HomeMy WebLinkAboutBLD9274 Final Addition - BLD Permit / Conditions - 7/21/1983 • BUILDING PERMIT APPLICATION.
• MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
r 426 5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS 8 STATE ZIP PHONE
CITY
/vim d 7`
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. S4
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
IvIAov
Valuation of work: $�! p u PLAN CHECK FEE PERMIT FEE
to �—
SPECIAL CONDITIONS:
BEDROOMS t DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT 1-1 ATTACHEDAIR CONDITIONING.
TOTAL SQ. FT. 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 FORA PERIOD OF 180 DAYS AT ANYTIME 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 ❑ SHORELINES ❑
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT. L j
OWNERS AFFIDAVIT HEALTH DEPT.
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 conformance therewith. OR VEHICLE PERMIT
P ATION AC P BY PLANS CHECK BY AfqROVED FOR ISSUANCE
Own Date. !J
PLAN CHECK VALIDATION CK.. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
EXEMPTION FROM SHORELINE
MANAGEMENT ACT SUBSTANTIAL
DEVELOPMENT PERMIT REQUIREMENT
T0: /7
(name and address of the applicant
The proposal by G t7</C �4�fI C1 �l� to undertake
( (name of applicant
i
the following deve l o ment ( 6 �9 0. rdo bewz
(be spec fic) T ,�/
upon the foiowing property SE YH krf, I �/�/ l�I/
( legal description; l .e., section to the
nearest quarter section)
within r` V and/or its associated
name of wafter area)
wetlands is exempt from the requirement of a substanttial development
permit because the development
/7 3 l Y - 67Yy ( 31
(identify exemptions as outlined in WAC 173-14-040)
(Corps Public Notice Number if available)
The proposed development is consistent or inconsistent with:
CHECK ONE
CONSISTENT INCONSISTENT
/ Policies of the Shoreline Management
E/ Act.
The guidelines of the Department of
Ecology where no master program has
been finally approved or adopted by
the department.
The master program.
P
afie (Signs re of Auth r zed Local Govern-
ment Official )
MASON COUNTY PLANNING DEPARTMENT
P.O. BOX 186 Shelton,Washington 98584
PLUMBING PERMIT APPLICATION
" IMPORTANT—Complete ALL items. Mark boxes where applicable.
Name o Mailing address—Number,street,city,and State Zip
jcode
L' Tel.No.
te
Owner f� 1 (" / SL �f�.
2. e L
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Sign re of applicant Address Application date
17
LEGAL DESCRIPTION
Location
Of i
Building (v—
NO.. PLUMBING FIXTURES FEE
WATER CLOSETS n �
BASINS oG
/ 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)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT ) SKETCH IN SEPTIC TANK& DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
�Appr by Permit fee Date pemit issued Permit number
Receipt No.
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#9274
Ransdell, Charles T. 1-9-81
Guf' &.3 I'<3
Rt. 4, Box 150 jtBQ. o#� c1saQQ,
SE YJ 26-21-2
Addition - 920 square feet
(Shoreline exemption o.k.)
$26,120.00
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