HomeMy WebLinkAboutBLD7832 Addition - BLD Permit / Conditions - 11/14/1977 VanderWegen, S. W. #7832
11-14-77
35-22-3 W 50' E 150' G. L. 3 N of Hwy & TL
Addition and Alteration (Adding second story)
Not increasing number of bedrooms.
$21,000.00 Plumbing Permit issued
Mechanical Permit issued
i
r - BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED
PERMIT NO.
OWNER �- AM MAIL ADDRESS CITY&STATE ZIP PHONE
w 13a '2 3 8 (,*!n I o n InL
DIRECTIONS
TO JOB SITE
LEGAL (❑SEE ATTACHED SHEET)
DESCR. � -.3 G(1 So F 1,61 / G L 3 N el ,,(- 7/--
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING ry) e-
Class of work: ❑ NEW EKADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
nor Ions4oe r ,n u r r-- 4 5ecor)cP =42Pr
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Valuation of work: $ PLAN CHECK FEE r PERMIT FEE 94
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SPECIAL CONDITIONS:
A ICATION ACCEPTED BYJ PLANS CHECK BY APPROVED FOR ISSUANCE Type of / Occupancy Division
e- 0'41tl
BY Const. Group�i �)' `
Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories Occ. Load /6 1
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT.
Firm PUBLIC WORKS
By
ROAD DEPT.
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
.iA. yf_ A SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Own er/11�t /, 11A-,cuv .w4et— Date. / J 7 WORK IS COMMENCED.
/ s
V _
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION 'CK. M.O. CASH
C MASON COUNTY PLANNING DEPARTMENT
P.O. BOX 186 Shelton, Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT — Complete ALL items. Mark boxes where applicable.
Name Mallingaddress—Number,street,city,and State Zip code Tel.No.
Owner
2.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signature oI cant Address Application date
1417
LEGAL DESCRIPTION �
Location — -� .� _ �I Q / �'�� L O �/"' •`��
Of
Building 2TU Z/Wlekl i'%J /N '1C7A-
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS
BATH TUBS
SHOWERS -
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.
PERMIT SKETCH IN SEPTIC TANK& DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
i A rov by ® Permit fee Date pemit issued Permit number Receipt No.
7 of
i
MASON COUNTY PLANNING DEPARTMENT
P.0. Box 400 Shelton, Washington 98584
1 �
` MECHANICAL PERMIT APPLICATION
IMPORTANT-Complete ALL items. Mark boxes where applicable.
t, LEGAL DESCRIPTION /
Location 7 .3 /S�
Of N S
Building N s
E W side of feet E W from intersection of
Sect. Twp. Range
NO. DESCRIPTIONS FEE NO. DESCRIPTIONS FEE
Forced air or gravity type furnace or burner including ducts I b 14. For the installation or relocation of each boiler or refrigeration
and vents, up to and including 100,000 Btu's-,U.00 4.66 compressor over 50 horse power or each absorption system over
1,750,000 Btu's--$25.00
2. Over 100,000 Btu's-$5.00
15. For each air handling unit to and including 10,000 cubic feet
3. Installation or relocation of floor furnace and vent, suspended per minute, including ducts attached thereto-$3.00
heater, or recessed wall heater-44.00
NOTE: This fee shall not apply to an air handling unit which
4. Installation, relocation, or replacement of each appliance vent is a portion of a factory assembled appliance, cooling
installed, not included in appliance permit-$2.00 unit, evaporative cooler or absorption unit for which
a permit is required elsewhere in this Code.
5. Repair, alteration or addition to each heating appliance, re-
frigeration unit, cooling unit, absorption unit, or evaporative 16. For each air handling unit over 10,000 cubic feet per minute
cooling system including installation of controls regulated by -$5.00
this code-$4.00
6. Installation or relocation of each boiler or compressor to and 17. For each evaporative cooler other than portable type-$3.00
including 3 horse power-$4.00 18. For each ventilation fan connected to a single duct-$2.00
7. Over 3 horse power to and including 15 horse power-$7.50 19. For each ventilation system which is not a portion of any heating
8. Over 15 horse power to and including 30 horse power-$10.00 or air conditioning system authorized by a permit-$3.00
9. Over 30 horse power to and including 50 horse power-$15.00 20, For the installation of each hood which is served by mechanical
exhaust, including ducts for such hoo"3.00
10. Installation or relocation of each absorption system to and
including 100,000 Btu'"4.00 21. For the installation or relocation of each domestic type in-
11. Over 100,000 Btu's to and including 500,000 Btu's-$7.50 cinerator- $5.00
12. Over 500,000 Btu's to and including 1,000,000 Btu's Commercial or industrial type incinerators-$20.00
_$10.00
22. For each appliance or piece of equipment regulated by this
13. Over 1,000,000 Btu's to and including 1,750,000 Btu's Code but not classed in other appliance catagories, or for which
-$15.00 no other fee is listed in this Code-$3.00
_ FIELD INSPECTION Basic Fee $3.00
Date By Remarks TOTAL
��Name �i f��+ Mailing address -- Number, street, city, and State ��/ Zip code q Tel Noo.
Owner �L(LL`� I /�/ L r/ (/ Q/V !/v 7��/4t
Contractor _
The owner of this building and the undersigned agree to conform to all applicable laws of MASON COUNTY
Sign at of apphcan Address Application date
/6 /,> e6&1,e�lt' 5,"-
DO NOT WRITE IN THIS SPACE - FOR OFFICE USE
Appr, ed by Permit fee IDate permit iss tl Permit number Receipt No.
SHELTON PRINTING CO.