HomeMy WebLinkAboutBLD11173 Final SFR - BLD Permit / Conditions - 11/21/1985 MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME. MAIL ADDRESS CITY Q STATE ZIP PHONE
Box 507 !,k M WN a
DIRECTIONS
TO JOB SITE Q I•AIKE YJFWDRY IMF
LEGAL _ // (❑BEE ATTACHED SHEET)
DESCR. :A 0 I A D I V I I• #KE .4 AND �// 4 ✓�
NAME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE
CONTRACTOR le
USE OF
BUILDING /fPs�1�eji(f C-11f.",
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
urn iN6- OWN H 011 A
Valuation of work: $ 30 PLAN CHECK FEE ' PERMIT FEE
SPECIAL CONDITIONS: Are,�
l�.e4o
BEDROOMS DECKS if CARPORT❑ NOTICE
BATHROOMS 2 TOTAL SO. FT.�_ GARAGE P` 376
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES ATTACHED BASEMENT❑ )( OR AIR CONDITIONING.
TOTAL SQ. FT FI GE❑ DETACHED ❑ THIS PEECOMEt;NULLAND VOID IF WORK OR CONSTRtJT10N AUTHOR
/�0 M
0 CONTRACTOR AFFIDAVIT izED i$NOT ENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED ORABANbONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK*COMMENCED.
the State of Washington and I am aware of the C
ordinance requirements regulating the work for which FOR FFIC "` U0 � LY
the permit is issued and all work done will be in
conformance therewith. PERMANENT SHORELINES
SEASONAL FLOODPLAIA❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT.
of the Mason County ordinance requirements for
ich this permit is issued and that all work done will ROAD ACCESS
In conformanc the with MOTOR VEHICLE PERMIT
JIM Q.� . g , PL ION PIED BY CHE Y APPROVED FOR ISSUANCE
�Iw
r Date. V /G/ BY
PLAN CHECK VALIDATION CK, M.O. CASH PERMIT VALIDAT)6N CK. M.O. CASH
PLOT PLAN
ADDRESS AIV D I . PERMIT NO.LEGAL
1s
3;
DESCRIPTION LOT T BLK ADDITION • /
SITE AREA Sq.Ft. AREA OF WE OC)CURIED BY BUILDINGS /Rr� Sq-Ft.
INSTRUCTIONS TO APPLICANT
THIS FORM NEED NOT BE USED WHEN PLOT PLANS.ORAWN TO SCALE OF NOT LESS THAN 1"-20' ARE
FILED WITH PERMIT APPLICATION. (EACH NJIL0jNG'81TE MUST HAVE A SEPARATE PLOT PLAN.)
FOR> W,BUt Nam,PkQVIOE POL.L�C�NNNC){ 11�►FOWATION IN THE,4PACE BELOW: LOCATION OF
PR NdN i►ND,iX &SHOW SUIL01N0.SITE,AND 8E7111ACK.:0IMEW
81 ,f1tN1 INAEE.FIRST FLOOR ELEVATIONl1NQELECTRICALkT G -
TION. D !CE ELM � 5 TION OF WATER. SEWE. . GAS
SERVICE LI LOCATION OI►>►URVEY PINS. IFY THE USE OF EACH BUILDING AND MAJOR POR-
TION`TMEREOF.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE W X W OR 1"=20'
00
i
I Lift Caftify that tM pr"ood corNtruction g11111 ggnfOrM1 t0 tM dHnanatona and 4NS Chown above and that no cMnpu will ba nlada without
first obtainitq approval.
SdHt�ENBF RG- r�
mAmstsl or O SITE l$Tptucvv,y,m (PRINT) owtm"(P OR AUTKORIZKO
D0 NOr.W EveAPPROVW
DISTRICT AS NOTED DATE
•Np.TON MINTING
i
MASON COUNTY_`RLANNING DEPARTMENT
P.O.BOX 186 SheltOn,washingtdn offim
PLUMBING PERMIT APPLICATION
IMPORTANT-Complete ALL Items.Mark boxes where applicable.
Name Mailing address—Number,street,city,and State Zip code Tel.No.
to oa eER6r 'BOX so7 M.WN wN 0504
Owner A� IS�rEN � Q�►
z.
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 applies in Address Application date
LEGAL DESCRIPTION
Location
Of oT SA 1 t-*AKffVrE v PR/YE MKOAAhfb Y144 ,
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS a
BASINS
BATH TUBS _
SHOWERS EVOU
WATER HEATERS
' AUTO.WASHERS
/ SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sower
DISH WASHER
1
DISPOSAL
URINAL
(Show Street Names b Property Lines)
au
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT SKETCH IN SEPTIC TANK 6 DRAIN FIELD LOCATION OR BtlBMiT
ON OTHER SKETCH.
i
DO NOT WRITE IN THIS SPACE FOR OFFICE USE
Approved by -- permit fee bete pamit baled Permit number PAWPt No.
//73
P. A.• Sox 3b7, Allyn
Lot 82, Div. 1,
i
Residence Contractor - Self
i
$44,304.00 Wood Stove Permit
Plumbing Permit
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