HomeMy WebLinkAboutBLD92-01050 SFR - BLD Permit / Conditions - 11/4/1997 MASON COUNTY PERMIT
- Mason County Bldg. III 426 W, Cedar NULL a VOID BY EXPIRATION
P.O. Box 186 Shelton, Washington 98584 DATE j/ BY
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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 Iby date ( 2 —/ — /�/by I date by
FRAMING Walls FIRE DEPT.
date by date by C J date by
PLUMBING OTHER
Groundwork Attic
date b date 12 — /� �7 by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
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MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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RETE MECHANICAL MOBILE HOME
s-Setback date by Ribbons
2 C�- byGas Piping date by
undation Walls date by Set Up
date n!/ 7,0 by Z 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 JL� -ZO 3 b L�,�� date by
D.W.V. WALLBOARD NAILING
date k S- Zy-qc by date by
Water Line FINAL INSPECTION
date 0/- �- ryc� by �� date by date by
614, -AV L
?1 ugtb -!g No
oi2.ecs Vent Svstems 3 3 . 00 /A�_
Sat`Z 3as i:s Vent ?ans X 3 . 00 _
l 3ath=-'�ibs _ No. Boilers/Compressors
Showers2. 0- 3 HP 6 . 00
Hot Ware= Ht= 2, 3 - 13 HP , 0
�Laundx Washer _ ?5- 3 0 3P
---� 3 0-S 0 HP r i
i o4 mains 50 + EP 5 . 0�
La��"� Basins No. Air 3a.adliaq Dni t
eDishwasher 2-. <= 10000 cam. 7 . 50_
Disposal > 10000 cam. 7 . 50
Urinals other
----other E'vap Coolers
Hoods _
Permit Basic Fee Fire Suppression
TOTAL PLmo=c $ _Domes. I.ncia_
Cn=l. Inc-;in.
Reloc/Repair 6 . 00
Mechanical FJXt��rc►a Gag Outlets X Z_00
No • Fuel Types Woodst:cve senarate'
Fu-- < 100K BTU 6. 00 Other
Fern >- 100K BTU 6 . 00_
Fur3 - Floor 6 . 00 Pernit Basic Fee 10 , 00
Seat. Pins 6 . 00 TOTAL MEC'i NICAL
NOT=(== BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AIIT'IORIZ.En IS NOT COMtMN® FTITFiIl'i 180 DAYS, OR TrCONSTRUC 70N OR WORK
IS S17SPMMEM OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANy=.,E AFI'F.,R WORK
I.S OGmmEN®
CWNBRS Arr=v= mac.70PS AFF=nV= I
I CERTIFY THAT I AM EXEMPT FROM THE MWIRE)"TS OF THE I CERTIFY THAT I AM A CURREIITLT REGISTEM COUTRACTOR
al"TRACTORS REGISTRATIOII LAY Rat 13.Z7 AM0 AM AwRE
OF THE MASOI CIZAITT ORD[MACE REWIReMEMTS FORIM THE STATE OF 4ASIIINGTOM A1R1 I AN AWJtE OF THE
THIS PERMIT [S ISSUED AUG WHICH ORDINANCE REQUIREWNTS ;EGULATIMG THE WRK FOR WHICH
ALL WRK Od+E WILL BE IN THE PERMIT IS ISSUED WR
Alm ALL K 00NE WILL BE IM
CONFORMANCE THEREWITH. N0 MOGES SMALL SE MADE a)NF0RMAMCF THEREWITH. NO CHANGES SMALL BE "ME
FIRST OBTAINING 1o*ROYAL FRaM THE gUIIpING OEPAR TMEJi T. ROM WITH T FTRST OBTAINING AP"MA� F THE BUILDING
CEPARTMUIT.
