HomeMy WebLinkAboutBLD2413 Duplex - BLD Permit / Conditions - 6/19/1978 Parkhurst, James•A. #2413
6-19-78
North Shore Road, right up Sandhill Road, 1.3 mi
turn left on Sandhill, Belfair Manor #3
Lot 3 Belfair Manor, 30-23-1
Duplex Plumbing Permit issued
$37,000.00
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•BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584 G r p
DATE ISSUED / �o
PERMIT NO.
OWNER NAME MAIL ADDRE S CITY&STATE ZIP &ONE
DIRECTIONS I Ay
TO JOB SITE �. Pe-RARf. _ °3 r T7 I r' Mina
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. _ #
CONTRACTOR
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
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USE OF
BUILDING
Class of work: [ANEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
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Valuation of work: $ PLAN CHECK FEE ��
o PERMIT FEE E-t)
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Type of Occupancy Division
BY Const. t Group J
Size of Bld/g. 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 X
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. IA
Firm PUBLIC WORKS
By
ROAD DEPT.
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 permi is issued and that all work done will
be in conform2(_�� �ate.
with. 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
Own/er WORK IS COMMENCED.
V
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION k,2JK M.O. CASH
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1henee. N7°o8 ' �l�o'' �, /go. huee. A' 990gV33 " 0 $77. 40 �ee.4 " 4a
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MASON COUNTY PLANNtJVCIII 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.
f O so, on 3
Owner
1Q
2.
Contractor
The owner of this buildin and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signa ure of applicant Address Application date
LEGAL DESCRIPTION +460-b el—
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Location
Of
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS
BATH TUBS
SHOWERS
WATER HEATERS
AUTO.WASHERS
SINKS _
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
I
DISH WASHER
DISPOSAL
URINAL
(Show Street Names & Property Lines)
3 INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT J'C) SKETCH IN SEPTIC TANK& DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Ap roved by Per fee Date pemit issued Permit number Receipt No.
kkAA-j fit- $ ,.�'/• '-� ��l q/7tf a2;�i3
k hti i, S-T S ✓. PLOT PLAN
ADDRESS 9 �,�/ �r._ Y \/ SD• lJ re l .Y - p�►�+u1 PERMIT NO.
LEGAL
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DESCRIPTION CYO ae- e-d LOT BLK ADDITION ry
SITE AREA -5� Sq.1W AREA OF SITE OCCUPIED BY BUILDINGS ��� O 75 Sq. Ft.
INSTRUCTIONS TO APPLICANT
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN 1-0 SCALE OF NOT LESS THAN 1"=20' ARE
FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.)
FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN-
SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA-
TION A"'D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR-
TION THEREOF.
d) INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
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I/We certify that the proposed construction will conform to the dimensions and uses shown�bove and that no changes will be made without
first obtaining approval. vi
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NAME(S) OF OWNER(S) OF SITE & STRUCTURE(S) (PRINT) SI TU F OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
1 6HELTON -M-TIN-