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HomeMy WebLinkAboutBLD15297 SFR - BLD Application - 2/17/1984 BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426 5593 DATE ISSUED >� PERMIT NO. OWNER NAME MAIL ADDRESS ��CIT �sTAT I� 1,)&i ZIP �ONI l t►6� tS -(E2 F ©o OLD eD DIRECTIONS rr�� TO JOB SITE lU _ 0� (� A- 10 t0 (:aL0 19 ELF/1? W � LEGAL �/ / (❑SEE ATTACHED SHEET) DESCR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR SA V.4 C-- , k EF(- be 1 USE OF BUILDING Class of work: r,?�NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Valuation of work: $ PLAN CHECK FEE PERMIT FEE o p 4 G 3 0. 17.. " `' 3yo. SPECIAL CONDITIONS: BEDROOMS DECKS CARPORT [] NOTICE BATHROOMS -Z TOTAL SO. FT.S GARAGE [; ATTACHED �' SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT`,do 7= 3 E OR AIR CONDITIONING. TOTAL SO. FT FIREPLACE a DETACHED LI THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- CONTRACTOR AFFIDAVIT IZED 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 I rtify that I am a currently registered contractor in WORK IS COMMENCED. e State of Washington and I the aware of the FOR OFFICE USE ONLY rdinance requirements regulating the work for which the permit is issued and all work done will be in conformance therewith. PERMANENT SHORELINES K C ��c H�� �0�� , SEASONAL f , FLOODPLAIN yhA( Firm y� J E.D. NO. S.E.P.A. [7 By `/� V1�vc F(Sufvt Special Approvals IN OUT YES APPROVED NO Lic. No. aTc 4"1 91vvt Date '2r-7- $q ZONING PLANNING DEPT. U U OWNERS AFFIDAVIT HEALTH DEPT. �+ q� PUBLIC WORKS I certify that I am exempt from the requirements of the FIRE MARSHAL contract or registration law RCW 18.27, and am aware of the Mason County ordinance requirements for BUILDING DEPT. whic this permit is . ued and that all work done will ROAD ACCESS i conformance h ewith. MOTOR VEHICLE PERMIT PLICATION ACCEPTED BY PLAN HECK BY APPROVED FOR ISSUANCE Owner Date PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT OF GENERAL SERVICES P. O. BOX 186 SHELTON, WgASHINGTON 98584 PHONE 206 - 426-5593 DATE ISSUED PERMIT NO. ` 5c,227 LEGAL DESC_ SEC. TWN. NO., RANGE WEST, W.M. PLAT DIV._ LOT OWNER 11« !P'c sip-lE2 ADDRESS Lb 13EL PA(fZ CONTRACTOR ADD ESS D ECTIONS TO SITE 2 13 T- 0LF- R --10 `j r 16H Wtav> �t y>r i2 132 L oGE E= / r-(0GD 6q o s_f ie c G"T_ THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREM TO COONNFQ TO ALL APPLICABLE LAWS OF MASON COUNTY AND THE STATE OF WASHINGTON. �_ 1-1 SIGNATURE OF APPLICANT NO BASIC FEE 10.00 1 Forced-air or gravity-type furnace or burner, including ducts and vents attached to such appliance up to and including 100,000 Btu/h 6.00 la Appliance over 100,000 Btu/h including ducts and vents attached 2 Floor furnace, including vent 6.00 3 Suspended heater , recessed wall heater or floor-mounted unit heater 6.00 4 Appliance vent installed and not included in an appliance permit 3.00 5 Repair or alteration of, or addition to each heating appliance, refrigeration unit, cooling unit, absorption unit, or each heating, cooling, absorption, or evaporation cooling system, including installation of controls regulated by this code 6.00 6 Boiler or compressor to and including three horsepower, or each absorption system to and including 100,000 Btu/h 6.00 6a Over three horsepower to and including 15 horsepower , or each absorption system over 100,000 Btu/h and including 500,000 Btu/h 11.00 6b Over 15 horsepower to and including 30 horsepower , or each absorption system over 500,000 Btu/h to and including 1,000,000 Btu/h 15.00 _ 6c Over 30 horsepower to and including 50 horsepower , or for each absorption system over 1,000,000 Btu/h to and including 1,750,000 Btu/h 22.50 6d Boiler or refrigeration compressor over 50 horsepower, or each absorption system over 1,750,000 Btu/h 37.50 7 Air-handling unit to and including 10,000 cubic feet per minute, including ducts attached thereto 4.50 7a Air-handling unit over 10,000 cfm 7.50 8 Evaporative cooler other than portable type 4.50 9 Ventilation fan connected to a single duct 3.00 10 Ventilation system which is not a portion of any heating or air-conditioning system authorized by a permit 4.50 11 Hood which is served by mechanical exhaust, including the ducts for such hood 4.50 12 Domestic-type incinerator 7.50 13 Commercial or industrial-type incinerator 30,00 14 For each appliance or piece of equipment regulated by this code but not classed in other appliance categories, or for which no other fee is listed in this code 4.50 15 For each gas-piping system of one to four outlets 2.00 15a For each gas-piping system of more than four outlets per outlet .50 ni TOTAL z SPECIAL CONDITIONS ' APPROVED BY DATE PEMIT VALIDATION �� CK. MO, CASH MASON COUNTY PLANNING DEPARTMENT 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 Stale Zip code Tel.No. ?7S'7N 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 Sign ur of licant Address Application date c— - 7 - LE L DESCRIPTION Location Of Building NO. PLUMBING FIXTURES FEE ^ WATER CLOSETS (, BASINS f^ BATH TUBS C SHOWERS \" ` WATER HEATERS rC� AUTO.WASHERS ,�CJ / SINKS 610 FLOOR DRAINS DRINKING FOUNTAINS LAUNDRY TRAYS Connect to City Sewer 'J C DISH WASHER CI�I DISPOSAL URINAL r 71 --- (Show Street Names & Property Lines) — — 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 Approved by Permit fee Date pemit issued Permit number Receipt No. PLOT PLAN ADDRESS PERMIT NO. /�C f f o = o n s � o LEGAL a DESCRIPTION LOT BILK ADDITION u SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq. Ft. INSTRUCTIONS TO APPLICANT THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.) FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN- SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA- TION A"D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR- TION THEREOF. 0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' Ll I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be merle without first obtaining approval. r'ti1 kle _ '1I L' _ L_- SEE t N AME(S) OF OWN R(�) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(5) OR AUTHORIZED REPRESENTATIVE ' DO NOT WRITE BELOW THIS LINE APPROVED r DISTRICT AS NOTED DATE , V— -� SHELTON PRINTIN3