HomeMy WebLinkAboutBLD5967 SFR w/ Garage - BLD Permit / Conditions - 9/19/1977 9eFrates, Levonne #5967
9-19-77
S 200' N 750' W 160' E 200' NE 1/2 SW 1/4 12-20-4
W on Springs Road to Park Place, go short distance
beyond Park Place turn right on dirt unmarked road
just beyond Yellow House on left
Residence w/garage Plumbing Permit issued
$50,100.00
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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.No.
1_evdM r Ar
Owner
2. G�9 pc �,�. �.��Cc. 1 j�o CF G �f��L r 6 V 7,P"
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Sig ure of icant Address �;Apphcafln date
LEGAL DESCRIP N
Location
Of
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS a
3 BASINS
BATH TUBS
SHOWERS 2
1 WATER HEATERS
AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
i LAUNDRY TRAYS
74— Connect to City Sewer `
I
DISH WASHER
DISPOSAL
URINAL
s (Show Street Names & Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT 2 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 Issued Permit number Receipt No.
23 - 7-7 �-z.._
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED � Z7
PERMIT NO. S a 7
OWNER NAME�,VdyA)c -]�cFfq MAIL ADDRESS n�5 OW 25 MALb � CITY 8 STATE IV? E�O - ? �,d. ZIP , v ���E/
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DIRECTIONS (,[1E -r ON✓S/,+eL. h-i�t�_-:! •;P/C� (A,`6% c� 4 G 131'QQ/C7KA-9 L�EJ 7D i9�PK J RC'c. n
TO JOB SIT O/P� Di Ate' Cj� O.t� P/�/'t.t' PL. O�fJ k'l6N7' r0 �4/tIP�4�EE.]g c[ "41A �k
LEGAL �PcITH .20a Of �N� O/P7i'f 7S"p r OF 7N� EST /b0r p � �Ef ` �/YS]EE 00l f>F
DESCR. E K1,v17,P/�' D'F 7 f - S LJ t(F�/c'7t:/Q SF, ,4) /a L� S- 070/✓ Jh41 We-sr kJ M
C AME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
ONTRACTOR
USE OF
BUILDING �/�/!/Fj y'E HOSE-
Class of work: V NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: )
/ff"T6' Cd�S 77?K C"7 Z D,N O)C AIC-Al ty6i E
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Valuation of work: $ O �j PLAN CHECK FEE PERMIT FEE
�3 s'O / oc✓
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLA C ECK BY APPROVED FOR ISSUANCE Type of Occupancy Division
BYE;' �� Const. Group
`•/%'� Size of Bldg. 2God 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.
HEALTH DEP
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 o formanc�th. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
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
0 � t Date. to"1Z'- 7 WORK IS COMMENCED.
7
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. M.O. CASH
BUILDING PERMIT PLOT PLAN
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. Box 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAME MAIL ADDRESS JJCITY&STATE ZIP PHONE
NNER 2 f' f4�� ' 7/ pKI( cv/��h �' n �} l,v �
RECTIONS
J JOB SITE UPSift-
PARCEL
LEGAL
NUMBER DESCR.
Indicate below: O Property lines and dimensions.
O Easements and roads.
O Septic, drainfield and reserve area, or sewer.
O Septic tank and drainfield setback distances from foundations.
0 O Location of proposed construction on property.
O Building&septic system setback distances from all property lines& easements.
Indicate North O Well and water line.
In Circle O Saltwater, lakes, rivers, streams,wetlands, drainage.
O Attach copy of septic system"as built' or septic permit approval.
O Indicate topography profile of property and structure on reverse side.
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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.
SIGNATURE OF OWNER(S)OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE