HomeMy WebLinkAboutBLD20663 Repair - BLD Permit / Conditions - 7/28/1987 Shorelines: Plumbing:
Setback: Mechanical :
Special Interior:
Conditions: FINAL:
Mobile Home:
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing: PFCR M IT
Fireplace: � uY t
Wood Stove: DATF-
TYPE REPAIR
Permit No. 20663 No. Floors Sq Ftg
Owner FOSS, Gerald Tel Date 7-28-87
Address NE 12971 Northshore Rd Belfair Zip
Contractor Self
Address Zip
Legal Description Madrona Mornin side Beach Lots 18-19
Direction to projec sl a Same address as above
20664
Plumbing X Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
REPLACE WINDOWS, NEW PANELING & FLOORING, REPLACE
FIXTURES IN BATHROOMS
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED 17
PERMIT
ME MAILA�DgRESS CITY&STA ZIP PHONE
OWNER
-eiQ 6 ICE 1 oeP eL (,A)A ?�Z-
DIRECTIONS
TO JOB SITE
PARCEL LEGAL
N U M B E f�.�( k��� � � DESCR-
NAME MAIL ADDRESS CIT Y&STATE LICENSE NO. ZIP PHONE
CONTRACTOR 5
USE OF
BUILDING � l
CLASS OF NEW FADDITION ALTERATION (REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK
fio e ,�� ,,I
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED 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
TOTAL SQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERSAFFIDAVIT 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 0 W-� DATE [ry- I k 7 X BY DATE
FOR OFFICE USE ONLY
DEPARTMENTYES NO YES NO APPROVED DEPARTMENT APPROVED BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING O 2 PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP -3 PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE < �;
STATESURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY APP VED FOR IS ANCE [PERMIT VALIDATION D ASH CK MO TOTAL �` �5c
PLUMBING & MECHANICAL PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED
PERMIT N(I`.::�'
NAME MAILADDRESS CITY&STATE ZIP PH
O E
OWNER Gerald R. Foss NE12971 Northshore Rd. Belfair, Wash. 98528 " t
DIRECTIONS
TO JOB SITE NE 12971 Northshore Road Belfair
LEGAL
DESCR. Madrona Morningside Beach Lots 18 & 19 (Ex E 32' Lot 18)
CONTRACTOR NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
Ettinger Plumbing 1207 East 64th Tacoma Wash. 98404
USE OFBUILDING
/Ll Z
PLUMBING FIXTURES MECHANICAL FIXTURES
NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE OF FIXTURE FEE
WATER CLOSETS FORCED-AIR/GRAVITY TYPE FURNACE 6.00
BASINS FLOOR/SUSPENDED FURNACE 6.00
BATH TUBS BOILER/COMPRESSOR 6.00
SHOWERS .r REPAIR/ALTERATION 6.00
WATER HEATERS u D REFRIGERATION COMPRESSOR SYSTEM 6.00
AUTO.WASHER �� AIR HANDLING UNITS 7.50
SINKS _ HEAT-PUMPS 6.00
FLOOR DRAINS �� EACH GAS PIPING SYS.2.00 PER OUTLET
DRINKING FOUNTAINS VENT.FAN SYS.3.00 PER UNIT
-� LAUNDRYTRAYS WOOD STOVES 5.00
CONNECT TO CITY SEWER �i� WOOD FURNACE 5.00
DISHWASHER
DISPOSAL
URINALS
PERMIT BASIC FEE PERMIT BASIC FEE 10.00
TOT J iao_ TOTAL
SPECIAL CONDITIONS: 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.
OWNERS AFFIDAVIT: I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF CONTRACTORS AFFIDAVIT: I CERTIFY THAT I AM A CURRENTLY REGISTERED
THE CONTRACT OR REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON CONTRACTOR IN THE STATE OF WASHINGTON AND I AM AWARE OF THE ORDINANCE
COUNTY ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL REQUIREMENTS REGULATING THE WORK FOR WHICH THIS PERMIT IS ISSUED AND ALL
WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. WITHOUT FI S NI E BUILDING DEPARTMENT.
X OWNER DATE X BY G APPROVAL F 0 THDATE 7
FOR OFFICE USE ONLY
APPjION ACCEPTED BY Pd7lNS C C�K BY BUILDING GROUP APPROVED FOR ISSUANCE PERMIT VALIDATION
/ Jf IC/J\J 7J d� — BY CASH CK MO