HomeMy WebLinkAboutBLD29743 3rd Addition - BLD Permit / Conditions - 12/20/1991 Plumbing:
Mech '�3
shorelines: a ca
,Wtback: 7
;pedal Final:
conditions: Mobile Home:
Smoke Detector:
Remarks:
ooting:
jetback:
roundation `•
Walls:
Framing:
Fireplace:
Woodstove.
TYPE: ADDr.ION
AREA:
ALFItED Tee: 27:-6580 Date: 12-20-91
'Jwner: A�OBOX 171, BELFAIIt,
Address: P.O.Permit #: 29743 Floors: 1 Sq Ft: 504
Contractor: SELF
Phone: S COyE DIV 6 LOT 6 LEFT) FOR
Legal Description: D
BEARHILL TO LARSON BLVD (
Direction to job site: SAND LEFT TO 3RD LOT ON LEFT
1/2 MI TO SALTY DRIB
y2ilot-iw" Woodstove X
Plumbing X Mechanical X Garage
Fireplace Deck
Basement Loft
Carport
Conditions: NONE
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED O ��
PERMIT NO.
NAME MAILADDRESS CITY&STATE ZIP PHONE
OWNER ALFRED M. ARDON P.O. Box 171 BELFAIR, WASH. 98528 275-6580
DIRECTIONS From Belfair take hwy. 300 to Sandhill Rd. , right on Sa.ndhill Rd.
TO JOB SITE . , g g
to Larson Blvd. , go left on Larson Blvd., for a 112 mile to Salty Dr, go left on
NUMBER 12330 53 00006 DESca. Beard's Cove Div. 6 Lot 6 Belfair Mason County.
NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR SELF
USE OF d eroom `� r��
BUILDING B �Qsp� C, n
CLASS OF NEW ADDITION im ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK New Construction
= 3
BEDROOMS_ DECKS n a CARPORT n a NOTICE
BATHROOMS TOTAL SQ.FT. GARAGE n a
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
CONDITIONING.
NO.OF STORIES 1 BASEMENT n a. ATTACHED na THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTALSQ. FT. 504 FIREPLACE n a DETACHED n/a ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT yes SHORELINE ri a
SEASONAL-m/a
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.
1/26/91
X OWNE `12 DATE _ X BY_ DATE__
FOR OFFICE USE ONLY
APPROVED APPROVED
DEPARTMENT YES No DEPARTMENT YES No BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING Q J2 FIRE BUILDING PERMIT Z -3 J
D.O.T. BUILDING � PLAN CHECK 7 f'
SPECIAL CONDITIONS BUILDING GROUP _ PRE-INSPECTION
SHORELINE
WOODSTOVE (11� /
.� l�
PLUMBINGno
LI pL �3� MECHANICAL
STATE BUILDING FEE L�
STATESURCHARGE
A CCATION ACCEPTED BY PLANS CHECK Y PP ED FOR ISSUANCE PERMIT VALIDATION TOTAL ��
''� B CASH CK MO
PLUMBING & MECHANICAL PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED D
PERMIT NO. 7
OWNER NAME MAILADDRESS CITY BSTATE ZIP PHONE
ALFRED M. ARDON P.O.B ox 171 BELFAIR, WASH. 98528 275-6580
DI OBIONE From Belfair take hwy. 300 to Sandhill Rd. go right on Sandhill Rd.
�RlWIVn J44. 919? ;fifthplifi:7'4dl*hg$iea 1 2 mile to Salty Dr.., go left on
LE AL Beard-Is Cove Div. 6, hot 6 Belfair, Wash. Mason County # 12330 53 000 6
CONTRACTOR AME MAILADDRESS CITY BSTATE LICENSE NO. ZIP PHONE
Self.
USE OF
BUILDING Bedroom
PLUMBING FIXTURES MECHANICAL FIXTURES
NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE OF FIXTURE FEE
L WATER CLOSETS > FORCED-AIR/GRAVITY TYPE FURNACE 6.00
1 BASINS FLOOR/SUSPENDED FURNACE 6.00
BATH TUBS Z co BOILER/COMPRESSOR 6.00
SHOWERS 2-0 REPAIR/ALTERATION 6.00
WATER HEATERS REFRIGERATION COMPRESSOR SYSTEM 6.00
AUTO.WASHER AIR HANDLING UNITS 7.50
SINKS 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 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 H _nc) - - TOTAL � 00
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 1 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 HEREWITH. NO CHANGES SHALL BE MADE WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
WITHOUT FIRST TAINING APPROVAL THE BU OILDING DEPARTMENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNER ^/ DATE 1/26/91 X BY DATE
FOR OFFICE USE ONLY
CATION ACCEPTED BY PLANS CHECK BY BUILDING GROUP AP ED FpfR ISSUANCE PERMIT VALIDATI
h BY s:��— CASH C MO