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HomeMy WebLinkAboutBLD9970 SFR - BLD Application - 10/12/1982 BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED /D PERMIT NO. CITY 8 E /J ZIP PHONE NAME MAI DDRESS /`/J� �j OWNER aw ✓ iy v DIRECTIONS TO JOB SITE (❑ SEE ATTACHED SHEET) LEGAL d�� / L E AL .LJ 7 v PHONE INAME MAIL ADDRESS CITY 8 STATE LICENSE NO. CONTRACTOR � USE OF BUILDING r Class of work: NEW ❑ ADDITION f7 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: PLAN CHECKFEE PERMIT FEE S Valuation of work: $ 00 Alf 0- SPECIAL CONDITIONS: BEDROOMS `DECKS CARPORT ❑ NOTICE BATHROOMS I TOTAL SO. FT. GARAGE ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING BASEMENT ❑ ATTACHED L OR AIR CONDITIONING. 7NO. OF STORIES_ _— DETACHED LAL SO. FTJ FIREPLACE iJ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- CONTRACTOR AFFIDAVIT IZED 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. I certify that I am a currently registered contractor in the State of Washington and I am aware of the F p R OFFICE USE ONLY ordinance requirements regulating the work for which the permit Is issued and all work done will be In PERMANENT [ SHORELINES conformance therewith. SEASONAL FLOODPLAIN n Firm E.D. NO. S.E.P.A. '-: Special—Approvals IN OUT YES APPROVED NO By ZONING Lic. No. Date PLANNING DEPT. HEALTH DEPT. �98 OWNERS AFFIDAVIT 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 th's permit is ' ed and that all work done will ROAD ACCESS big in nformanc ter ith. MOTOR VEHICLE PERMIT � Q APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED R ISSUANCE Owner Date . © 0/�%� PERMIT VALIDATION CK. M.O. CASH P CHECK VALIDATION CK. M.O. CASH MASON COUNTY PLANNING DEPARTMENT 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. 1. 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 of applicant Address Application date LEGAL DESCRIPTION Location Of [Building � NO.. PLUMBING FIXTURES FEE WATER CLOSETS 6 V I BASINS BATH TUBS a+•d SHOWERS ' WATER HEATERS 2•0 d AUTO.WASHERS d SINKS FLOOR DRAINS DRINKING FOUNTAINS -t LAUNDRY TRAYS Connect to City Sewer DISH WASHER DISPOSAL O it URINAL (Show Street Names & Property Lines) INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER. tJ v 7aP SKETCH IN SEPTIC TANK& DRAIN FIELD LOCATION OR SUBMIT PERMIT ``� ON OTHER SKETCH. DO NOT WRITE IN THIS SPACE — FOR OFFICE USE Approved by Permit fee Date pemit issued Permit number Receipt No. ` , i x s �a� �'�` � ��� � ��, � �o�e �� ,� 3 `� � �� � � �_.�. �. �� �`� + r ' F S � p 4 � �f. i ! F � �� � � •{'�, � �, � �� � ``��- .� �., `� ��`, �` �„ -, ,ty j � w }d L` 1 d ` `. �R. S .R,w. ^..,,��� �:... ��t�l „�. �z �� �v.,� r '�r:.. fi. M . � i