HomeMy WebLinkAboutBLD92-01325 Cancelled Retaining Wall - BLD Permit / Conditions - 9/24/1999 MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P,O, Box 186 Shelton, Washington 98584
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JI1G PRNI, tev.. 01J.11/11 (;ONPI. IANCi 10 AT IALHI 11 CONUI I IONS IS Rhu111RE0
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date y Gas Piping date b
Founda Its 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 b date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
MASON COUNTY
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Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584 j
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Permit No_BLD
MASON COUNTY
BUILDING PERMIT APPLICATION
PLEASE PRINT
n 1 Owner ?OA/ Zr,i, 7 Phone#
Site Address e Z7S/ C--c-p2 C-d4 r
City QAPF i/i�zc,/ St Zip �18�L1(�
Directions to Job Site
Owner Mailing Address c3Zil E' 0,8CCFY HVLJy
City % �, t"Id S t Zip G SY 3 Z_
Lien/Title Holder
Address
City St
Zip_
42 Contractor Name .2 06 c boi'vy Contractor Reg#I 61""✓!Blot S
Address.'/xii li5wi,i J LAY Oat 6-ov; Expiration date /Z/
City 6pzy;rr1116./ St1tiP VsYL Phone
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply Well
(If residential, proof of potable water may be required)
#4 Parcel No.
Legal Descriptionj—
#5 Building Square Footage: (axisting/proposed)
Zst FI_ / 2nd PI / 3rd PI _ / Loft /
Basement / Deck / #bedrooms _ #bathrooms_
Garage / Carport / (Circle: Attached or Detached?)
Other sq ft /
*6 Use of building Describe work
,&7A-,V y✓
#7 Type of Job: New Add Alt Repair Demolition
Woodstove` Re-Roof Bulkhead Other
#8 MS2BILE FOMF INFORMA'T'T N
Model Year_ Make Model
Length__ Width_ Serial No.
#Bedrooms #Bath..-rooms Type of Heat
#9 Any water on or adjacent to property: saltwater lake
river pond wetland seasonal runoff
other - - -
Show following on th0 site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements
Name of Flanking Street Scale:
Name of Fronting Street Date:
APPLICANT TO DRAW SITE PLAN BELO
y
Z
N 4.
3
PLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
I
------------
r �
No._Toilets Vent Systems X 3 . 00
Bath Basis -------
vent Fans X 3 . 00
Bath Tubs �—
C=Mpressors
Showers No. Bailers/
Hot Wace= Htr 0-3 HP -- �
3-15 Ep
Lat:.a�^l Washer 15-3 0 �
S i-t ks _G Floor D -
30-50 H
La �
Bas SO + Hp 6
ttnr�--y .,
No. Air Haadliag Unit
Dishwasher <� am.
Disposal 10000 c 7. 50
U 10000
rals Other
—Other wrap Coolers _
Hoods
Permit Basic Fee _3 . 00 —Fire Suppression
TOTAL PLUM ZUG $ Domes . LBCia.
Corz;mi . Incia. �-
Reloc/Repair _ 6 . 00
�iechanr•a� F;�ZtToQ Gas Outlets X Z .00
No. Fuel Types seoaTa�o
—Fu.^ < 10 0 R BTU Woodstove2 Other
Fur a- 10 0 K BTU 6 . 0 0
Fu.-3 Floor 6 . 00 Pe i t Basic Fee
Heac Pu=s �_ - �
TOTAL MSCSANICAL $
NCTIC8: THIS PERMIT BECOMES NULL Ai) VOID IF WORK OR CONSTRUL'I'ION
A=ORIZFD IS NOT COMMENCED WIT= 180 DAYS, OR IF CONSTR =ON OR WORE
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT AyrZ=. ' AZ= WC)Rg
IS COMMENCED
OWNERS AFF=STI'_' C@RRAG"C3RS AFr=v=
I CERTIFY flat I AM E71EWT FROII THE REGtAIRH ITS OF T11E I CEltTIFf TUT I AMA LIRZRDITLT REGISTERED CaItTRACTOR
MVTRACTM REGISTRATION LAY RCSA 1E.27 , AND All AYARE IN THE STATE of WASNINGTCNtE AND I AM AwNE t THE
TW TIIE IVIT I CISSUEMAM ADIMAAICF REQUIRE?�IITS FOR BE(CN ORDINANCE MMUIREM ITS REGULATING THE WK FQ WNIGI
TRIS PER7IIT IS ISSUED AJD TiUT ALL WORK OONE WILL BE IN
C>alfORl1AMCE fl►EAIEYITM. MO C]IA TIE PMtT IS ISSUED AID ALL WORK DONE WILL a IN
uGES SMALL SE MOE CDNFORNANa TReMaTB. NO CRAMS SMALL sE MADE
CEPART T FIRST OBTAINING A?PRQVAL FRON THE BUILDING
DEPAAITMEItT. WITH= FIRST OBTAINING A/PRMAL F" THE BUILDING
DEPARTHM.OWNER ((\\
ZBY �u " � U
IIATS DATE 2� Z
I
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Return pest to: Depa-t=mPRt of General Ser7ices
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
FOR OFFICCAL USZ ONLY: Accepted by: Date: �0 �lz
DtYAKINDENTAL REVIEW
FM OFFICE USE MMY
ACOr°r+d ;Cand Hold
oval
Plaaa4ag: l'Gc2'Z�2
Eaviroumeatal Health: �n
Building Plan Review: DLA
Occupancy Group :_ J 7,A 7-T 7►-�, L
Fire Marshall :
Other:
paFc
IlSpeci al Conditions:
II II iiSite snspect-on I I(
II Il I (
II II IlBuildinq Perini t I II
�I II I
(I (1 llViclation Fee I II
fl II I
II IlViolaticn Investigation Fee I II
II II I � f
Il Il II Plan Check ( lam`' II
II II I f
11 II II Plumbing Fee
�� II
�� I► IlMectanical Fee I II
it II I I
II II IlWoodstove Fee I Il
( Il IlBuilding State- Fee
'I I I
1113uilding Valuation: II II TOTAL,I II
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