Loading...
HomeMy WebLinkAboutBLD1951 Final SFR - BLD Permit / Conditions - 6/10/1975 BUILDING. P APPLICATION MASON COUNTY P. O. Box 400 Shelton, Washinqton 98584 DATE —40 PERMIT NO.�S� Applicant to complete numbered spaces only. « JOB ADDRESS LEGAL 1 (ZSEE A ACHED SHEET) DESCR. /� /1 P/�'-c .1` n 7` lot o v b-i o f /' 3 Gc 2`L. aJ OWNER MAIL ADDRESS ZIP ` PHONE 2- �- O l 7f oVI-Ir CO RACTOR MAIL ADDRESS - PHONE LICENSE NO. e c .(Jl .fjdV �� 7�— o/ es�GZ3- 01-/7P'8' ARC ITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. 4 ENGINEER MAIL ADDRESS - PHONE LICENSE NO. 5 LENDER MAIL ADDRESS BRANCH 8 � / CC rl C� ��L USE BUILDING i 8 Class of work: _ONEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑MOVE ❑REMOVE 9 Describe work: 10 Change of use from Change of use to 11 Valuation of work:$ p(� PLAN CHECK FEE ot,)1`, ?r PERMIT FEE SPECIAL CONDITIONS: Type of .Occupancy Const. Group T Division Size of Bldg•.Zf/XSG No.of Max. (Total)Sq.Ft. Stories ! Occ.Load Fire Use Fire Sprinkler APPLICATION ACCEPTED BY: I PLANS CHECKEO BY:. APPROVED FOR.ISSUA E BY: Zone zone Required ❑Yes ON. No.of OFFSTREET PARKING SPACES: oiling Units Covered I Uncovered N 0 T I C E .80ocial Approvals Required Received Not Required ZONING. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. HEALTH DEPT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION FIRE DEPT. AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC- &rHER (specify) TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be, complied with whether specified herein or not. The granting of a Permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) (DATE) PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH eNELTON PRINTING CO. PLOT PLAN ADDR SS i✓ r✓ PERMIT NO. S = s R s LEGAL ' g QESCIJIPTION LOT e2 BL-If "a a SITE AREA D0 0 Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq.Ft. INSTRUCTIONS TO APPLICANT THIS FORM,N D NOT BE USED WHEN PLOT PLANS BRAWN TO SCALE OF NOT LESS THAN 1"-20' ARE FILED"WITH Pt?MIT APPLICATION.::(EACH BUILDING SITE MUST HAVE A'SEPARATE PLOT PLAN.) FOR NEW BUILDIN PROVIDE THE FOLLOWING.INFORMATION IN THE SPACE BELOW: LOCATION OF PROPOSED CONS7`R ION 'NpT IIXISTING,IMPROVE.MENTS.SHOW BUILDING,SITE,MODSE'T CK DiMEN- SIONS.SHCO lA T8,i�{NISN ONTOURI9 OR DRAINAGE; FIRST FLOOR'ELEVATION, STR ET ELEVA- TION A'"d SE114 SE111VICE ELEVATION. SR& LOCATION OF WATER, SEWER, GAS AND. ELECTRICAL SERVICE LINE&SiHd1111I_OCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR- TION THEREOF. INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5`X 5' OR 1"-20' di Sales t 'pp a R /We certify that the°proposed canstruM{on will conform to the dimensions and uses shown and that no changes will be made without Wet obtaining approval. 7 0t N ME ) OF-OWNER(S) OF SITE R ST"CTURE(S) (PRINT) IG AT' F OWNER(S) ORAUTHORIZKQ.RWPRKSENTATI,VK DO NOT WRITE BELOW THIS L NE APPROVED DISTRICT AS NOTED - /� DATE (p /.0 7 f BNGLTON PRIN TINS • MASON COUNTY PLANNING DEPARTMENT P.0.Box 400 Shelton,Washington 98584 PLUMBING PERMIT APPLICATION IMPORTANT-Complete ALL items.Mark boxes where applicables I, LROAI.080CPt1110TION Location o s Of NS NS Building E W side of , ./feet E W.from intersection of /' ..Sect. .? Z- Twp. N Range . N GAS Ej PLUMBING NO. PLUMBING FIXTURES FEE NO. GAS APPLIANCES FEE 1.50 EACH UNDER 60 MBTU SEWER SEPTIC TANK WATER CLOSETS r BASINS J d EACH 60 TO 120 MBTU I /of O BATH TUBS EACH 120 TO 200 MBTU_ A7 _ 1 SHOWERS EACH 200 TO 500 MBTU_ `S�t�elf WATER HEATERS EACH OVER 500 MBTU rn AUTO. WASHERSW—jC SINKS FLOOR DRAINS DRINKING FOUNTAINS LAUNDRY TRAYS Connect to City Sewer SERVICE CONNECTION DISH WASHER DISPOSAL URINAL Distribution System By Special Permit (Show Street Names & Property Lines) • INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR GAS AND WATER. SKETCH.IN SEPTIC TANK& DRAIN FIELD LOCATION OR SUBMIT ON OTHER SKETCH. PERMIT 0�©0 PERMIT FIELD INSPECTION Date By Remarks Name Mailing address—Number, street, city,and State Zip code Tel. No. i, .G 14 f `/ f / Owner 2. It Contractor The owner of this building and the undersigned agree to conform to all applicable laws of.Mason County A ress J Application date Si nature f,applicant DO NOT WRITE IN THIS SPACE.— FOR OFFICE USE s Permit fee Date permit issued Permit number Receipt No. Approved by Tyee Well Drilling Cols, Inc. 11951 6-10-75 G.L. #3, 32-22-1 (Tract 2 Short Plat #100) 1 I Residence $17,000.00 011V '{{i 1 i � � � � i ` I � � ; ��I ; � �', � � : �� � '' �,