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HomeMy WebLinkAboutBLD26714 Addition - BLD Application - 9/14/1990 BUILDING PERMIT APPLICATION MASON COUNTY , P DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 (� 427-9670 DATE ISSUED �� PERMIT NO. OWNER NAME MAIL DRESS CITY STATE ZIP ��10N �� ! NE a IL DIRECTIONS I TO JOB SITE c� fl�,ti '�(�� PARCEL GAL NUMBER DESCR. € LAJ,k CONTRACTOR NO. NAME MAIL ADDRESS CI 3STATE LICENSE ZIP PHONE USE BUILDING CLASS OF NEW A DITION WORK ALTERATION REPAIR MOVE REMOVE ✓ DESCRIBE WORK o V - v !00x_q(Q BEDROOMS DECKS Y OR N CARPORT NOTICE TOTAL SO.FT. BATHROOMS DECK GARAGE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR TOTAL SQ.FT. TOTAL SO.FT. CONDITIONING. NO.OF STORIES -/- BASEMENT Y OR N THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHQAIZED IS NOT LIVING AREA BASEMENT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SO.FT. TOTAL SQ.FT. CHECK ONE ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT--Y-45 FIREPLACE ATTACHED SEASONAL SHORELINE DETACHED/�� _ OWNERSAFFIDAVIT 6mvI-t 0 ` CONTRACTORS AFFIDAVIT I CE Y THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REG TRAT�I�N LAW RCW/8.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE RE IRE' TS 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 I CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING TAINING APPROVAL FROM THE BUILDING DEPARTMENT. �j APPROVAL FROM THE BUILDING DEPARTMENT. X OWNER TE ��U ~y� X BY DATE FOR OFFICE USE ONLY o DEPARTMENT YES APPROVEDJO DEPARTMENT YES DEPARTMENTBUILDING VALUATION _ l HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK Z� SPECIAL CONDITIONS BUILDING GROUP _Z PRE-INSPECTION SHORELINE WOODSTOVE 4 C� PLUMBING MECHANICAL STATE BUILDING FEE STATESURCHARGE APPLICATION ACCEPTED BY P NS CHECK BY PRO D SSUANCE PERMIT VALIDATION bu L7— /:?�— /0 I BY CASH CK MO TOTAL PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 9 427-9670 DATE ISSUED U_ PERMIT N . OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE 1 SJp��DIRECTIONS J TO JOB SITE LEGAL DESCR. CONTRACTOR NAME MAILADDRESS CITY&STATE 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 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 DISHWASHER DISPOSAL URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL j TOTAL ©Q 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 OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. X OWNER DATE X BY DATE FOR OFFICE USE ONLY �LICATION ACCEPTED BY IPTCHECKBY c� BUrG GROUP A R ED F R I SUANCE PERMIT VALIDATION O v BY CASH CK MO