x oWrrsa �r a sr
nAr a - OATZ
Ret-L-= Der=jt to : Depart=eut of General Serrices
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426 N. Ce ax/p _Q . Box 186, Shelton, NA 38584 427 -9670 1-/ d00-562 -5629
?CR 'OFF--mAL usz mmy: Ac-en_ ced \ Dace :e :
3 .Z
Permit No.3LD
MASON COUNTY
� BUILDING PERMIT APPLICATION
PIEAU PRINT
#1 Owner C—m6� _z J �FAnI �/�� �iy 4/ ane# F76 -7 q 7/
Site Address /c7 3 PARK
City %A Racy St &//f Zip fir'
Directions to Jab Site 1-106P C11,,1
4Kr, C' 2isT i�c/� D 2 �'o Co S'7b/� S�c�c.' T u2�✓
P.r 4-1AJ� Gb T_G) 1_ N fl OF- Row
Owner Mailing Address F PUl 6r2K �? �'rr�r c 7-tY B
City St Zip 2R39
Lien/Title Holder 4u AJ�E
Address -:X-5CkD -7""40 1
City %r �Aur��RA,�i St zip 3 /s
#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-4fss well
(If residential, proof of potable water may be required)
#4 Parcel No. 2 t'oD
regal Desc=iption Lors / /5- �/�K.I= �!{d21s i,i/r
#5 Building Square Footage: (4WGi2tt=rJpzop0sed)
ist Fl 3 2nd FI o e 3rd FI / Loft /
Basement Deck / S�` #bedrooms athrooms�
Garage---�_ Carport / (Circle- ttached Oetadhed?)
Other sq ft / tc N
f� 1
#b Use of building 122JET, Describe work Ftlt b /-/,0 6
#7 Type of Job: New_ Add Alt Repair Demolition
Woodstove Re-Roof Bulkhead_ Other
"8 MOBILE KOHL INFO MATTON
Model Year Make Model
Length_ Width Serial No
"Bedrooms "Bathrooms Type of Heat
"9 Any water on or adjacent to property: salcwacer lake_
river pond_ wetland seasonal :u note
show following on the site plan
Lot Dimensions Flood Zonesl
Existing Structures Fences
Stzlsczure Setbacks Driveways
Water Lines Shorelines
Drainage ?!an Topography
Septic Systems Wells
Proposed Z=rcvements Easements
Name of Flanking Street Scale:
Name of Fronting Street Date: n9 -c�,�- �Z
r11PPLICANT To DRAW SITE PLAN BELOW
�ire�� � '�` 7 2 • � ,000
N
c
0 �-
Q
N 40 06 643 " o r
O
-1�
E '
_ 51 . 42
N 2 70 8 0 0
29 F.
PLICANT TO DRAW TOPOGRAPHY PROFILE BELO
c
�Wr-rT- OF
- , a=�1,4;v A roe /o/✓
DEPARTNIEN'TAL REVIEW
Fm OFFIcs u= auLT ,
'— Appi'ovd Cond Mold
- Approval
P l a=ing:
Eavi onmental Health: t t- ,.�� a a
uildinq P Review: v� Sec �9Fj7 a -�-`
osc. �++
Occupancy Group:
Fire Marshall:
Other:
IlSpecial tioas: II aSite Znspectioa II
Il � 5 �3 II
II *15 II IIBUUding Pe= :Lt
II 3 II r I1
�j cv = II Ilviclation Fee I II
II S II Ilviolation Investigation Fee 1 II
II
Il 661 II II Plan checkfill
II II Il Plumbing- Fee c� p
11 11 IlMeclianical Fee 1 11
II II I. it
I( II IlWaadstove Fee I II
I, 11 IlHuilding Stace Fee 1 11
1 C f
IlHuild :g valuac:on: II II TOTALI 1 it L
DEPARTMENTAL REVIEW MASON COUNTY Permit No.BLD
FOR OFFICE USE ONLY BUILDING PERMIT APPLICATION
a..•.4 o.L aw
•�..i PLEASE PRINT
Planning:
#1 Owner / Phone#
Site Address ,% /Z2
City -7r .f�, c i i 4a State ZCA Zip_a'E
/fir, %� �F� �'�, , f ,.�Y, �°
Environmental Health: Directions to Job Site���F�' j�^'Sa
Owner Mailing Address
Building Plan Review: City_.— //> �Ja Z State Zip s 'j
Lien/Title Holder_ it/!A
Address
Occupancy Group: City State Zip
Fire Marshall: #2 Contractor Name 4-17)� ;-yf>� F ;� 6'Afls fContractor Reg - >��BF
Address / /.-r' c � �lr' (�' - cs Expiration Date el—
City f/�f�-m A-- State 1Z,;x14 Zip �)JCiPhonq(�C - r
Other: #3 If septic is located on project site, include records.
