HomeMy WebLinkAboutBLD92-1153 Cancelled Bulkhead - BLD Permit / Conditions - 11/12/1997 MASON COUNTY PERMIT
Mason County Bldg, 111 426 W. Cedar NULL & VOID BY EXFnRATIO)k
P.O. Box 186 Shelton, Washington 98584 DATE BY
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CONCRETE MECHANICAL MOBILE HOME
Footin Sett 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 Attic OTHER
Groundwork
date by date by
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. III 426 `JV, Cedar
RO, Box 186 Shelton, Washington 98584
R
Permit No.BLD
MASON COUNTY
BUILDING PERMIT APPLICATION
PLEASE PRINT
#1 Owner ltty 1��('_� Phone# 6_00 2�5 -0,SOO
Site Address tN E L10 C'o\k%NS -P\
City `rAQ 4uuA- St ij.p#oHit'6G-mJ Zip q8m
Directions to Job Site Cc. Ws-! r��i�� 5-7 is ,nark ¢ 4c.crn y-;[4_
nn-fr, 2pe►-k-ttr =f huu iri. Cnr, Ce�r o, -C-w Yn 1c , LAy4j OnI1MS A&,
lC YlmriritN.f, •-NArn Ri,hf on'ict L.A-keZr- 4n biCuhC
Mtn rv, i,44 nr1-4n er,16 Tnc P 1
Owner Mailing Address 6 AMf
City St Zip
Lien/Title Holder L_.
Address ---+900
City-�,�K�r��ie�d St Zip g330
#2 Contractor Name � Nb ontractor Reg#
Address Expiration date
City St Zip Phone
#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)
2-7-3�a1 00* 2-
#4 Parcel No. -
Legal Description CA t r* J*_ 3 L 'r �—
#5 Building Square Footage: (existing/proposed)
1st Fl I0od l 2nd Fl WOl 3rd Fl / Loft
Basement / Deck #bedrooms _ #bathrooms�1_
Garage / Carport / (Circle: Attached or Detached?)
Other sq ft /
#6 Use of building ?Tla'`` l" Describe work A',
#7 Type of Job: New Add Alt Repair Demolition
Woodstove Re-Roof Bulkhead Other
#8 MOBILE HOME INFORMATION
Model Year Make Model
Length Width Serial No.
#Bedrooms #Bathrooms Type of Heat
#9 Any water on or adjacent to property: saltwater lake
river pond wetland seasonal runoff
other
Show following on the site plan —�
Lot Dimensidris 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:
APPLI'QCANT TO DRAW SITE PLAN BELOW
4 g ti
M �
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
otiv kf�i�1G,l
Plumbincq Fixtures ($2 each) Fee Fee
No. Toilets r Vent Systems X 3 . 00
Bath Basins Vent Fans X 3 . 00
Bath Tubs No. Boilers/Compressors
Showers 0-3 HP 6 . 00
Hot Water Htr 3 - 15 HP 6 . 00
Laundr.1 Washer 15-30 HP 6 . 00
Sinks 30-50 HP 6 . 00
Floor Drains 50 + HP 6 . 00
Laundry Basins No. Air Handling Unit
Dishwasher 10000 cfm. 7 . 50
Disposal > 10000 cfm. 7 . 50
Urinals Other
Other Evap Coolers
Hoods
Permit Basic Fee 3 . 00 Fire Suppression
TOTAL PLUMBING $ Domes . Incin.
Comml . Incin.
Reloc/Repair 6 . 00
Mechanical Fixtures Gas Outlets X 2 .00
No. Fuel Types Woodstove separate
Furn < 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 $
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 AN 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 AN 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 1N
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 I X BY
DATE A I DATE
Return permit to: Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
FOR OFFICIAL USE ONLY: Accepted by: Date:
I '
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond Mold
Approval
Planning:
Environmental Health:
Building Plan Review:
(J�c
Occupancy Group:
Fire Marshall:
Other:
FEES
IlSpecial Conditions: it Ilsite Inspection I II
11 II
II I Buildin Permit `' l
II II g
II II I
II II Ilviolation Fee I II
II
II I -�I
II II Ilviolation Investigation Fee I II
Gt, ERy►cES
II II II Plan Check
II II I. i)
II II II Plumbing Fee I II
II II I. it
II II IlMechanical Fee I II
II II C it
II II IlWaadstove Fee I II
II H -;I
II IlBuilding State Fee i II
IIiBuilding valuation: ` II II TOTALI � j
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