HomeMy WebLinkAboutBLD15726 Remodel - BLD Permit / Conditions - 6/19/1984 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 —
DATE ISSUED
PERMIT NO. 16
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OWNER NAME MAIL ADDRESS CITY&ST TE ZIP PHONE
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TO JOB SITE �X 1•2_""`tt¢ To $FZFAr2 µAwes 'TUP L15F - 6-0 3//0 Mlt-F_ 1,0T
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LEGAL __ �EE ATTA HED SHEET)
DESCR. �� iI i/ 3 Z3►�' I C�+ �I�o� S
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF �X �,/ \\
BUILDING _ mQC f
Class of work: ❑ NEW >X<ADDITION4- ALTERATION REPAIR ❑ MOVE ❑ REMOVE
Describe work:
M ` n 0.r CL Q and
14
laoNeck tZSoa.
Valuation of work: $ PLAN CHECK FEE PERMIT FEE -5 a
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT I, NOTICE
BATHROOMS J_— ITOTAL SO. FT. GARAGE I 1
� ATTACHED C SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES�_� BASEMENT I OR AIR CONDITIONING.
TOTAL SO. FT.tL_%Q I FIREPLACE : DETACHED Ll
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
I certify that I am a currently registered contractor In WORK IS COMMENCED.
the State of Washington and I the
aware of the F O OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
co ormance therewith. PERMANENT IV' SHORELINES
SEASONAL [] FLOODPLAIN
Firm E.D. NO. S.E.P.A. C
By Special Approvals IN OUT YES APPROVED NO
Lic. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. 0
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
of the Mason County ordinance requirements for BUILDING DEPT. �
which this permit is iss ed and that all work done will ROAD ACCESS
be in c nformance t rewittl. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS NECK BY APPROVED FOR ISSUANCE
Owner Date Olt
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
MASON COUNTY
P.O. BOX 186 Shelton,Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT—Complete ALL items.Mark boxes where applicable. Zip toes Tel.No.
Name Mailing address—Number,street,city,antl State
Owner C I, �j� 9
2.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington poll a n date
Address L
Sign of ant G
LEGAL DESCRIPTION
Location
Ot
Building
PLUMBING FIXTURES FEE
NO. O
WATER CLOSETS
BASINS
p O
BATH TUBS I Mo4ja p—
SHOWERS
? OO
WATER HEATERS
AUTO.WASHERS o
W Cu—
0 o t. �w SHOT 0i
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS 1/�.,!-/•
LAUNDRY TRAYS
Connect to City Sewer I _ rlgx pY
DISH WASHER
BOO
DISPOSAL
URINAL
j 6. Got
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(Show Street Name6 8 Property Lines)
INDICATE LOCATION OF MAIN (SHUTOFF VALVE FOR WATER.
f n O d SKETCH IN SEPTIC TANK 6 DRAIN FIELD LOCATION OR SUBMIT
PERMIT / ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE RecelPt No
-- e pemit Issued Permit number
Date J Permit fee 1
EPPI.
d DY ✓�
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