HomeMy WebLinkAboutBLD30524 SFR - BLD Permit / Conditions - 5/26/1992 shorelines: Plumbing:�* kJ4 0Z
setback: Mechanical:ok:D� 6TA�.
special Interior: _
:orditions: Final: ):
Mobile Home:
Smoke Detector:
Remarks:
noting: (&Wlg?
setback: J; u , acsDk 'N��l
oundation
Walls-
Framing: 7 J z1 4Z
P ireplace:
Voodstove:
LREA: #1 - FAW VER TYPE: RESIDENCE
)caner: MI KVICKA, MARC Tel: 525-4402 Date: 05-26-92
Lddress: 5719 CONISTON RD NE, SF, TLE 98105
'ermit #: 30524 Floors: 2 Sq Ft: 1S`00
:ontractor: SAME ,t�/ M!5 I
'hone: f .
,egal Description: 23-20-3 TR 9 GL 4
hrection to job site: AGATE STORK ISO -IfflEAD TOWARD
VATER TURN RT JUST AFTER MITE HOUSE FOLLOW&
"O VARAGON FOR SALE SXQJJ ON PROPERTY
'lumbing X _Yleciiamca X Woodstove X
ireplace Deck 575 Garage
;arport Basement 1500 Loft
;onditions: NONE
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MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
14 4.*Jr A a 1 4' f44 Ui V* V, Ut In 1: 1" 1 OR r N',P I. U, I 1 4?7---9610
81.09Z-0/27 VARCUL Y.620,;?31400090 F
JOP E 166 LIGHTHOUSE RO SHV I- JOH
OWNI'+ .- MARC INRKV.ICKA S25-4402
CON 11` '. 1 OR OWNFR IS CON'tRACI OR
It I Ilf 601 ttl 4 & TAX 26#-J f S 09631
WORK NEW H U.U R x 0 8A UH a 0 TYPE 111109111 By 0411 1ttCfiPT TYPE 4#00#1 NY &AIF RtUIPT
I OF Ij S.,E OTH 5 T 0 R I E S . . I . . . . 1 0
0070P . GkOUP , . H It.D6 HEIGHT 0IJ wl t is,#$ Div 611 zj)l 309i1
TY i�t:' 01- ON';I F I R E P L A c F S . . . .
(14 i'UP - t 0A0, . WoOl)�0*Ovts . , . .
N I i's 0 PARK I NO SPACES i 0 i
I N',1'! 1 I I (,N A RE.A I `JHOR1,1CINF? -
10 f I,f. T F ti F I I to ',i— H 0 1 1 1 1:11"1 1:0 P 171011 j I t. Homf
0 L BATH BASINS , . 0 HP
Of t: 8 A I H 0 1!,; HP P . 0 MOOT I -
:;
1 0 f t, SHOWUR`, - - . . . .. 0 F L1 14 N < 1004(, 11111 0 1 �:-30 tip 0 I'M At f
S I U E. 0 f t 'WAII*R NfkrEk') . 0 TURN I 00t, H 1'.11 to 50 --bo It,1) (4
0 f t CLOfHES WASHEkS . 0 FIjkN f I 1104i 0 + III, o A it
AREA 0 H t-,A I PUMP ,
1.01 D FLOOR I,AINci . . . . . .. 0 VE.N I ':-Y I FM 0 1 '4 A P C 0 0 1 1, 14'. to 1 UN61H ,• 0
HII J i. it) Ni., Os' -f OR [Nis IN6 FOUNT to vu N I- I A!q 0 jjwqjs 0 Wit)114 0
HA".LML NI 0 f LAUNDRY TRAY - 0 OOMU," I Ni: I N 0 14 1 A I IT --
DF C K�i . . . . . . 0 f 1)1.1�HW A -i HE,Rfi . . . . . . 0 AIR HAN01 I N6 ON 1 11, - t OMML > I Nil fN- 0
6 A k 11 C f k f, 06 1: 6 A R 8 P T S P w-3 A 1. 0 < — 1,0000 0 kE( O(. IRt=PAiR 0
AT . . . . . . vi > 1 0 0*41 ran, - 0 OT141714 0
MVC PI-M I I.XTAIRE ; -. 0 6 A!i 01) 11.F1 04
sloo
PROMI I'0fATJO?j!A6AIt STORE 60 STkAfligt f0I?* 0010 61111YU RO 30�31 PASO Willif 8011st !C11811111 & K181116 1114PS) PROUED TO 'ifif
1011 P[F#I.l 614olit'i 0911 AND VOID It 400k 41 (0051luflION AUTHOwfo Is Ohl (okof,we VITHIN to# DAYS, Of it kolisliteclIAN AR tA@#t 15 qqslorwhift 1`411 A Pf0jap
of O AY*f�fA OR[[ANY 1141",Afll.f 118111 13 EVIPENU OF (011TIIIIIIAT1611 0 Wept IS 1`04601`31� 111Spf(114$ 41181111 IN( lot DAY PfI11401 f1#AI FN%?ff1jI"Q NNST Of
AMOMO IlUlt 10
OWNER %
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 FRAMING by date by date by
Walls FIRE DEPT.
