HomeMy WebLinkAboutBLD0375 Garage - BLD Application - 5/14/1991 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAMI MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER c p SBZ 1 1 U/ 5_2f3 (z 275-2
DIRECTIONS * I
TO JOB SITE OF /,v ERSEG c,v U 4,,y 10(c C' Srlol E + hwy 3 Twa
RIGHT AT REALTY 7 reLf-eLu 5�✓TH DRIVIEWAy ALCNG CHAIv L-Ivk Frz,'cE To 13 ,,,E F}c pA-' NILt
�QI v r1 Y.
PARCEL LEGAL S/-1M B 77hELEA tic•-lE CAPPOV T4AGTS
NUMBER 12331 -SLj-60`03 DESCR. 62,i' 0,F �Vj,66' oF 27, TA lAtb OF ? � S/-3. AIR * 23 0 Oo 0
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR E
USE OF
BUILDING E
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK
DESCRIBE
WORK
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTALSO.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED 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
TOTAL SO.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
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.
X OWNER DATE
FOR OFFICE USE ONLY
DEPARTMENT YES APPROVEDJO DEPARTMENT YES DEPARTMENTBUILDING VALUATION
HEALTH ��. � PUBLIC WORKS FEE
PLANNING 41L.- FIRE BUILDING PERMIT
D.O.T. BUILDING :: ` PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP / PRE-INSPECTION
J SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE y STATE SURCHARGE
APPLICATION ACCEPTED BY P�LAANSS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
$��Y ✓L�l cJT f _/Y-��� BY./7 ^i YJ /� CASH CK MO TOTAL '�
PLUMBING & MECHANICAL PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 IVI
427-9670 DATE ISSUED S 5fly_/
PERMIT NO.0:3 T-S--
NAME MAILADDRESS CITY 8 STATE ZIP PHONE
OWNER 6 Box 5.&2 BC-LFAIA, W4 9,05281-75--ZSIA
DIRECTIONS
TO JOB SITE Ili NoRld OF HW D& C-Soyrn S8,08d 4 Hivy 3 Tugv gi&HT Ar REAi_ry Z FOu,C
Svvi H DR►VEkAt ALDA/d CHA►4/ Lltil< Fi_veE -p BLUE Howl_ O.v Hat pT Fva OF DalvfwAy
LEGAL SAM 8 TMELER10ME 6ARJ)EAI TRAcm W 7b5 OF E 1 0- B ,S O /b8 OF TR 29_
DESCR. T8 IA 13OF SP * 1523, EdRCEL # 3
CONTRACTOR NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
USE OF
BUILDING
PLUMBING FIXTURES MECHANICAL FIXTURES
NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE_OF FIXTURE FEE
WATER CLOSETS / FORCED-AIR/GRAVITY TYPE FURNACE 6.00
BASINS �' / FLOOR/SUSPENDED FURNACE 6.00
BATH TUBS BOILER/COMPRESSOR 6.00
SHOWERS 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 WOOD STOVES 5.00
CONNECT TO CITY SEWER WOOD FURNACE 5.00
DISHWASHER
DISPOSAL
URINALS
PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00
TOTAL / TOTAL
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 I 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 THEREWITH. NO CHANGES SHALL BE MADE WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
WITHOUT FIRST TAINING APPROV L FROM THE BUILDING DEPARTMENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT,
X OWNER DATE 5 X BY DATE
FOR OFFICE USE ONLY
APPLICATION ACCEPTED BY P S C ECK BY BUILDING GROUP APPRqV.ED FOR ISSUANCE PERMIT VALIDATION
BY �y C,/ CASH CK MO
BUILDING PERMIT PLOT PLAN
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. Box 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER dQ 02- fil ' Lth' c135.26 (21-104-75-25-98
DIRECTIONS
TO JOB SITE18 1 AloR " OF /A1TERS6CT10A1 Of O(7 (SOV18 SdeRk `Y RIVY U IGNt
Ar REA1?Y 7 Fou--w Sbvrii nRIVr-WAY &,v6 CHAvv LtAK FEkE T. OLVE t4OVSF_ 19T )EVb 0F1DqjVELAY
PARCEL LEGAL AM rl ROEA1 ALTS W 7 OF 181 cI 92.5
NUMBER L332�-50- DESCR. L6 OF TA 29 `" 3 # o
Indicate below: O Property lines and dimensions.
O Easements and roads.
O Septic, drainfield and reserve area, or sewer.
O Septic tank and drainfield setback distances from foundations.
0 O Location of proposed construction on property.
O Building & septic system setback distances from all property lines& easements.
Indicate North O Well and water line.
O Saltwater, lakes, rivers, streams,wetlands, drainage.
In Circle O Attach copy of septic system"as built" or septic permit approval.
O Indicate topography profile of property and structure on reverse side.
� GE
� I
� 1AW E
QkAiAll ' - 5
30 2 0
l
TA AIX 8z.5'
' 2.5' l0 26
1PRIVITE Li y 20' N
6
I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without first obtaining approval.
X —5z- /2 2 7 1 —
SIGNATURE OF OWNER(S)OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED-- _
DISTRICT AS NOTED , )/S-/y F1 DATE
k �
TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE
POISE