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HomeMy WebLinkAboutBLD28280 SFR/GARAGE - BLD Application - 6/4/1991 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO.- NAME� � �/�MAILAQDRESS_O CITY&STATE/ipV^ h 7 !�C Av ram , Z s2 Z PHONE=a6g DIRECTIONS TO JOB SITE 3 O L aP LL OAIJ LEFT AV >� D/1E DAB vE� ,��oCk dN A'C/ ? PARCEL LEGAL NUMBER �ZZZD -,�Q -Q©Q 7 DESCR. 407 "�Op /t/lS^lD�/ CONTRACTOR NAME MAILADDRESS CITY BSTATE -LICENSE-NO. ZIP PHONE �� _ USE OF BUILDING j b"tvC� CLASS OF WORK NEW v ADDITION ALTERATION REPAIR MOVE REMOVE DESCRIBE WORK u tes6- 6v/ BEDROOMS 3 DECKS CARPORT NOTICE BATHROOMS �' TOTAL SQ.FT. GARAGE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. NO.OF STORIES / BASEMENT�= ATTACHED_ .� THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT TOTAL SQ.FT. 3 S COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE A(!Q 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. p APPROVAL FROM THE BUILDING DEPARTMENT. X OW DATE 7 ' Z 3 r (� X BY _ DATE FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED / YES No YES NO BUILDING VALUATION HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT Z78.—o D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP -?J _ (�� PRE-INSPECTION �l SHORELINE WOODSTOVE 3 J5 PLUMBING MECHANICAL STATE BUILDING FEE cJro STATE SURCHARGE APPLICATION ACCEPTED BY PLANS CHECK BY {tP QQVVED fF R ISSUANCE PERMIT VALIDATION \Y / CASH CK MO TOTAL PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED �W PERMIT NO.—..- NAME MAIL ADDRESS CITY&STATE OWNER - , /z.7ry Po /J Ao J ZIP PHONE DIRECTIONS J�fr'�` /'/ x --��� Al y TO JOB SITE %(- '7*6 I.LC If yAl u,,O lLL oAl 44kF4ANA ®4 L EFT 4,4KC fia Ze-T ,DR/UF 64. a !� /�� �� s rc� tDESCR. > ��f� d LOT 7� %IV�S/ON / ��yA V1q,+6_4ACTOR NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE �7G _ 6J 1,6 6w PLUMBING FIXTURES MECHANICAL FIXTURES NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE OF FIXTURE FEE WATER CLOSETS ` C L: FORCED-AIR/GRAVITY TYPE FURNACE 6.00 Z BASINS G FLOOR/SUSPENDED FURNACE 6.00 Z BATH TUBS BOILER/COMPRESSOR C 6.00 SHOWERS REPAIR/ALTERATION 6.00 WATER HEATERS Z REFRIGERATION COMPRESSOR SYSTEM 6.QQ -- --- - ---- -- -- AUTO.WASHER —Z C)Q AIR HANDLING UNITS 7.50 SINKS v HEAT-PUMPS 6.00 FLOOR DRAINS EACH GAS PIPING SYS.2.00 PER OUTLET DRINKING FOUNTAINS VENT.FAN SYS.3.00 PER UNIT LAUNDRYTRAYS _ WOOD STOVES 5.00 CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISHWASHER DISPOSAL URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL 5.00 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 F THE BUILDING DEPARTMENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT, X OW •ATE l L 3 "9/ X BY — DATE FOR OFFICE USE ONLY APPLICATION ACCEPTED BY PLANS CHECK BY B NG GROUP A D�ISSUANCE PERMIT VALIDATION Lu —q d �l� ' B __ CASH CK MO