HomeMy WebLinkAboutBLD95-00420 Cancelled Picnic Cover - BLD Permit / Conditions - 1/19/1999 MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
e 0 1 L.. n 1 rJ Ca P EF R M I "T FOR INSPECTIONS CALL 427--9670
BETWEEN 5pm AND Bans 427-7262 1T
BL.D95--0420 PARCEL ;223047'190110 PLAT : DIV. BLKi ��N
JOB ADDRESS : NE 7151 T YA BLACKSMITH RD BELFAIR � �(�
OWNER , B I L 275 - 088 �`yl. BY
CONTRACTOR :
LEGAL - TA if-A Of SOIV 13141 T1 A Of SP 11791 DATA
CLASS OF WORK . . :NEW BEDR : it BATH . 0 1YPF AMOUNT By DAZE RECEIPT HYPE AMODHI BY 9AIf. NECEIPI
TYPE OF IISF . . . . :ACC STORIES . . . . . . . :0 -
OCCUP . GROUP . , :? BLDG . HEIGHT . . ; 0 .0ft ADDR 1; 5.00 KS #4121195 39435
TYPE OF CONST . . :? F I REPLACES . . . . : 0 PAST = 41.00 KS J4121195 39435
OCCUP . LOAD • . . . : 0 WOODSTOVES . . . . : 0 PLCK 1 16.50 KS 06121195 39435
DWELL.. .UN ITS . . . . : 0 PARKING SPACES : 0 S1FE 1 4.!+0 KS 06121/95 39435
INSPECTION AREA : 1 S HORE:t I NE? . . . . :Y TOTAL: 67.60 VAI ULAT ION: 2410
— -� :
SETBACKS--_ _ __._-__-__.- TOILETS . . . . . . . . . . : 0 FUEI_ TYPES-----.-_--- BOILERS/COMP---- MOBILE. HOME---
FRONT —W 35 .Oft BATH BASINS . . . . . . : 0 0 3 HP _ 0
REAR . . . .E 175 .Oft BATH 'TUBS . . . . . . . . : 0 3--15 HP . : 0 MODEL :
SIDE ( 1 ) .N 20 .0f-t SHOWERS . . . . . . . . . . : 0 FURN < 100K STU : 0 15_-30 HP . : 0 - MAKE -.-------
SfDE (2. ) .S 20 .Oft WATER HEATERS . . . . : 0 FURN >-100K BTU : 0 30-50 HP . : 0
SHRI. I NE .W 35 .Oft CLOTHES WASHERS- : 0 FURN - F LOUR . . , : 0 50 t- lip . : 0 --YEAR--- - - - -
AREA ---_---- ---------- K I TCHFN SINKS . . . . : 0 HEAT PUMP . . . . . . : 0
i LOT SIZE . . : FLOOR DRAINS . . . . . : 0 VENT SYSTEMS . . . : 0 EVAP COOLERS : 0 I. NGTH : 0
BUILDING . . . : 300sf DRINKING FOUNT . . . : 0 VENT FANS . .. . . . . : 0 HOODS . . . . . . . : 0 WIDTH . : 0
BASEMENT . . . : Osf t_AUNDRY TRAYS . . . . : 0 DOMES . I NC I N :0 -SER I A1..4I- ---
DECK:S . . . . . . : Osf DISHWASHERS . . . . . . : 0 AIR HANDLING UNITS— COMML . 1 NC I N :O
GAR/CARP :? Osf GARB DISPOSALS . . . : 0 <= 10000 otm . : 0 RELOC/REPAIR : 0
AT/DT . :? URINALS . . . . . . . . . . : 0 > 10000 cfm . : 0 OTHER UNITS . : 0
M 1 SC PLM FIXTURES : 0 GAS OUTLETS. : 0
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PROJECT DESCRIPTION:PICNIC COVER 00 EXISTING SLAB
PROJECT I.00ATION:LOT 11A tnICKSON LAKE, 314 MILE SOUTH Of BH FAIP, DEIAITO P.D ON 1AHUYA, RIACKSNITH RD.
THIS PERMIT BECOMES NULI AND VOID IF 10119 OD CONITRUCTION AUINOR17ZO IS NOT CONNENCED NITNIN 144 DAY:, OR If CONSIIUC;T104 OR MURK IS SUSPEPOEO FOR P PERIOD
OF 160 DAYS Al ANY TIME AFTER WORK IS CO11fNCEU. EVIDENCE Of CONTINUATION Of WORK IS A PROGRESS INSPECTION WITHIN THE 150 DAY PERIOD. FINAL INSPECTION OUST BF
APPROVED BEFORE BUILOINB CAN Bf OCCUPIED,
ONNiR OR AGENT:_._,_�
DATE.
