HomeMy WebLinkAboutBLD5755 Final SFR - BLD Permit / Conditions - 1/2/1980 C.arstensen, Donald M. #5755
` 8-15-77
Lot 19 & 20 Jesfield Tracts 30-23-1
E. of Mission Creek Tracts about 1 block E of
Jesfield.
Residence Plumbing Permit issued
$24,640.00
f� 77��.
4.. BUILDING PERMIT APPLICATION
' MASON COUNTY
P.O. Box 1816 Shelton, Washington 98584
DATE ISSUED X
PERMIT'NO.
OWNER , N, MAIL
A . DDR SS CITY h STATE ZIP PHONE p
a „— O d!'D
DIRECTIONS
TO JOB SITE
LEGAL ,t_ (❑SEE ATTACHED SHEET)
DESCR.p C l� ', v2O �a�a/��c�l✓ �C�_�� — f
NAM IL ADDRESS CITY 6 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: EW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
I
Valuation of work: $ PLAN CHECK FEE _ �,�} PERMIT FEE C
` SPECIAL CONDITIONS:
A LIGATION ACCEPTED BY PLANS CHECK BY APP ED FOR ISS ANCE Type of Occupancy Division
BY G$. Const. Group
,t'L
Size of Bldg. No. of Max.
(Total)Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT.
Firm PUBLIC WORKS
ROAD DEPT.
!I Sy
/Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIREDFOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be yil conformance thereWth. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
/ IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner Date. WORK IS COMMENCED.
J LAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK M.O. CASH
MASON COUNTY PLANNING DEPARTMENT
P.O. BOX 186 Shelton,'Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT— Complete ALL items. Mark boxes where applicable.
Name Mailing address—Number,street,city,and State Zip code Tel.No.
Owner } pa
2. f
Contractor L
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
SignatVi f applicant jam/ Address /} / Application date Q// I�c+, ll✓�; ��U
LEGAL DESCRIPTION
Location ����
Of f 7— _/J
Building �. G L d t C /� �l G` �'� �' /j/i✓ /`i
NO.. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS
BATH TUBS
SHOWERS A
WATER HEATERS J e5 Ll TVP��S
AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS `
LAUNDRY TRAYS
N
Connect to City Sewer ��� \
DISH WASHER n
DISPOSAL
URINAL
- _ 11,6
(Show Street Names &i roperty Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT 00 MS SKETCH IN SEPTIC TANK & DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
p rov by �D Permit fee Date pemit Issued Permit number
umbe Receipt No.