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HomeMy WebLinkAboutBLD26471 Cancelled SFR - BLD Permit / Conditions - 7/22/1990 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 —/� C 427-9670 DATE ISSUED C PERMIT NO. 4Z'7� OWNER NAME MAIL AD RESS CITY&STATE ZIP PHONE DIRECTIONS TO JOB SITE /��� !Q S�aR 06 . P 4/1 R SO/►� �� r T tj P Nil 2 R1 4'S �0 PARCEL LEGAL NUMBER DESCR. L Q ��1 �./T �� �L`� Ll NAME MA CONTRACTOR IL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE USE OF � �y BUILDING J{u /� �\�(� `( CLASS OF NEW lei' ADDITION ALTERATION REPAIR MOVE WORK ✓ REMOVE DESCRIBE � ^ WORK �'c� - I'-/C ✓1t 10 b BEDROOMS _ DECKS R N CARPORT TOTAL NOTICE TOTAL SQ.FT. BATHROOMS_ DECK GARAGE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR TOTAL SQ.FT. TOTAL SO.FT. CONDITIONING. NO.OF STORIES BASEMENT Y OR N THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT LIVING AREA BASEMENT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SO.FT. TOTAL SQ.FT. CHECK ONE ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT - FIREPLACE ATTACHED SEASONAL SHORELINE DETACHED OWNER AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIF THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTR ION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIRE ENTS 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 CON RMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAI G APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. X OWNER TE 2_'Z �� X BY DATE FOR OFFICE USE ONLY DEPARTMENT YES SPPROVE NO DEPARTMENT YES No BUILDING VALUATION HEALTH PUBLIC WORKS FEE PLANNING V FIRE BUILDING PERMIT 6 O D.O.T. BUILDING PLAN CHECK 0 0 SPECIAL CONDITIONS BUILDING GROUP �713 PRE-INSPECTION SHORELINE WOODSTOVE j PLUMBING 0"d L L- C-0 MECHANICAL ©o STATE BUILDING FEE J!'� STATE SURCHARGE , APPLICATION ACCEPTED BY PLANS CHECK BY PRO SSUANCE PERMIT VALIDATION 'p`�cn BY CASH CK MO TOTAL PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 �7' _(,"'� 427-9670 DATE ISSUED '�✓' C PERMIT NO. OWNER AME MAILADDRESS CITYaSTA ZIP PH NE DIRECTIONS TO JOB SITE 7 y v 5 HoR C� 7-0 1 - I \ s 0/V L LEGAL �v e DESCR. CONTRACTOR NAAMME/-r MAILADDRESS CITY BSTATE LICENSE NO. ZIP PHONE USE OF BUILDING PLUMBING FIXTURES MECHANICAL FIXTURES NO. 1 2.00 PER FIXTURE OR TRAP FEE NO. TYPE OF FIXTURE FEE WATER CLOSETS FORCED-AIR/GRAVITY TYPE FURNACE 6.00 BASINS ?�y a FLOOR/SUSPENDED FURNACE 6.00 BATHTUBS BOILER/COMPRESSOR 6.00 SHOWERS REPAIR/ALTERATION 6.00 WATER HEATERS 4� REFRIGERATION COMPRESSOR SYSTEM 6.00 AUTO.WASHER d-� AIR HANDLING UNITS 7.50 SINKS � .0 HEAT•PUMPS 6.00 FLOOR DRAINS EACH GAS PIPING SYS.2.00 PER OUTLET DRINKING FOUNTAINS Z VENT.FAN SYS.3.00 PER UNIT LAUNDRY TRAYS WOOD STOVES 5.00 CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISHWASHER DISPOSAL 4111D - -o U URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL - vd TOTAL SPECIAL CONDITIONS: NOTICE: 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 ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. OWNERS AFFIDAVIT: I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF CONTRACTORS AFFIDAVIT: I CERTIFY THAT I AM A CURRENTLY REGISTERED THE CONTRACT OR REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON CONTRACTOR IN THE STATE OF WASHINGTON AND I AM AWARE OF THE ORDINANCE COUNTY ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL REQUIREMENTS REGULATING THE WORK FOR WHICH THIS PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN CONFORMANCE THER ITH. NO CHANGES SHALL BE MADE WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST STAINING APPROVAZFR M TH BUILDING DEPARTMENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. XOWNER DATE 7 2 Q XBY DATE FOR OFFICE USE ONLY APPLICATION ACCEPTED BY PLANS BY BUILDING GROUP APP O SUANCE PERMIT VALIDATION �Z -tV BY CASH K MO PLOT PLAN ADDRESS G? PERMIT NO o s o LEGAL DESCRIPTION LOT , BLK ADDITION SITE AREA S� ' 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 V 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. SH'iW 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. J) INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' ` A r r\ zr I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no change:will be made without first obtaining approval. PNAME(S) OF O NER(S) OF SITE S STRUCT RVIII (PRINT) SIGNATURE F OWNER(S) OR AUT IZEDREPRESENTATIVE DO NOT WRITE BELOW TH/S LINE APPROVED DISTRICT AS NOTED DATE milli Shorelines: Plumbing: Setback: Mechanics Special Interior: Conditions: FINAL: Mobile Smoke Detector: Remarks: 0o ing: Setback: Foundation Walls: Framing: Fireplace: PERM!I NULL Wood Stove: 1 TJCJN BY TYPE RESIDENCE Permit No. 26471 No. Floors Sq Ftg Ron Owner BRUMBAUGH, ROY Tel 427-01Q6 Date 9_10_90 Address PQ BOX 824,joodsoort Zip Contractor self Address zip Legal Description L.,Xncb_Cove di v 3 lot 79 Direction to project site Nnrth Shnra Rr1 to I Arcnn I k Pd Up hill hlks to RArhara Rlvrl turn 11 hlnrk nn rnrnor Plumbing XX— c anica weer Wood Stove _ Fireplace Deck Garage --:-sport Basement —Loft 444—Other I