Any form that is not complete will be returned. If you have any questions please feel free to call Mark Tompkins or myself at 427-9670 ext 352. Thank you, Desi King Building Department Clerk - -y S. Gordon Craig the mason-county . assessor Dear We have recently received a copy of tax certificate for mobile home movement on your mobile home. In order that we may accurately value you mobile home, please complete the questions below and return this form to our office by It is imperative that this information be provided to prevent a possible double assessment. MOBILE HOME DATA LENCH WIDTH MODEL MAKE MODEL YEAR MOBILE HOME LOCATION INFORMATION SERIAL , A. My privately owned land. YES NO B. If rented or leased land who from? NAME ADDRESS CITY b STATE C. Real Property Parcel (tax statement �) D. MaLEL name and *address• for owner of mobile home- ADDRESS/ ✓L !o/ /r9}/ /eG!/�' �y CITY a STATE r14 E. Location address of mobile home CITY F. Date mobile home was placed on present site G. Purchase Price DATE: SIC NATUR TYPE OR PRINT NAME TELEPHONE NUMBER Courthouse Shelton,Washington98584 Phone 427-9670