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HomeMy WebLinkAboutBLD29861 SFR - BLD Application - 1/23/1992 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED �71 PERMIT NO NAME MAILADDRESS CITY&STATE ZIP PHONE OWNER 14R L fiMiAlzion a u6timE 5.E 6 6 l�f. w�DIRECTIONS yZ6-776 TO JOB SITE / 54 PARCEL LEGAL , � 0n NUMBER ��`�b3 ySI CIOD7b DESCR. ?�, n/� ofhl S.-b./ fw. see. h�'3nm NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR T 3 Hawes. 5.6 6,6 ,,, . 1 Sleld Tle/ t� (3�. 6G-4�1'�b USE OF BUILDING CLASS OF NEW r �_ ADDITION AL R IR MOVE REMOVE WORK DESCRIBE WORK O T BEDROOMS 3 - DECKS $' CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS aJ__Z TOTAL SQ.FT. GARAGE CONDITIONING. NO.OF STORIES 3 BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT ..��,,,,8 COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SQ.FT.a0 - FIREPLACE � DETACHED ABANDONEDFORA PERIODOF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED. PERMANENT_�W- 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. XOWNER DATE XBY DATE FOR OFFICE U st bNLY E DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION YES NO YS NO HEALTH 14 PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP - PRE-INSPECTION SHORELINE / WOODSTOVE V PLUMBING MECHANICAL STATE BUILDING FEE STATESURCHARGE P CATION ACCEPTED BY PLA H BY APPROVE FOR IS�SU N PERMIT VALIDATION TOTAL - _ 4 X` CASH CK MO I PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. o NAME MAIL ADDRESS CITY&STATE ZIP PHONE OWNER 12 G r- (» 0 ,C7 66 4 7766. DIRECTIONS �!1 ! (n, JH'' / TO JOB SITE 46 t" LEGAL LL _ A-SL5 n D SCR. �or, 1'1 Yz o� /1�z 44 S•g& ©f Sb 1 L/ ;j GSM Co. CONTRACTOR NAME MAILADDRESS CITY&STATE L LICENSE NO. ZIP PHONE ref i3 f 5. S� , 6 46 � s/?`?Q►I_ r �$ Bw QB 866- USE OF BUILDING �S• PLUMBING FIXTURES MECHANICAL FIXTURES NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE OF FIXTURE FEE WATER CLOSETS FORCED-AIR/GRAVITY TYPE FURNACE 6.00 3 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 HEAT-PUMPS 6.00 FLOOR DRAINS EACH GAS PIPING SYS.2.00 PER OUTLET DRINKING FOUNTAINS V NT.FAN SYS.3.00 PER UNIT LAUNDRYTRAYS WOODSTOVES7g11e'.Srame_ 5.00 CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISHWASHER DISPOSAL URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL 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 DONEbL B�GA CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. WITHOUT FITPPROVAL FROM THE BUILDING DEPARTMENT. X OWNER DATE X BY DATE `4�-r FOR OFFICE U E ON L APPLICATION ACCEPTED BY PLA CHE BY BUILDING GROUP APPRO F ZR�SUA VALIDATION BY WERMIT ASH CK MO