HomeMy WebLinkAboutBLD4557 SFR - BLD Permit / Conditions - 4/25/1979 Taylor, Wayne H. #4557
4-25-79
Div. 1 Lot 138 Lake Limerick
Contractor
Residence J. R. Sobotka
Plumbing Permit
$28,000.00
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED 77
1 PERMIT NO. 5���
OWNER NAME MAID ADDRESS . CITY&STAT ZIP O E
DIRECTIONS
TO JOB SITE IS* L— L'ay,— j %
LEGAL (❑ SEE ATTACH SHEET)
DESCR. ` LL
�
CONTRACTOR
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
r
USE OF
BUILDING
Class of work: S.,,NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLAN HECK BY ApeROVED FOR SUANCE Type of Occupancy Division
Y Const.� � Group
Size of Bldg. No. of Max.
(Total) Sq. Ft. �'� Stories ` Occ. Load
CONTRACTOR AFFIDAVIT r
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. ZONING
HEALTH DEPT.
F' �' �� PUBLIC WORKS
B ROAD DEPT.
Li N 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 SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in confor a�therewith. ' 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
-`�
Owner " Date. Z WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CAS
A
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.
Owner
2.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Si re of applicant Address Application date
LEGAL DESCRIPTION
Location JJ `
Of
Building '
NO. PLUMBING FIXTURES FEE
WATER CLOSETS J"
BASINS
/ BATH TUBS
SHOWERS
WATER HEATERS - / {)
AUTO.WASHERS
/ SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER j
DISPOSAL
URINAL
(Show Street Names & Property Lines)
d�
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 issued Permit number Receipt No.