HomeMy WebLinkAboutBLD5016 Final SFR - BLD Permit / Conditions - 12/21/1979 Nutt, Reuben J . #5016
• 9-29-76
Lake Limerick, Div. 5 Lot 124
Residence Plumbing Permit issued
$25,500.00
BUILDING PERMIT APPLICATION '
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED 92?9.17 6
PERMIT NO. -5—(/f
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
xeuben ,� 2669
DIRECTIONS
TO JOB SITE Court,hake TjmP_7,j:Ck.
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING Family Residence
Class of work: 10 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Two story Barn roof, frame structure. with full Basement.
Valuation of work: $ PLAN CHECK FEE /tr' PERMIT FEE
11111300-121()
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Type of Occupancy Division
BY Const. Group
Size of Bldg.,2 14,.3 b No. of Max.
(Total) Sq. Ft �6 0 Stories 12 Occ. Load /C9
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor In RESIDENCE
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.
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 SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
ch this permit is issued and that all work done will
e n nfor ance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
fill" SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner JA Date. —" " WORK IS COMMENCED.
P CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION kCKl M.O. CASH
MASON COUNTY PLANNING [DEPARTMENT
P.O. BOX 186 Shelton, Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT — Complete ALL items. Mark boxes where applicable.
Name Mailingaddress—Number,street,city,and State Zip code Tel.No.
,. Reuben J Nutt 98584
Owner
2.
Contractor
The owner of this b di g and t undersigned agree to conform to all appiicable laws of M!.son County and State of Washington
Signature of appll Address Q�� Application date
V
966q:
V � - `
LLYGAL DESCRIPTION
Location Lot 124 of Lake T,i mPrick Div. No. 5
Of
Building _ _—_
NO. PLUMBING FIXTURES FEE
3 WATER CLOSETS d
3 BASINS
BATH TUBS C C
SHOWERS
1 WATER HEATERS
1 AUTO.WASHERS
SINKS
FLOOR DRAINS
i DRINKING FOUNTAINS —
LAUNDRY TRAYS
Connect to city Sewer _ 1
~- DISH WASHER
I DISPOSAL
URINAL
SCE'
/
(Show Street Names & Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT , SKETCH IN SEPTIC TANK& DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
,Receipt No.
I Appr by Permit fee Date pemit issued Permit number