The URL can be used to link to this page

Home My WebLink AboutBLD28326 Addition - BLD Permit / Conditions - 6/10/1991 Shorelines: Plumbing: A Setback: Mechanical: 11 Special Interior: , Conditions: FINAL:�,� �- Mole I Mobile Hcme: Smoke Detector: Remarks�z ; oot ing: Setback: Foundation Walls: � •�; ► 0�. Framing: Fireplace. Wood Stove: TYPE ADDI T IO-b! Permit No. 28326 No. Floors 1 Sq Ftg 300 Owner BALDING, DAVID C. Tel 426-5821 Date 6-1091 Address E 50 Park Place, Shelton Zip Contractor Self Address Zip Legal Description Parkwood Lot 27 Direction to project site Shelton Springs Road to Parkwood subdivision 300 feet west from Island Lake Rd to Park Place P MIT ing Mechanical Sewer Wood Stove Fireplace Deck mirage arport Basement -Loft Other BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED -( PERMIT NO. (, OWNER NAME MAILADDRESS CITY&STATE ZIPS H0NE DIRECTIONS TO JOB SITE PARCEL LEGAL NUMBERA 40oUDESCR. 10 d ko� NAME VAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK DESCRIBE WORK �i / O/1/ TD BEDROOMS4/Ar DECKS CARPORT /Yd NOTICE n`Q SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS N1- TOTALSQ.FT. /�� GARAGE /� CONDITIONING NO.OF STORIES ASEMENT ATTACHED /Yk THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT ',� COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR T'P4 T.f FIREPLACE DETACHED /� ABANDONED FOR A PERIOD OF 180 DAYS ATANYTIME AFTERWORK IS COMMENCED. PERMANENT SHORELINE AA SEASONAL_- K111+-_ OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. X OWN DATE X BY DATE FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION ' YES NO YES NO HEALTH f PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK old- -SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTED BY I P/LANDJS CCHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION BY L' /L�r�� CASH CK MO TOTAL ' ' 0 Permit No. MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584. 427-9670 PLEASE PRINT (� #1 Owner Dovvc ,uckL� +\ Phone# Site Address LeD k Q City �hP�` St ✓.4 Zip S Directions to Job Site Owner Mailing Address City St Zip Lien/Title Holder Address City St Zip #2 Contractor NameJLUj0QjQ I C Lb Contractor Reg. # L� yY11� Z) w Address S g Expiration date City St _ZipgR S� Phone � — S #3 Parcel No. 2. -�2- OJQ2 J Legal Description #4 Us of building Describe work Cllc o #5 T e of Job: New Add Alt Repair Plumbing Fixtures ($3 each) Fee Mechanical Fixtures h No._Toilets CIRCLE FUEL TYPE: Gas, lectric, _Bath Basins Heatpump, Other _Bath Tubs No. U!jLa Fees _Showers Furn 1S1 C--W BTU _Hot Water Htr Heatpumps _Laundry Washer _ Vent Systems _Sinks Spot Vent Fans _Floor Drains No. Boilers/Compressors _Laundry Basins HP _Dishwasher No. Air Handling Units _Disposal cfm# _Urinals No. Other _Other Gas Outlets Wood, Gas, Pellet Stove Permit Basic Fee 15.00 TOTAL PLUMBING $ Permit Basic Fee 15.00 TOTAL MECHANICAL $ NOTICE: This permit becomes null and void if work or construction authorized is not commenced within 180 days or if construction or work is suspended or abandoned for a period of 180 days at any time after work is commenced. Proof of continuation of work is by means of a progress inspection. NOTE: If this permit application includes the placement of a fuel tank, heat pump or other unit to be located outside of the existing structures, a plot plan MUST be submitted as required below: Show following on the site plan below: Lot Dimensions, Existing Structures, Structure Setbacks, Water Lines, Septic Systems, Flood Zones, Wells, Shorelines, Easements, Name of Flanking & Fronting Streets. Indicate directional by N, S, E, W, etc. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRAC- THE CONTRACTORS REGISTRATION LAW RCW 18.27,AND AM TOR IN THE STATE OF WASHINGTON AND I AM AWARE OF THE AWARE OFTHE MASON COUNTYORDINANCE REQUIREMENTS ORDINANCE REQUIREMENTS REGULATING THE WORK FOR FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN DONE WILL BE IN CONFORMANCE THEREWITH.NO CHANGES CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE SHALLBE MADEWITHOUT FIRSTOBTAINING APPROVAL FROM WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER X BY DATE DATE Return permit to: Department of General Services 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 . 427-9670/1-800-562-5628 FOR OFFICIAL USE ONLY: Accepted by: Date. Receipt No. Referred To DEPARTMENTAL REVIEW Proposal Proposal FOR OFFICIAL USE ONLY Approved Denied Planning: Building: Fire Marshal: . h1 N y � N 1 h � Zee �1 �I 0