HomeMy WebLinkAboutBLD8893 Addition - BLD Application - 2/24/1976 13. `iesf e-id
BUILDING PERMIT APPLICATION
i MASON COUNTY
P. 0. Box 400 Shelton, Washington 98584
DATE ISSUED
PERMIT NO.
r PHONE
OWNER p�c`-'�a UI BOX � b3 R g i{G,n �d �O 27
DIRECTIONS
TO JOB SITEL _/ A i S S t b dam-
MAIL ADDRESS 21P
LEGAL ( -SEE ATTACHED SHEET)
DF.SCR.
- — -
--- ---- •MAIL ADDRESS PHONE
CONTRACTOR
USE OF MAIL ADDRESS PHONE LICENSE NO.
BUILDING I
Class of work: ❑NEW ;4 ADDITION ❑ALTERATION 'Cl REPAIR ❑MOVE ❑ REMOVE
- Describe work: t (� r Gti U U .`t t l� -�(U'i S-yo OL A 6 E P( mlv
Valuation of work:$ — I ( PLAN CHECK FEE PERMIT FEE , r-
SPECIAL CONDITIONS: M-
APPLICATION ACCEPTED BY PLANS CHECKED BY APPRQVED FOR ISSUANCE BY
�LtR Type of •W V Occupancy
Const. QAt� Group I. Division
_ Size of Bldg. '�1 No.of Max.
(Total)Sq. Ft. �v Stories Occ. Load
CONTRACTOR AFFIDAVIT $pselat Approvals Required Received Not Require
I Certify that I am a currently registered contractor In the State (311
of Washington and the County of Mason and I am aware of the HEAL-rH OF-PT.
ordinance requirEments regulating the work for which the permit _IRKIS
Is issued and all work done will be in conformance therewith. AD 0 E6FP*T.
J
Firm
By
Lic. No. Date _
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the contract
or registration law RCW 18.27, and am aware of the Mason N 0 T I C E
County ordinance requirements for which this permit is issued
and that all work done will be in conformance therewith. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING. VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC-
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
QNfI@ Date L 1 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
SHEL.TON PRINTING GO.
MASON COUNTY PLANNING DEPARTMENT
P.0. Box 400 Shelton, Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT—Complete ALL items. Mark boxes where applicable.
LEGAJPESCR1PTl0N
Location �� �
Of IN N S
Building
E W side of feet E W from intersection of
Sect. Twp. Range
NO. PLUMBING FIXTURES FEE NO. GAS APPLIANCES FEE
GAS PLUMBING
WATER CLOSETS EACH UNDER 60 MBTU SEWER El SEPTIC TANK
BASINS EACH 60 TO 120 MBTU 1 a
BATH TUBS EACH 120 TO 200 MBTU
SHOWERS EACH 200 TO 500 MBTU
r
r
WATER HEATERS EACH OVER 500 MBTU
AUTO. WASHERS ��SO
r
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS �.
LAUNDRY TRAYS
I
f •1 �
Connect to City Sewer SERVICE CONNECTION 1
DISH WASHER C�
DISPOSAL
l
URINAL
La A I t
K-�� 6Z � 1 I� 10" E�
Distribution System
By Special Permit
(Show Street Names & Property Lines)
1-ere ,od
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR
GAS AND WATER. SKETCH IN SEPTIC TANK & DRAIN
FIELD LOCATION OR SUBMIT ON OTHER SKETCH.
PERMIT r' PERMIT
FIELD INSPECTION
Date By Remarks
_ Name r 'I jMraiilling address — Number, street, city, and State Zip code Tel. No.
�S� 1 I V 1'v�/ . C7 1 J
Owner x-( ,
2.
Contractor
The owner of this building an he LAndersigged P99ee,to conform to all applicable laws of.Mason County
Siqw9ure of applicant Ad ress Application date
( O. Qn 2�3
O NOT.WRITE IN THIS SPACE_— FOR OFFICE USE _
Approved byS 4 Permit fee Date permit issued Permit number Receipt No.