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HomeMy WebLinkAboutBLD94-00334 Final Mobile Home - BLD Permit / Conditions - 6/8/1994 ------------------------ - CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date z b- by Gas Piping date b Foundation Walls date by Set Up L -� date by INSULATION date C5V L- b by BG/SLAB Insulation Floors Final date by date by date FRAMING Walls FIRE DEPT. date by date by date by PLUMBING Attic OTHER Groundwork date b date b y D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by r 1 !J�l7CiV .-7 I-�jell 4 i MASON COUNTY Mason County Bldg, 111 426 W. Cedar P.0, Box 186 Shelton, Washington 98584 P t It 1 N*- Pt I I I I N', f I i w n, i rII I I I pA­ I ilIt ?11 1 1) I i M if i 'kil t .-i o I I I M tllf� m I f I I I I I I I I I III f Ir. I j it i t itj- I q It I 1 4 I it It I I It I N f I (IN 1 1, C i ml J c'-it r.,rtiit I i fl o I it t - 1; — — —-------— i MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 li i i - - -� Permit No. MASON COUNTY BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 Owner 3�vy-, 14 op-m rE e2 Phone# Site Address NJJ 10 � �+�6Dc.y L,�( Fire District# City C icc-1:::700,2 ��✓� �fl Z'sr St Zip Directions to Job Site 14 k-,/ 3&0 70 t;E s x L9ti! c.����rC R2 - �Z C cL�- rD�- 7c� l2✓ z;,4 6ow L.�/ - JZ�q jf i- LO"T 0/-,/ Z41411 i ✓�i Owner Mailing Address eo t3px 6- 3 3 City D(--�✓ki�� S 1*9to0 S w.�4 �l�S�o �1 St Zip Lien/Title Holder �a L-C)-v 1 gau Address City St Zip #2 Contractor Name (9G 6-kqyM� SAC L-L_c;C Contractor Reg#oAga -H6 t i t Pw Address Po -Expiration Date_10 /_Lt City S -� �zO.��r St w/�- Zip 3 3 Phone# "Zfu 3 ?2-6�! Z #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. ZZ3 Z5� - 60 Legal Description K,r75 Z� G'Z4LCK B i Z #5 BuildingSquare Footage: (existing/proposed) q 9 1st FI / 2nd FI / 3rd FI / 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 Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year a � Make F11AiA- Model�_Ot4 Length Width_Serial No. #Bedrooms 3 # Bathrooms Type of Heat CL,�u',2�L Purchase Price$ c1©f QSLO #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Driveways Scale 1"=30 North Arrow r L)RJ7A-N FT� LI� TNaI� � I�OQ o � rn y 4D APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW rr,L'crr ---------- MOT %o � L r Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each) No'._Toilets CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins Heatpump, Other _Bath Tubs No. Units 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- 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 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 j FOR OFFICIAL USE ONLY: Accepted by: Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: C Environmental Health: Building Plan Review M F G- 50P c S M N -LI1 N tMG,5 , Pow /4PDee SS /l.L Occupancy Group:R-3 y Type of Const: s N Fire Marshal: Other: Special Conditions: FEES Building Permit Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other Other Building Valuation: TOTAL FEE