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Home My WebLink AboutBLD26914 SFR - BLD Application - 10/15/1990 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 /�� (� 427-9670 DATE ISSUEDA PERMIT NO. ^ rq lL NAME MAILADDRESS CITY&STATE ZIP PHONE OWNER L O0 9�s5 DIRECTIONS TO JOB SITE O\ PA CEL LEGAL NUMBER �� DESCR. CONTRACTOR AME MAIL ADDRESS CITY&STATE LICENSE NO. )'D ZIP PHONE USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK DESCRIBE WORK &( / BEDROOMS DECKS @DR N CARPORT NOTICE TOTAL SQ.FT. DECK GARAGE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTAL SO.FT. ) TOTAL SQ.FT. CONDITIONING. NO.OF STORIES BASEMENT Y OR N THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT LIVING AREA BASEMENT COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SO.FT. TOTAL SQ.FT. CHECK ONE ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT FIREPLACE ATTACHED SEASONAL T SHORELINE DETACHED r OWNERSAFF DAVIT CONTRACTORS AFFIDAVIT I CERTIFY TH I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATIO LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMEN 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 CONFOR ANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING PROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. X OW DATE X BY DATE FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED YES NO YES NO BUILDING VALUATION /d Z "DO P HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK O SPECIAL CONDITIONS BUILDING GROUP --3 PRE-INSPECTION FA pA SHORELINE WOODSTOVE PLUMBING 7 0 MECHANICAL O STATE BUILDING FEE 60 STATESURCHARGE APPLICA ON ACCEPTED BY PLANS CHE BY APPROVEDOR I UANCE PERMIT VALIDATION v" ^y� BY �r�'` CASH CK MID TOTAL �( n PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 �J 427-9670 DATE ISSUED PERMIT NO. OWNER AME MAILADDRESS CITY&ST E ZIP PHONE s�ov mr 9y DIRECTIONS TO JOB SITE IV iOL LEGAL 7-11 K- DESCR. CONTRACTOR A MAILA RESS CITY&STATE 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 6, o C7 FORCED-AIR 1 GRAVITY TYPE FURNACE 6.00 BASINS p FLOOR/SUSPENDED FURNACE 6.00 BATH TUBS p Q BOILER I COMPRESSOR 6.00 SHOWERS C REPAIR/ALTERATION 6.00 WATER HEATERS 0 REFRIGERATION COMPRESSOR SYSTEM 6.00 AUTO.WASHER V.pQ AIR HANDLING UNITS 7.50 SINKS �9 HEAT.PUMPS 6.00 FLOOR DRAINS EACH GAS PIPING SYS.2.00 PER OUTLET p� DRINKING FOUNTAINS VENT.FAN SYS.3.00 PER UNIT LAUNDRY TRAYS WOOD STOVES 5.00 CONNECT TO CITY SEWER WOOD FURNACE 5.00 r DISHWASHER O G' DISPOSAL URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL , 0 TOTAL 14,. p 0 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 OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. WITHOUT OBTA NING APPR UAL FROM THE BUILDING DEPARTMENT. X OWNER DATE X DATE FOR OFFICE L16E ONLY APPLICATION ACCEPTED BY PLANS C_HEC. Y BUILDING GROUP APPROVED R ISSU NCE PERMIT VALIDATION K .� -3 BY CASH CK MO _ _ _ _ __ _ , _ __ _ __ -_ _ ___ _ _ ___ _ _ 1 no/1 n/ran WATINI IN tiara i rin A :' - AJ IMMARY R�-_ ,lRT Fas�nrc► 1 P T f F r•\W^A\�;rar`?1 1 N^F Wnl IPP T r)F=NT T F T rAT T nN ----------------------------------------------------------------------------------- Wry t•::--r. Tr)• 1 It. 1 'I I tv - Mtacnn rr tr•Ity P1 Ir) Nn :? Arir^Ir",=!-:: • Al I T^nN AMPP. I nT' Ica Aria l v%:t • wri I Y RI IFr:HFI f?t t 1 1 r1r✓r • PAF?An T^F Rl I T 1 r)F F,n I r,r,a t 1 nrr ni YMP T A'I nt,tnar • I YI F NFI ^nN F1 nnr Ar.-a • •1 Q/1'D. +t.':" xceaau x a:xr_-Ysscxrm:rsocaam rm:rex,mms,zxux f 11 lAI T F-T(^.A'T•T nN r`R,�r TF=P T A wemsse nu�xa+n w:acw: ®a.m mcmcn,arsxce: m o:x. ! ":r 1F7F Fi rinnr) r`.F=NTr;/ ! i NnPTHWF•^T FNFRr3Y rnr)F 1-tGFF'RF=Nr:F r IRRF'NT F:,FInprl.^-,Fr) ! ! Tt.,arrna 1 Ga•r•f'rtrrnartr•a AR'l IULI ! F:'nar`r'Yv F?t tr^Ir`t.::•t•. i k W!-,l•F t.!?.._vr r. •� •�y `>, �� ::; r.:;�? r 1 I ! 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Box 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. NAME MAIL ADDRESS CITY&STATE ZIP PHONE OWNER S DIRECTIONS TO JOB SITE TL -e- i6 ` PARCEL LEGAL 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. 0 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. a 0 O 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. S TURE Oro W- NER(S)OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BOW THIS LINE APPROVED DISTRICT AS NOTED DATE TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE