HomeMy WebLinkAboutBLDAB-6 Remodel - BLD Application - 4/28/1977 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED 4-28-77
PERMIT NO. AB W 6
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
Union Wa. 98592
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. Alderbrook Country Club, Lot #22
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
— is & W Contrsptor,15497 Glenwood Rd. .,S.W..,Port Qrchard.,Wa. 223-01—SWCON244Q4 876-9348
USE OF
BUILDING Motel Rental
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION EXREPAIR ❑ MOVE ❑ REMOVE
Describe work:
Remodel
Valuation of work: $ 3,650 PLAN CHECK FEE PERMIT FEE 28.00
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE TZpe of Occupancy Division
BY Const. Group
Size o(Bldg—. No. of Max.
(Total) Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor In RESIDENCE
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT.
Firm PUBLIC WORKS
By
ROAD DEPT.
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
1 ,�/f SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Own @r��j"�T "L ti�L4 0 Date. y WORK IS COMMENCED.
C�AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
MASON. COUNTY F" AI NiNc. nEPARTMTHT
P.O. BOX 186 Shelton, Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT — Complete ALL items. Mark boxes where applicable.
Name Mallingaddress—Number,street,city,and State Zip code Tel.No.
t. Wes Johnson Union., Wa.___ 98592
Owner
z.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signature of applicant Address — Applicatlo date
LEGAL DEISCelPTION
Location Alderbrook Country ClUb., Lot --Of
Building _
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS
BATH TUBS
SHOWERS
1 WATER HEATERS
AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
(Show Street Names & Property Lines)
Basic Fee •00 1 INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT 9.oo SKETCH IN SEPTIC TANK& DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
ApproVr d by Permit fee Date pemit issued Permit number Receipt No.
$ 9.00 4-28-77 AB-W 6
i