The URL can be used to link to this page

Home My WebLink AboutBLD25801 SFR - BLD Application - 5/31/1990 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED C6/ �Q PERMIT NO.��Q� AME MAIL ADDRESS CITY&STATE ZIP PHONE OWNER _ r! 7 �0• e-Llcctiv a. 28 a.7s- .321 DIRECTIONS DD / yp TO JOB SITE e M� Qc [� e cu T Tu rN/ /V�c vrl i r TD fa vGL X SOr/ �s o f /i o D eA/S �-3- N MBER /a 1 31 QOo/o PARCEL v DESCR. NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR G rJlr✓,vev USE OF ,J BUILDING /7 UMe CLASS OF NEW ADDITION ALTERATION REPAIR MOVE TR-EMOVE WORK r DESCRIBE WORK Lti L % e,-r ore BEDROOMS DECKS g X a•`/ CARPORT llX,2 NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTALSQ.FT. 19;2- GARAGE &,19- CONDITIONING. NO.OF STORI ES BASEMENT a - ATTACHED Al#_ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SQ.FT. FIREPLACE Kc TACH ED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL OWNERS FFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY HAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTR ON LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIRE ENTS 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 CON RMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAIN G APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. O ER � DATE X BY DATE FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION ��J`1 YES NO YES NO J x HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT C), , D.O.T. BUILDING PLAN CHECK Q,S7� SPECIAL CONDITIONS BUILDINGGROUP -31 PRE-INSPECTION tic SHORELINE WOODSTOVE ALL CONSTRUM ION MUS I WE 1 �� pC PLUMBING OR "sICEED 1.01154%L CONS. IF ANYJ� (� MECHANICAL --z-, I . P!JASE CALL THIS STATE BUILDING FEE 0F � '; "31ICTIQN STATE SURCHARGE APPLICATION ACCEPTED BY PLANS CHECK BY A �FrIISUAN CE PERMIT VALIDATION � �' �- I-)-ci�, BY CASH CK MO TOTAL PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. OWNER NAME MAILADDRESS CITY 8 STATE ZIP PHONE P_o•By c� DIRECTIONS TO JOB SITE o� T6 ew" i�-k Tu rev o a l i s c� cv0 «-T sar s W enTr NX%5_76) LEGAL DESCR. CONTRACTOR NAME MAILADDRESS CITY BSTATE LICENSE NO. ZIP PHONE USE OF BUILDING 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 O FLOOR/SUSPENDED FURNACE 6.00 BATH TUBS BOILER/COMPRESSOR 6.00 2 SHOWERS Q v REPAIR/ALTERATION 6.00 WATER HEATERS '�p�: ' REFRIGERATION COMPRESSOR SYSTEM 6.00 AUTO.WASHER 2-0C' AIR HANDLING UNITS 7.50 SINKS Q L} HEAT-PUMPS 6.00 FLOOR DRAINS EACH GAS PIPING SYS.2.00 PER OUTLET DRINKING FOUNTAINS VENT.FAN SYS.3.00 PER UNIT O LAUNDRY TRAYS `2-,0 0, CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISHWASHER Z 0 C DISPOSAL URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL Pj, 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 FIRST OBTAININ PPRO AL FROM THE BUILDING DEPARTMENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. X OWNER DATE _�T-�y X BY __ DATE__ FOR OFFICE USE ONLY APPLICATION ACCEPTED BY PLANS CHECK BY BUILDING GROUP APPROVN F SUANCE PERMIT VALIDATION •— � C'' i k�' J BY CASH CK MO PLOT PLAN ADDRESS PERMIT N0. 0 o S� 7T —A i SKe 7`� f . a LEGAL �1 ' " DESCRIPTION LOT BLK ADDITION )0.. 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 AND 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' )ic .T 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. �� AP-1f ?� NAME(S) OF OWNER(S) OF SITE s STRUCTURE(S) (PRINT) SIGNATURE OF OWNERIS) OR AUTHORIZED REP ESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE