The URL can be used to link to this page

Home My WebLink AboutBLD N/A 4 Units - 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. NAME MAIL ADDRESS CITY&STATE ZIP PHONE OWNER 4 /Yjgt' ' eJ 1e kI di, S Q ! c ►R 4' 9 51-Y 2 71 jC9 ToECT OBIONS SIITE 3 y`c /f'1I v ►-A el de FAiR dN o4 Dc 613;k- Nw4 . 15r Irl ✓Z A co t'c/Vfir 4 0-,'4 clFvtl 1 lyty S . ' tv PARCEL LEGAL NUMBER DESCR. - �- NAME MAIL ADDRESS CITY&STATE ZIP PHONE LICENSE NO. CONTRACTOR �✓ j9 d p p eL 4 i l� 2.'r 2 7S C d' USE OF BUILDING CLASS OF NEW Iv` ADDITION ALTERATION REPAIR MOVE REMOVE WORK DESCRIBE WORK AREA: I i NUMBER OF: PLEASE INDICATE: NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR RESIDENCE-j(gL9dSqFt STORIES a SHORELINE❑ CONDITIONING. BASEMENT 0 SgFt BEDROOMS PRIMARY RES.&- THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT DECKS S Ft BATHROOMS _ SEASONAL RES.❑ 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 -2 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 THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. XOWNER �CATE /J L( � X BY DATE___ FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION YES NO YES NO ,6 t)D HEALTH PUBLIC WORKS FEE PLANNING FIRE MARSHAL BUILDING PERMIT q 5 , 7jO D.O.T. BUILDING I PLAN CHECK L ' )r SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION J 33 ' SHORELINE WOODSTOVE PLUMBING MECHANICAL y� STATE BUILDING FEE APPLICATION ACCEPTED BY PUNS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION TOTAL b �� BY CASH CK MO h -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. OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE !+ i c t C'h Po ax SSGp Qe 4jawR s�:xe A7S 3 DIRECTONS TO JOB ISIITE 3 'L� �9 i L-e S /v f)r 7�i1 D,& apt?/ o 17 w l0 artve Uv4 PA st C 0 awl, GA ►-JeAt r/Yn/ �'� - 4/ LEGAL DESCR. CONTRACTOR NAME MAILADURESS CITY&STATE LICENSE NO. ZIP PHONE ,FtA t,vc Iyj�, ti'cv�•ct, Qt3�x �vGO 13_tt FAIy 0 6vN4r �8 SZI 2-7536$3 USE OF BUILDING 14 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 '9 AIR HANDLING UNITS 7.50 SINKS HEAT-PUMPS 6.00 FLOOR DRAINS CH GAS PIPING SYS.2.00 PER OUTLET DRINKING FOUNTAINS I. T.FAN SYS.3.00 PER UNIT LAUNDRY TRAYS FIRE SUPPRESSION 5.00 CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISHWASHER p DISPOSAL URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL rj -- TOTAL Illb 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 BTAINING APPR VAL FR M THE BUILDING DEPARTMENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. X OWNER J X BY DATE FOR OFFICE USE ONLY APPLICATION ACCEPTED BY PLAN CHECK BY BUILDING ROUP APPROVED FOR ISSUANCE PERMIT VALIDATION iZ- BY CASH CK MO