HomeMy WebLinkAboutBLD9924 Final Alteration/Addition - BLD Permit / Conditions - 6/29/1982 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS C TY&STATE ZIP PHONE
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DIRECTIOTO JOB SITE E F7 I41 0c U-A)� �Lh f�21l) �.�1 L np�l 0�� (� 1,a,j;t� �.(�N
LEGAL L O b� LaAeLkNd V Ski t a- Ma.4, ��-G faded LJO 1. Q OgSEE ATTACHED SHEET)
DESCR. J f�a 9E 89 I'11a sa N �.
NAME MAIL ADDRESS CITY 8 STATE �� LICENSE NO.-k 3.2'Rb S PHONE
CONTRACTOR 'b' '1 S (.'hVj V0 NOL"O bEWALC a(S--?�30
USE OF T
BUILDING1 I
fe�S L £N c
Class of work: ❑ NEW ❑ ADDITION )d ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: F r' N Q 1C c,
v r7 4 F-Pv -1 ` aA, /2-_-4 (2,c modEl at Pp_e_4-f U
49
Valuation of rk: $ eq PLAN CHECK FEE PERMIT FEE o
7.3(01 a
SPECIAL CONDITIONS:
BEDROOMS- `DECKS CARPORT ❑ NOTICE
BATHROOMS (TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ 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 FOR A PERIOD OF 180 DAYS AT ANY TIME 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
ormance therewith. PERMANENT ❑ SHORELINES ❑
s, SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
By �/� ' /;, y� Special Approvals IN OUT YES APPROVED NO
Lic. No.�F N/�ii-�- �o�Q'//t�ate '�'v , J 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
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS HECK BY APPROVED OR ISSUANCE
Owner Date. BY
PLV CHECK VALIDATION CK.. M.O. CASH PERMIT VALIDATION 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.
1.
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
BASINS
BATH TUBS
SHOWERS
WATER HEATERS
AUTO.WASHERS �y a
/ SINKS
FLOOR MAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Serer
DISH WASHER
DISPOSAL G D
URINAL
(Show Street Names & Property Lines)
IIiDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT j typ SKETCH IN SEPTIC TANK it DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved by -- Permit fee Deft pl mit issued Permit number Receipt No.
S
LePere, Donald R. #"24
275-3629 6/29/8Z
Lot 16, Lakeland Village No. 6
E 141 Country Club Drive, Lakeland Village.
Addition/Alteration Contractor:
DeWalt Construction
i
$36,280.00 Wood Stove Permit
Plumbing Permit
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