HomeMy WebLinkAboutMIS92-0118 Final Wood Stove - MIS Permit / Conditions - 10/23/1992 -------------------------------------------------------
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
NI_ I C 0 L L i W . . . . . . . . 1 $1140 1 A
WOOW'A 0vt
I I ON
COIL IN'- P1 BLUE HOUSE ON CORNER Of C0tL1Nk* LAKE PIACt
061 f ki i I . I
j0" I tvi, 1011dil'-J., OuhO
00 (4)Nt fi It A#tt N 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 Final
Floors
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER �UC
Groundwork Attdate ic b
date by y
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date j by
1
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PLEASE PRINT a f
#1 Owner/AlPhone#
Site Address / n I Wtc
City—�2=� �-�b '4 7AJ+0Y:- St Zip , . '
Directions to Job Site � T
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IV
Owner Mailing Address
City St Zip
Lien/Title Holder
Address
City St Zip
#2 Contractor Name01,J -� Contractor Reg#
Address Expiration date
City St Zip Phone
f #3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply_ Well
4 (If residential roof of p potable water may be required)
#4 Parcel No. _ a �/ -5-1 - OOb�j�
Legal Description _Coll +n S LaK.�e— t7i U , '5 Lvf 5
#5 Building Square Footage: (existing/proposed)
� e:g ( 4/ProPosed)
V
1st Fl / 2nd Fl / 3rd Fl / Loft /
Basement / Deck ' / #bedrooms_ #bathrooms_
Garage / Carport / (Circle: Attached or Detached?)
Other sq ft /
#6 Use of building Describe work
f #7 Type of Job: New Add Alt Repair Demolition
Woodstove Re-Roof Bulkhead Other
j #8 MOBILE HOME INFORMATION
Model Year Mate
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
Lot Dimensions Flood Zones
Existing Strictures 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:
AE'PLICANr TO DRAW SITE PLAN BELO
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=APPLICANT TO DRAW TOPOGRAPHY PROFILE BELO
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