HomeMy WebLinkAboutBLD1895 SFR - BLD Permit / Conditions - 5/26/1975 Waite Construction #1895
5-26-75
Springwood, Lot #6
Residence
$20,000.00
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BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Box 400 Shelton, Washinqton 98584
DATE_
��2&Z,?_s- 1
Applicant to complete numbered spaces only. PERMIT NO. �
JOB ADDR E55
LEGAL ( SEE ATTACHED SHEET)
1 DESCR. / OLIO
)1 1
OWNER MAIL ADDRESS ZIP PHONE
CONTRACTOR MAIL ADDRESS PHONE LICENSE NO.
ARCHITECT Oh OLF31ONER MAIL ADDRESS PHONE LICENSE NO.
4
ENGINEER MAIL ADDRESS PHONE LICENSE NO.
5
LENDER MAIL ADDRESS BRANCH
6
USE OF BUILDING
7
P I� J
8 Class of work:( K NEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
9 Describe work: )
10 Change of use from
Change of use to
11 Valuation of work: $
an a d C/�I r�� PLAN CHECK FEE 1 y `a PERMIT FEE 14
SPECIAL CONDITIONS: � 4 V
Type of Occupancy _
Const. Group 1 Division
Size of Bldg. No.of Max.
(Total)Sq. Ft.3U Stories / Occ. Load /L
Fire Use Fire Sprinklers
APPLICATION ACCEPTED BY. PLANS CHECKED BY APPROVED FOR ISSUANCE BY. Zone Zone Required ❑Yes ❑No
No.Of OFFSTREET PARKING SPACES:
!�. Q../'• ,�'� Dwelling Units Covered Uncovered
N O T I C E Special Approvals Required Received Not Required
ZONINC.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING, VENTILATING OR AIR CONDITIONING. HEALTH DEPT. j
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION FIRE DEPT.
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC- OTHER fSoeclfy)
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
I hereby certify that 1 have read and examined this application and
know the same to be true and correct. All provisions of laws and
ordinances governing this type of work will be complied with whether
specified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any other state or
local law regulating construction or the perf rmance of construction.
S16NAT 4.OF CONTRACTOR OR AU TNORIZ ED AGENT (DATE)
51GNATURE OF OWNER IF OWNER BUILDER DATE)
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
SNELTON PRINTING CO-
MASON COUNTY PLANNING DEPARTMENT
P.0. Box 400 Shelton, Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT —Complete ALL items. Mark boxes where applicable.
1. LEGAL DESCRIPTION
Location 12
Of
N S N S
Building
F W side of feet E W from intersection of
Sect. _____ _ Twp. Range
NO. PLUMBING FIXTURES FEE NO. GAS APPLIANCES F:E GAS PLUMBING
2 WATER CLOSETS EACH UNDER 60 MBTU SEWER SEPTIC TANK
BASINS /. o EACH 60 TO 120 MBTU
BATH TUBS /�.;5-0 EACH 120 TO 200 MBTU
SHOWERS EACH 200 TO 500 MBT
t1 WATER HEATERS /SG EACH OVER 500 MBTU _
' AUTO. WASHERS i.SO
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer SERVICE CONNECTION
DISH WASHER Q
DISPOSAL
URINAL
JS
Distribution System
By Special Permit
- --- (Snow Street Names & Property Lines)
S
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR
S� GAS AND WATER. SKETCH IN SEPTIC TANK & DRAIN
PERMIT /r FIELD LOCATION OR SUBMIT ON OTHER SKETCH.
PERMIT
FIELD INSPECTION
Date By Remarks
Name Mailing address —Number, street, city, and State Zip code Tel. No.
1. `l
Owner ��
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County
Signature of t Addr Application date
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approv d by Permit fee Date permit issued Permit number Receipt No.
a .
PLOT PLAN
ADDRESS D21 kj!�, W0.0Q I .2i PERMIT NO. z�9s o 0
— F o
In D
D O
LEGAL °z
DESCRIPTION LOT BLK ADDITION
U
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS 1 19 n Sq. Ft.
INSTRUCTIONS TO APPLICANT
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE
FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.)
FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN-
SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA-
TION A"'D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR-
TION THEREOF.
0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
TI
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.
NAME(S) OF OWNER(S) OF SITE & STRUCTURE(S) (PRINT) SIGNATURE OF OWNERS) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED Q� z ,�_; " DATE
6HEL-ON PRTN7f1,