HomeMy WebLinkAboutBLD4827 SFR - BLD Permit / Conditions - 8/27/1976 Edwards, James D. #4827
8-27-76
Rt. 10 Box 570, Shelton
Blevins Rd, 1=20-4
Residence Plumbing Permit issued
$40,000.00
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BUILDING PERMIT APPLICATION ,J
- MASON CO�NTY
P.O. Box 186 Shelton, W2lshington 98584
DATE ISSUED
PERMIT NO.
''J .I
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER G :u 4F37- at.''6`f
DIRECTIONS _
TO JOB SITE &FVIJ( V — -Jg ,6a5,k'
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. !V W% �. o —
NAME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF T�
BUILDING -�/,�®IE, C ,-
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE J REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE o PERMIT FEE
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY. P NS CHECK BY APP VED FOR ISSUANCE Type of Occupancy Division
� BY� Const. Group :
Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT 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. !v 7.S"5`
Firm PUBLIC WORKS
By ROAD DEPT.
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
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIREDFOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conformance therewith. THIS PE RMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
J IS NOI COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
1 SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner Date . WORK S COMMENCED.
VAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CCK.i 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 Mailingaddress—Number,street,city,and State Zip code Tel.No.
Jax
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
Sign atur of applicant Address Application date
Or LEGAL DESCRIPTION F /f
Location ''
Of
Building _
NO. PLUMBING FIXTURES FEE
WATER CLOSETS G
BASINS
I ' BATH TUBS
SHOWERS a �
WATER HEATERS
An AUTO.WASHERS
I r SINKS - �
I FLOOR DRAINS
Qom.
DRINKING FOUNTAINS
Q
j LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
I
DISPOSAL
URINAL {�Wes •
H
i
nn (Show Street Names & Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT c, GO SKETCH IN SEPTIC TANK& DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
7 DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
i Approved by Permit fee Date pemit issued Permit number Receipt No.
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