HomeMy WebLinkAboutBLD2049 Condo Unit - BLD Application - 6/4/1979r
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
L�'G ER I,VNERS SSOc IA'rf O PERMIT NO.
OWNER NAME MAIL ADDRESS CITY 3 STATE ZIP PHONE
ST#R Wr.# rBox S9m 1114POA 11, . 98S9 P'4g--31a3
DIRECTIONS
TO JOB SITE
LEGAL ( E ATTACHED SHEET)
DESCR. F7IF—ly(4(C
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
C'tYnE ur,E .114.2f ao �e S,, S64 X y, 4. u-i°iF -�' �'1 34 a )<
USE OF �y ,, Q, - •
BUILDING CGk-"�
Class of work: ❑ NEW ❑ ADDITION UYALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
n
Valuation of work: $ Q PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS / TOTAL SO. FT. GARAGE ❑
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ElATTACHED ❑ OR AIR CONDITIONING.
TOTAL SO. FIREPLACE SI DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 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
conformance therewith. PERMANENT LI SHORELINES Ll
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. i1 — Date 7 / 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 BUILDING DEPT.
of the Mason County ordinance requirements for
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 APP VED FOR IS CE
Ow/r Date_ BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION C CK M.O. CASH
. �` - • MASON COUNTY PLANNING DEPARTMENT
.,� P.O. BOX 186 Shelton,Washington 98584
1 PLUMBING PERMIT APPLICATION
IMPORTANT—Complete ALL items. Mark boxes where applicable.
Name Mailing address—Number,street,city,and State Zip code Tel.No.
Owner
Q A' .!�
2.
Contractor
jo
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
LocationOf
1 /�
Building :� � r'l —
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS
BATH TUBS
SHOWERS &t
WATER HEATERS
AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer i
DISH WASHER
DISPOSAL
URINAL
(Show Street Names & Property Lines)
•'',, INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT O� SKETCH IN SEPTIC TANK d DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved by Permit fee Date pemit Issued Permit number Receipt No.