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Home My WebLink AboutBLD15845 Mount Cabin on Pier Blocks - BLD Application - 7/17/1984 BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATEISSUED PERMIT NO. OWNER AME MAIL ADD ESS CITY 8 STATE ZIP PHONE 3 �ELF�►r /ti DIRECTIONS TO JOB SITE '40GN�/ LEGAL c / (' (❑ SEE ATTACHED SHEET) DESCR. J Z �F/1'/1 L o�J S I T 2 3 el W w/rI CONTRACTOR NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE S'EL.r USE OF BUILDING 50"141E'L _ /ESi,prtiCt r.r I� TF Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATIO I AOVE ❑ REMOVE Describe work: _ Nov-A-T 0,4 61-1 o,t-, « 14 t-4. s 76-1 IF— G liM r3r'-v ZG'ecL'1!L T vd Valuation of work: $ PLAN CHECK FEE PERMIT FEE SPECIAL CONDITIONS: BEDROOMS_ _ I DECKS_ _ CARPORT I ' NOTICE BATHROOMS__ TOTAL SQ. FT. GARAGE I 1 '1 ATTACHED IJ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT L_ OR AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE [ ; 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 certify th19A I am a currently registered contractor in WORK IS COMMENCED. the Stat lyof Washington and I am aware of the FOR F F I C E USE ONLY ordinan requirements regulating the work for which the p mit is issued and all work done will be in conf mance therewith. PERMANENT SHORELIN SEASONAL ! FLOODPLAIN FI E.D. NO. S.E.P.A. By Special Approvals IN OUT YES APPROVED NO Lic. Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. �- 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. which this permit is issued and that all work done will ROAD ACCESS be in conformance there ' h. MOTOR VEHICLE PERMIT 1 LICA ON ACCEPTED BY PLANSf�ECK BY APPROVED FOR Owner—* Date PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH MASON COUNTY 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. ll b,, 3� 3EL /2 �� gI652g Owner 2. ^�L r 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 v cd ��X 3i� Ef1mm- � ,�s LE Al-DESCRIPTION j 6FA1 d%�c L pF �1 / / .2 2 � �//f� Location J Of (q-c,� E-"4 K Z V Building NO, PLUMBING FIXTURES FEE WATER CLOSETS �S BASINS BATH TUBS SHOWERS r WATER HEATERS f AUTO.WASHERS ISINKS `J FLOOR DRAINS DRINKING FOUNTAINS s�l7U u,9 7cti LAUNDRY TRAYS ;yam r Connect to City Sewer DISH WASHER DISPOSAL URINAL -- (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 i`✓ Date pemit issued Permit number Receipt No. PLOT PLAN ADDRESS , //'7 l C PERMIT NO. 0 o n s a o LEGAL 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"ID 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. INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' P7� ABM I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without first obtaining approval. NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE 6H ELTON PRINTING