Loading...
HomeMy WebLinkAboutBLD93-0321 Final Pole Bldg - BLD Application - 7/27/1993 MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 a % � r 81 043--0311 1 01<1 1 1 1 0t,?0 4 : �i 4AH r11+IIr'f `, 1.. 116 Hft I. lop . . . . . . . Pt InHillsY tttl'Vi #i 1—fSIIR CNl t1I I/1'P!".'fN 'I%- c: IHI r.001 4mi l " AI PIPIT ct:l`: I01111 hull ►) ImInq 061 'ron, #i 11'i l 0 VI1`,t E1+ f I trot I '= 1 irf, lit I ';111 4? c, t itLy; :,y S - EN 1 f ' } t PI at 1 rd I # i a f., I 1 ., Jx !l± V�t11' 1_f!AP !'i w+ff)I!`, { 110 i 1 . Itld 1-f z Itr I't+1' I I III, I ;i, i ti, t �Vl } IW t� i ! ! I 0 4't 1 I tIIit it I.—, 110 1 F ii HI A l l i.; -. 0 , Hn 0 i ph ± ? "N o 1, y I P r+ .t�l.Its, Tit i, t± f I. }it ji i l; ,w r t "k 1 i"•I:11 alr1 Iri Ilit t 1'�O.tEf1 ti1 ';iFli'iIIsF;•Vp1t 1{It}IltlNt:� _ _ . .. Pia+il6j 'I twits mi-±f11 {d'i :.Ali upm 14 4il'mm, i#VN Will , h , # Mir± 4 #; i±l'{I:I "N 1441 1N{S PHIl11 BtlhlliN 011 kNO :'614 it IJP;j 01 in11,11r 11OW S#±IE++`fl; t #i pcj , eMMfliflo 1I'11il'N In Rai`., up 1; ; +!{I 111111lfp$ 4h Moil K •1+<,Sl �! OF 131 1AW At ANY 11M1 c# 11, 0lal 1 = rmfliith tviNtN± i fit 101110IlAHVII Wit 13 0 PIutOV4 iowliIINN WIN!" INN [AN f+Rl I'tkAO 111r, iPPkat" It Itik1 NIJItf+13,, ,,:,' ' t of ± IIFt11� ( !!N`i'! 6 A►+t', 1 !! ii 1 1 sit-ft II !,IIPl1!1 a+:#', i ', it! ill! i 1{1 I� 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 by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Attic Groundworky,�� date by date by p W WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by d ate by i✓J date by I I, I� MASON COUNTY Mason County Bldg. III 426 W. Cedar ` P.O. Box 186 Shelton, Washington 98584 4 N ------zD /Q-z �.. 0 0� • Permit No. MASON COUNTY BUILDING PERMIT APPLICATION PRINT Q/ 93 /\3 l Owner &5Yier Ckr 17f te( K S 'f K Phone# 27 S'- G 19 l Site Address &' E- 120 Hi*er /'/a c-e Fire District # - , City T4�L<y4 St L,l)q. Zip q g, S' g8 Directions to Job Site n//Ih t La ky- vt to e,o . 71k rY\ Xt_ �a /Z /oc �c �i`s' aKc� _ �3'� o� e �"tc, on Owner Mailin Address /U E ( 2O HT 1(get City. q St LO R Zip `7 �'S k H Lien/Title Holder /y w-, pi'a Fe -crec / Sa� �` ►t9 S' Address City Ae 14 z tr r St Zip Contractor Name 1l f �� CitSA41 Contractor Reg# 1 I MCI — • Address 2 vr'1 A 3 ti. `f Expiration date S- /Z / `� City a �� St 'aZip 81 Phone 36Z- SC 2- 5' If septic is located on project site, include ecords . 1 Connect to Septic? /`� t- Public water Supply 1c' well (If residential, proof of potable water is required) Parcel No. 2Z 331 51 - b O e 4 r? Legal Description Cj I ri5 L—K- D O' I Lo L4-7 Building Square Footage: lst F1 2nd F1 3rd F1 Loft Basement Deck #bedrooms #bathrooms Garage $D Carport Age arport: Attached or Detached Other Use'-of Y uildin a✓'a Des—ribe wozk�l^If ffZOA g 77C'x 13 4 00 4c.''kr ZC` KZ-q Rra�f ��`"�lo��'arport./ Type of Job: New �"� Add Alt Repair Demolition Re-Roof Bulkhead Other MOBILE HOME INFORMATION Model Year Make Model Length Width S 1 No. #Bedrooms #Bathr0 ms e f Heat Any water on or adjac nt to e yt water lake river pond a lan / seas easonal 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 Name of Flanking Street Scale: , Name of Fronting Street Date: 11 PPLICANT TO DRAW SITE PLAN BELOW cz� C, C1 � _PPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW C-t C.,✓czd e- .-lumbing Fixtures Fee Mechanical Fixtures 110. Toilets Primary Heat Source (circle type) Bath Basins Ele�t/heatpump/other Bath Tubs Showe` s NO.`, FEE Hot Wa er Htr Purn Laundry ashen' Heat Pumps Sinks Ve#t Sys (Central) Floor Drai Vent Fans (Spot/Who e) Laundry Si Bo .lers/Compres rs Dishwas er HP Dispo 1 Air dandling nit Urin s �� cfm. Oth Fire Prot ction Systems Permit Basic Fee TOTAL PLUMBING $ then Gas Outlets .Hoo ps Wood/Pellet/Gas tove Other Permit Basic Fee TOTAL MECHANICAL $ NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR CONTRACTORS REGISTRATION LAW RCW 18.27 , AND AM AWARE IN THE STATE OF WASHINGTON AND I AM AWARE OF THE OF THE MASON COUNTY 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 APPROVAL FROM THE BUILDING DEPARTMENT. /� DEPARTMENT. X OWNER k l X BY DATE Z_ DATE =turn permit to: Department of General Services Z6 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 FOR :OFF`ICTAT; tFSE -ONLY AccegCec .. ?ate � Y DEPARTYMNTAL REVIEW FOR OFFICE USE ONLY Approved Cond Hold Approval Planning: Environmental Health: -y L:!4 Building Plan Review: Occupancy Group: Fire Marshal: Other: FEES Ilspecial Conditions: II IlSite Inspection I II IIa II H i I 11 © 0-- l 00 Il IlBuilding Permit II �2 O e o0 II I I II II 11violation Fee I 11 II II H i il II II IlViolation Investigation Fee I II Il 11 I I 11 11 IlPlan Check 1 II 2�.E3� II II I I 11 11 IlPlumbing Fee 1 11 11 11 H 11 11 11 11Mechanical Fee 1 11 11 11 I i 11 11 IlWoodstove Fee I II II 11 I i 11 11 IlBuilding State Fee 1 �. 11 IlBuilding Valuation: 11 11 TOTAL I I()I, roll L- It I �I