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Home My WebLink AboutAddition - BLD Application - 6/9/1981 BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATEISSUED PERMIT NO. OWNER NAME T MAIL ADDRE�j CITY&STATE ZIP PHONE ,,,NAME 15zL_r- �T to Deft`{fo 5- St4 l 4210- DIRECTIONS TO JOB SITE GN Rptt.tZ.0!� m PIAD PQOP. Tt41214 TotoMRa PRISON - 'TAKE 6k JwsrgE�ORE LEGAL (❑ SEE ATTACHED SHEET) S DESCR. Sec If, (o�a�.IS►tIP tow R"&* 44W+a1-1 T47 mE�4 NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR 190 A Sb S�ROS,\ol.►51- %-MUFUSST SH&-t_rolt ?A-Q5-bPj-C-zLL0 42(-- 54I USE OF ff�� BUILDING Pb-D_ of j Re,5 t l�>_W Class of work: ❑ NEW ADDITIO ALTERATION REPAIR ❑ MOVE ❑ REMOVE y Describe work: 42 env a /'^ aO X.zL4 �� 4v rcS tt M t h C. FxcQroo►u-S , WnA Yca H.. 41 a r e-0 w Valuation of work: $ / PLAN CHECK FEE PERMIT 3Cr /ISa o o � SPECIAL CONDITION . BEDROOMS 4&Pf DECKS CARPORT ❑ NOTICE BATHROOMS46ff TOTAL SO. FT. GARAGE ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE ❑ DETACHED ❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- a CONTRACTOR AFFIDAVIT IZED 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 I certify that I am a currently registered contractor in WORK IS COMMENCED. the State of Washington and I the aware of the FOR OFFICE USE ONLY ordinance requirements regulating the work for which the permit is issued and all work done will be in �jconformance therewith. PERMANENT SHORELINES Firm L 1 01.1 120S oNC'm( _croxt SEASONAL[] FLOODPLAIN E.D. NO. S.E.P.A. [-] By Special Approvals IN OUT YES APPROVED NO Lic. No. 'O�-C 2tloQ Date �o -9`81 ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. PUBLIC WORKS I certify that I am exempt from the requirements of the FIRE MARSHAL contract or registration law RCW 18.27, and am aware g, Q of the Mason County ordinance requirements for BUILDING DEPT. which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Owner Date . BY PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 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. Ll E z.� - � � n � 4 ( � Owner 2. Sd�lSoS 14pk q "ram v v�1ks 'C '` 5 Contractor The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington Signature of applicant Address Application date LEGAL DESCRIPTION Location Of Building NO. PLUMBING FIXTURES FEE WATER CLOSETS i BASINS BATH TUBS _ SHOWERS O� WATER HEATERS AUTO.WASHERS SINKS FLOOR DRAINS DRINKING FOUNTAINS LAUNDRY TRAYS Connect to City Sewer DISH WASHER DISPOSAL URINAL (Show Street Names & Property Lines) —--- - -- _ INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER. I PERMIT SKETCH IN SEPTIC TANK & DRAIN FIELD LOCATION OR SUBMIT 1 ON OTHER SKETCH. DO NOT WRITE IN THIS SPACE — FOR OFFICE USE Approved by � Permit fee Date pemit issued Permit number Receipt No. PLOT PLAN ADDRESS A / /Q �c7X PERMIT NO. F o = v � i o LEGAL S5C 1 N 20 I�7, y ww pt '1 NIE X, NI-'4t DESCRIPTION LOT BILK ADDITION u SITE AREA 34 Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS 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 Pl"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' .Ef 1/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. NAMES) OF OWNER(S) OF SITE h STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED 6 Q DISTRICT AS NOTED / DATE 1 6HELTON PRINTIN^.l ate_ t►a00?)a3�rJ �3ssew WC)O'�d ! C Nin%1 I � �l3MQNS -d 2lar^ 1.or Go 18 � r N� Al., �t7 off, .0-- G Ix �r�10d- o3V w 00?JO�g o 9NiG IS ---- ' 41 f,15pRoo m a � .00�► } APPRC ED MASON B�`l�DiTOR G N IN PECI -r-, CH NGES SUBJECT O APPROVAL Li OL I \A/ (� r - __ _ 8 A-rtq ATH Vt v r �Oo M M A STE i2 C3€DRooM �.