HomeMy WebLinkAboutBLD8432 SFR - BLD Permit / Conditions - 9/3/1975 Newsome, Robert S., Jr. #8432
9-3-75
Tract 3 SWµ, SEµ, 17-23-1
Residence
$35,700.00
DOOLIZ
k6e,LV�OM�
BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Box 400 Shelton Washinqton 98584 67
DATE ISSUED �``�—�`� _
PERMIT NO.
—_—� --- MAIL ADDRESS ZIP PHONE
OWN i 60 ,L�Re Pj�
DI (INS Ih
LEGAL MAIL ADDRESS ZIP QSEE ATTACHED SHEET)
AWL ADDRESS PNONE
CONTRACTO ,/ &V—,&
USE OF MAIL ADDRESS cam-,ta/ PHONE LICENIIX NO.
BUILDING
Class of work: NEW ❑ADDITION O ALTERATION O REPAIR O MOVE O REMOVE
Describe work: S tl
� a
Valuation of work:$ `�' / O O PLAN CHECK FEE aJ�, PERMIT FEE
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY
Type of occupancy
Cont. Group Division
4v LC-
Size of Bldg. No.of Max.
(Total)SC.Ft. Stories occ.Load
CONTRACTOR AFFIDAVIT Special Approvals Required Received Not Required
I Certify that I am a currently registered contractor in the State
of Washington and the County of Mason and I am aware of the EAL7H offm
ordinance requirements regulating the work for which the permit PtilaL.10 WORKS
Is issued and all work done wi;l be in conformance therewith. �pT,
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 /� at /9J„�0 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
j PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
SHELTON PRINTING—
MASON COUNTY PLANNING DEPARTMENT
P.0. Box 400 Shelton, Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT—Complete ALL items. Mark boxes where applicable.
1. LEGAL DESCRIPTION P�
Location Y 114 -j F `)`f 11 —
Of N s
Building N 5
E W side of feet E W from intersection of
Sect. Twp. Range
NO. PLUMBING FIXTURES FEE NO. GAS APPLIANCES FEE GAS PLUMBING
3 WATER CLOSETS EACH UNDER 60 MBTU SEWER SEPTIC TANK
B_AS_INS •7� EACH 60 TO 120 MBTU
BATH—TUBS f EACH 120 TO 200 MBTU _—
SHOWERS _ • + EACH 200 TO 500 MBTU _
WATER HEATERS '��a EACH OVER 500 MBTU
AUTO. WASHERS I* 0
SINKS /•
FLOOR DRAINS
DRINKING FOUNTAINS
1�
LAUNDRY TRAYS /�I
Connect to City Sewer `` SERVICE CONNECTION
/ DISH WASHER / 7�
DISPOSAL
URINAL
Distribution System
By Special Permit
(Show Street Names & Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR
GAS AND WATER. SKETCH IN SEPTIC TANK & DRAIN
PERMIT ERMIT
FIELD LOCATION OR SUBMIT ON OTHER SKETCH.
P
FIELD INSPECTION
Date By Remarks
Name Mailing address — Number,,street, city,land State Zip code Tel. No.
Owner — Rob sd S. — iJox S60
4N eat)
RA►.p1L
Contractor The owner of this building and the undersigned agree to conform to all applicable laws of.Mason County
Signature plicant I Address a$3$ pplication date
.00 P.0 . -Box 9 b 3
DO NOT WRITE IN THIS SPACE.— FOR OFFICE USE
Approved by c Permit fee Date permit issued Permit number Receipt No.