HomeMy WebLinkAboutBLD78-7645 ALT/REP - BLD Permit / Conditions - 10/17/1978 #7645
Brown, Art 10-17-78
Tr. 4 Sw 1/4 8w 1/4 8-20-4
Route 10 Box 476, Shelton
Alteration and Repair
$6,100.00 �o rj
Oos-r
BUILDING PERMIT APPLICATION
MASON COUNrTY
P.O. Box 186 Shelton, Washing�6n 98584
426-5593 "7
DATE ISSUED l
PERMIT NO. —7& 41=y-
OWNER NAME MAIL ADDRESS CITY&ST TE ZIP PHON
DIRECTIONS /_
TO JOB SITE � ? — �6K Y74! Iris !�' t9 ,�� ,Jb Cd/7. J4EfU� 3 /LAPI f, RP /b r.
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. �� � ` ' �� 4P' Y4 JrGt If71, lye. 'o,wmj kip ;Iv/V A4P, �40/ 4','Avl.
NAME MAIL ADDRESS CITY&ST NtE LICENSE NO. PHONE
CONTRACTOR '7 OCUA e/L 1-0 Ac,
USE OF ,.-
BUILDING , d� 2M,`4y
Class of work: ❑ NEW ❑ ADDITION KALTERATION VREPAIR ❑ MOVE ❑ REMOVE
Describe work:C �/ .J J p a
/V d v,#TF /°� r 7"7//`c�J l� lflez /.v 4- .fie d G ,C tu#-i�ef �Fj
W" %6 rzA-� ,�/�✓•v /2a40 M -- sri o / a r y �.v 1.��-� e.a 7`in,P 40(1-1 6'LP /7-4,OV AV Ale
eP44Cc .414 /ale&V J -07 eL`c•. ( �/r k `/roa ��i��c �� �� ��
Valuation of work: $ p PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED C' SEPARATE PER ITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ DETACHED
THIS PERMIT BEC i OMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ,ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMM l NCED.
the State of Washington and I the
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 LI SHORELINES ❑
SEASONAL ❑ FLOODPLAIN I I
Firm
E.D. NO. S.E.P.A. LD
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.,
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
1 certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT.'
the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. r MOTOR VEHICLE PERMIT
Owner Date, 1 � p
�_! !/ APPLICATIACC pTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
AVdaC G�
LPYLACHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
MASQN COUNTY PLANNING DiEPARTMENT
P.O. BOX 186 Shelton,Wash ingto698584
PLUMBING PERMIT APPLICATI N
IMPORTANT—Complete ALL items. Mark box where applicable.
Name Mailing address—Number,street,city,and State Zip code Tel.No.
Owner Er I� (, v'/�wF F 77Z,
2.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County an !,State of Washington
Signature f applic nt Address Application date
LEGAL DESCRIPTION
T&j Url� ✓e.� l�f�
Location p
Building
N ,19 IZ � /3O K 7(c .rd �Ys e-
•�
NO. PLUMBING FIXTURES FEE
WATER CLOSETS -�
BASINS
BATH TUBS C G "t-A'-t � ----------
SHOWERS f?,,07-C /0 f K
WATER HEATERS
AUTO.WASHERS rL v
SINKS �flr—p Lac r -�
FLOOR DRAINS
DRINKING FOUNTAINS j /'✓
LAUNDRY TRAYS
III
Connect to City Sewer
DISH WASHER
DISPOSAL I
URINAL i
(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
Approved by Permit fee Date pemit i $ued Permit number Receipt No.