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HomeMy WebLinkAboutBLD25789 SFR - BLD Application - 5/29/1990 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED _9?2?_p"p�40 PERMIT NO.S= JS /4 NAME MAILADDRESS CITYSSTATE ZIP �,PHONE OWNER v� m to S �y Symms♦ /Jat T�ca1w,�. �►� 416y67 -279-3665? DIRECTIONS TO JOB SITE f Y%rew j m_ I J4 On lorD.Hoh16 /O iS OIL PARCEL —TL—EGAL e �f NUMBER 7-11 '060114 1 ESCR. NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR acv#%nr USE (�+A Cqh ` � BUILDING Cq� �p CLASS OF NEW �� ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE WORK by�1 c� S f' W1c IJ�Gli lId/) 2. badvoo sl BEDROOMS DECKS Y R N CARPORT - NOTICE TOTAL SQ.FT. DECK �/,r� SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTAL SQ.FT. � TOTAL SQ.FT. - CONDITIONING. NO.OF STORIES 1-3 BASEMENT Y OR® THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT LIVING AREA BASEMENT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SQ.FT. 130 TOTAL SQ.FT. CHECK ONE ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT VIIIIIII11MOPM ATTACHED SEASONAL/ SHORELINE AQ— DETACHED OWNE AFFIDAVIT CONTRACTORS AFFIDAVIT I CERT THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGIST ATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUI MENTS 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 C FORMANCE THEREWIT . NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAI ING APPROVAL FR M BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. NFFRk��UctL DATE SV X BY DATE f FOR OFFICE USE ONLY DEPARTMENT YES SPPROVEDJO DEPARTMENT YES NO BUILDING VALUATION 8 SRO HEALTH Q( PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT b/� .S O D.O.T. BUILDING PLAN CHECK , CID SPECIAL CONDITIONS BUILDINGGROUP i33 PRE-INSPECTION SHORELINE #u 0D I d WOODSTOVE PLUMBING " a MECHANICAL O STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTED BY PLANS CH CJ(BY n APPROVED FOR ISSUANCE PERMIT VALIDATION �,� � ,�/// TOTAL BY CASH CK MO PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. NAME MAILADDRESS CITY&STATE p ZIP PHONE N >'v+ OWNER S ly .5sf. -rkL � /� !gG 6 Z 7 -366p DIRECTIONS / TO JOB SITE ry e f ©� /O /S Dn le LEGAL D ESC R. CONTRACTOR NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE awpAr USE OF BUILDING PLUMBING FIXTURES MECHANICAL FIXTURES NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE OF FIXTURE FEE �. WATER CLOSETS AJ,QQ FORCED-AIR/GRAVITY TYPE FURNACE 6.00 Z BASINS ,Q c7 FLOOR/SUSPENDED FURNACE 6.00 BATH TUBS . 00 BOILER/COMPRESSOR 6.00 SHOWERS REPAIR/ALTERATION 6.00 WATER HEATERS Z.Q 0 REFRIGERATION COMPRESSOR SYSTEM 6.00 AUTO.WASHER AIR HANDLING UNITS 7.50 SINKS Z,dCj HEAT-PUMPS 6.00 FLOOR DRAINS EACH GAS PIPING SYS.2.00 PER OUTLET DRINKING FOUNTAINS VENT.FAN SYS.3.00 PER UNIT LAUNDRY TRAYS WOOD STOVES 5.00 CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISHWASHER 00 DISPOSAL URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL 171,60 TOTAL 2Z_00 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 REQUIRE NTS 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 O RMANCE THEREWITH. NO CHANGES SHALL BE MADE WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUTFIl OBTAININ P AL FROM THE BUILDING DEPARTMENT. �j WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. X OWNE DATE >7_ y X BY DATE FOR OFFICE USE ONLY APPLICATION ACCEPTED BY PLANS CH qK BY , BUILDING GROUP APPROVED FOR ISSU NCE PERMIT VALIDATION J BY z"I' CASH CK MO