HomeMy WebLinkAboutBLD93-00372 Final Dock - BLD Permit / Conditions - 5/27/1993 MASON COUNTY
Mason County Bldg. III 426 W. Cedar
` P.O. Box 186 Shelton, Washington 98584
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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 FRAMING by date by date by
Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
te WALLBOARD NAILING
D.date by date by
Water Line FINAL INSPECTION
date by date��� ��—y 3 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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41
DEPARTMENTAL REVIEW Permit No.BLD 213- (13`7
MASON COUNTY
FOR OFFICE USE ONLY BUILDING PERMIT APPLICATION
AVPu.d Cbi !btl �
Af.; PLEASE PRINT
Planning:
#1 Owner /{'ul Z e G4 Phone# •2-7S- 5-4.3 0
Site Address Q74 0 TG KUJ n - LCA
City h ct State (A Zip
Directions to Job Site /11ar 4 d✓e L4
Environmental Health: �,
qhr} c.//��.c/ � !'?�yt1�r�„n (�'r� U 4
�a v/i'� j�/Ivy a%�e. /��� 7keae, c.,;J) he- ck ��c,H -44LI- 50,y ` d� � /Fr A,
1-O►S U;M,` #4�� a P{31� rJ►r JtJS2 40 �arY
Owner Mailing dd)zess G � n /
ALL CONSTRUCTION .=c city- State
Building Plan Review:OR EXCEED LOCAL CODES. IF ANY Eq
y Zlpa�SOUESTICN L Lien/Title Hol er
GFFI6EOreg G{:O'avc ;rnnN�
Address
City State Zip
Occupancy Group z—
Fire Marshall: #2 Contractor Name Contractor Reg # lyy y-a-sC. - l SS 1
Address lobs Expiration Date 3 / 31 / (f
City �rl, State- (Zip q?,!jat Phone 275-SOA9
.jthher: #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. )
FEES #4 Parcel No. a--)� - -
Special Conditions:. Legal Description �- lc)Oo 'n G. L O Y A 1 IYh
S ite Inspection `J O1 . 1{ p� p1u�s Pa�-k, 41 1 r,COrdS 0-G VV1 H50n COvnjv
#5 Building Square Footage: (existing/proposed) O
I
Building Permit � `f 1st F1 / 2nd F1 / 3rd Fl / Loft /
Basement / Deck / #Bedrooms / #Bathrooms /
Violation Fee Garage / Carport / (Circle: Attached or Detached?)
Other C1 e� ,��►� sq f
Violation Investigation Fee '
#6 Use of building Des ribe work --
Plan Check
1
#7 Type of Job: New Add Alt Repair Demolition
Plumbing Fee Woodstove Re-r of- Bulkhead Other��� [)cX�
Mechanical Fee ' #S Mobile Home Information
Model Year Make Model
Woodstove Fee Length Width Serial No.
#Bedrooms #Bathrooms Type of Heat
BuildingState Fee �7'
#9 Any water on or adjacent to property: Saltwater Lake River
Building Valuation: L41 TOTAL Pond Wetland Seasonal runoff Other
�
Pliunbing Fixtures ($2 . 00 each) Fee: No. Boilers/Compressor Fees:
Show following on the site plan No. Toilets 0-3 HP 6.00
Bath basins 6.00
Lot Dimensions Flood. Zones 3-15 HP
Existing Structures Fences Bath Tubs 15-3 0 HP 6,00
Structure Setbacks Driveways Showers 6.00
water Lines Shorelines 30-50 HP
Drainage Plan Topography Hot Water Htr
50 + HP 6.00
Septic System Wells Laundry Washer
Proposed Improvements Easements
Name of Flanking Street .Scale: Sinks No. Air Handling Unit
Name of Fronting streetL . Floor Drains <= 10, 000 Cfm. 7.50
'-Date
Laundry Basins > 10 , 000 cfm. 7.50
APPLICANT TO DRAW SITE PLAN BELOW Dishwasher
Disposal Other
Urinals Evap Coolers
Other Hoods
Fire Suppression
Permit Basic Fee 3 .00 Domes . Incin.
TOTAL PLUMBING $ Conunl. Incin.
Reloc/Repair 6.00
Mechanical Fixtures Gas Outlets x 2 . 00
No. Fuel Types Woodstove separate
-Furs < 100K BTU 6.00 Other
Furn >= 100K BTU 6.00
Furn - Floor 6.00 Permit Basic Fee 10.00
Heat Pumps 6.00 TOTAL MECHANICAL $
Vent System x 3 .00
Vent Fans x 3 . 00
NOTICE: THIS PERMIT . .BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED.
s
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
contractors registration law RCW 18.27 , and am the State of Washington and I am aware of the
aware of the Mason County Ordinance requirements for ordinance requirements regulating the work for which
which this permit is issued and that all work done will the permit is issued and all work done will be in
be in conformance therewith. No changes shall be conformance therewith. No changes shall be made
made without first obtaining approval from the Building without first obtaining approval from the Building
Department. Department.
X OWNER X By
DATE: DATE "U
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: A�_'X& l Dater ZZ'Z'/