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Home My WebLink AboutBLD N/A SFR/Garage - BLD Application - 12/6/1991 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES 426 W. CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. M ^ /� r `, yr , M;IL ADDRES U C G �CI�&STATE C �n + ZIP ��PHONE ' f� OWNER /J'( / l Y1 Tb �/ L DIRECTIONS _ TO JOB SITE �I Z t �116Z Q L� `�t► A I(Z 4 f Co Lk IIff-iC, -J-) k)I-) PARCEL LEGAL NUMBER DESCR. NAME MAIL ADDRESS CITY&STATE ZIP PHONE LICENSE NO. CONTRACTOR USE BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK r i 1 7 1 DESCRIBE WORK AREA: NUMBER OF: PLEASE INDICATE: NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR RESIDENCE SgFt STORIES SHORELINE❑ CONDITIONING. BASEMENT SgFt BEDROOMS PRIMARY RES.❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT DECKS S Ft BATHROOMS SEASONAL RES.0 COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR g ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. CARPORT SgFt FIREPLACE IS CARPORT/GARAGE GARAGE SgFt ( � ATTACHED❑DETACHED❑ 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 THEBUILDING DEPARTMENT. g / q APPROVAL FROM THE BUILDING DEPARTMENT. X OWNERC �/" ' DATE / �F / ( X BY_ _ DATE FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION �� YES NO YES NO HEALTH PUBLIC WORKS FEE PLANNING FIRE MARSHAL BUILDING PERMIT D.O.T. BUILDING PLAN CHECK �7 SPECIAL CONDITIONS BUILDING GROUP �l 1 PRE-INSPECTION SHORELINE (� z% WOODSTOVE PLUMBING �3 MECHANICAL 1-( STATE BUILDING FEE AICIT ION CCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION �, BY CASH CK MO TOTAL . i �� u�� ti�� r PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES 426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. NAME MAIL ADDRES CITY ZIP PHONE OWNER 44 �T (� ` -ll DIRECTIONS TO JOB SITE LEGAL �3- I DESCR. CONTRACTOR N E MAIL ADDRESS CITY BSTATE 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 FLOOR/SUSPENDED FURNACE 6.00 / BATH TUBS BOILER/COMPRESSOR 6.00 SHOWERS REPAIR/ALTERATION 6.00 WATER HEATERS REFRIGERATION COMPRESSOR SYSTEM 6.00 AUTO.WASHER a 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 FIRE SUPPRESSION 5.00 CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISHWASHER 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 STAINING APPR VAL FROM THE BU LDING DEPARTMENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. X OWNER E L X BY DATE FOR OFFICE USE ONLY APPLICATION ACCEPTED BY PLANS CHECK BY IT NG GROUP APPROVED FOR ISSUANCE PERMIT VALIDATION BY CASH CK MO