HomeMy WebLinkAboutBLD2070 Officel Bldg - BLD Application - 6/11/1979 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED 79
PERMIT NO. clw 7 d
OWNER NA MAIL ADDRESS CITY&STATE ZIP PHONE
DIRECTIONS O JOB S T E C'/�jg��o� 10r y
LEGAL (❑ SEE ATT CHED SHEE
DESCR. ,r4c1 dJA 5,Aw tl/- /�� �� �L kj Z� , W
NAME / MAIL ADDRESS V ,CIITY&STATE J , LICENSE NO. PHONE
CONTRACTOR ')V�o Flo- /¢ !/�PJC (N /i�� ��5=(o 6 3
USE OF
BUILDING
Class of work: >nNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE vY}
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT LJ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED f 1 SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT [� OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE LI DETACHED fI
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT 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
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT 11 SHORELINES 1 i
SEASONAL[ i FLOODPLAIN I I
Firm E.D. NO. S.E.P.A. [I
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
i formance therewith. MOTOR VEHICLE PERMIT
x 4�q ..�� APPLICATION ACCEPT BY PLA HE CK BY YAP OVED FO I UANCE
Own Date . J B
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
MASON COUNTY PLANNING DEPARTMENT
I
P.O. BOX 186 Sheltpn,Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT—Complete ALL items. Mark boxes where applicable.
Name y /�Mailing address—Number,street,city,and State S y Zip code Tel.No.
Ch
o'y o < OZO 1 j j
Owner
2. ✓�Y1t9
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signature of applicantf ,�� Address Application date
LEGAL DESCRIPP6N
Location
Of �91` 3ff lij �1Pe-3o? o23til (.cJ
Building
NO. PLUMBING FIXTURES FEE
3 WATER CLOSETS ` o0
BASINS
BATH TUBS
SHOWERS
I WATER HEATERS 1
AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS I �e
Connect to City Sewer
DISH WASHER Ir
DISPOSAL 1
~fit
URINAL
(Show Street Names 8 Property Lines)
�QS/G et .�i
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT 7 O O SKETCH IN SEPTIC TANK 6 DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Appr by �j Permit fee Date pemit issued Permit number Receipt No.