HomeMy WebLinkAboutBLD13925 Addition - BLD Permit / Conditions - 5/4/1983 i
BYILDING PERMIT APPLICATION
M ,SO"N COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED -}7
PERMIT NO. ) :
r
OWNE NANJ�Vee" MAIL ADDRESS CITYBSTATE ZIP PHONE
v f 58 2& $3
DIRECTIONS if
TO J08 WE n„T ncr.k.(aJ �7
LEGX LL g / A (❑ SEE ATTACHED SHEET)
DESCC2. �z-ZO-t �haCT �- OU�.f toAC*" `.Z /}
NAME MA L ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR A leeri
USE OF
BUILDING
Class of work: ❑ NEW tWADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: ,
o KSi` ih tL � / AI
Valuation of work: $ PLAN CHECK FEE PERMIT FFE s O
o yC I . J
SPECIAL CONDITIONS:
BEDROOMS (DECKS CARPORT ElNOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SO. FT. g FIREPLACE ❑ DETACHED ❑
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 ANYTIME AFTER
I Certify that I am a currently registered contractor in WORK IS COMMENCED.
the $foie of Washington and I
the
aware of the FOR OFFICE USE''. ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT ❑ SHORELINES
SEASONAL r7 FLOODPLAIN El
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT. 5 p3 tJ'
DEPT.
OWNERS AFFIDAVIT HEALTH
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 confor ante therewithlil M TOR VEHICLE PERMIT
O LIGATION ACC PTED�BY PLANS ECK BV APPROVED FOR ISSUANCE
Owner DateL_
PLV CHECK VALIDATION CK. M.O. CASH p( RMIT VALIDATION �CK. M.O. CASH
i
r MASON COh1NT* 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
Contractor
ICI 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
I
i
NO. PLUMBING FIXTURES FEE
Z WATER CLOSETS OD
BASINS D O
BATH TUBS
J SHOWERS ®Q
/ WATER HEATERS
AUTO.WASHERS ��Q
/ SINKS *9-p0
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
I DISH WASHER
I !
DISPOSAL I
URINAL '
I
I
2a�
O d
(Show Street Names 8 Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT / O 0, SKETCH IN SEPTIC TANK 6 DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved by Per it fee Date pemit issued Permit number Receipt No.
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Glaser, Joe J. #13925
426-8883 5/4/83
12-20-2, Tract 2 of Govt. Loetl, Tract 2A
Hartstene Island, Ballow Road 7o E 770 Col. Wright Road
driveway at 770. ',Y fw
Addition / Contractor;
288 Sq. Ft. Same
$8,640.00 Plumbing 'Permit
Shoreline Exemption
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Glaser, Joe J. (5114:8
5 (�d� a�_41
426-8383 3 /0-
12-20-2, Tract 2 of Govt. Loetl, Tract 2A
Hartstene Island, Ballow Road o E 770 Col. Wright Road
driveway at 770. i�.�o•!lo- .A7ct .
Addition Contractor;
288 Sq. 'Ft. Same
$8,640.00 Plumbing 'Permit
Shoreline Exemption
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MASON COUNTY
I DEPARTMENT of GENERAL SERVICES
Courthouse Annex I N. fourth & W Cedar
P.O. Box 186 Shelton, Washington 98584
(206) 427.9670
building environmental health maintenance landfill parks&recreation fair/convention center planning sewer&water
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CHECKLIST FOR PROPOSED CONSTRUCTION
i
No yes
C ] E %-J Within 200 feet of deisignated shoreline or wetla
C J C - Proposed construction on/ove:-/in wet'.and
Proposed construction within floocplairn ,
CtY L ] Commercial Development (Parking Standards, Sign
Ordinance, Public Works Review, other applicable
agencies)
i
Mobile Home and/or R. V. Park l
What Type Of Construction is Being Proposed?
C\Y C ] Exempt from building permit application
C ] C ] Exempt from S .E.P.A. process (WAC 197-11-305,
WAC 197-11-800 )
C ] C ] Meet all requirements (Which section (s) of
S.M.P. does proposed construction pertain to?
LA.
C ] C ] Variance or Conditional Use Permit required
C J C ] Exempt from Shoreline Substantial Development
Permit process (WAC 173-14-040 )
C ] C ] Exempt from Substantial Development but within
Army Corp.jurisdaction ( WAC 1.73-14-115 )
Printed S/e9
t DatIe Ini als
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