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Home My WebLink AboutBLD79-4088 - BLD Permit / Conditions - 1/31/1979 'Borek, joe ��40881-31-79 Woodland Manor Div. 1 Lot Contrl tor c Harol Wilson Duplex Plumbing P it issued $38,000.00 r ;� �J ; � . n �l� \ � n � t �1 � � ti � `� � I� a M BUILDING PERMIT APP 'ICATIDN MASON COUN P.O. Box 186 Shelton, Washing ion 98584 426-5593 ry DATE ISSUED PERMIT NO. '/Q cFF AME MAIL ADDRESS CITY&STA . ZIP PHONE OWNER JE 7% ..� 4A t 9 s o QO >�70 DIRECTIONS TO JOB SITE LEGAL / (0�SEE ATTACHED S ET) DESCR. �J r✓� /i.'/ NAME MAIL ADDRESS CITY&ST E LICENSE NO. PHONE CONTRACTOR USE OF BUILDING AS Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ M VE ❑ REMOVE Describe work: /t Valuation of work: $ PLAN CHECK FEE xj PERMIT FEE s 4 v SPECIAL CONDITIONS: i BEDROOMS DECKS_ CARPORT ❑ NOTICE BATHROOMS TOTAL SQ. FT. GARAGE ❑ ATTACHED SEPARATE PER ITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT ❑ OR AIR CONDITI NING. TOTAL SQ. FT. O FIREPLACE ❑ DETACHED ❑ THIS PERMIT BE )MES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED CONTRACTOR AFFIDAVIT IS NOT COMM CED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR BANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER I certify that I am a currently registered contractor In WORK IS COMM NCED. the State of Washington and I aware of the FO 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 LJ Firm E.D. NO. S.E.P.A. ❑ By Special Approvals IN OUT YES APPROVED NO Lic. No. Date ZONING PLANNING DEP . 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. MOTOR VEHICLE PERMIT APPLICATION ACCEFTED BY PLAN HECK BY APPROVED FOR ISSUANCE Owner N: 4�® ".ez Date .� BY PLY CHECK VALIDATION CK. M.O. CASH DERMIT VALIDATION CK. M.O. CASH MASON COUNTY PLANNING D PARTMENT P.O. BOX 186 Shelton,Washington 98584 • - PLUMBING PERMIT APPLICATI lN IMPORTANT—Complete ALL items. Mark bOXE where applicable. Name Mailing address—Number,street, i y,and State Zip code Tel.No. Owner 2. Contractor The owner of this building and the undersigned agree to conform to all applicable laws of Mason County an tate of Washington Signature of applic nt Address Application date LEGAL DESCRIPTION Location Of Building NO. PLUMBING FIXTURES FEE WATER CLOSETS 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 j 6� SKETCH IN SEPTIC TANK 8 DRAIN FIELD LOCATION OR SUBMIT ON OTHER SKETCH. DO NOT WRITE IN THIS SPACE — FOR QFFICE USE Approve °y Permit fee Date pemit s ued Permit number Receipt No. PLOT PLAN ADDRESS ERMIT NO, f 10 : ° � s LEGAL / J�� DESCRIPTION LOT -et'FE' , ADDITION /( �( � 'lp m J ° SITE AREA / Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS �Sq.Ft. INSTRUCTIONS TO APPLICANT THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE �y FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HA A SEPARATE PLOT PLAN.) `1 FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN ' HE SPACE BELOW: LOCATION OF PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN- SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST F OOR ELEVATION, STREET ELEVA- TION A"ID SEWER SERVICE ELEVATION. SHOW LOCATION OF WAT SEWER, GAS AND ELECTRICAL t1 SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE EACH BUILDING AND MAJOR POR- TION THEREOF. INDICATE NORTH IN CIRCLE l3RAPH SQUARES ARE 5' X 5' OR 1"=20 I r I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without first obtaining approval. r NAME(S) OF OWNER(S) OF SITE & STRUCTURE(S) (PRINT) SIGNATURE OF OWNERM OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED ' DISTRICT AS NOTED DATE ��7�79 6HELTON PRINTING