HomeMy WebLinkAboutBLD4641 Partial Block Foundation - BLD Permit / Conditions - 5/8/1979 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED .�- �' 7q
PERMIT NO.
OWNER
NAME MAIL ADDORESS CITY 8 STATE ZIP PHONE
.4/.0
DIRECTIONS
TO JOB SITE sv/
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: D
L9
Valuation of work: $ ` h4 PLAN CHECK FEE PERMIT FEE �"f1
SPECIAL CONDITIONS:
BEDROOMS (DECKS CARPORT LJ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT fl OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE LJ DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 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 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 LJ SHORELINES I I
SEASONAL fl FLOODPLAIN F-
Firm E.D. NO. S.E.P.A. F1
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
1 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
pfOrmance there it MOTOR VEHICLE PERMIT f APPLICATION ACCEPTED BYPLANS CHECK BV APPROVED FOR ISSUANCE
Owne ML'' Date
i
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT 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.
2 6 9Y.3/o 3T3 8d
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
Si a f hcant Atltlress Application date /�7
D ///
LEGAL DESCRIPTION
Location il
Of � # —
rt/
Building 46
NO. PLUMBING FIXTURES FEE
WATER CLOSETS a, 0"6
BASINS
BATH TUBS
SHOWERS
WATER HEATERS
AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
(Show Street Names & Property Lines)
i
P�
- INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT SKETCH IN SEPTIC TANK 8 DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved by Permit fee TIII Date pemit issued Permit number Receipt No.
f>.�-ernt��u I�
Ahearn, Robert L. #4641
5-8-79
Haven Lake Lot 70
Partial B_1_o oundation
AiiH3S3ffi%i Plumbing Permit
$800.00