HomeMy WebLinkAboutBLD10269 Final Addition - BLD Permit / Conditions - 3/24/1981 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 A/�e
DATE ISSUED
PERMIT NO. A*-P Q
OWNER
NAME MAIL ADDRESS CITY✓k STATE ZIP PHONE
G N 741- t D (r . 37-e
DIRECTIONS PA*-f I►,pO .S R -owf- L1AV3 : .40#0 AAOP& 7"b A4kSk wMy 4WAMD. -LCPT T3 04"4AW,0 LMVAF-
TO JOB SITE I T • r16 kom-a AweLAL 10 SEE ��rr
DESCR. f.A"f' Q-- fj L64L o'er Q�/►to7 t7 F -Ti4�o is S��It�a4wrAcHt9;P7 enl
�/NAMk MAIL 60DRESS CITY 6 STATE LICENSE NO. PHONE
CONTRACTOR V1k Cw' o. 7 s - r 4 O
USE OF
BUILDING
I
Class of work: ❑ NEW ^ ;^bDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
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Describe work: 14 x `.7
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Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CON _,TIONS:
BEDROOMS DECKS CARPORT❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING VONTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLA ,E ❑ DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR .AFFIDAVIT IZED 1S NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED ORASANDONED 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: 1 .am aware of the
ordinance requirements regulating the work for which FOR OFFICE USE ONLY
the permit is issued and all 'work done will`be in
conformance therewith. PERMANENT ❑ SHORELINES❑
SEASONAL ❑ FLOODPLAIN ❑
E.D. NO. S.E.P.A. ❑
B IN.
d Special Approvals IN OUT YES APPROVED NO
Lic. No. 223--0/ y9/A J 2 Date 3'_2 7 � ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DE PT.
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 PLACHECK BY APPROVED FOR ISSUANCE
Owner Date. ex
B
PLAN CHECK VALIDATION CK.. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
MASON COUNTY PI ANNING DEPARTMENT
P.O.BOX 188 Shelton,'WsWngton 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. o�
Owner
2. r'xvrIc wears . G, 7 2 o,%jt! titer 'me., 0 y►'r»ps A" yPrOC V-1`44VIo
Contractor
The owner of this buildingA the undersigned agree to conform to ail applicable laws of Mason County and State of Washington
SI t re of appl bt - Address Application date
7G2P s b is ` Fes. D tJitJ. 3—Z�• P/
LEGAL DESCRIPTION
Location
- /�,L e cry, o�tl�-- t'. �9•� o F o .�' �" �D�,, .
Of
Building
NiO. 'PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS
BATH TUBS
SHOWERS
WATER HEATERS
AUTO.WASHERS Q
SINKS ! O
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
(Show Street Names & Property Lines)
C INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT OQ SKETCH IN S6PTIC TANK 3 DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO.NOT WRITE IN THIS'SPACE — FOR OFFICE USE
Approved by • Permit fee Dote pemR levied Permit number PA"Wpt No.
LUMBERME
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Goehring, James - #10269
3-24-81
Lot 9 Blk 1 Replat of Jacoby's Shoftcrest Addn.
Agate Store out leeds Loop road to Parkway Blvd.
left to Orchard Lane, right on Orchard Lane
Addition
Contractor
Nervik Const. Co.
$14,280
Plumbing Permit
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