HomeMy WebLinkAboutBLD8659 SFR - BLD Permit / Conditions - 11/12/1975 Mud Bay Construe h,8659
11-12-75
Woodland Manor##22,,Lot #3
Residence
$18,500.00
2113171,
MASON COUNTY PLANNING DEPARTMENT
P.0. Box 400 Shelton, Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT—Complete ALL items. Mark boxes where applicable.
LEGAL EBCRIPTION �j.,
Location �/lQ +�-tc�
Of NS NS
Building
E W side of feet E W from intersection of
Sect. Twp. Range
NO. PLUMBING FIXTURES FEE NO. GAS APPLIANCES FEE
GAS PLUMBING �f
WATER CLOSETS �{S� EACH UNDER 60 MBTU SEWER SEPTIC TANK
_ BASINS / s� EACH 60 TO 120 MBTU
BATH TUBS f EACH 120 TO 200 MBTU
SHOW_E_RS EACH 200 TO 500 MBTU
WATER HEATERS wi EACH OVER 500 MBTU
AUTO. WASHERS 6
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer SERVICE CONNECTION
DISH WASHER
DISPOSAL
URINAL
Distribution System
By Special Permit
(Show Street Names & Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR
O-0 GAS AND WATER. SKETCH IN SEPTIC TANK & DRAIN
FIELD LOCATION OR SUBMIT ON OTHER SKETCH.
PERMIT PERMIT
FIELD INSPECTION
Date By Remarks
Name K/ Mailing address — Number, street, city, and State Zip code Tel. No.
Owner -
- Aix) 6 > fes x 9�s�-231. -.14y(
Contractor The owner of this building and the undersigned agree to conform to all applicable laws of.Mason County
Signat ' of applicant Address Application date
_ DO NOT WRITE IN THIS SPACE _— FOR OFFICE USE _
Approved by Permit fee Date permit issued Permit number Receipt No.
J o p �p
BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Bog 400 Shelton, Washinqton 98584
DATE ISSUED —
PERMIT N0.
—�—OWNER MAIL ADORE
�88 ZIP PHONE
�
DIRECTIONS
TO 10B SITE
LE•GAL MAIL ADDRESS ZIP ,f'1s[[ATTACHED SHEET)
DESCR. �1 �?n?-5
— MAI LAIL ADDRESS
— P ONE
I CONTRACTOR I '
USE OF MAIL ADDRESS PHONE LIc ENsr.No.
BUILDING
Class of work: f4 NEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑MOVE ❑ REMOVE
Describe work:
Valuation of work:a PLAN CHECK FE@r' DO PERMIT FEEzz
Q Q
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY
Type of Occupancy
Const. Group Division
"ize of Bldg. No.of Max.
(Total)Sq. Ft.Meg Stories r Occ.Load
CONTRACTOR AFFIDAVIT Special Approvals Required Received Not Required
I Certify that I am a currently registered contractor In the State ZONING
of Washington and the County of Mason and I am aware of the HEALTH DEPT.
ordinance requirements regulating the wclk for which the permit PUIBLIC WORR111111;
is issued and all work done wi:l be in conformance therewith. D&PT.
Firm
By -�
Lic. No. Date
OWNERS AFFIDAV T
I certify that I am exempt from the requirements of the contract.
or registration law RCW 18.27, and am aware of the Mason N 0 T I C E
County ordinance requirements for which this permit is issued
and that all work done will be in conformance therewith. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING. VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC-
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
Owner Date 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION oK. M.O. CASH
/ SHEL.TON PRINTING CO.
toPOGRAPHY:
Slopev to ,.
+Lot Graf ng Type - i
I
PLOY PL A�� I
4
41 Via,
q • � /B,q�y arnS
� r
`+ LEGAL DESCRIPTION
MUD SAY CONSTRUCTION
a" 450 SIMPSON AVE. n
McCL,EARY, WASHINGTON 90557 Jl of lA�x�l;/Lf!)NOR ti
/hSISD A.
., BY: DATE: