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Home My WebLink AboutBLD19005 Addition - BLD Permit / Conditions - 7/21/1986 . . E � m O ILI \ ] % IOU k m » rl t ® ® b � f \ ) 0 o w c 7 / � � ƒ � / \ L c � 2\ \ \ / m \� = \ e 9 n \ ' \ D 9 \ « / \ \ D \ \ / � \ 7 / (D | 0 erg g ID � 0 \ % a . \ _ � � k =0 4J • 0 a F-4 Lu .06 ti 4-) r4 ow 13)Id _)4 *H 4-) 004 BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED PERMIT NO. OWNER ,. NAME _ AIL DDRESS - f O"pew ^ CITY BESTATE ZIP 1. ,V � Ll/C. Q PHONE DIRECTIONS TO JOB SITE Hwv loq `/00 li� / n' LEGAL f� !y -/ O� Il,V/0/V r i�i�/�. lt� g��'CJr DESCR. 5&6 A /f &� ^/I _ / (�EE ATTACHED SHEET) Lf, N NAME C/f� ' �'��I II CONTRACTOR MAIL ADDREss —Tr�. [pRA ��fs.�� ;�� &STAY LICENSE NO. PHONE USE O F J/ �31C1�+ A4 jc Se -r0TqEkL tv� g00Z j j-D g fW y 1 B 3 M BUILDING `�� Class of work: ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: I>D 17-1 o tj 7-0 )C5 (<n ENE, i t. iv A P� 22►k 24 � /UF S P—Lj 90 1 TI 4 1OF l�r chi r/G C v Valuation of work: $ LAN�Fi,ECK F LCXXJJ RMIT FEE S SPECIAL CONDITIONS: 3EDROOMS {DECKS 'CAI?i - 3ATHROOMS ._ TOTAL SQ. FT.� GARAGE � NOTICE JO. OF STORIES BASEMENT(1-," TTACHED>< SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OTAL SQ. FT OR AIR CONDITIONING. FIREPLACE G DETACHED C�' CONTRACTOR AFFIDAVIT THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- 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 certify that I am a currently registered Contractor in WORK IS COMMENCED. It he State of Washington and I am aware of the the ordinance permit requirements regulating the work for which FOR OFFICE USE ONLY the permit is issued and all work done will be in conformance therewith. PERMANENT _ 'y— SHORELINES " I -v I u, �j� � ;f 01i SEASONAL Ll FLOODPLAIN �/C {7 E.D. NO. S.E.P.A. 1 \ 2� Special Approvals IN OUT APPROVED Vo. 47J6 0 We jQi3MC' Date � � r� ZONING YES NO PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. I certify that I am exempt from the requirements of the PUBLIC WORKS contract or registration law RCW 18.27, and am aware FIRE MARSHAL of the Mason County ordinance requirements for BUILDING DEPT. which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT Date APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE �� -- _ BY HECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT OF GENERAL SERVICES P. O. BOX 186 SHELTON , WASHINGTON 98584 PHONE 206 - 4 26-5593 DATE ISSUED PEMI T LEGAL ESC_ : C.�� TWN. NO., RANGE WEST, W.M. r' � -�� 'Clr�Q/,CQrr�/ . e6) i5i"f��' PLAT DIV._ LOT- 0 W N E R /' C Z1'-f",e' ADDRESS C0NTRACTO ADDRESS /'�G«✓�GL ��T//�'� DIRECTIONS TO SITE- THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS OF MASON COUNTY AND THE STATE OF WASHINGTON. SIGNATURE OF APPLICANT 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 including100,000 Btu/h 6.00 la Appliance over 100,000 Btu/h including ducts and vents attached 7.50 2 Floor furnace, including vent 6.00 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 e- SPECIAL CONDITIONS APPROVED DATE PEMIT VALIDATION CK. MO. CASH G� PLOT PLAN ADDRESS ��' '-' 1/ "" y /0"/ OU10N I WA gW12 PERMIT NO. � o LEGAL S 1EG AT A&0 t D aft, DESCRIPTION LOT P4rT—OF ELKS 7&+OZ ADDITION - u 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.) S 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 Pm"D 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. INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR''RW Nl 1 L �3j JO/ Nil l i IR .. Of 10, Q `. D Tic Ij I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without first obtaining approval. NAMES) OF OWNER(S) OF SITE Q STRUCTURE(W (PRINT) SIGNATORE OF 0 ) OR AUTHORIZED REP ESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE CHRISTMASTOWN PRINTING