HomeMy WebLinkAboutMIS94-00342 Final Dock - MIS Permit / Conditions - 8/23/1994 '07 Ono
MASON COUNTY
Mason County Bldg, 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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COMPI I ANCE TO A I I'ACHF-0 COmo i I I owi I
R F Q U I R F 1)
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 L-��j` ` 23_ q C� by [ ✓ date by
MASON COUNTY
I
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
[MR (BROWN90 Permit No.
MASON COUNTY
MAY 3 1 S% BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PL S T ` /►
#1 wrier1 — PhQne# 54kc- V70
Site Address Fire District#
City :M L SA St zip s
Directions to Job Site PATS cj"Q
Owner Mailing Address j S'l
City F-A 1'Y ordY S St 11)0l, Zip d
Lien/Title Holder &Wk7E.(Z
Address
Clty St Zip
#2 Contractor NameIPA:��f c Contractor Reg# (oOO
Addr s 1� Expiration Date_/ 3l / QJ
City �Z 11� St- )-)Q--zip Phone# a-7-s -soa R
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No��Lq - SCI _-��
Legal Description 'WoOTGN L AKc. L gr S:
#5 Building Square Footage: (existing/proposed)
1st FI / 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other f)P.u] sq. ft. Q G D /�P S4or-K4 0 s0s94 0 l�
#6 Use of building Describe work
#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 nLLake
ater is on or adjacent to subject property:
River Pond Creek Stream Wetland Marsh Saltwater Seasonal Runoff Other
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways t F
Water Lines Shorelines it
Drainage Plan Topography .3
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
•
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Plumbing_Fixtures ($3 eachl Fee Mechanical Fixtures ($6 each)
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
Bath Basins Heatpump, Other
Bath Tubs No nila 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
X OWNER
X BY
DATE DATE
FOR OFFICIAL USE ONLY: Accepted by: /� Dater
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: See- Criyi M ►'PT y? 10 I VQ.._Mchy1 ONS
Environmental Health:
i
Building Plan Review. o
Occupancy Group: Type of Const: o C
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit p p
Plan Check ((P .<p
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee 4 d
Other
Other
Building Valuation: �P S TOTAL FEE
I