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Home My WebLink AboutBLD N/A RV Storage and Shop - BLD Application - 4/3/1991 BUILDING PERMIT APPLICATION G� MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. NAME MAIL ADDRESS CITY&STATE ZIP PHONE OWNER DIRECTIONS TO JOB SITEj6j Z /jilC _ lle 1AV OA.,-, DKILkc. f 1� "1Z5:LZ✓ -ZsL<< 1v .1 ,- A/a'i :z) G44SS -40 ,v �L� L F !� -k - PARCEL LEGAL NUMBER DESCR. _ 7&W - �✓M NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR iS/a &/il C _ , USE OF BUILDING V ,S76K/16C CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ / DESCRIBE , WORK v ti 576XIke r Sf1-Ili BEDROOMS DECKS CARPORT P-' 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 OWNERS AFFIDAVIT 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 OWNER DATE X BY '-------DATE 3 TO DATE TIME _ AM DEPARTMI� � I r"ZS IING VALUATION LQ PM HEALTH u FROM AREfACODE FEE PLANNINC O OF NO. )ING PERMIT D.O.T. N _ EXT CHECK SPECIAL C E M ✓J NSPECTION E IELINE E $ _ DSTOVE G M BING O iANICAL LC u NE E BUILDING FEE PHONED/ CALL RE URNED I� WANTS TO r WILL L n WAS IN ENT BACK CALL SEE YOU AGAIN ESURCHARGE APPLICATION ACCEPTED BY I PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION G TOTAL _�" l BY CASH CK MO PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED 1 PERMIT NO. OWNER E MAILADDRESS CIT a TAT ZIP PHOME i' DIRECTIONS TO JOB SITE eVc w O LEGAL DESCR. CONTRACTOR NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE USE OF BUILDING V ,S KA t 5 h10 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 1 BASINS FLOOR/SUSPENDED FURNACE 6.00 BATH TUBS BOILER/COMPRESSOR 6.00 SHOWERS REPAIR/ALTERATION 6.00 WATER HEATERS REFRIGERATION COMPRESSOR SYSTEM 6.00 1 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 DISH WASHER DISPOSAL URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL 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 OB INNl APPROV FROM THE BUILDING DEPARTMENT. X OWNER DATE X BY s!—azlF:�'�s""� DATE 7 13 / 2 FOR OFFICE USE ONLY APPLICATION ACCEPTED BY PLANS CHECK BY BUILDING GROUP APPROVED FOR ISSUANCE PERMIT VALIDATION IBY CASH CK MO BUILDING PERMIT PLOT PLAN MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. Box 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. NAME MAIL ADDRESS CITY&STATE ZIP PHONE OWNER DIRECTIONS TO JOB SITE ?l/iCJI� d �►✓ P� S d cc�%I7T�� PARCEL EGAL NUMBER ,Z,/91,W (tESCR. Indicate below: O Property lines and dimensions. O Easements and roads. O Septic, drainfield and reserve area, or sewer. O Septic tank and drainfield setback distances from foundations. O Location of proposed construction on property. O Building& septic system setback distances from all property lines& easements. Indicate North O Well and water line. In Circle O Saltwater, lakes, rivers, streams,wetlands, drainage. O Attach copy of septic system as built or septic permit approval. O Indicate topography profile of property and structure on reverse side. 5� JS U I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without first obtaining approval. SIGNATURE OF OWNER(S)OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE