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HomeMy WebLinkAboutBLD0473 SFR - BLD Application - 5/19/1992 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES 426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 _ v ` 427-9670 DATE ISSUED/ PERMIT NO. ?3 NAME MAIL DRESS CITYr ZIP PHONE OWNER P 142 A I DIRECTIONS l- 11 T TO JOB SITE 3C� ►"l 1 CsdNoe_zLk Eh 0-F IZ I r e I .PARCEL LEGAL NUMBER /k3� 4/, Cj" DESCR. GV jg' NAME l CONTRACTOR MAIL ADDRESS CITY&STATE ZIP PHONE LICENSE NO. el USE BUILDING CLASS OF NEW /� ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE Ca�S�Un ]� '{- 6m c WORK C. l� MEU AREA: 1 NUMBER OF: PLEASE INDICATE: NOTICE ��1 SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR RESIDENCE &qFt STORIES SHORELINE CONDITIONING. BASEMENT- SgFt BEDROOMS PRIMARY RES. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT DECKS SgFt BATHROOMS rn SEASONAL RES.❑ 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. CARPORT © SgFt FIREPLACE_ IS CARPORT/GARAGE GARAGE C) SgFt ATTACHED O DETACHED❑ 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 APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. XOWNER E 3 X BY DATE FOR OFFICE USE ONLY _ DEPARTMENT APPROVEDJO DEPARTMENT YESPPROVEDJO BUILDING VALUATION �, J HEALTH PUBLIC WORKS FEE PLANNING FIRE MARSHAL BUILDING PERMIT y D.O.T. BUILDING PLAN CHECK C. SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE WOODSTOVE NP�Iu See Clh:�� t}if Ir[I � .4�'n �., JeJc� S 7�Q12zz PLUMBING MECHANICAL STATE BUILDING FEE :Y PPLICATION CEP_TED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION ' 3 B CASH CK MO TOTAL / Q PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES 426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. OWNER NAME. PAAIL AD RESS CITY B�TATE ZIP PHONE i ..6 Z 0a. � 's ",�W - Q DIRECTIONS (� TO JOB SITE Ic �'1� L Red-f I r I� . De n r ra n LEGAL /Op2f4 L DESCR. T!Z 16 qq< Nui SG' K 6066(t) CONTRACTOR NAME MAILADDRESS CITY SSTATE LICENSE NO. ZIP PHONE S ELI= _ OF BUIELD NG Nov ov w'— PLUMBING FIXTURES MECHANICAL FIXTURES NO. 2.00 PER FIXTURE OR TRAP F E5,) NO. TYPE OF FIXTURE FEE WATER CLOSETS FORCED-AIR/GRAVITY TYPE FURNACE 6.00 3 BASINS FLOOR SUSPENDED FURNACE 6.00 BATH TUBS - BOILER/COMPRESSOR 6.00 ell SHOWERS B REPAIR/ALTERATION 6.00 WATER HEATERS _ '� REFRIGERATION COMPRESSOR SYSTEM 6.00 AUTO.WASHER - AIR HANDLING UNITS 7.50 j SINKS I 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 FIRE SUPPRESSION 5.00 CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISHWASHER DISPOSAL URINALS PERMIT BASIC FEE 3.00 (J PERMIT BASIC FEE 10.00 TOTAL TOTAL , $_P_ECIAL 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 AMA 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 HICH THIS PERMIT IS ISSUED AND THAT ALL REQUIREMENTS REGULATING THE WORK FOR WHICH THIS PERMIT IS ISSUED AND ALL WORK DONE WILL BEIIN CONFORMAN HEREWITH. NO CHANGES SHALL BE MADE WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAIN NG ROV F M THE BUILDING DEPARTMENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. X OWNE � DATE -? - g' 7 2 X BY DATE FOR OFFICE USE ONLY APFLJCATIOV VCJEPTED BY PLANS CHECK BY BUILDING GROUP APPROVED FOR ISSUANCE PERMIT VALIDATION BY CASH CK MO