HomeMy WebLinkAboutBLD93-0409 Final Dock - BLD Permit / Conditions - 8/25/1993 MASON COUNTY
Mason County Bldg. III 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 9_S,5_ by J o date by
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
000
� d �L Q plo- 1
4
Mason Lake
�,/ daj Mason Lake
5 t ( ,
1
20 FT
PROPERTY LINE
PROPERTY LINE
3 FT
WELL HOUSE 6 FT
a
WELL - - - - - - - - - - - - 11 FT
292 FT HOUSE
267 FT i
WRTER LINE ; ft
SEPTIC
8 ft
5 ft
15 FT
DRIUEWflY
5FTE EM T 18FT
DRflIN FIELD
20 FT
22 FT
MRSON LRKE DRIVE ERST
e
Permit No.BLD
MASON COUNTY
UILDING PERMIT APPLICATION
LEASE flRTE,
G93
GbA�fE I� Ei�1/ICELSA oN Phone#T Jq,-2(o -69/e
Site Address Ea246/ HiSm LAKE RIVE E s -
City (S PA-PE"Ut w State WA Zip `18SS�eo
Directions to Job Site14WY 3 70 AIASnIV R NSnA) 9 0. (,e-) WES i
PAST Fllfg- /4.4GL Tn E M&snA) L4.K E hQ(v E --4,�T. Go mwkTff
Owner Mailing Address Q` ISo/v "LC- DR, E46
CityMPEME-Vi State WA zip �SYh
Lien/Title Holder 1JETje6 foLtTaN FEOERA-L SA•V zea g Go4,&1 455OL OF 5'z.4T- /_
Address l Sao FOUR7H ,4V E•.
City SE4TTLE State U/,4• ZiD7g16(-/6y8
Contractor N e .LU'l 5�1�✓ �c:���,s,/ Contractor Reg
Address Expiration Date _ _3 / 3% /2 q
Cit r ' State L,"X Zip L,,_�9JV�Phone
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. )
Parcel No. 22,233 S,. - 000 92-
Legal Description NV L.OT R,� OF MAI AJ67 S S U AJAJ4 :S#QR -
Building Square Footage: existin proposed)
1st Fl 1760 / 2nd Fl / 3rd Fl / Loft
Basement / Deck / #Bedrooms 3 / #Bathrooms„ /
Garage / Carport--/ (Circle: Attached or Detached?)
Other PUMP i4OU SA' sq f t 80 /
'l9f building
44 escr
ibe work prU f
J c
Type of Job: New Add Alt Repair Demolition
Woodstove Re-roof Bulkhead Other Ee___ t
Mobile Home Information
Model Year Make MARLET re- Model b666 i MAA)oR,
Length 6i F% Width e2 7 F-1-_ Serial No. 14 00 6239 A R
#Bedrooms 3 #Bathrooms 02, Type of Heat &,EcTt14, - r 0,tC-&0A1R
Any water on or adjacent to property: Saltwater Lake _River
Pond Wetland 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 System wells
Proposed Improvements Easements
Name of Flanking Street Scale:
Name of Fronting Street
Date
APPLICANT TO DRAW SITE PLAN BELOW
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Plumb�,nc,_Fixtures ($2 . 00 each) Fee: No. Boilers/Compressor Fees:
No., Toilets 0-3 HP 6.00
Bath Basins 3-15 HP 6.00
Bath Tubs 15-30 HP 6.00
Showers 30-50 HP _ 6.00
Hot Water Htr 50 + HP
6.00
Laundry Washer
Sinks No. Air Handl ' g Unit
Floor Drains <= 10, 0 cfm. 7.50
Laundry Basins > 1 , 000 cfm. 7.50
Dishwasher
Disposal Other
Urinals Evap Coolers
Other Hoods
Fire Suppression
Permit Basic Fee 3.00 Domes . Incin.
TOTAL PLUMBING 1 $ Comml . Incin.
Reloc/Repair 6.00
Mec-hanical Fixtures Gas Outlets x 2 . 00
No. Fuel Types Woodstove separate
Furn < 100K BTU 6.00 Other
Furn >a 100K B 6.00
Furn - Floor 6.00 Permit Basic Fee 10.00
Heat iyuzs
6.00 TOTAL MECHANICAL $
Vent m x 3 .00
Vent x 3 .00
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 FO$:.:A: PERIOD OF 180 DAYS AT ANY TIME 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 in
contractors registration law RCW 18.27 , and am the State of Washington and I am aware of the
aware of the Mason County Ordinance requirements for ordinance requirements regulating the work for which
which this permit is issued and that all work done will the permit is issued and all work done will be in
be in conformance therewith. No changes shall be conformance therewith. No changes shall be made
made without first obtaining approval from the Building without first obtaining approval from the Building
Department. Department.
X OWNER X BY
DATE: DATE
Return permit to: Department of General Services 426 W. Cedar Street/P.O. Box 186
Shelton, WA 98584 427-9670/1-800-562-5638
FOR OFFICIAL USE ONLY: Accepted by; �� Date: '3
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
AVPe� Cow& H.W
APP-1
Planning:
#1
Environmental Health:
Building Plan Review:
I
Occupancy Group: /17l
Fire Marshall: #2
I
Other: #3
FEES #4
Speci 1 Cg ditions:
Site Inspection
#5
iBuilding Permit y/
I �
Violation Fee
Violation Investigation Fee
#6
Plan Check S_
' #7
Plumbing Fee
Mechanical Fee ' #8
Woodstove Fee
Building State Fee
! #9
Building Valuation: � Z
TOTAL