HomeMy WebLinkAboutMIS97-00393 Cancelled Storage - MIS Application - 6/30/1997 06-�1.27/1997 14:05 3604791050 BUY RITE HOMES PAGE 02
` Permit No, _.�`._....
/�,9 `'�� MASON COUNTY
BUILDING PERMIT APPLICATION
I �
426 W. Cedar/P.O. Box 186,Shelton,WA 98584 427-9670/1-800-562-5628 VN C 010
.EnSF PRINT 6-5-4- ( (09,S
I Owner _ c 11 Phone j) a b 0 V 3 0 - O -7 -L-
Site Address _Fire District#
city -�.z�s 5t_� Zip��. ?, �-.
Directions to Job Site _ ��ew. 3���.�:r cso otAT pI.� L '# - CNA4
IU2 Coo ,Ae41cll 3 tMI(LS Go I ok—2 -Toe►.fER\3�1I�---
+ p�,tom, 0a I ,e. �, t t lr � k
Owner Mailing Address s
City —.. St Zip___,
Lion/Title Holder _—
Address �,a
City --� St 06. Zip. qL 3 8a
Contractor Name S.c I Contractor Reg
Address '- -p , I eX Expiration Date
City St Zip Phone #
3 If septic is located onprole�site, Include records.
3 Connect to Septic, Public Water Supply WbN�
Connect to Sewer System? Name of System �+
(If residential, proof of potable water Is required) JON 27 07
I Parcel No.,2;t,3o%3 -,1-5- - 000/0
Legal Description Vt ^.S D S" 'I (�E-S—
Building Square Footage: (existing/proposed)
1st FI If a Q �2nd�T 1
Basement / Deck / bsdrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other aq. ft. /
3 Use of bull ng ascribe work �o-r-lw
�nwt u..C4r.+-- - LT
.r tt4o 066-L_ 0 --
7 Type of Job; New ,V--- Add AN Repair Other
3 MOBILE/MANUFACTURED HOME,INFORMATION
Model Year �°ISd3 . Makd -0"Model_ _
Length_,.3-i2 _Width .7- _Serial No. 07-2$ n.
# Bedrooms _it Bathrooms��Type of He1tt
Purchase Price $ „��O �` T -
Indicate by circling the applicable source If any water Is on or adjacent rty:
River Pond Creek Stream Wetland Lake Marsh Saltwat easonal Runofff Other
06/11/1997 14: 02 3604791050 BUY RITE HOMES PAGE 03
-
Show following on the site plan
Lot Dimensions All Flood Zones ✓
Existing Structures Fences • ✓ 5
Structure Setbacks Driveways ko'
Water Lines Shorelines r
Drainage Plan Topography
Septic Systems Wells ✓
Proposed Improvements Easements ✓Name of Flanking Street Indicate Directional by (N. S, E, W)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW S TE PLAN BELOW
C�I►Tf� of N� G/!I NE�coNR.o1e.S
IG y� R`�tSQ
- A 36 t,%w► Cl1 l�iT f w1 �.
0 — 4
N 1 S�•
o
'T�tC} `ids �i►JbEL W,nc ,.J��.e ouT
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
�o^D,
a
06/27/19g7 14: 05 3604791050 BUY RITE HOMES PAGE 05
Plumbing Fixtures ($3 each1 E@fl dechanlcal Fixtures ($6 eachl
No. _Toilets CIRCLE FUEL TYPE:XGas. ctric,
___Bath Basins Heatpump, Other
Bath lb\s � UR"
___Showers �� F BTU
—Hot Water Htr� Heatpumps
_-_Laundry Washer ----r-- Vent Systems
__--Sinks — Spot Vent Fans
_Floor Drains NO. Boilers/Compressors
_„Laundry Basins HP
_Dishwasher big. AJr Handlina Units
_,_Disposal ofm#
_—_Urinals &L Fire Prgfection Systems
—Other_ Auto. Fire Alarm Sys 50.00
/ d Fire Supp. Sys 50.00
Permit Basic F 16.00 _ Auto Sprink Sys 25.00
TOTAL P�UMBING $! 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
OF 180 DAYS AT ANY TIME AFTER WORK IS COM- TOTAL MECHANICAL
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 CONT ACTOR IN THE STATE OF WASHINGTON AND I
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AMAWAREOFTHE ORDINANCE REQUIREMENTS REGU-
ORDINANCE REQUIREMENTS FOR WHICH THIS PER- IATING 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 BTAINING APPROVAL FROM FIRST OBTAINING AP ROVAL FROM THE BUILDING
THE BUILDIN EPAR M NT. DEPARTMEN
X OWNER(��% A
--- — X BY
DATE _ 1 DATE Ll -- -- ----
l z e w*S
FOR OFFICIAL USE ONLY: Acce ed t M
p 6 „., ,..
-- � Date
06/11./1997 14: 02 3604791050 BUY RITE HOMES PAGE 07
DEPARTMIENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: j
I
— I
I
Environmental Health:
Building Plan Review
Occupancy Group: Type of Const:
Fire Marshal:
Other:
Special CondlWns: FEFS
Buftnp Permit
Plgn Check
Plumbing Fee
Mephanical Fee __..- ------ - -
Wood/Gas/Pellet Stove
Radon Monitor
Vlolttlon Fee Site Inspection
Building State Fee --
Other
.. Other
ullding Valuation: TOTAL FEE -- -~- - —_