HomeMy WebLinkAboutBLD9661 SFR - BLD Permit / Conditions - 7/1/1976 Ridge, Jack #9661
4 1. 7-1=76
SWZ, SEu, 9-23-1
Plumbing PLirmit issued (1978;
Residence
I > 06(X 7/7
$14,500.00
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BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Box 400 Shelton, Washinqton 98584
DATE ISSUED
PERMIT NO.
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^ MAIL DDRESS ZIP PHONE
OWNER i
_ ��II�- �-a.� � — _ �1�.__.f��:, Lax► 1/s�
DIREC�NS /�
TO!0 SITE C'�r,`!.y/�
EGAL 19
MAIL ADDRESS ZIP (❑SEE ATTACHED SHEET)
DESCR. 4_1
MAIL ADDRESS PHONE
CONTRACTOR
USE OF MAIL ADDRESS PHONE LICENSE NO.
BUILDING o
Class of work: NEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑MOVE ❑ REMOVE
Describe work:
Valuation of work:$ O PLAN CHECK FEE n�5. �o PERMIT FEE
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CH�IECCIKKED BY APPROVED FOR ISSUANCE BY
Tyne Q Occupancy
22 f , Const. w` Group Division
Size of eldlo No.of / Max.
(Total)Sq.Ft./t1� / Stories /� Oec.Load
CONTRACTOR AFFIDAVIT Species APProvale Required Received Not equ
I Certify that I am a currently registered contractor In the State NINO
of Washington and the County of Mason and 1 am aware of the 91CALTH OKFPr. fos"
ordinance requirements regulating the work for which the permit POINLIC WORRG
Is Issued and all work done will be in conformance therewith. 5irar.
Firm
By
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the contract
or registration law RCW 18.27, and am aware of the Mason N 0 T I C E
County ordinance requirements for which this permit Is issued
and that all work done will be in conformance therewith. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING. VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC-
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
Owner I Date 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
�_ SHELTON PRINTING CO.
IF THIS IS WITHIN THE°LIMI.TS OF A RECORDE 'PLATTED PROPERRTY7T0 L•R - r
yy _ y
4t / �. ' ��S -,:^� �i Y.Y�1OF ,, ,p!, ''�`r'.1`'Lt'1•w F ��T�`' �� •''• <` : '� x 'Y4 �`""a'�.�.'{� �jy.a'"". 'CyufCSf�.< ,
`. \�ti , 7 - �. .,%r T{r j \ 'N ,t Y L 1' l t`// e? � A. �,�, '6 t'4' 5 ��•
(GIVE NAME OF PLAT OR ADDITION)
That part o!
of th e SF;� of th e SE tt
> 6. LEGAL DESCRIPTION OF LANDS ON WHICH THE WATER IS USED: =
section 9, twp 23 notch range 1'west WM described as follows: Beginning at a point-.csn Vhe
uesterV line of C6unty roa-ul
of Primary State Highway No, 21� 575.6 feet easterly (as measured along said'southerly line
of hiZhway) of its intersection with e west line of sald southeast quarter; r ng hence
along said veterly line of road south'61025110" east 168.29 feet, south 1704 130 east_
feet, Southo wes ,� yfeet and sou 65tfeet more or Tess
to a point south of the point of b6gnning'of this description; thence notth to said
point of beginning.
COUNTY I
7. PURPOSE(S) FOR WHICH WATER IS USED: Single Fa.-Aly Dvelling Dcnestic use.
l8. THE LEGAL DOCTRINE(S) UPON WHICH THE RIGHT OF CLAIM IS BASED:
�` a W.R.I.A �5
�.a• a ., f •,�
(LEAVE BLANK)
•
~• MASON COUNTY PLANNING DEPARTMENT 7-
P.O. BOX 186 Shelton,Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT—Complete ALL items. Mark boxes where applicable.
Name Mailing address—Number,street,city,and State Zip code Tel.No.
5 ep110 225-30
Owner
2.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signature of applicant Address ` Application date
52
LEGAL DESCRIPTION
Location
Of
Building
NO. PLUMBING FIXTURES FEE
2 WATER CLOSETS
BASINS —
BATH TUBS
SHOWERS
WATER HEATERS
AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
— (Show Street Names & Property Lines)
t0
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT SKETCH IN SEPTIC TANK & DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
A proved by Permit fee Date pemit issued Permit number Receipt No.