HomeMy WebLinkAboutBLD4038 Final SFR - BLD Permit / Conditions - 12/15/1977 R
411
MASON COUNTY
P.O. Box 186 Shelton, Washington 9M4
DATE ISSUED /� !li
PERMIT NO. 43�
OWN& N MAIL ADDRESS w CITY A ST 23P PH
1 AME
F=&Xk %- V- ar1WA)
DIRECTIONS I }
TO JOB SITE O 0 O / W
LEGAL SEE ATTACHED SHEET)
DESCR. —
NAME MAIL ADDRESS CITY S STATE LICENSE NO. PHONE
CONTRACTO Aiiilm 43 M
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: tjLAN CHECK FEE_S PERMIT FEE
SPECIAL CONDITIONS:
TI 8 PLAN CHECK BY APPROVED FORrISSUANCE Type of Occupancy DIVISIOX
AW gYn Cont. GroupAMY IL,
T
Size of Bldg. No. of l Max.
(Total)Sq. Ft./, D Stories Ooc. Load !d
CONTRACTOR AFFIDAVIT
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
conform nce therewith. ZONING
HEALTH DEPT. d
i PUBLIC WORKS
,' ROAD DEPT.
No. Date /S-76
r
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.
hich this permit is Issued and that all work done will
In conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
i' 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
Date. WORK IS COMMENCED.
K VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O.' CASH
1s
--------------------
MASON COUNTY PLANNING 'DEPARTMENT
P.O. BOX 188 Shelton,Washington 98584
PLUMBING PERMIT APPLICATION C ,
IMPORTANT — Complete ALL items. Mark boxes where applicable.
Name
MaI11ngeddross—Number,street,city,and State
1• _ Zip code Tat.No^
Owner
2.
Contractor
The owner of this building and the underolgned
agree to conform to alb pliCable Taws of Signature of aPPli t Mason County and State of Washington
gn
Address
AppligtIon date
LEGAL' SCR TION
Location w, I
Of _
Building
NO.
PLUMBING FIXTURES
WATER CLOSETS FEE
BASINS 0-d
BATH TUBS 0 O
SHOWERS M
WATER HEATERS
AUTO.WASHERS •C1-0
SINKS �.
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
I
DISPOSAL
URINAL
i
j
PERMIT (Show Street Names & Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
CO SKETCH IN SEPTIC TANK& DRAIN FIELD LOCATION on SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE FOR OFFICE USE
iroved by
Permit f�— Data pemit Issued Permit number
[` Receipt No.
ng, R. N.
038
11-22-76
N E# N E# 31-22-1 f
On Hlll West Of Allyn Contracto
Armstrong Homes
Residence
Pl— in-= pelt iaaue4
$22,400.00
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