HomeMy WebLinkAboutBLD10833 SFR - BLD Application - 6/19/1981 • BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED 7 Q/
PERMIT NO. l�9 33
OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
a I`4C.%r Ct 40 e U ' r uj Wd'. -2. -n
DIRECTIONS _
TO JOB SITE L -r r 3 t0. v 10 v d , k d 04 1
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
O a
CONTRACTOR NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
USE OF
BUILDING S F, e L
Class of work: >-NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
o? /c2, S'0
VQ3.00
C� .Sa
Valuation of work: $ O '/ PLAN CHECK FEE r PERMIT FEE„��`�.��
SPECIAL CONDITIONS:
BEDROOMS -4' �"� DECKS CARPORT 9 NOTICE
�
BATHROOMS 'L TOTAL SQ. FT. te0 GARAGE ❑
NO. OF STORIES I BASEMENT a(� ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
DQ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS AT ANYTIME 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. PERMANENT SHORELINES K
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT
YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT. g g
OWNERS AFFIDAVIT E TH DEPT. f
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT. / 51' /
of the Mason County ordinance requirements for
lill
ch this permit is issued and that all work done will ROAD ACCESS
b i co ormance therewith. MOTOR VEHICLE PERMIT
PPL ATI A EPTED Y PLANS CHECK BY APPROVED FOR ISSUANCE
OW r e. BY /
AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIO CK. M.O. CASH
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.
t.
Owner
2.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signature of applicant Address Application date
LEGAL DESCRIPTION
Location
Of
Building
NO.. PLUMBING FIXTURES FEE
WATER CLOSETS 001-
BASINS Cr
BATH TUBS
SHOWERS fJp
WATER HEATERS
AUTO.WASHERS 00
SINKS 640
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer Q�
DISH WASHER
DISPOSAL
URINAL
(Show Street Names 8 Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT SKETCH IN SEPTIC TANK A DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved by Permit fee Date pemit issued Permit number Receipt No.
MASON COWITY PLANNING DEPARTMENT
P.O.Box 186 Shelton,Washington 98584
MECHANICAL PERMIT APPLICATION
IMPORTANT-Complete ALL items.Mark boxes where applicable.
1. LEGAL DESCRIPTION `
Location LC? 13
Of N S N S
Building
E W side of feet E W from intersection of
Sect. Twp. Range
NO. DESCRIPTIONS FEE NO. DESCRIPTIONS FEE
1. Forced air or gravity type furnace or burner including ducts ,J On 14. For the installation or relocation of each boiler or refrigeration
and vents, up to .and including 100,000 Btu's-$4.00 compressor over 50 horse power or each absorption system over
1,750,000 Btu's-$25.00
2. Over 100,000 Btu's-$5.00
15. For each air handling unit to and including 10,000 cubic feet
3. Installation or relocation of floor furnace and vent, suspended per minute, including ducts attached thereto-$3.00
heater, or recessed wall heater-44.00 NOTE: This fee shall not apply to an air handling unit which
4. Installation, relocation, or replacement of each appliance vent is a portion of a factory assembled appliance, cooling
installed, not included in appliance permit-$2.00 unit, evaporative cooler or absorption unit for which
a permit is required elsewhere in this Code.
5. Repair, alteration or addition to each heating appliance, re
frigeration unit, cooling unit, absorption unit, or evaporative 16. For.each air handling unit over 10,000 cubic feet per minute
cooling system including installation of controls regulated by -$5.00
this code-P.00
17. For each evaporative cooler other than portable type- $3.00
6. Installation or relocation of each boiler or compressor to and
including 3 horse power-$4.00 18. For each ventilation fan connected to a single duct-$2.00
7. Over 3 horse power to and including 15 horse power-$7.50 19. For each ventilation system which is not a portion of any heating
8. Over 15 horse power to and including 30 horse power--$10.00 or air conditioning system authorized by a permit-$3.00
9. Over 30 horse power to and including 50 horse power-$15.00 20. For the installation of each hood which is served by mechanical
exhaust, including ducts for such hoodA3.00
10. Installation or relocation of each absorption system to and
including 100,000 Btu's--$4.00 21. For the installation or relocation of each domestic type in-
11. Over 100,000 Btu's to and including 500,000 Btu's-$7.50 cinerator-$5.00
12. Over 500,000 Btu's to and including 1,000,000 Btu's Commercial or industrial type incinerators-420.00
-410.00
22. For each appliance or piece of equipment regulated by this
13. Over 1,000,000 Btu's to and including 1,750,000 Btu's Code but not classed in other appliance catagories, or for which
-$15.00 no other fee is listed in this Code-43.00
FIELD INSPECTION Basic Fee $3.00
Date By Remarks TOTAL 7,101)
Name pMailing address - Number, street, city, and State r Zip Gcode Tel. No.
Owner F-4Y u1 e \t _Grc,�a���eW �Q. G ���0 gOrJy{. f
-Tivea e I . Dviv�t
2. SeL4 S�iNt
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of MASON COUNTY
na re of applicant Address Application date
DO NOT WRITE IN THIS SPACE - FOR OFFICE USE
Approvetl by Perm*j fee Date permit issued Permit number Receipt No.