HomeMy WebLinkAboutMIS97-00451 Storage - MIS Application - 5/8/1997 07/22/1997 11: 14 3604791050 / RITE HOMES
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DIN �IIT APPLICATIO 4 PLEASE VFitNT pp
426 W. Cedar/P,O. Box i Shejitw n, WA 98W 427-9670/1-800-562-5628 J U L 2 2 1997
#1 Owner rx- j Gk � ���t�1ii6.. m Phone#1yIL" Nff, SEWI�.�ES
lie Address___ Firs District #
City —st klG� zip 9 ��
' ate
e or
City r St zip `-
Lien/Title Holder �Gw� 7W4'W
Address
City /C,gf-A !mow Zip
#2 Contractor Na Contractor Reg
Address 13-5-_ ._._._ _ - Expiration Date c V l per/ 9
Cityr�r_l.Zlr�i.r�1�1 St !L/6 _ 21p_ 9 r3 K 7 Phone # /tcb--
#3 If septic Is located on project site, Include records.
Connect to Septic? Public Water Supply WAIT ✓ �C O) ; g'
Connect to Sewer System? Name of System _
(If residential, proof of potable water Is required) _
#4 cel No�; - 1,11,1
eAal Description F
#5 Building Square Footage: (existing/proposed)
1st FI_ / 2nd FI / 3rd Ft / Loft
Basement / Deck / #bedrooms /_ # bathrooms _J
Garage /Carport / (Circle: Attached or Detached?)
Other sq. f*1 / 00 S� J4-
96 Use of bulldln Describe work
Type of Job: New_. Add Aft Repair Other
08 MOBILE/MANUFACTURED H ME INFORMATION
Model Year f'lq 7 Make S Modetc r rat
I_ength.. 4(W_Width Serial No.�t'f D 79- .S -A g
# Bedrooms_ -S-#Bathrooms Type of Heat- f`olfc-f ,1
Purchase Price $ pp
#9 Indicate by circling the applicable source If any water is on or adjacent to subject property:
River Pond Creek Stream Wetland Lake Marsh Saftwater Seasonal Runoff Other N
07/22/1997 11: 14 3604791050 BUY RITE HOMES PAGE 04
Show fallowing on the alto plan
o
.0fei"age Plan r—Ifemy awl
- JUL 2 1997
ms
pfmmoml
tFaAammft
Indicate Dlre�"WF5, VJCES
PUams-of Fronting Street in rela on to plot plan
(APPLICANT TO DRAW PLAN BELOW
Nd • � 'QoeoSo�
tl►"¢ 0�
/ _1y scrr, r
1�7
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
07/22/1997 11:14 3604791050 BUY RITE HOME'_ PAGE 05
PIur1LInQ hxtute$ (S3,21 _.eacW FPS MgManicaj FI=reLLiR2WW2
JUL 2 21997
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
bath Basins Heatpump, Other 1APAI TH RFERVICES
Ba Tubs xg, Qhb FM
—Showers __ Fum BTU
____Hot Water Htr Heatp ps
`Laundry Washer t Systems
Sinks Spot Vent Fans
Floor Drains BQllers/Compressors
Laundry Basins _ HP
Dishwasher Alr HangIIIna UnRs
_pisposal _ Cfm0 w.. -- _ ---
Urinals h& Ell:st f?rQtQj;jjon Systems
Other Auto. Fire Alarm Sys 50.00
Fixed Fire Supp, Sys 50.00
Permit Basic Fee / 18.76 _ Auto Fire Sprink Sys 35.00
TOTAL PLUMS $
Gas bets
Wood, G , 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 Bask: Fee 16.75
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD
OF 180 DAYS AT ANY TIME AFTER WORK IS CC*A- 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 CONTRACTOR IN THE STATE OF WASHINGTON AND I
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OF THE ORDINANCE REQUI REM ENTS R EGU-
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.
X OWNER X BY
DATE DATE
FOR OFFICIAL USE ONLY;
07/22/1997 11:14 3604791050 BUY RITE HOMES PAGE 06
DEPARTMENTAL REVIEW a � � � 0
FOR 6FFIC9 USE ONLY go
Approved Cond. Hold
Approval
Planning: ' 41 ICE
Environmental Heahh:
Building Plan Review
Occupancy Group: Type of Const: '----
Fire Marshal:
....
Other:
Special Conditions: FEES
Bulding Permit
Plan Check
Plumbing Fes _
Mechanical Fee ---"`--- --�.--__._
Wood/GaWPellet Stove
Radon Monitor
Violation Fee
Sltb Inspettion
9uilding State Fee _—.�--------.� ..
5 pp
Other
Building Valuation: TOTAL FEE
07f22,''1997 11: 14 3604791050 BUY RITE HOMES PAGE 01
BUY-RITE HOMES
:1 9 M 0 T N Do
rml ORCHM*A 963ft
JUL 221997
Ua to : � 1. �i •
SERVICES
To
Reference:
From! 15cr � �-�'--�,�----_.-------_.---__
360-479--0795
1-800=654-1695
Fax# 360-479-1050