Connect to Septic? C Public Water Supply 1/r`� Well
(If residential, proof of potable water may be required. )
FEES #4 Parcel No. �2a 5 0 C? -4(2 � t
Special Conditions: Legal Description �,A-lr-gSite Inspection
I #5 Building Square Footage: (existing/proposed)
Building Permit 1st F1 57L / 2nd Fl 3rd Fl / Loft
;"Basement / Deck y�'c� #Bedrooms c' / #Bathrooms /
Violation Fee .-Garage ?C�?C-' / Carport / (Circle: Attached or Detached?)
Other sq ft /
Violation investigation Fee
#b Use of building - Describe work 4jA/ �-tf
Plan Check i
#7 Type of Job: New /Add Alt Repair Demolition
Plumbing Fee
Woodstove Re-roof Bulkhead Other
Mechanical Fee #8 Mobile Home Information
Model Year Make Model
lWoodstove Fee Length Width Serial No.
#Bedrooms #Bathrooms Type of Heat
Buildin State Fee
Building Valuation:
#9 Any water on or ad'acent to
7 property: Saltwater Lake River
TOTAL Pond_Wetland Seasonal runoff-Other-
Show- fo1a0...4 �< � ($2 .00 each) Fee: No. B
the a ► Plumbincr ix urns
D rr. R, z oilers Co Lot Dimensions ;`
No. z Toilets mpressor Fees:
"Flood Zones ry - h 0-3 HP
Existing Structures Fences -� Bath Basins 00
SlruCture Setbacks " ' ' 3-15 HP Water Lines Driveways Tubs Tub �00
Drainage Plan Shorelines 2- Showers 15-3 0 HIP 00
Septic System TOp�aphY 3 0-5 O HP Proposed Wells _ _HOC Water Htr 6.00
Name of Flanking
Basements 50 + HP
ankin Street _j_Laundry Washer �00
:...
Name of Frcntin
g Street Scale:.
Sin
ks s No A� Handling
Date....; Unit
r U '
' Floor Drains
APPLICANT TO DRAW SITE PLAN BELOW Laundry Basins <= 10, 000 cfm. 7.50
> 10, 000 cfm.
—L_Dishwasher 7.50
t Disposal
Urinals Other
Other Evap Coolers
Hoods
Permit Basic Fee Fire Suppression
3.00 Domes. Incin.
TOTAL PLUMBING $
Ccmm1- Incin.
Mechanical Fixtures Reloc/Repair 6.00
Q } No. Fuel Types Gas Outlets x 2.00
Furn < 100K BTU Other t3dstove 6.00 sea�te
Oth
--/ Furn >- 100K BTU 6,00
Furn - Floor _ 6.00 Permit Basic Fee
Heat Pumps 6.00 �10.00
Vent System x 3.00 TOTS MECHANICAL' $
'-� Vent Fans x 3.00
NOTICE: THIS PFRhfTT .BECOMES
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
AUTHORIZED IS NOT CObm1ENC M._WITHIN 180 DAYS OOR IFFCONSTRUCTIO ONSTRIICTION
SUSPENDED OR ABANDONED FOR.7l PERIOD OF 18O:::DAYS AT ANY: TIDD3 R'.?PORR:;:.IS
CaMMENCED. ,a ....,::
r. .wn.:•Y.. - -
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I certify that I am exempt from the requirements of the I certify that I am a currently registered contractor in
~ f d" C� contractors registration law RCW 18.27 , and am
aware of the Mason County Ordinance requirements for the State of Washington and 1 am aware of the
r�yn� which this permit is issued and that all work done will ordinance requirements regulating the work for which
be in conformance therewith. No changes shall be the permit is issued and all work done will be in
made without first obtaining a conformance therewith. No changes shall be made
g approval from the Building without first obtaining a
J�puts� D Department. 0 approval from the Building
�hp Department. �
X OWNER
#7,0 -FIo,U DATE: X By c tij�L•
Return permit to: Department of General Services 426 W. Cedar Street/P.o. Box 186
Shelton, WA 98584 427-9670/1-800-562-5638
FOR OFFICIAL, USE ONLY: Accepted by:
Date: