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HomeMy WebLinkAboutBLD3108 SFR - BLD Application - 9/22/1978 BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 c DATE ISSUED Z �O PERMIT NO. OWNER AME MAIL ADDRESS 8 STATE ZIP J PHONE DIRECTIONS ; roe??, TO JOB SITE /_/W LEGAL / (❑ SEE ATTACHED EET)/S Cj-yt 14e P f DESCR. NAME MAIL AD RESS CITY&STATE LICENSE NO. PHONE CONTRACTOR Z7Z7& _ 7- r f USE OF BUILDING _ ; Class of work: XNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: 3 .0.;)35- -�5- Q0l Valuation of work: $ '� � W PLAN CHECK FEE /D 9 s� PERMIT FEE /Q SPECIAL CONDITIONS: BEDROOMS DECKS CARPORT ❑ NOTICE BATHROOMS TOTAL SO. FT. GARAGE 41 qd 41 SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES f BASEMENT e-- ATTACHED ❑ OR AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE Ll DETACHED ❑ THIS PERMIT BECOMES 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 COMMENCED. the State of Washington and 1 the aware of the FOR OFFICE USE ONLY ordinance requirements regulating the work for which the permit is issued and all work done will be in conformance therewith. PERMANENT i_1 SHORELINES I i SEASONAL [ ] FLOODPLAIN I Firm E.D. NO. S.E.P.A. I I 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 of the Mason County ordinance requirements for BUILDING DEPT. which this permit is issued and that all work done will ROAD ACCESS be in c ther MOTOR VEHICLE PERMIT APPLICATION ACCEPTED BY PLA _CHECK BY APPROVED FOR ISSUANCE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. 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 Mailing address—Number,street,city,and State Zip code Tel.N 1. D ' Owner /� 2. Contractor or ax The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington Signatur f cant Address Application date / I 9 L GAL DESCRI­PT N! Location 7 Of Building NO. PLUMBING FIXTURES FEE WATER CLOSETS Ie 3 BASINS BATH TUBS _ —--- SHOWERS WATER HEATERS / AUTO.WASHERS r SINKS J FLOOR DRAINS DRINKING FOUNTAINS / LAUNDRY TRAYS Connect to City Sewer r / DISH WASHER DISPOSAL URINAL ---- --- - (Show Street Names & Property Lines) _1 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 iissued Permit numberReceipt No. PLOT PLAN ADDRESS PERMIT NO. LEGAL 7 DESCRIPTION LOT �� BLKGE, ADDITION SITE AREA q. Ft. AREA OF SITE OCCU Y BUILDINGS Sq. Ft. INSTRUCTIONS TO ICANT THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO S LE OF NOT LESS THAN 1"=20' ARE FILEO WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAV SEPARATE PLOT PLAN.) FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE S E BELOW: LOCATION OF PROPOSE-D CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SIT D SETBACK DIMEN- IONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATIO , STREET ELEVA- TION P1"D SEWER SERVICE ELEVATION.-SHOW-LOCATION OF WATER, SEWER, GAS AN LECTRICAL SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND OR POR- TION THEREOF. A INDICATE NORTH IN CIRCLE u GRAPH SQUARE X 5' OR 1"=20' 4 l c \ �Q I 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. N AME(SI OF WN ER(S) OF SITE 6 STRUCTURE(S) (PRINT) - ` NATURE OF O NER( OR ED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVEDK�7DISTRICT AS NOTED DATE 6H ELTON PRiN TN� 4F� MASON COUNTY PLANNING DEPARTMENT P.O'Box 186 Shelton,Washington 98584 MECHANICAL PERMIT APPLICATION IMPORTANT- Complete ALL items. Mark boxes where applicable. 1. LEGAL DESCRIPTION Location Of N S Building N E W side of feet E W om intersection of Sect. `J�J Twp. Range NO. DESCRIPTIONS FEE NO. DESCRIPTIONS FEE 1. Forced air or gravity type furnace or burner including ducts 14. For the installation or relocation of each boiler or refrigeration and vents, up to .and including 100,000 Btu's--$4.00 compressor over 50 horse power or each absorption system over 1,750,000 Btu's--$25.00 2. Over 100,000 Btu's-$5.00 15. For each air handling unit to and including 10,000 cubic feet 3. Installation or relocation of floor furnace and vent, suspended per minute, including ducts attached thereto-$3.00 heater, or recessed wall heater-$4.00 NOTE: This fee shall not apply to an air handling unit which 4. Installation, relocation, or replacement of each appliance vent is a portion of a factory assembled appliance, cooling installed, not included in appliance permit-$2.00 unit, evaporative cooler or absorption unit for which a permit is required elsewhere in this Code. 5. Repair, alteration or addition to each heating appliance, re- frigeration unit, cooling unit, absorption unit, or evaporative 16. For each air handling unit over 10,000 cubic feet per minute cooling system including installation of controls regulated by -45.00 this code--4.00 6. Installation or relocation of each boiler or compressor to and 17. For each evaporative cooler other than portable type-$3.00 including 3 horse power-$4.00 18. For each ventilation fan connected to a single duct-$2.00 7. Over 3 horse power to and including 15 horse power-$7.50 19. For each ventilation system which is not a portion of any heating 8. Over 15 horse power to and including 30 horse power-$10.00 or air conditioning system authorized by a permit-$3.00 9. Over 30 horse power to and including 50 horse power-$15.00 20. For the installation of each hood which is served by mechanical exhaust, including ducts for such hoods--$3.00 10. Installation or relocation of each absorption system to and including 100,000 Btu's,--$4.00 21. For the installation or relocation of each domestic type in- 11. Over 100,000 Btu's to and including 500,000 Btu's-$7.50 cinerator-$5.00 12. Over 500,000 Btu's to and including 1,000,000 Btu's Commercial or industrial type incinerators-420.00 _$10.00 22. For each appliance o piece of equipmen r g at�by this 13. Over 1,000,000 Btu's to and including 1,750,000 Btu's Code but not classed in other appliance catagories, or for which -$15.00 no other fee is listed in this Code--$3.00 _ FIELD INSPECTION Basic Fee $3.00 Date By Remarks TOTAL Name d (Mailing address Number, street, city, and State Zip code Tel. No. Owner Ill� �l 1Gi�f �7'�2 � 8x- � � 7 K 1 ��KJ![•S!f - -- - J 2. Contractor The owner of this a ersigne rce to confor►rf to all applicable laws of MASON COUNTY' Sign r ppllcant Address A piicat�o tlate O DO NOT WRITE IN THIS SPACE - FOR OFFICE USE Approved by Permit fee Date permit issued Permit number Receipt No. 7w/ 6HELTON PRINTING CO.