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Home My WebLink AboutBLD29825 MFG Home - BLD Application - 1/14/1992 J BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES 426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 II 427-9670 DATE ISSUED lL PERMIT NO. D NAME MAILADDRESS CITY&STATE ZIP PHONE OWNER r 1 rq/IS- /3 S` DIRECTIONS TO JOB SITE 01Y c e G k PARCEL LEGAL I NUMBER DESCR. `—S O NAME MAIL ADDRESS CITY&STATE ZIP PHONE LICENSE NO. CONTRACTOR G USE OF BUILDING (�(C CC CLASS OF NEW -7 ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ v DESCRIBE WORK AREA: 7p+` NUMBER OF: PLEASE INDICATE: NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR RESIDENCE -'bqFt STORIES SHORELINE❑ CONDITIONING. BASEMENT SgFt BEDROOMS ~ PRIMARY RE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT DECKS $ Ft BATHROOMS SEASONAL RES.❑ COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR g ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. CARPORT SgFt FIREPLACE IS CARPORT/GARAGE GARAGE SgFt ATTACHED 0 DETACHED❑ 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. APPRO L FROM THE BUILDING DEPARTMENT, X OWNER DATE X BY r x�ATE FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION 34 )99 YES NO YES NO � HEALTH k�-��,'� �Ai, �'\ PUBLIC WORKS FEE PLANNING FIRE MARSHAL BUILDING PERMIT i0 q 1,5 D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE WOODSTOVE SSJ PLUMBING MECHANICAL STATE BUILDING FEE APPLIC TION ACCEPTED BY PLANS CH C BY APPR D F ISSUANCE PERMIT VALIDATION 4 BY I 11 '' CASH CK MO TOTAL PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES 426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 427-9670 DATE ISSUED 3/61 PERMIT NO. NAME MAILADDRESS CITY&STATE ( ZIP PHONE OWNER o „ a ; w v 0Z S, r a. sk {e IS$ 0�v d1 2 y2s` BPS of DIRECTIONS // r TO JOB/SITEAl., t/ v 3 Z a � kt c{vLA �r T fD p L wr p le u L LEGAL / DESCR. �a4 .-3 � Gi �� '� i1c Li �•, [atoic � CONTRACTOR NAME I MAILADDRESS CITY&STATE ( LICENSE NO ZIP PHONE d z o r4 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 Z DRINKING FOUNTAINS VENT.FAN SYS.3.00 PER UNIT LAUNDRY TRAYS FIRE SUPPRESSION 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 TA NING APPROVAL FRO rCTHE BUILDING DEPARTME�N+T. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. X�WNER DATE S / L X BY _ _ _ DATE__ FOR OFFICE USE ONLY APPLICATION ACCEPTED BY PLANS CHECK BY ILDING GROUP APPROVE FOR SSUANCE PERMIT VALIDATION BY CASH CK Mo ' BUILDING PERMIT PLOT PLAN MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. Box 186 SHELTON, WASHINGTON 98584 427-9670 oar ISSUED PERMIT NO. NAmE MAiL ADDRESS I i d TATE ZIP PHONE OWNER I avt` J4 dd3 S Akk 5 34;6, # 't V2sh S`U( ?Y3 Ly 01RECT10NS TO JOB SITEOld I a A.4 C 'RCC 'V(!Fj (_T_ ;:SZ r' t_-- <.� Cll� PARCEL LEGAL ��,,S NUMBER I DES(:;;DES(:;; i NC `c� `d"- �Pf V 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. 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. I I 1 I ( ( i II 4 1 1 W 1 1 1 _ �in2^.S CnS and uS2S 5`Jwn above and:oat no changes NiII bE^dC2 vit`Ju:lira,J7tai^.nCy apprJval. TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE III I I I II I I i l l l i II II II IIII ► 1