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HomeMy WebLinkAboutBLD N/A - BLD Application - 7/25/1987 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 426-5593 DATE ISSUED Uk wv PERMIT NO. OWNERv AME M LADDRESS CITY&STATE ZIP PHONE DIRECTIONS TO JOB SITE .-- �j go I - — a 19 P / . j ► 1 U B 40 DSCR L 766 — CON RACTOR Dlk ME MAILA ESS ITY&STATE LICENSE NO. ZIP PHONE CvC1 C) d )L - J USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE /� 74 L22c—�`-1 WORK • qye ? k 7 i � / ice' ?i cl rr� BEDROOMS DECKS jV 0 CARPORT NOTICE NO PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTALSQ.FT. GARAGE CONDITIONING. NO.OF STORIES BASEMENT ATTACHED No 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 TOTAL SQ.FT. FIREPLACE TACHED� ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL Ze- OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. XOWN L Z", DATE XBY DATE FOR OFFICE USE ONLY DEPARTMENT YESPPROVENo DEPARTMENT YESPPROVENo BUILDING VALUATION HEALTH PUBLIC WORKS FEE PLANNING , FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING O MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTED BY PLA APP D F S CE PERMIT VALIDATION TOTAL t/✓/ iJ� CASH CK MO GOR- 7W" CrIAIr 4PSESSOR T H E "": A S 0 1" C O �! I T Y :^ S S E .S S 0 R PnJnLAS .Jn%,ES "IEF nFn: UTY PLEASE SUPPLY THE P9LL0"'IC,O F'FO�:""Jjnp REG AP.D I sr v01171 "071 LE HO."E: �rr Owners Name: �� tAj Tel e # 6 Mailing Address 69 Previous Mobile Horne Owners Name � Address ' 6-4 Description of Mobile Horne: (Inforretion is on your registration certificate) 1Sake,&au't'��'Yaa-j - Size '70 Year_!qg C� Serial # /� (> Year Purchased�Price (Less furniture & sales tax) $ 16 If locating in Mobile Home Park: Naale of Park: Space # If N101 in Mobile Home Park: Do you own the land on which the home is placed? Yes mo ` Real Property description /� (1-L Owner of Land if you are NOT the Owner: Brief direction to location: Date Mobile Home Entered V-ason County: Date you anticipate roving Mobile Horne to another location: If moved from a Mobile Nome Park�ciJve: Nape of Park: 6t.y Space # Your horse will be placed on the rolls of fiason County. We would appreciate a prompt reply. Please feel free to contact this office if you have any questions at all . Very truly yours, Helen Claser Personal Property Department: (� �� '9 Owners Si nnature 1ZDate--- PLOT PLAN ADDRESS PERMIT NO. o s o 0 s LEGAL " DESCRIPTION LOT BLK ADDITION SITE AREA Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq.Ft. INSTRUCTIONS TO APPLICANT THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"-20' ARE FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.) FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN- SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA- TION AND SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR- TION THEREOF. 0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' IM Lr © � 1 I/We certify that the proposed construction will conform to the dimerai and uses shown above and that no changes will be made without first obtaining approval. NAME(a) OF OWNERM OF SITE-6 STRUCTURE(') (PRINT) SIGNATURE OF OWNER(') OR AUTHORIZED R P ES NTATIV DO NOT WRITE BELOW THIS LINE APPROVED DATE DISTRICT AS NOTED MASON COUNTY 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. 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 f plicant Address Appligation datp ' �)IfIA✓,f>' 74 �/. &GALDE66RIPTION Location Of Building NO.. PLUMBING FIXTURES FEE WATER CLOSETS C �? = BASINS C CA BATH TUBS SHOWERS WATER HEATERS S2. 1 .j- — C? AUTO.WASHERS SINKS FLOOR DRAINS r DRINKING FOUNTAINS 4— w� LAUNDRY TRAYS Connect to City Sewer DISH WASHER I DISPOSAL 2 p�� URINAL (Show Street Names & Property Lines) INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER. PERMIT CJ SKETCH IN SEPTIC TANK 6 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 IN $ �y c 6 CHRISTMASTOWN PRINTING MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT OF GENERAL SERVICES P. O.'BOX 186 SHELTON, WASHINGTON 98584 PHONE 206 — 426-5593 DATE ISSUED PERMIT NO. -EGA E C.01TWN��;VNO., RANGE __�_ WEST, W.M. PLAT DIV._ LOT OWNER C ADDRESS CP llis� (c� CONTRACTOR ADDRESS DIRECTIONS TO SITE: THE OWNER OF THIS BUILDING AND THE UNDERSIGNED GR�E TO NF /fi0 ALL APPLICABLE LAWS OF MASON COUNTY AND THE STATE OF WASHINGTON. SIGNATURE OF APPLICANT RE NO BASIC FEE 10.00 1 Forced-air or gravity-type furnace or burner, including ducts and vents attached to such appliance up to and including 100,000 Btu/h 6.00 I/la Appliance over 100,000 Btu/h includingducts and vents attached 7.50 2 Floor furnace, including vent 6. 0 3 Suspended heater, recessed wall heater or floor-mounted unit heater 6.00 4 Appliance vent installed and not included in an appliance permit 3.00 5 Repair or alteration of, or addition to each heating appliance, refrigeration unit, cooling unit, absorption unit, or each heating, cooling, absorption, or evaporation cooling system, including installation of controls regulated by this code 6.00 6 Boiler or compressor to and including three horsepower , or each absorption system to and including 100,000 Btu/h 6.00 6a Over three horsepower to and including 15 horsepower , or each absorption system over 100,000 Btu/h and including 500,000 Btu/h 11.00 6b Over 15 horsepower to and including 30 horsepower , or each absorption system over 500,000 Btu/h to and including 1,000,000 Btu/h 15.00 6c Over 30 horsepower to and including 50 horsepower , or for each absorption system over 1,000,000 Btu/h to and including 1,750,000 Btu/h 22.50 6d Boiler or refrigeration compressor over 50 horsepower, or each absorption system over 1,750,000 Btu/h 37.50 7 Air-handling unit to and including 10,000 cubic feet per minute, including ducts attached thereto 4.50 7a Air-handling unit over 10,000 cfm 7.50 8 Evaporative cooler other than portable type 4.50 9 Ventilation fan connected to a single duct 3.00 10 Ventilation system which is not a portion of any heating or air-conditioning system authorized by a permit 4.50 11 Hood which is served by mechanical exhaust, including the ducts for such hood 4.50 12 Domestic-type incinerator 7.50 13 Commercial or industrial-type incinerator 30,00 14 For each appliance or piece of equipment regulated by this code but not classed in other appliance categories, or for which no other fee is listed in this code 4.50 15 For each gas-piping system of one to four outlets 2.00 15a For each gas-piping system of more than four outlets per outlet .50 TOTAL SPECIAL CONDITIONS : APPROVED BY DATE PEMIT VALIDATION CK. MO. CASH