HomeMy WebLinkAboutBLD77-5286 ADD - BLD Permit / Conditions - 6/2/1977 Fitzgerald, Gerald #5286
6-2-77
Woodland Manor Lot 2
2nd House on left Contractor
Clyde Knight
Addition
$10,000.00
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f BUILDING PERMIT APP ICATION
MASON COUN Y
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED _7
PERMIT NO. b
OWNER NAM 1 MAIL RESS CI &ST ZIP PHONE
erct er �i'� t - � h rTS - 3
DIRECTIONS ` II
TO JOB SITE Vood
LEGAL (❑ SEE ATTACHE 3 SHEET)
DESCR. k1eQJ10V14041111 j
ME MAIL ADDRESS CITY&ST E LICENSE N PHONE
CONTRACTOR t .it �r Q L�J9
USE OF
BUILDING es !G� PI�tC
Class of work: ❑ NEW VKb5bITION ❑ ALTERATION ❑ REPAIR ❑ M VE ❑ REMOVE
Describe work:
Valuation of work: $ /�y O0 0 PLAN CHECK FEE L P RMIT Ff-E,-4--;? �
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Type of /, Occupancy Division
J BY
>> Const. Group
Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories / Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEAS NAL 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 Approval Required Received Not Required
conformance therewi h. ZONING
`\ HEALTH DEPT.
Firm "� � PUBLIC WORKS
ROAD DEPT.
By
Lic. No.CL- � q 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 PER IITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OF 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 OF CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF PONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner Date, WORK IS COMM LACED.
PI/AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION C M.O. CASH
MA'z�nN COUNTY PLANNING DEPARTMENT
P.O. BOX 186 Shelton, Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT — Complete ALL items. Mark boxz,,, where applicable.
Name Maiiingaddress—Number,street,6),and State Zip code Tel.No.
-
Owner I
Contractor r
L The owner of this building and the undersigned agree to conform to all appliceb;e laws of Mason Cnunty nd State of Washington
Signature Address Application date
Y e
AEGAL DESCRIPTIQN. OF
Location
Of
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS e'0
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)
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 Of�FIGE USE
Approved by [Pem—fee — Date emit is jed Permit number Receipt No.
5� $