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HomeMy WebLinkAboutBLD92-0487 - BLD Permit / Conditions - 8/7/1992MASON C DING PE IT ICATION PLEASE PRINT Owner Site Address 5'u Owner Address Lien/Title Holder AddrDescribeWork/:41)4.' #2 Contractor Name _c • #3 #4 #5 Address y Pc, City P c," ,‘ly Phone# City. t,L City ty (-;' '14C�:.. r .Zip Zip Zip / i Contractor Reg#_!,'/<- Y iration is on date Zap Phoney; If septic is located on project site, include Connect to Septic? Public Water Supply Parcel No. 1 q/1 - ( - - C c c=! Legal Description. Building Square Footage: 1st Fl, / 2nd Fl Basement / Deck #bedrooms / #bathrooms Other sq ft #6 Use of building #7 Type of fob.: New Add Pl ing Only Mechanica Bulkhead Other #8 Plumbing Fixtures No. Toilets Bathtubs Showers Bath basins Sinks Dishwasher -, Hot Water Htr Laun Washer Floor Drains Other Garage 7 records. Well X Loft Carpor Repair Demolition y Woodstove Re -Roof Mechanical Fixtures No. Fuel es Furn < 100K BTU Furn >- 100K BTU Furn - Floor Heat P s Vent Systems Vent Fans Boilers/C ressors 0-3 HP 3-15 HP 15-30 HP 30-50 HP 50 + HP #9 NOpIJ,E HOME, I O TIQ1 Model Year Make, Model #Bedrooms - Width # athroomsSerial No. #10 Any water on or adjacent to property: river , pond wetland ,.... other No. Air Handling Units < 1000© cfm. > 10000 cfm. Other Evap Coolers Hoods Domes. Incin . Comma. Incin. Reloc/Repair Gas Outlets Woodstove Other saltwater X lake seasonal runoff 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 I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS REGISTRATION LAW RCW 18.27 , AND AM AWARE OF THE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. Return permit to: Department of General Services Shelton, WA 98584 427-9670/1-840-562-5628 426 W. Cedar/P.O.S Box 186, FOR OFFICIAL USE ONLY: Accepted by: DEP Date: FOR OFFICE USE sew following on the site plan Lot Dimensions Existing Structures ,.Structure Setbacks Water Lines Drainage Plan Septic Systems Proposed Improvements Easements Name of Flanking Street Name of Fronting Street Flood Zones Fences Driveways Shorelines Topography Wells PROFILE BELO Directions to job site A;Crw;.-h -ft) lisyr�' MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 F.11. ILL IR Pill :1L —11- BLD92-0487 PARCEL: 319111200070 PLAT: JOB ADDRESS: 4090 LYNCH RD SHELTON OWNER: GEORGE BOOTH 426-5525 CONTRACTOR: LEGAL: TR 7 OF GOVT LOT 1 b TAX 595A-1 FS 19232 CLASS OF WORK..:ADO TYPE OF USE .... :ACC OCCUP. GROUP •° TYPE OF CONST..:? OCCUP. LOAD....: DWELL.UNITS..... 0 'INSPECTION AREA: 2 BEDR: 0 .BATH: 0 STORIES.......:0 BLDG. HEIGHT..: Oft FIREPLACES 0 0 WOODSTOVES....: 0 PARKING SPACES: 0 SHORELINE? :Y FOR INSPECTIONS CALL 427-9670 DIV: BLK: LOT: TYPE AMOUNT BY DATE RECEIPT TYPE AMOUNT BY DATE RECEIPT PRAT $ PLCK $ STFE $ 38.54 N3P 08/01/92 31055 19.25 NIP 08/07/92 31055 4.50 NIP 08/01/92 31055 TOTAL: 62.25 VALULATION: 2448 SETBACKS------------ TOILETS 0 FUEL TYPES---- ------ BOILERS/COMP---- MOBILE HOME-- FRONT...N 10ft BATH BASINS 0 :? . 0-3 HP.: 0 REAR....3 200ft BATH TUBS........: 0 3-15 HP.: 0 MODEL:? SIDE(1).E 100ft SHOWERS 0 FURN < 100K BTU: 0 15-30 HP.: 0 -MAKE------ SIDE(2).E 100ft WATER HEATERS 0 FURN >100K BTU: 0 30-50 HP.: 0 ? SHRLINE.S 200ft CLOTHES WASHERS... 0 FURN - FLOOR...: 0 50+ HP.: 0 -YEAR------ AREA KITCHEN SINKS 0 HEAT PUMP 0 ? LOT SIZE..:? FLOOR DRAINS 0 VENT SYSTEMS...: 0 EVAP COOLERS: 0 LENGTH: 0 BUILDING...: Osf DRINKING FOUNT: 0 VENT FANS......: 0 HOODS.......: 0 WIDTH.: 0 BASEMENT...: Osf LAUNDRY TRAYS 0 DOMES. INCIN:O —SERIAL##---- DECKS Osf DISHWASHERS......: 0 AIR HANDLING UNITS-- COMML. INCIN:0 ? GAR/CARP:6 288sf GARB DISPOSALS...: 0 <= 10000 cfm.: 0 RELOC/REPAIR: 0 AT/DT.:A URINALS • 0 > 10000 cfm.: 0 OTHER UNITS.: 0 MISC PLM FIXTURES: 0 GAS OUTLETS.: 0 PROJECT OESCRIPTION:GARAGE ADDITON PROJECT LOCATION:GO NORTH TO TAYLOR TOWNE TURN LEFT ON LYNCH RD 60 3 1/2 NILES TO ROAD SIGN THAT HAS AN ARROW MAKE RIGHT INTO DRIVE WRY THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 GAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED FOR A PERIOD OF 180 DAYS AT ANY TINE AFTER WORK IS COMMENCED. EVIDENCE OF CONTINUATION OF WORK IS A PROGRESS INSPECTION WITHIN THE 180 DAY PERIOD. FINAL INSPECTION HOST BE APPROVED BEFORE BUILDING CAN BE OCCUPIED, OWNER OR AGENT: j.� BLD_PRMT, rev: 03/31/91 DATE:_' 7 9 2 — COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 Q_. [::;iI: Frird :11_ q'" C: IC"J3 3_ u r: ID NI S Case No.: BLO92-0487 For: GEORGE BOOTH Page: 1 1) Approved per site —plan. 2) No septic records for drainfield owner aasumes all responsibility if drainfield area enci.ambered. -r�y1 l�trv�— CONCRETE Foot,wtgs • Setback date Foundation Walls date,..: ,: ; BG�SLAB Insutati)rt date ' FRAMING date PLUMBING Groundwork date ©.w.u. date Water line. date by by by by by by by MECHANICAL Gas P ping date INSULATION n focus date Waits Attic date WALLBOARD NAILING date__ FINAL INSPECTION date 9. j 9; -by by by by MOBILE HOME :date Set' Up :date Final date :FIRE DEPT, OTHER by date by