HomeMy WebLinkAboutMIS95-00636 Retaining Wall - MIS Permit / Conditions - 4/27/1996 MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
M I L3,(-. ate. L.._ L_ A N FE C3 LJ P I>" M I 1 FOR I NSPEC'r ONS CALL. 427--9670
MI S96-6636 PARCEL. :222335200066 PI A. " €�IAPL.O D I V ; RL_K : LOT :
JOB ADDRFS S : . E 2771 MASON I..AKE DR E R 1'FV I EW
APPL 1 CANT , 'SCOTT SE 1BfzR 936-4718 1
OWNER : SCOTT S1 LRE'R 936---4718
L.EGAJ. : NADINGS SUNNY SNIDE AD# 16- TA 86 E illi E MASON Li( to
PROJECT DESCRIPTION
RF'TAINING WALL .
,yam
PROJECT L.00AT I ON : r`��
RWY 3 LEFT ON MASON BENSON PAS1 i I RE HALL TO STOP Ttllf�R I GNT Al W I ND I ME RE SIGN .
PPOJI:.CT NOTES :
crheck I i f,t required
..yz. _
TYPE AMOUNT BY LEA TE RECE. I PT
PRMT 1; 41 00 KS 10/30/95 40607
IS,TFE $ 5)0 KS 10/ 30/95 40607
PLCK 1 163 50 KS 10/30/95 40607
� ra'rAl_ : 62 .00 r'J .'t ' fiWN t3R AG�NT___.�_ ., ___r ..____,. DATE
� P
NI S Fill , revs 04101192 `COMFL I ANCF TO ATTACHED CONDITIONS IS
REQUIRED
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
PLUMBING date by 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
y 7-
1
Permit No. 611�Q 5 b1101ro
MASON COUNTY �j'
BUILDING PERMIT APPLICATION A et) p
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 �
PLEASE PRINT
#1 wne 5&&z Phone# �06� 93(Q r4 7 I8
O;i-te Address F Z-7 ( /y1/J30,J LK �,C C-�17� Fire District# 5
City 6UFW" lFw' St u/A Zip CT8:&4
Directions to Job Site f}I LjOY 3 -TCt IYlA60A!' J CA IGE OGIU C, C
I6kT ZZJ
Owner Mailing Address M4 FICLU A, IL 6
City M—&MA) St W Zip 9803
Lien/Title Holder 6AMe
Address
City St Zip
#2 Contractor Name 6GC-n, hg='1J"JX Contractor Reg# � ► )4K Kl!q3 S7
Address E /x1, Nd4)(w 1-ic at GIN r Expiration Date_L/ Z/ l_6_
City (1E4P&1C-'J St L✓A Zipa$S(((cam Phone#
#3 If septic is located on project site, include records. IV
Connect to Septic?_'4�rPublic Water Supply Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 egal
. 2ZZ33 - `�Z - 000G6
cription MbbjAf6 SQnJV-/ 3W0RC (o LOT G
#5 Building Square Footage: (existing/proposed)
1st FI / 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other sq.ft.. /
#6 Use of building ?&M1A1(1V4 "Z/J V-- ( (2 ' 60"Ld A16� Describe work
/�EPC�J�f WZ60 AOC74QVIN6 44/6 LL uJ /Tyt C6,d ljdM6 eCO�(inI
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make Model
Length Width Serial No.
# Bedrooms #Bathrooms Type of Heat
Purchase Price$
#9 Indicate by circling the applicable source if am 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 Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
i 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
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Mo6�u'
rLg
J
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each)
No. Toilets CIRQLE FUEL TYPE: Gas, Electric,
Bath Basins Heaipump, Other
_Bath Tubs No. Units Fees
Showers i Furn BTU
Hot Water Htr Heatpumps
Laundry Washer Vent Systems
Sinks Spot Vent Fans
Floor Drains No..., Boilers/Compressors
Laundry Basins HP
i
Dishwasher NN. Air Handling Units
Disposal cfm#
Urinals Nam. Fire Protection Systems
Other _ Auto. Fire Alarm Sys %00
Fixed Fire Supp. Sys 50.00
Permit Basic Fee 15.00 Auto Fire Sprink Sys 25.00
TOTAL PLUMBING $ 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 TOTAL MECHANICAL $
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 G
DATE DATE ��
FOR OFFICIAL USE ONLY: Accepted by: Date:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: -# 69262 /oo•oo0�1��
I
Environmental Health:
Building Plan Review
q-'7-9
Occupancy Group: Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit Li! ou
Plan Check to
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee 5
Other
Other
Building Valuation: S �`J�� TOTAL FEE