date by date by date by
PLUMBING Attic OTHER
Groundwork
date by date by
D W WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by dates �� _�� by ;� date by
MASON COUNTY ,
Mason County Bldg, III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584 1
11:T 11,...11 ::IL: 0 F::11 ::11: 11".41 il::iii If:" II::::: 11•,:r 11'°111 :.11:: .11. FOR INSPECTIONS CALL 427-9670
BLD92-0727 PARCEL : 32O2314OOO9O PLAF : DIV: BLK : LOT :
JOB ADDRESS : E 156 LIGHTHOUSE RD SHELTON
OWNER : MARC MRKVICKA 525-4402
CONTRACTOR : OWNER IS CONTRACTOR
L E G A L : TR 9 OF 60VT LOT 4 i TAX 261-3 FS 18537
CLASS OF WORK . . : NEW BEDR : 0 BATH : 0 TYPE AMOUNT BY DATE RECEIPT TYPE AMDUNT 8Y DATE RECEIPT
TYPE OF USE . . . . : OTH STORIES . . . . . . . : O
OCCUP . GROUP . . . : ? B L 0 G . HEIGHT . . : Ott WDST j 15.00 D J K 0 7/2 2/9 2 30931
TYPE OF CONST . . : ? FIREPLACES . . . . : 0
OCCUP . LOAD . . . . : 0 WOODSTOVES . . . . : 1
DWELL . UNITS . . . . : 0 PARKING SPACES : 0
INSPECTION AREA : 1 SHORELINE ?. . . . : ? TOTAL: 15.00 VALULATION: 0
SETBACKS-------------- TOILETS . . . . . . . . . . : 0 FUEL TYPES---------- BOILERS /COMP------ MOBILE HOME--
FRONT . . . ? Oft BATH BASINS . . . . . . : 0 : ? : 0-3 HP . : 0
REAR . . . . ? Oft BATH TUBS . . . . . . . . : 0 3-15 HP . : 0 MODEL : ?
SIDE ( 1 ) . ? Oft SHOWERS . . . . . . . . . . : 0 FURN < 1O0K BTU : 0 15-30 HP . : 0 —MAKE------
SIDE (2 ) . ? Oft WATER HEATERS . . . . : 0 FURN >=1OOK BTU : 0 30-50 HP . : 0 ?
SHRLINE . ? Oft CLOTHES WASHERS . . : 0 FURN — FLOOR . . . : 0 50+ HP . : 0 —YEAR------
AREA ----------- -- -- KITCHEN SINKS . . . . : 0 HEAT PUMP . . . . . . : O
LOT SIZE . . : ? FLOOR DRAINS . . . . . : 0 VENT SYSTEMS . . . : 0 EVAP COOLERS : 0 LENGTH : 0
BUILDING . . . : OG,t DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 0 HOODS . . . . . . . : 0 WIDTH . : 0
BASEMENT. . . : Osf LAUNDRY TRAYS . . . . : 0 DOMES . INCIN : O —SERIAL#----
DECKS . . . . . . : Ost DISHWASHERS . . . . . . : 0 AIR HANDLING UNITS-- COMML . INCIN : O ?
GAR/CARP : ? Osf GARB DISPOSALS . . . : 0 <= 10000 cfm. : 0 RELOC /REPAIR : 0
AT/DT . : ? URINALS . . . . . . . . . . : 0 ) 10000 cfm. : 0 OTHER UNITS . : 0
MISC PLM FIXTURES : 0 GAS OUTLETS . : 0
PROJECT OESCRIPTION:PELLET STOVE
PROJECT LOCAT10N:A6ATE STORE 60 STRAIGHT TURN ONTO GRAVEL RD JUST PAST WHITE HOUSE (CABINET 6 W E L 0 1 N 6 SHOPS) PROCEED TO SITE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED FOR A PERIOD
DF 180 DAYS AT ANY TIME AFT � WORK IS COMMENCED. EVIDENCE OF CONTINUATION OF WORK IS A P R 0 6 R E S S INSPECTION WITHIN THE 180 DAY PERIOD. FINAL INSPECTION MUST 8E
APPROVED BEFORE BUILDING OC UPIED.
