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HomeMy WebLinkAboutBLD30067 SFR - BLD Permit / Conditions - 3/12/1992 BUILDING PERMIT APPLICATION Jr MASON COUNTY DEPARTMENT of GENERAL SERVICES 426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 / � 427-9670 DATE ISSUED PERMIT NO. Q(V OWNER NAME , MAIL DRESS CITY&STATE ZIP PHONE Cleve 14 DIRECTIONS T DD Z- j�lp TO JOB SITE 5e 1 A I� �r d 0 00 X P RCEL LEGAL '7 NUMBER a0 3 DESCR. C o2 _.TS ES '��-- o(V- (_f NAME MAIL ADDRESS CITY&STATE ZIP PHONE UCEM E NO. CONTRACTOR 5 n j cr. F/�1O /I), 4 Z) S Gc/ USE OF - BUILDING R !ol en !\ CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE WORK e_ AREA: NUMBER OF: PLEASE INDICATE: NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR RESIDENCE aL4_�SgFt STORIES SHORELINE O CONDITIONING. BASEMENT SgFt BEDROOMS ,� PRIMARY RES)( THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT DECKS SgFt BATHROOM�_ SEASONAL RES.O 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. CARPORT-SgFt FIREPLACE IS CARPORT/GARAGE GARAGE 4000 SgFt ATTACHED)kDETACHED D 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 I oZ 'y`q� X BY DATE FOR OFFICE USE ONLY DEPARTMENT YES PPROVENo DEPARTMENT YESAD No BUILDING VALUATION inc,2-�6 lu HEALTH mhn PUBLIC WORKS FEE PLANNING ngFIRE MARSHAL BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDINGGROUP PRE INSPECTION SHORELINE WOODSTOVE 3 PLUMBING Z`j `l MECHANICAL STATE BUILDING FEE ApPLIahON ACCEPTED BY PLANS CHECK BY A 0 F DANCE PERMIT VALIDATION S � !' BY CASH CK MO TOTAL 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. NAME MAILADDRESS CIT ESTATE ZIP PHONE OWNER CLEVt LA / ker DIRECTIONS qZ6_ wl _�i� TO JOB SITE s 11z LEGAL DESCR. C-a L e5 _ /— O NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR qO M USE OF BUILDING PLUMBING FIXTURES MECHANICAL FIXTURES NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE OF FIXTURE FEE WATER CLOSETS 010 FORCED-AIR/GRAVITY TYPE FURNACE 6.00 a BASINS Q FLOOR/SUSPENDED FURNACE 6.00 pC BATHTUBS qj_ojo Q BOILER/COMPRESSOR 6.00 SHOWERS Q REPAIR/ALTERATION 6.00 WATER HEATERS .�� REFRIGERATION COMPRESSOR SYSTEM 6.00 AUTO.WASHER o AIR HANDLING UNITS 7.50 SINKS C , ,. HEAT-PUMPS 6.00 Q FLOOR DRAINS 0EACH GAS PIPING SYS.2.00 PER OUTLET © DRINKING FOUNTAINS VENT.FAN SYS.3.00 PER UNIT Q LAUNDRY TRAYS FIRE SUPPRESSION 5.00 © CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISHWASHER Q DISPOSAL © URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL TOTAL !2 50 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 TAINING APPROV L FROM THE PALDING DEPARTMENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. X OWNER DATE 1,2-4 X BY DATE FOR OFFICE USE ONLY ATION ACCEPTED BY PUN ECK BY BUI G GROUP ( AP OVED OR I S ANCE PERMIT VALIDATION _- aY ICASHA 1 "" .,00 BUILDING PERMIT PLOT PLAN MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. Box 186 SHEL.TON, WASHINGTON 98584 c�)7.99?n PE�M�T VQ. NA&I :.II.;uQ C�3 f b ��i C j1 t� r` 1 OWNED Clc.uelgnc( lid efy' tc) '110 l7ay W P /e& S w a�9 TICNs I a b �s79 I 0 icS SSt PAnCCL � NUMBER -36DOScn tea. o / - a 0I 31 " Ica - 3 W Indicate te!ew: r Prrpe—" am-' d:mens-!-i. O Easements and roads O Septic drainfield and reserve area, or se'Ner. _ O Septic tank and drainfie!d setback distances from foundations. O Location of proposed construction on property. O Building & septic system setback distances from all property lines easements. Indicate North O Well and water Gne. In Circle O Saltwater, lakes, rivers, steams,wetlands,drainage. _ O AI`ach copy of septic system as built"or septic permit-approval. O Indicate topography profile of property and structure on reverse side. I III 'III IIII ill III I I I I I I I I I IIIII I I I I I PIT I I II I I I I I I I I I I I � ( I I I I _ S I I I I I I I I I I I Iot fi I I I I f _ I I I I I I I IIII I I I I I I I I I I I ! 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