HomeMy WebLinkAboutBLD5918 SFR - BLD Application - 3/3/1980 BUILDING`PEUMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 ?
DATE ISSUED J—
PERMIT NO. ir
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
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DIRECTIONS
TO JOB SITE SON 2/ f�iP
LEGAL -� Se (❑ SEE ATTACHED SHEET) ,p
DESCR. Y. 2// o� '`/4 S CM s 2— A s RrC r f,L 6— 'tr *es P4 ff y ra iiv�L
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENS NO. ¢3sHON oe
USE OF
BUILDING
S
Class of work: XNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describes work:
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Valuation of work: $ PLAN CHECK FEE 7 PERMIT FEE/9 ,
SPECIAL CONDITIONS: / �G.•� 7
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. , A PERMANENT ❑ SHORELINES ❑
Firm. ul ccw ze�� SEASONAL ❑ FLOODPLAIN El
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E.D. NO. S.E.P.A. ❑
BY6SA ALA D. i ei-O L i)W Special Approvals IN OUT YES APPROVED NO
Lic. No. IT1,)"C®I --7 1(�� Date Z-Z ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registr tion law RCW 18.27, and am aware
of the Mason C my ordinan requirements for BUILDING DEPT.
which this permit i 'slued and t a all work done will ROAD ACCESS
e in conformance t erewith. MOTOR VEHICLE PERMIT
A LIGATION AC EPTED BY PLAN HECK BY APPROVED FOR ISSUANCE
Owner Date. "' ,o/J� By
PLAbd CHECK VAL ATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
MASON COUNTY PLANNING DEPARTMENT
P.O.BOX 186 Sheiton,'Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT—Complete ALL items.Mark boxes where applicable.
Name Mailing address—Number,street,city,and State Zip code Tel.No.
Owner
z• Ck7 ec,,ys*qci6o�0.T 2 35 r!c7 ,1 Ll6 _Aas�B
Contractor
The owner of this building and the undersigns agree to conform to all applicable laws of Mason County and State of Washington
Signature of nt Address Appli lion da
G!�
EGA DE RI ION t �� y
Location
B AS'G K E uJ
Building
NO.. PLUMBING FIXTURES FEE
WATER CLOSETS 0 d
BASINS •0'�
BATH TUBS
SHOWERS
WATER HEATERS
/ AUTO.WASHERS
® SINKS a-V
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Severer
/ DISH WASHER
DISPOSAL `
URINAL
(Show Street Names & Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT SKETCH IN SEPTIC TANK 3 DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved Permit fee Date pemit issued Permit number RO Npt No.
CV #
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