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Home My WebLink AboutBLD20447 Skylights, Small Dormer, Remodel - BLD Application - 6/18/1987 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 / �f c5w 426-5593 DATE ISSUED C:5�cRea PERMIT NO. NAME MAIL ADDRESS mot. G(>OQ CITY&STATE ZIPS HONE OWNER > y ea '3v / ��'- / �;Ki DIRECTIONS y' S� e,4 TO JOB SITE ,�-7.5'f a{ 611710P, Wq, dSs Rd Al,,!, X r¢r7 !/act tr �� CQr�as — � 7p / , 11 ,7 'V_ PARCEL LEGAL NUMBER DESCR. }c'-C 5 3 �(/% /��S �LC� /YIiJrUh��'✓� ` NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR �l,.p USE OF BUILDING !y`c rrl CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK DESCRIBE WORK �/�' /! i Si17J/r�G� .ti..t.L,1•`. �`e /l7 e 1 !��/I c --I- fq L11 BEDROOMS DECKS CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTALSQ.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 OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY TFjkT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATICIN LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMEICTS 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 CONFO ANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAININ PPROVAL FROM WE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. X OW R (•G DATE /J / X BY DATE FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION 77r— YES NO YES NO -� GGO HEALTH �✓ PUBLIC WORKS FEE PLANNING � FIRE BUILDING PERMIT D.O.T. BUILDING �l PLAN CHECK Z�5 SPECIAL CONDITIONS BUILDING GROUP -j PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING C/�) MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTED BY I PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION a / -1 TOTAL ,L BY CASH CK MO I PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 426-5593 DATE ISSUED PERMIT NO. OWNER j,AME MAILADDRESS CITY& TATE ZIP PHONE DIRECTIONS TO JOB SITE LEGAL DESCR. CONTRACTOR NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE USE OF BUILDING 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 c C FLOOR/SUSPENDED FURNACE 6.00 BATH TUBS BOILER/COMPRESSOR 6.00 SHOWERS REPAIR/ALTERATION 6.00 WATER HEATERS �.��C 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 LAUNDRY TRAYS WOOD STOVES 5.00 CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISHWASHER U DISPOSAL URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL c ,-' 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 FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT, X OWNER DATE X BY DATE FOR OFFICE USE ONLY APPLICATION ACCEPTED BY PLANS CHECK BY BUILDING GROUP APPROVED FOR ISSUANCE PERMIT VALIDATION IBY CASH CK MO