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Home My WebLink AboutBLD N/A Wood Frame Bldg on Slab - BLD Application - 3/15/1991 T G�(ft�'•�i Galmr� �� '�� BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE 444 DIRECTIONS TO JOB SITE PARCEL 'LEGAL yf. NUMBER t _ v ' DESCR. f+- NAME MAIL ADDRESS CITY&STATE LICENSE ZIP P NE CONTRACTOR L _ Z USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE WORK BEDROOMS__ DECKS CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING. NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT TOTAL SQ.FT.3 COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR FIREPLACE___ DETACHED ABANDONED FOR A PERIOD OF180 DAYS AT ANYTIME AFTER WORKISCOMMENCED PERMANENT SHORELINE SEASONAL OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENTS 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 IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING AP ROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. XOWNER r ATE .i�,t, � XBY _ DATE FOR OFFICE USE ONLY DEPARTMENT YES PPROVENo DEPARTMENT YESPPROVENO BUILDING VALUATION HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION `J — 5 SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE STATESURCHARGE APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION TOTAL IBY I CASH CK MO BUILDING PERMIT PLOT PLAN MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. Box 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. NAME MAIL ADDRESS CITY&STATE ZIP PHONE OWNER �� Z DIRECTIONS TO JOB SITE PARCEL LEGAL O` NUMBER DESCR. Indicate below: O Property lines and dimensions. O Easements and roads. O Septic, drainfield and reserve area, or sewer. O Septic tank and drainfield setback distances from foundations. O Location of proposed construction on property. O Building &septic system setback distances from all property lines& easements. Indicate North O Well and water line. In Circle O Saltwater, lakes, rivers, streams,wetlands, drainage. O Attach copy of septic system"as built" or septic permit approval. O Indicate topography profile of property and structure on reverse side. i i ' o � y � 3 a 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. SIGNATURE OF NER(S) R AUTHOR D REPRESENTATIVE DO NOT WRITE BELOW THIS E APPROVED DISTRICT AS NOTED DATE TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE I PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 426-5593 DATE ISSUED PERMIT NO. NAME MAIL ADDRESS CITY&STATE ZIP PHONE OWNER DIRECTIONS TO JOB SITE LEGAL DESCR. I 3 _ [�,/ V. CONTRACTOR NAME MAILADDRESS CI Y&STATE LICENSE NO. ZIP PHONE USE OF BUILDING (j 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 TOTAL 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 FIRSI OBTAINING APPROVAL.FROM THE BUILDING DEPARTMENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. X OWNER -DATE � X BY DATE FOR OFFICE USE ONLY APPLICATION ACCEPTED BY PLANS CHECK BY BUILDING GROUP APPROVED FOR ISSUANCE PERMIT VALIDATION BY CASH CK MO