HomeMy WebLinkAboutBLD1537 SFR - BLD Permit / Conditions - 2/6/1975 01011din, /lctx /#/5. 7
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BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Box 400 Shelton, Washinqton 98584
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DATE
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Applicant to complete numbered spaces only. PERMIT N0. 15_3 7
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JOB ADDR ESS N
LEGAL �' ( SEE ATTACHED SHEET)
1 DESCR. }
OWNER
/�(. /J��'�(M/91L A DREESS/S ZIP y PHONE
;74
CO TRAC OR M L ADDRESS PH ON I� L CEN .���'��
ARCHITECT OR DESIGNE MAIL ADDRE55 PHONE LICENSE NO. �.
'ENGINEER MAIL ADDRESS PHONE LICENSE NO.
53
LENDER MAIL ADDRESS BRANCH C
6U5 BUILDING
- NC
8 Class of work: ❑ NEW ❑ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
9 Describe work:
10 Change of use from TO 71
Change of use to (/_.,V
/� s
11 Valuation of work: $ l� Q✓
� v PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS: Type of Occupancy
Const. Group Division
Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories Occ. Load
Fire Use Fire Sprinklers
APPLICATION ACCEPTED BY. PLANS CHECKED BY APPROVED FOR ISSUANCE BY Zone Zone Required ❑yes ONO
No. of OFFSTREET PARKING SPACES:
Dwelling Units Covered Uncovered
N 0 T I C E Special Approvals Required Received Not Required
ZONINC.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING, VENTILATING OR AIR CONDITIONING. HEALTH DEPT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION FIRE DEPT.
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC- OTHER (Soecffy)
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
I hereby certify that I have read and examined this application and
know the same to be true and correct. All provisions of laws and
ordinances governing this type of work will be complied with whether
specified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any other state or
local law regu ting cq^truction r the performance of construction.
P'
GNATURE 0 CONTRACTO R AUTHORI j AGENT (DA/E)
SIGNATURE OF OWNER 'IF OWNER BUILDER DATE)
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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MASON COUNTY PLANNING DEPARTMENT
P.0. Box 400 Shelton, Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT—Complete ALL items. Mark boxes where applicable.
I. LEGAL DESCRIPTION
Location c Li R , .SI&Y A; /�. � 9Z
Of NS NS
Building I
E W side of feet E W from intersection of
Sect. Twp. Range
NO. PLUMBING FIXTURES FEE NO. GAS APPLIANCES FEE GAS PLUMBING
WATER CLOSETS f.3 V 14v EACH UNDER 60 MBTU SEWER SEPTIC TANK
BASINS .SO EACH 60 TO 120 MBTU
BATH TUBS t EACH 120 TO 200 MBTU
SHOWERS ,J EACH 200 TO 500 MBTU
WATER HEATERS EACH OVER 500 MBTU
AUTO. WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer SERVICE CONNECTION
DISH WASHER (�
DISPOSAL
URINAL
Distribution System
By Special Permit
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INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR
GAS AND WATER. SKETCH IN SEPTIC TANK & DRAIN
FIELD LOCATION OR SUBMIT ON OTHER SKETCH.
PERMIT 00 PERMIT
FIELD INSPECTION
Date By Remarks
�7 Name Mailing ad ress — Number, street, city, and State ip code Tel. No. �]
Owneras
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I
Contractor —
The owner of is build in nd t e ndersigned agree to conform to all applicable laws of.Ma n COunty _
Si at redy plican Ap is lion ate
NOT WRITE IN THIS SPACE — FOR OFFICE US
Appr ed by Permit fee Date permit issued it num er Receipt No.
$ 1� z G �3� / s 37