HomeMy WebLinkAboutBLD92-01387 Final SFR - BLD Permit / Conditions - 7/2/1997 MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
N.... II:;M :.:N:: 11".41 IF:e K:::::: N:;!: Kw'K K:: 1" F O R INSPECTIONS CALL 4 2 7—9 6 7 0
BETWEEN 5pm AND Sam 427-7262
BLD92-1387 PARCEL : 223254490021 PLAT : DIV: ? BLK : ? LUI : '
JOB ADDRESS : NE 1311 MISSION CREEK RD BELFAIR
OWNER : JOHN JOHNSON 275-6734
CONTRACTOR : JOHNSON 275-6734
LEGAL : Tr 2 of S1/2 SE SE
CLASS OF WORK NEW BEDR : 3 BATH : 2 TYPE AMOUNT BY DATE RECEIPT TYPE AMOUNT BY DATE RECEIPT
TYPE OF USE . . . . : SF STORIES . . . . . . . : 1
OCCUP . GROUP . . . : ? BLDG . HEIGHT . . : 0 . 0 f t IPRMT $ 265.11 KS 12/16/92 31865
TYPE OF CONST . . : ? FIREPLACES . . . . : 0 PICK $ 25.60 KS 12/16/92 31865
OCCUP . LOAD . . . . : 0 WOODSTOVES . . . . : 0 P L M $ 27.00 KS 12116/92 3 18 65
DWELL . UNITS . . . . : 0 PARKING SPACES : 0 M C H $ 22.11 KS 12/16/92 31865
INSPECTION AREA : 1 SHORELINE? . . . . : N STFE $ 4.50 KS 12/16/92 31865 TOTAL: 343.50 VALULAT10M 45 95 2 7
SETBACKS-------------- TOILETS . . . . . . . . . . : 2 FUEL ! YPES---------- BOILERS /COMP---- MOBILE HOME--
FRONT . . . S 5 . 0ft BATH BASINS . . . . . . : 2 : ? 0-3 HP . : 0
REAR . . . . N 5 . Oft BATH TUBS . . . . . . . . : 1 3-15 HP . : 0 MODEL : ?
SIDE ( 1 ) . E 5 . Oft SHOWERS . . . . . . . . . . : 0 FURN < 100K BTU : 0 15-30 HP . : 0 —MAKE------
SIDE ( 2) .W 5 . Oft WATER HEATERS . . . . : 1 FURN )=100K BTU : 0 30-50 HP . : 0 ?
SHRLINE . ? 0 . Oft CLOTHES WASHERS . . : 1 FURN — FLOOR . . . : 0 50+ HP . : 0 —YEAR------
AREA --------------- KITCHEN SINKS . . . . : 1 HEAT PUMP . . . . . . : 0 ?
LOT SIZE . . : ? FLOOR DRAINS . . . . . : 0 VENT SYSTEMS . . . : 0 EVAP COOLERS : 0 LENGTH : 0
BUILDING . . . : 1232sf DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 0 HOODS . . . . . . . : 0 WIDTH . : 0
BASEMENT. . . : 0sf LAUNDRY TRAYS . . . . : 0 DOMES . INCIN : O —SERIAL#—---
DECKS . . . . . . : Osf DISHWASHERS . . . . . . : 1 AIR HANDLING UNITS-- COMML . INCIN : O
GAR/CARP : ? Osf GARB DISPOSALS . . . : 0 <= 10000 cfm. : 0 RELOC /REPAIR : 0
AT/DT . : ? URINALS . . . . . . . . . . : 0 ) 10000 cfm . : 0 OTHER UNITS . : 0
MISC PLM FIXTURES : 0 GAS OUTLETS . : 0
PROJECT 0ESCRIPTI0N:RESI0ENCE
PROJECT L0CATI0N:ENTER MISSION CREEK RD TURN LEFT AT 1171 ON DIRT RD. DIRT RD "T"S KEEP RT 60 A P P R 0 X 811 FEET RD MAKES S H A R T LEFT LOT IS SIRAI6HT AHEAD ON RT
oHHI1SggPERAyyjg pHpiEAlyMyyESTTIINUEELLAEATNEDRVUuOOIggDggCiIFgWCCORMMENCED. EVIDENCE OFTCONTINUATIONOOFCWORKNISDAWPROGRES81INSPU TIONIWITHINTTHET180 DAYWPERIOD.SFINALDINSPECTIONEMUST BE
APPROVE BEfDRE BUILDlA6 CAA BE OCCOPIEB.
