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Home My WebLink AboutBLD28570 SFR - BLD Application - 5/17/1991 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES 426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. t2 y F) I L OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE . .�� 3 j3r 3 3 3y 9- 9-3 DIRECTIONS pp• � TO JOB SITE /� �..Gnv✓l d- .�. o`rs/ .2�e � Alf 44or A>LL PARCEL LEGAL NUMBE /.2,:) z-B-Sa-OD DESCR. 441 = y_y , yi •,.t NAME MAILADDRESS IlY&S TE ZIP PHONE deCSENO. CONTRACTOR .r>yg 3 .�y91Y 3 USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK r WORK DESCRIBE AREA: NUMBER OF: PLEASE INDICATE: NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR RESIDENC67fIJSgFt STORIES.2 �'� SHORELINE)( CONDITIONING. BASEMENTE17 Ft BEDROOMS 3 PRIMARY RES.❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT DECKS Ft BATHROOMS SEASONAL RES. COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR �I -Z ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. CARPORT SgFt FIREPLACE_ IS CARPORT/GARAGE GARAGE 'J^SgFt ATTACHEDX DETACHED a OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENTS FOR WHICH THIS PER ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN IN CONFORMANCE,THEREWITH. V6 CHA GES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING APPR AL FROM THE ILDING PARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. X OA DATE S-1 T 9 I X BY DATE FOR OFFICE USE ONLY APPROVED APPROVED ✓ DEPARTMENT YES No DEPARTMENT YES No BUILDING VALUATION HEALTH PUBLIC WORKS FEE PLANNING FIRE MARSHAL BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE APPLICATION ACCE PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION I. L J 7 BY CASH CK MO BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 426-5593 DATE ISSUED I: �z --,4/ OY -- PERMIT NO. OWNER A RESSv CITY&ST ZIPor HONE DIRECTIONS 70��Yo TO JOB SITE PA eEL' LEGAL N U M B E R DESCR. . NAME MAIL ADDRESS CITY&STATE LICEN O. ZIP PHONE CONTRACTOR USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE WORK BED OOMS y DECKS CARPORT NOTICE - SEPARATE PERMITS ARE REQUIRED FOR UMBING, E ING, VENTILATING OR AIR BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING. NO.OF STORIES BASEMENT ATTACHED 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 TOTAL SO.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. X OWNER DATE X BY DATE FOR OFFICE USE ONLY DEPARTMENT YES SPPRovENo DEPARTMENT YES No BUILDING VALUATION HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CH SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION ---------------- - r- - t' SHORELINE WOODSTOVE - PLUMBING j MECHANICAL STATE BUILDING FEE STATE SURCHARGE 17! ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION TOTAL IBY CASH CK MO PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES 426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. T �� OWNER / N ME MAILADDRESS CITY SSTATE ZIP PHONE /, .O. 3 .� �.� 3 DIRECTIONS TO JOB SITE - LEGAL DESCR. CONTRACTOR NAME MAILADDRE CITY SSTATE ICENSENO. ZIP PHONE USE OF BUILDING PLUMBING FIXTURES MECHANICAL FIXTURES NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE OF FIXTURE FEE wRT=%ri *eTS`�'Cj(( r / FORCED-AIR/GRAVITY TYPE FURNACE 6.00 BASINS FLOOR/SUSPENDED FURNACE 6.00 BATH TUBS BOILER/COMPRESSOR 6.00 SHOWERS !, - REPAIR/ALTERATION 6.00 WATER HEATERS _ REFRIGERATION COMPRESSOR SYSTEM 6.00 AUTO.WASHER AIR HANDLING UNITS 7.50 SINKS l' I HEAT-PUMPS 6.00 ® FLOOR DRAINS EACH GAS PIPING SYS.2.00 PER OUTLET Q DRINKING FOUNTAINS VENT.FAN SYS.3.00 PER UNIT -' LAUNDRY TRAYS FIRE SUPPRESSION 5.00 0 CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISHWASHER DISPOSAL O URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL I," TOTAL SPECIAL CONDITIONS: 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 ANY TIME AFTER WORK IS COMMENCED. OWNERS AFFIDAVIT: I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF CONTRACTORS AFFIDAVIT: I CERTIFY THAT I AM A CURRENTLY REGISTERED THE CONTRACT OR REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON CONTRACTOR IN THE STATE OF WASHINGTON AND I AM AWARE OF THE ORDINANCE COUNTY ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL REQUIREMENTS REGULATING THE WORK FOR WHICH THIS PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. X OWNER DATE X BY DATE FOR OFFICE USE ONLY APPLICATION ACCEPTED BY PLANS CHECK BY BUILDING GROUP APPROVED FOR ISSUANCE PERMIT VALIDATION •`' r' � ��' S °`'._ IBY CASH CK MO