HomeMy WebLinkAboutBLD8055 SFR - BLD Permit / Conditions - 6/25/1975 Suko; A. ' #8055
6-25-75
Lake Limerick #4, Lot #131
Cabin
$12,457.60
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BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Box 400 Shelton, Washington 98584
DATE_
D
PERMIT NO.—,51�2��
Applicant to complete numbered spaces only.
JOB ADDR ESS
LAKE LiMg etc V -biJ -- - --=Lv 1 - --
1 DESCR. 1eAg
3LEGAL - ISEE ATTACHED SHEET)
�/^ 1 I I` _�
OWNER MAIL ADDRE55 ZP PHONE
CONTRACTOR MAIL ADDRESS PH ON F. LICENSE NO.
3 _ CONPI
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.
4
ENGINEER MAIL ADDRESS PHONE _ LICENSE NO.
5 tt o K3 _ 1`4&1011 C�
LENDER MAIL ADDRESS BRANCH
6 —
USE OF BUILDING
8 Class of work: X NEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
9 Describe work:
10 Change of use from
Change of use to
11 Valuation of work: $ —�6 /
4 S (J PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
Type of Occupancy _
Const. V Group Division
Size of Bldg. No. of > Max. /
(Total)Sq. Ft.// c, Stories / Z Occ. Load l
Fire p Use Fire Sprinklers
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY. Zone Zone Required ❑Yes []No
No. of O ET PARKING SPACES: ,
Dwelling Units Covered
Uncovered
N O T I C E Special Approvals Required Received Not Required
ZONINC.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEALTH DEPT.
HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION FIRE DEPT.
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC- OTHER (SDecify)
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
I hereby certify that I have read and examined this application and
know the same to be true and correct. All provisions of laws and
ordinances governing this type of work will be complied with whether
specified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any other state or
local law regulating construction or the performance of construction.
1
51G ATU RE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
SIGNATURE OF OWNER IF O NER BUILDER DATE)
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
V _.H CLTON PfItNTitiG CO
MASON COUNTY PLANNING DEPARTMENT
P.0. Box 400 Shelton, Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT —Complete ALL items. Mark boxes where applicable.
1. LEGAL DESCRIPTION
Of
to L1ri�l� �-V— � 1— -- -- - —
N S N S 1 —
Building
E W side of _ __- _ ) feet E W from intersection of
�ZlSect. Twp. —�C./ ��i __ Range _ __
NO. PLUMBING FIXTURES FEE NO. GAS APPLIANCES FEE GAS PLUMBING
WATER CLOSETS r S0 EACH UNDER 60 MBTU SEWER SEPTIC TANK
BASINS /ISO EACH 60 TO 120 MBTU
BATH TUBS r Q EACH 120 TO 200 MBTU
SHOWERS EACH 200 TO 500 MBTU
WATER HEATERS EACH OVER 500 MBTU
AUTO. WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer SERVICE CONNECTION
DISH WASHER
DISPOSAL
URINAL
Distribution System
By Special Permit
c (Snow Street Names & Property Lines)
,Od
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR
GAS AND WATER, SKETCH IN SEPTIC TANK & DRAIN
FIELD LOCATION OR SUBMIT ON OTHER SKETCH.
PERMIT 1. � PERMIT
FIELD INSPECTION
Date By Remarks
Name Mailing address —Number, street, city, and State Zip code Tel. No.
Owner ---------------- — -
Contractor --.-- -- —
The owner of this building and the undersigned agree to conform to all applicable laws of.Mason County
Signature of applicant Address Application date
DO NOT WRITE IN THIS SPACE _— FOR OFFICE USE _
Appr ed by Permit fee 51 Date permit issued Permit number Receipt No.
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