OWNER OR AGENT: J't c DATE: &
BLD_PRMT. rev: 13 1/91 COMPLIANCE TO
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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"1101AQ ANTIOUR1104 Of WOAK IS A WAW)s 101'Ilof"111111 141 1114
CONCRETk- MECHANICALe)f/< MOBILE HOME
dateSetback date �; - �3 by Ribbons
date - by Gas Piping date b
Foundation Walls date by Set Up
We by INSULATION date by
BG/SLAB Insulation Floors Final
date FRAMING by date by date by
Walls C FIRE DEPT.
date " � by date 4/—/.� "3 b date by
PLUMBING OTHER
Groundwork,Q Attic e,4D
!� date by tp
date.?—.2 _!3 by
WALLBOARD NAILING
D.W.V. 01
date by date by
Water Line FINAL INSPECTION
date by date}-V .7_2_� by L C,) date by
Gvery?t=T)
a�
1 STEPHEN JOHNSON, INC.
N.E.70I MISSION CREEK ROAD
/J BELFAIR,WA 98528
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Site Address n I i`13t St(.lYtZip
Owner Address ,C' P� (,x
Lien/Title Holder
Address Ci ty St Zip
Describe Work 7,, 711 C"r'r ems- 7,'
�2 Contractor Name e Contractor Reg�fe
Address —7� ( =SS c`� 2�L iration date �-
City L", SC�j(Z.ip 9R ZVPbone 7.5-F_`7_'�;V
?"r 3 If septic is located on project site, include -ecords_
Connect to Septic? Public Water Supply ell
,r4 Parcel No. z_ - --r-�-r-�� o1 a 3 a 5 -� - e�� a:3
Legal Description
rr5 Building Sure Footage:
Z 7 festi.^_g/proposed)
1st FI ( � 2nd F1 / 3rd FI / Loft
Basement Deck / Garage �;71C� Carport /
#bedrooms ba chrooms
Other /sa- f t /
m6 Use of building��� �I e-L-r
r7 Tvae of job: New Add Alt Repair Demoli tion
P1 umbi-ng Only Mechani cal Only Woods Love Re-Roof
Bulkhead Other
Plumbing Fixtures t!echaui cal Fixtures
No. ZToil e cs No. reel Types No. Air Eandling Units
ZBa tb tubs Fury < 10 OK BTU <- 10000 cfm.
Showers Furn >- 100K BTU > 10000 cfm.
ZBa tb basins F urn - Floor Other
Sinks Heat Pumas Fran Cool e_Ts
r Dishwasher Vent Systems Hoods
Ho t Wa ter Htr Ven t Fans Domes. In cin.
Laundry Washer Boilers/Compressors Comml . Iacin.
Floor Drains 0-3 HP Reloc/Repair
Other 3-15 I£D Gas Outlets
.15-30 �_T woodstove
30-50 1E) Other
50 +
�9 MOBILE HOME INFOP-MATION
Model Year Make Model
Le--gat Wi d th Ser al No.
