HomeMy WebLinkAboutBLD93-0625 Final Mobile Home - BLD Permit / Conditions - 11/16/1993 --- ------ -- ------------
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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RURI HU'DRICK 21h—.�0114
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CONCRETE MECHANICAL MOBILE HOME +fit
Footings-Setback date by Ribbons
date by Gas Piping date MG-17-4/3 b L �
Foundation Walls date by Set Up
date by INSULATION date -r 2 --53 by ✓
BG/SLAB Insulation Final _
Floors y L �,
date by date by date l - `%.S b
FRAMING Walls FIRE DEPT.
date by date 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
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MASON COUNTY
Mason County Bldg, 111 426 W, Cedar
P.O. Box 186 Shelton, Washington 98584
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Permit NOBLM3��
MASON WUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT
#1-� Owner .E 1 ' Phone#
Site Address —'� ''� AIPT 60 6 ,,,a Q Fire District#
City St Zip
Directions to Jd Site
Owner Mailing Address
City C�1Tl�A) LUASf� St Zip .�
Lien/Title Holder
Address
City St Zip
2.� ADR V# 6OX° 6 Z
#2 Contractor Name Gfl�l'� Contracto Reg 6
Address *Xq S o 3 AJIF Expiration Date / -;Lg/�
City 5C'A✓UA k.,O A4 '�, —St—A zip ' AlPhone#
#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. 2' D-33 6 -5 00 - 03 ( %
Legal Description Lb 7" 44- 31 -)q P 16 (.AILS AS r-5—CO E40 ✓OL g K A 6 Lt 00C
�IjNTS IPpq(- t ( Cot O� Vet J- (20 L Asr'�
#5 Building Square Footage: (existing/proposed)
1st FI / 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms/ #bathrooms _/
arage / Carport / (Circle: Attached or Detached?)
Other sq. ft. /
#6 Use f b 'I 'ng M Describe work
#7 Type of Job: New Add Alt Repair Other
/�&
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year 19�t 3 Make I.iB rY Model*TN0L!PEr /PAWV �
Length 14 L , Widths Serial No. 61 UA k Z{Q X (A 41
# Bedrooms # Bathrooms -">- Type of Heat FORCEb A i 2 EA-J16C t/LL L-
Purchase Price$ i`a 6
#9 Indicate by circling the applicable sowrop f paLWaW is on or adjacent to subject property:
River Pond Creek Stream Wetl n fUkel Marsh Saltwater Seasonal Runoff Other
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements Indicate Directional by (N, S, E, W)
Name of Flanking Street
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Plumbing Fixtures ($3 eacW 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 PPROVAL FROM THE BUILDING
THE BUILDING PARTMENT. DEPARTMENT. '
X OWNER� X BY C,4
DATE J�/��13 _ DATE c 12 J
FOR OFFICIAL USE ONLY: Accepted by: r Date:
-- -- __— _ --- - - 1 "_
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
fts
Environmental Health:
Building Plan Review,-
Occupancy Group: Type of Const:
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