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Home My WebLink AboutBLD0310 SFR - BLD Application - 10/9/1990 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED /%/p PERMIT NO. 3 10 NAME MAIL ADDRESS CITY&STATE ZIP PHONE OWNER APST_ /YI c C O LE55 �q$o OLO gEc� fl7w c3E�� 9�S Z)S-¢7 DIRECTIONS TO JOB SITE Aj&X isEc F f- 1jW17 PARCEL �7-3z9 // fo0 9D LEGAL Or N tiE C ��eL 3 aF bP 0 /J7Z NUMBER DE§CR. T29 NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR TIM&R. wa- co,LuT f r 0. 30)( 77Z EcF,gh2 -72)m13E'G /24Ko 7-7S-0/2 USE OF BUILDING ZES O�Lr` CLASS OF NEW ADDITION ALTERATION FREAIR MOVE REMOVE WORK DESCRIBE WORK BEDROOMS Z DECKS OR N CARPORT y NOTICE TOTAL SQ.FT. -A DECK GARAGE to- PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS 2' TOTAL SO.FT. go TOTAL SQ.FT. CONDITIONING. NO.OF STORIES Z' BASEMENT Y OF& THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT LIVING AREA BASEMENT COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SO.FT. 1#29 TOTAL SQ.FT. CHECK ONE ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT '� FIREPLACE ATTACHED SEASONAL s,06RELINE DETACHED OWN/PROVAL CONTRACTORS AFFIDAVIT I CER EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIHICH 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 COHEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAI FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. Q X OWNER DATE X BY 9o)7 3e� —DATE / 3 -1?0 FOR OFFICE USE ON Y DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION 7 S 7�O YES NO YES NO , HEALTH UE PUBLIC WORKS FEE PLANNING AFIRE BUILDING PERMIT d O D.O.T. BUILDING PLAN CHECK C)eD SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION AIA (� SHORELINE N 1►v 1 t\1 LG F1>ty 17 r L� to 10 Q, l WOODSTOVE r N , PLUMBING l 9 0 MECHANICAL a STATE BUILDING FEE 0 STATE SURCHARGE APPLICATION ACCEPTED BY I PLANS C K BY APPROVED FOR I UANCE PERMIT VALIDATION TOTAL -, BY v/ CASH CK MO PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. OWNER AME MAIL ADDRESS CITYRSTATE ZIP PHONE YhLC OG�s 'r8v ono (3&_Ff'� !•lt4v - 8SZ6 a7S-47 DIRECTIONS TO JOB SITE d) 7`0 pLP LEGAL G� LEGAL (Z3 Z 1 1 `�Ob %0 0t= ifJE-A/&_ P4tccZ 3 o Fs CONTRACTOR NAME MAILADDRESS CITY SSTATE LICENSE NO. ZIP PHONE ImBZ-Et-t r?0,117- 5t-Lfi-e- ►n5er-/z4Cv 2a5-9317-7 USE OF e� BUILDING ( DG PLUMBING FIXTURES MECHANICAL FIXTURES NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE_OF FIXTURE 0< FEE Z WATER CLOSETS a / FORCED-AIR/GRAVITY TYPE FURNACE 6.00 Z BASINS d FLOOR I SUSPENDED FURNACE 6.00 BATHTUBS / '5#?UICr_ Lo O BOILER/COMPRESSOR 6.00 / SHOWERS .� REPAIR/ALTERATION 6.00 7 WATER HEATERS Q REFRIGERATION COMPRESSOR SYSTEM 6.00 AUTO.WASHER AIR HANDLING UNITS 7.50 SINKS Orr, Q6 HEAT-PUMPS 6.00 FLOOR DRAINS Z EACH GAS PIPING SYS.2.00 PER OUTLET 040 DRINKING FOUNTAINS VENT.FAN SYS.3.00 PER UNIT LAUNDRYTRAYS / WOOD STOVES 5.00 CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISH WASHER DISPOSAL URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL / , pQ TOTAL -72 0'D SPECIAL CONDITIONS: � _ F_-- NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 1 h� AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS ►_L 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 Vqq BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. WITHOUT FIR TAINING ROV FROM THE BUILDING DEPARTMENT. V XOWNER DATE __ XBY DATE / 3 --CIO FOR OFFICE USE ONLY APPLICATION ACCEPTED BY PLAN OK BY BUILDING GROUP APPROVED OR IS NCE PERMIT VALIDATION IBY CASH CK MO PLOT PLAN ADDRESS "�� dLi� ��L�jJ//� ►�lu. i PERMIT NO. 4 `o LEGAL TKO of Air. /V� / Af'cEL f%1 Kt t c o DESCRIPTION LOT BILK ADDITION 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. INDICATE NORTH IN CIRCLE G7t7X?FrSWARI=S-Aflf"5' X 5' Off=i=Wq0f' O O d 0 P1 E C F R + iZ %f U 000, RL V IV. �1 t w �51 I' W / I I ' i r E I/We Cartify 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(3) OF OWNER(SI OF SITE i STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(!) OR AUTHORIZED REP ESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE