HomeMy WebLinkAboutBLD2275 Frame and Foundation Only - BLD Application - 5/26/1978 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED
PERMIT NO. 02 a2 7�
OWNER C NAME
c i V1 MAIL ADORES 1424 _ CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITE
LEGAL ` i ► (� (❑SEE ATTACHED SHEET)
DESCR. J►` D� o�o� �. V+� m n of W Q
NAME •� MAIL ADDRESS CITY&STAT LICENSE NO. PHONE
CONTRACTOR
q Po, y�$ -t -c*- ; J7 9y90
USE OF
BUILDING
Class of work: trINEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
F /�t�zs n��TiON
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Type of ✓ Occupancy - Division
BY Const. i / Group 3
Size of Bldg. No. of Max.
CONTRACTOR AFFIDAVIT (Total)Sq. Ft. Stories l Occ. Load
PERMANENT SEASONAL E.D.NUMBER
I Certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
Firm /S a17 �'r HEALTH DEPT.
PUBLIC WORKS
By ROAD DEPT.
Lic. No.�/�'��-C � 2 334/✓ Date `rr/7 7�
L.
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be In C rrnance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
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
Owne Date. WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K M.O. CASH
i
MASON COUNTY PLANNING DEPARTMENT
P.O. BOX 186 Shelton,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
1
2.
Contractor
The owner of this building and the undersigned agree to conform to all a w licable laws of Mason County and State of Washington
Signature of icant Address Application date
w
E, LEGAL DESCRIPTION '
Location ,
Of
Building
f A yt
NO.. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS
cp-
BATH TUBS
SHOWERS _
WATER HEATERS
AUTO.WASHERS
' SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
(Show Street Names & Property Lines)
14-4 INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT SKETCH IN SEPTIC TANK& DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
g DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
pprov d by Permit fe�ej, Dattee�pemit issued Permit number Receipt No.