1
BLO-PINT, rev: 0313I 111 COMPLIANCE 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 b date by
FRAMING y
Walls FIRE DEPT.
date by date by date by
PLUMBING Attic OTHER
Groundwork
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
I
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
P F PM 1 "r C C) N "_ I I I C.) NJ
Case No . , BLD95-.0420
Fort 1311A. HURLEY
page '. I
1 ) Approved per site-plan . X.
2 ) 2 ) Apt) I i cant sha I I use gutter and downspout to route roof runoff away from lake info
ditch wibich flows to low area behind slab area .
X
3 ) Applicant shall not convert this structure from outside reoreational use to
reside I -..use .
1use .
X
4 ) Applicant shall maintain 50 toot ve(jetation buffer around lake ( limited tree/shrub
trim or el ear ing of shoreline vef4etati on ) .
X
3 ) No %eptlo records owner/builder assumes, all responsibility if circa infield area is
encumberp-d
CnPy
3 TAB ROOF
PREFAB TRUSES ON 112 PLYWOOD
ON 2' centers Da „d L,,,5` C- c)o.blc.
ofj er� cn d5 ' i u �
���!'lnt:c�'G1 'KcySS4S
10"DIA. poles
10' TALL
KILN DRIED
EXISTING SLAB
20'x15'x4" with wir4mesh /
and j b os
P4
i
IS^';. DL
� f
G�S�\
ES S I3JECT AL
No" —j 5
a
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PAW- ems,
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71
" 14. Permit No. DI gI o 4,Z
MASON COUNTY
MAR 3 L
BUILDING PERMIT APPLICATION 1�A
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLE PR
#1 ne l( l C y Phone# 170 g�
Address j� ? l S I ��h vuc�. �K�m 14-. 4C , r� Fire District#
CityI�Cu/t St U Zip �1852
Directions to Job Site A &- T /� ��i � �Sa N A Akl;�
_So v i--A o i= 13 )F L F //Z - a/ (A ) 14 fl-o i .D o L)
MA Ny � 14 inn
Owner Mailing Address s C&) I- Iq / S O
City E ��r4 i0 St BY1 l4 Zip 457t5 •2
Lien/Title Holder - ' /U G '
Address 6BOX 7-
City Stja.� _Zip 5'A-3/2
#2 Contractor Name Contractor Reg#
Address Expiration Date
City St Zip Phone#
#3 If septic is located on project site, include records.
Connect to Septic?_/O__Public Water Supply ✓ Well / �1
Connect to Sewer System? Name of System lv t2 i c-K S on 4 k t /fo m f('�wAl c►S 4. 50-
(If residential, proof of potable water is required)
L al Description
#5' Building Square Footage: (existing/proposed)
1st FI / 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms / #bathrooms /
Garage /�_Carport / (Circle:Attached or Detached?)
Other-'' C Coo-(A sq.ft. Oa
#6 " Use of building -P► N I C AREA Describe work
?o fi A 20o -7-�ItOF Gov 9 6UF2 FXisriMq 54A3
#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 any water is on or adjacent to subject property:
River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other
1
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
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 SITE PLAN BELOW
e10o, pit-�
Gn �.
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
I
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each)
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
Bath Basins Heatpump, Other
Bath Tubs No. Units Fees
Showers Furn BTU
Hot Water Htr Heatpumps
_Laundry Washer _ Vent Systems
Sinks _ Spot Vent Fans
Floor Drains No.. Boilers/Compressors
Laundry Basins _ HP
Dishwasher No.. Air Handling Units
_Disposal _ cfm#
_Urinals No.. Fire Protection Systems
Other _ Auto. Fire Alarm Sys 50.00
Fixed Fire Supp. Sys 50.00
Permit Basic Fee 15.00 _ Auto Fire Sprink Sys 25.00
TOTAL PLUMBING $ No. 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-
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.
&J!�eX OWNER X BY
DATE DATE
FOR OFFICIAL USE ONLY:Accepted by: Date:
I
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
1�o�ih.OLt,� /L (/
Planning: Utf/�- l�l�
�G
Environmental Health:
Building Plan Review
Occupancy Group: Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit
Plan Check
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee
Other Pjdr ,5 on
Other
Building Valuation: TOTAL FEE �`