HomeMy WebLinkAboutBLD94-0167 Garage and Rec Room - BLD Application - 2/10/1994�k MASON COII=.—
BUH-DLNG PERMIT APPLICATIOI 0
Pt. AS'c PRINT `
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! Si to Address k& 41C k,'. Ti6,Ek LK. k'D. City �� ,tJ St&)A Zip 4_
I Owner Address - Ci ty St Zi
Lien/Title Holder
Address "341-00 DekT c -TAQ Ok ty '77�CCI°-cam Stt�a4-,Zip�
Describe Work G AP_kCC
�2 Con ractor Name SE1- Ccm=actor Reg#
Address Epiza ti on date
` sty St Zip Phone
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#3 If septic is located on project site, include records.
Connect to Septic? Public Wate_T Supply Well x_
Parcel No. _�&) -,j - CSC`)o go "
Legal Description '7l�'-C-�'_ LflI�F GC�U L6)7-,2_
Building Square r^oo Cage: (ems 7/proposed)
I Ist F1 / 2nd FI / 3rd FI / Loft /
Basement 1 Deck / Garage
bedrooms / #bathrooms /
Othe_T ieC SCT f t
rr
6 Use of buildin �C'A C-' kC
u7 7vne of Job: New Add Alt Repair Demolition
I Plumbing 0n1 y Mechanical Qal y woods Love Re-Roof
E Bulkbead Othez
18 Diumbincr Fix"ures Mec'zanical =zx^zres
No. Toilets No. Fuel Types No. Air Aanr17 Tag Uhiis
Bathtubs Fur= < 200K BTU <- 10000 cfm.
Showers Fu_-m >- 100K 3= > 10000 cfm.
` Bath basins --F u= - Floor Other
f Sulks Heat Pumas EraD Cool er s
Dishwasher Vert Systems Hoods
Hot Water Htr Vent Fans Domes. Incin.
Laundry Washe_Y Boilers/Compressors Coamil . Incin_
Floor Drains 0-3 HP Reloc/Repair
Other 3-15 HP Gas Outlets
15-30 PEP Woodstove
30-50 HP Other
50 + FV
n9 MOB rLE HOM7' INrop_K 1TION
Model�\ Year_f 3 Make .;itL�Cl2Ci��s"( Modele? M ��J_ &6-7 Le_^.gt..t Widat 3�&"" Seria? No U 3 '�-NKAO'7 -R
RBe�?~ooms "Ba c�--ooms
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ver pcnd we tl and seascr.a:
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PLC f�l�
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Q aaTd a:4T ar,� Qo 5QrMa�o3 wogs
APPLICANT TO DRAW SIT'r' PLAN 3EL0
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NOT1C =' IS P=R.M= BECOMES NULL AND VOID 1r WORK, OR CONSTRUC*r::ON
AU-7'- ORIZrD IS NOT COI-*-'NCKD W=TH-7N 180 DAYS , OR Ir CONSTRUCTION OR WORK
IS SUSP=77 OR ABANDONL FOR A PERIOD Or 180 DAYS AT ANYTIME Ar:zR WORK
IS COMMTC.J
OWNLP.S ;F'=aV;T - CON'iaZAC:vRS ArFCOA�
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTJFT THAT I AM A CURRINTLT REGISTERED CONTRACTOR
CONTRACTORS REGISTRATION LAW RCJ la.Z7 , AND AM AWARE IN THE STATE OF WASHINGTON AND I AM AWARE OF THE
OF THE MASON COUMT� ORDINANCE REQUIREMENTS FOR WNICH ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH
THIS PERMIT IS ISSUED AND THAT ALL WRK DONE WILL HE IN THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
CONFORMANCE THEREWITH. NO CHANCES SHALL BE MADE CONFORMANCE THEREWITH. NO CHANCES SMALL BE MADE
WITHOUT FTRST OBTAINING APPROVAL FROM THE BUILDING WITNaJT FIRST OBTAINING APPROVAL FROM THE. BUILDING
DEPARTMENT. DEPARTMENT.
x OW= a air
Ret== pe--DLit to: Deparl=ent of General Services
426 W. Cedar/P.0 Bc-x 186, Shelton, WA 98 84 427-9670/1-800-562-•5628
FOR. OFFICSAL USE ONLY: Acce ted b t
P Y= Date.
DEPAR AL X%JLj W
FOR OFFICE USS ONLY
Approved Cond Hold
Approval
PlAnn4n
s
E'XvirC)=ental Health:
l
Buildtag Plan Review: 2 3 yvt �
Fire *Marshall:
Other .
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