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BLD Permit / Conditions - 8/9/1989
BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES • P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO NAME /l /GLJ'JG/ MAILADDRESS CITY&STATE ZIP PHONE OWNER ,CLQ2 S T "T d • 91,960 DIRECTIONS TO JOB SITE J-9 E o c PARCEL _ LEGAL N U M B E R f - Z DESCR. AIA NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR ,E t4 ( Zvi Ci8 '( USE OF BUILDING Rmtt)EA e CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE WORK #j Qco c S v C'E�� '� S To BEDROOMS DECKS CARPORT ' NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS_ TOTAL T. GARAGE 3 > CONDITIONING. NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT �-�� COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SO.FT.(,]_Lz- FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT �_ SHORELINE SEASONAL OWNER AFFIDAVIT CONTRACTORS AFFIDAVIT 1 CERTIF THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY GISTERED CONTRACTOR IN THE STATE OF REGISTR TION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF E RDINANCE REQUIREMENTS REGULATING THE REQUIR ENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE ERMI P IS I UED AND ALL WORK DONE WILL BE IN H.IT S IN CO ORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCETHEREW APPROVAL FROM THE BUILDING D PART ENTHALL BE MADE WITHOUT FIRST OBTAINING OBTAI NG APPROVAL FROM THE BUILDING DEPARTMENT. X NER DATE I X DATE FOR OFFICE USE ONLY APPROVED DEPARTMENT APPROVED BUILDING VALUATION o DEPARTMENT YES No YES No HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING wk PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP 3 PRE-INSPECTION IAIK SHORELINE WOODSTOVE PLUMBING , y, O MECHANICAL 3� X S-/ STATE BUILDING FEE STATE SURCHARGE , APPLICATION ACCEPTED BY IP N CHECK BY APPROVED FOR IS_5 UAt4CE�p PERMIT VALIDATION TOTAL QA-71 � BY V ` 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 44 Ad �ILADDRESS TY&STATE © I PHONE OWNER DIRECTIONS JL TO JOB SITE Q �: LEGAL DESCR. CONTRACTOR N�/ E AILAQDRESS CITY&STATE ll NSENO� ZIP�� L PHO E�� L GZ • ` ilV�. SV Y BUILD NG 2� `USE OF ItiC e 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 BASINS FLOOR/SUSPENDED FURNACE 6A0 BATH TUBS BOILER/COMPRESSOR 6.00 SHOWERS s 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 VENT.FAN SYS.3.00 PER UNIT or ?� LAUNDRY TRAYS WOOD STOVES 5.00 CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISHWASHER ,2��- 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. 3 OWNERS AFFIDAVIT: I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF CONTRACTORS AFFIDAV I ERTIFY THAT I AM A CURRENTLY REGISTERED THE CONTRACT OR REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON CONTRACTOR IN THE STATE WAS NGTON AND I AM AWARE OF THE ORDINANCE COUNTY ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL REQUIREMENTS REGULATING HE WO K FOR WHICH THIS PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WORK DONE WILL BE IN C FOR CE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. WIT IRST OBTAINING AL FROM THE BUILDING DEPARTMENT. X OWNER DATE X C4- DATE 5-(- g�I FOR OFFICE USE ONLY APPLICATION ACCEPTED BY P N CHECK BY BUILDING GROUP APPROVE FOR ISSUANCE PERMIT VALIDATION �� /J'I- BY CASH CK MO Shorelines: Plumbing: � /yam 9 Setback: Mechanics : Special Interior: Conditions: FINAL:Q Mobileryome; '--- Smoke Detector: Rensarks: OOt ing; �L'1idr Setback Foundation Walls: Framing: Fireplace: Wood Stove: TYPE RESIDENCE Permit NO. 24233 No. Floors Sq Owner LELAND Allen Tel Ftg Address 91, Facu tv aDate '—gg' 89 Contractor Tousa kc ZipsEart Address 8429 Delphi Olvm is Legal Description Harstee P rote Div 4 Int p n Direction -- to project site F 4�h_esapeak Drive ing x chanical r Od Love _� Fireplace Deck � Garage U Z arport Basement Loft Other 3 bdrm i i