OWNER OR AGENT: DATE:_
BLD—PRMT, rev: 03/31/91
MASON COUNTY
BUILDING PERMIT APPLICATION
PWSE PRINT
#1 Owner ec-4 ✓ Phone# _ o
Site Address L
City St 1-0 `yip
Directions to Job Site - O S
L Li�ps Zee To
Owner Mailing Address , C
City l ` /P St /��-- Zip �;8/os--
Lien/Title Holder
Address
City St Zip
#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? Public Water Supply_ Well
(If residential, proof of potable water may be required)
#4 Parcel No.
Legal Description
#5 Building Square Footage: (existing/proposed)
lst Fl / 2nd Fl / 3rd Fl / Loft /
Basement / Deck / #bedrooms #bathrooms_
Garage / Carport / (Circle: Attached or Detached?)
Other sq ft /
#6 Use of building Describe work
#7 Type of Job: New Add Alt Repair Demolition
Woodstove Re-Roof Bulkhead_ Other
#8 MOBILE HOME MFORMA. TMN
Model Year Make Model
Length Width_ Serial No.
"Bedrooms "Bathrooms 'I�rpe of Heac
»9 Any wace= on or adjacent cc property: saltwater lake
rive= pond_ wetland seasonal runc.,if
oc!ier
show Lollowing on the site plan
Lot Dimensj.ors Flood Zones
Exist-4--9 tE=sctsres Fences
St--craze Setbacks Driveways
Water Lines Shoreli:es
Drainage Plan Topography
sancic Svstem9 wells
Proposed T rovements Easements
Name og� s3nr Street Scale:
Name St:eet Date:
A.PPL.ICA,NT TO DRAW SITr PLAN 3ELC
APPLICANT TO DRAW TOPOGRApHy PROFILE 9EL0
i
i
0 0
No. Toilets Vent Systems X 3 . 00
_ Bath Basins Vent cans X 3 . 00 _
Hat: ?'uhs No. Boil0-rs/Compressors
Showers 0-3 HP 5. 00
Sot Water Htr 3 -15 HP 6 . 00
Laundry Washer 15-30 :ro 0_
Sinks - 3 0-5 0.� ��
- Floor Drains 50 + gp `
Laundry Basins No. Air Handling Unit
Dishwasher <= 10000 cfm. �_
Disposal > 10000 cf=. 7 . 50
Urinals Other
Other Evap Coolers _
Hoods _
Permit Basic Fee 3 . 00 Fire Suanression _
TOTAL PLMM ING $ Domes . Incin. _
Comml . Incin.
Reloc/Repair 6 . 00
Mechanical Fixtures Gas Outlets X 2 . 00
No. Fuel Types Woodstove seoarate
Furn < 100K BTU 6 . 00 Other
Furn >- 100K BTU 6 . 00
Furs - Floor 6 . 00 Permit Basic Fee 10 . 00
Heat Pumps 6 . 00 TOTAL MEC3ANICAL $
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENC D WITHIN 180 DAYS, OR IF CONSTRUCT ION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTLZE AFTER WORK
IS COMMENCED
OWNERS AFFIDAVIT CONTRACTORS AF7=VI,
I CERTIFY THAT I AN EM PT FROM THE REQUIREMENTS OF THE I CERTIFY THAT I AN A CURRENTLY REGISTERED C13MTRACTOR
CONTRACTORS REGISTRATION LAW RCW 18.27 ANO AM AWARE IN THE STATE OF WASHINGTON AND I AM AWARE OF rHE
OF rNE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH 010INANCE REQUIRE31ENTS REGULATING THE WORK Fm WNICM
THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL 3E IN THE PERMIT IS ISSUED AMID ALL WDRK DONE WILL SE IN
CONFORMANCE THEREWITH. MO CHANGES SMALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SNAIL SE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE 3UILDIMG WITHOUT FIRST OBTAINING APPROVAL F" rNE su1LDIMG
DEPARTMENT. DEPARTMENT.
X OWNER X BY
DATE DATE
Ret.= pe=it to: Department of General Services
426 N. Cedar/P.O. Box 186 , Shelton, ALA 98584 427 -9670/1-800 - 562 - 5628
FOR OFPICI L USE ONLY: Accented by: Dace :
UVrrICS USE aNLY
�PPr 4d care Hold
� AQprovsl
Planning:.
Enviro �� Eealth:
Building Plan Review:
Occupancy Group:
Fire Marshal:
Other:
I(Special Conditions: FEFS
II II IlSice Inspection I II
n I
II II 11Building Pe=it I II
II II I I
II II Ilviclacion Fee I II
II II I
II II Ilviclacion Iavescigation Fee I II
it II 1i I1
II 11 II Plan Check I II
II II I I
Il 11 11Plumbing Fee I II
II II I I
II 11 IIMec:ianical Fee I II
II II I I
11 11 II Wands c ove Fee I II
II II I � 1
I� 11 IIBuilding Stace Fee I II
II9�_1di;;q valuation: 1 1 1
II II
TOTAC.I I1