RBe^--ocros ZBa Grooms
T10 Any water on or adjace_nc cc drecercy: sal t-.4a cer lake
raver pcnd .recla,^d sease^al r cf=
�o
S�cl� G 'Z
MASON COUNTY
BUILDING PERMIT APPLICATION
PLEASE PRINT � C r' # C>142- 3 q Z- l 'i
#1 Owner 7ULly, i✓C,,v,, Phone# Z? S ��37
\. Site Address Q 6 E 1'73 City $i-AFau. St Ur � 3
P�
Owner Address C. E3 C,x i 1 S"7 Ci t zip_y_
Lien/Ti tle Holder
Address Ci ty —St—zip--
Describe Work _�r�
1r2 Contractor Name L Ed:. E - Contractor Re p (-) ('J?C-�t)
Address - ��- f /_til r=s S< e, /2 ,g�ppaxa ti on date
Ci ty_( � '� rz S02, zip Ze hone 7.5-�--7�V
#3 If septic is located on project site, include cords.
Connect to Septic? Public Water Supply 11
#4 Parcel No. a,--P-3 a 5 - 94
Legal
#5 Building Square Footage: (e dsti r77/proposed)
Ist F1 2nd F1 / 3rd FI / Loft /
Basement Deck / Garage �Zlb Carport /
#bedrooms #bathrooms ���
Other sq ft /
#6 Use of building. , de va C-Q
#7 Tme of Job: New Add Alt Repair Demolition
Plumbing Only Mechanical Only Woodstove Re-Roof
Bulkhead Other
#8 PI umbing Fixtures Mechani cal Fixtures
No. 2-Toilets No. Fuel Types No. Air Handling Units
ZBathtubs Fur= < 100K BTU <- 10000 cfm.
Showers Furn >- 100% BTU > 10000 cfm.
2-Bath basins Furn - Floor Other
=Sirks Heat Pumps Evap Coolers
Dishwasher Vent Systems Hoods
t Hot Water Htr Vent Fans —Domes. Incin.
Laundry Washer Boilers/Compressors Comml . Incin.
Floor Drains 0-3 HP ReZoc/Repair
Other 3-15 HP Gas Outlets
Zu v"'zJ� 15-30 RP Woodstove
3 o� 20-50 HP Other
�Z? 50 + HP
#9 MOBILE HOME INFOR-MATION
Model Year Make Model
Length Width Serial No.
#Bedrooms #Ba C21--toms
#10 Any grater on or adjacent to property: saltwater lake
river pond wecland seasonal runofr
ocher
Show fol.1ow.ing on the site plan Directions to job site
Lot Dimensions Flood Zones
Existing Structures Fences yip fVIr _ J/ r C�
Strscture Setbacks Driveways
Water Li�zes Shorelines p �� � 3 cf 0 AD
Drainage Plan Topography -
Septic Sy_szjems wells
Proposed Iamrovements Easements
Name of Flanking Street `0 .? 0.1
Name of Fronting Street
I
Scale:
Date:
—APPLICANT TO DRAW TOpOGRApgv PROFILE HELD
7 < •
NOTICE: Tr IS PERMIT 3ECOb�S NULL Ate VOID IF WORK OR CONSZ—a1 71ON
A=ORIZED IS NOT COM.Mz'NCED WI,^'??IN 180 DAYS , OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK
IS COMM.E V5C�D'
OWNnRS AFr IDAVI r' CONTRACTORS AFFIOAV7'^
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTU' THAT I AM A CURREH-TLT REGISTERED CONTRACTOR
CONTRACTORS REGISTRATION LAW RCW 18.27 , AND AM AWARE IN THE STATE OF WASHINGTOII AND I AM AWARE OF THE
OF THE MASON COUNTI' ORDINANCE REQUIREMENTS FOR WHICH ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH
THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING A L FROM THE BUILDING
DEPARTMENT. DEPARTMENT.
X OWNER x BY
Return permit to: Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, DMA 98584 427-9670/1-800-562-5628
FOR: OFFICIAL USE ONLY: Accepted by: Dater } •••• �2
DEPAR AL REIE VW
FOR OFFICE USE ONLY
Approved Cond Hold
Approval
Planning;
Environmental Heal the
M�
Building Plan Re ew:
O
Fire Marshall :
Other :
I