HomeMy WebLinkAboutBLD9343 Final SFR - BLD Permit / Conditions - 3/21/1978 Buller - Bur►chart #9343
2-14-78
Lake Cushman Div. 7 Lot 28
Residence Plumbing Permit issued
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Compliance Card received
$22,680.00
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584 7+
DATEISSUED
PERMIT NO. 9 <X3
NAME MAIL ADDRESS CITY&STATE ZIP f
OWNER 7� 3
DIRECTIONS
TO JOB SITE
LEGAL /t (❑ SEE ATTACHED SHEET)
DESCR. L,A, Ke 1. ✓5 � 1'Y� .-J iL, i V: 7 C9� v2
NAME �t MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR L.. u W PQ �a t .2 Nk�o.✓ C��sl� '''--L—C L <' 17 L j
USE OF r
BUILDING1 Sr .t� L (`f ,r, �. 1 . <> C_11, &7
Class of work: ® NEW ❑ ADDITION ❑ ALTERATION ❑ R PAIR ❑ MOVE ❑ REMOVE
Describe work: I
Valuation of work: $ PLAN CHECK FEE 42S PERMIT FEE Id.,
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY1 PLANS CHECK BY APPROVED FOR ISSUANCE Type of �i Occupancy Division
BY Const. Group
. J v
Size of Bldg. No. f Max.
(Total) Sq. Ft. Stori s � Occ. Load
CONTRACTOR AFFIDAVIT
PEFIMAN T SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am aware Of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT. ".2 77 Z'
Firm PUBLIC WORKS
ROAD DEPT.
By
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
,( IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
U'�� SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
OW of �/ - Date, WORK IS COMMENCED.
V
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT V LIDATION M.O. CASH
I
MASON COUNTY PLANNiNis. nFP4RTMFNT
P.O. BOX 186 Shelton, Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT — Complete ALL items. Mark boxes where applicable.
Name Mailingaddress—Number,street,city,and State i Zip code Tel.No.
Owner
z. t�NY c� 13ox 37 1 00- �. 1 5 77`5 7/
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
nature of a I nt /A_` Address Application date
LEG ESC
Location Of J y�
Building �-
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
` BASINS V .
BATH TUBS ' —s
SHOWERS
WATER HEATERS
I AUTO.WASHERS
/ SINKS v
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
Approve by , Permit fee Date pemit issued Permit number Receipt No.