HomeMy WebLinkAboutBLD324 SFR - BLD Permit / Conditions - 9/6/1979 Orr, Collin #324
9-6-79
NW 1/4 NW 1/4 SE 1/4 34-21-3
Go 5 mile north of Shelton on Hwy 3, turn left on i
Mason Lake Lake Limerick Road, go 1 mile & turn
right on Mickelson Road, go 1/4 mile & turn right
on logging road, go o/4 mile and turn left onto
property.
Residence Plumbing Permit
Mechanical Permit
$32,232.00
• BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
Co
CD A. 9 P33T Pf'/-3z1p
DIRECTIONS 3., �t�.c.v /rft O� rrJaroY LQEQ —Lode L.�sr��t.eEK411
TO JOB SITE ti o✓ f�.ck r/I o v RW fo ,c 7r�•�N 0,
LEGAL (❑ SEE ATTACHED SHEET) 7✓� tv /P
DESCR. 4'u eY SL LY .S 34• j Z/ 3 w (fni�v o�
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PH NE
CONTRACTOR
0 C.c%v t�C
USE OF / -
BUILDING
Class of work: Ac NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: T/
O,J,I 2uc
Valuation of work: $ ill �7 PLAN CHECK FEE �J1- K) PERMIT FEE /
c�( OC K L►°t
SPECIAL CONDITIONS:
BEDROOMS DECKS / CARPORT❑ NOTICE
BATHROOMS / TOTAL SO. FT.`/ GARAGE&i
ATTACHED ! SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES 2 BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FT./J'IY FIREPLACE ❑ DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
�8ONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
l% 0- 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 ❑ SHORELINES i
SEASONAL ❑ FLOODPLAIN Lj
Firm E.D. NO. S.E.P.A.
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
be in conformance therewith. MOTOR VEHICLE PERMIT
Owner Date.
7U APPLICATION ACCEPTED BY PLAN""HECK BY APPROVED FOR ISSUANCE
7� � � BY
PLAN HECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. 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 nn n Mailing address-Number,street,city,and State J/ Zip code Tel.No.
O�%/v Cr• (J /��• Si ZSC,7r y >P L! ! �4,1z O0'f (i A- s`'!J f S" P�Y 2l?U
Owner
z. 4m
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 plicant Address Application date
LEGAL DESCRIPTION ,
/j/w�4 /fiw ly S L` �y S 3,1 % 1 / e 3 fj1J
Location
Of
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS C-6
BASINS •
BATH TUBS
SHOWERS 0
WATER HEATERS l?d
AUTO.WASHERS d-jj Fl j
SINKS E-C I 5 4- 5,
1 l�
FLOOR DRAINS
DRINKING FOUNTAINS xL J- '
0 75
\� x
LAUNDRY TRAYS V
Connect to City Sewer
j DISH WASHER $
�v
DISPOSAL -
URINAL
-- ---- -- (Show Street Names & Property Lines)
- -- - --- — INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT 7 SKETCH
IN SEPTIC TANK & DRAIN FIELD LOCATION OR SUBMIT
OTHERON
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved by Permit fee Date pemit issued Permit number Receipt No.
Zd---��44-W -k $ /7• 0-6 9- 4- 7'? &D-2 ell
MASON COUNTY PLANNING DEPARTMENT
P.O.Box 186 Shelton,Washington 98584
MECHANICAL PERMIT APPLICATION
IMPORTANT- Complete ALL items.Mark boxes where applicable.
1. LEGAL DESCRIPTION
Location W /� tiGu
Of N s
Building N s J
E W side of feet E W from intersection of
Sect. Twp. Range 3
NO. DESCRIPTIONS FEE NO. DESCRIPTIONS FEE
1. Forced air or gravity type furnace or burner including ducts 14. For the installation or relocation of each boiler or refrigeration
and vents, up to .and including 100,000 Btu's-$4.00 compressor over 50 horse power or each absorption system over
1,750,000 Btu's--$25.00
2. Over 100,000 Btu's-$5.00
15. For each air handling unit to and including 10,000 cubic feet
3. Installation or relocation of floor furnace and vent, suspended per minute, including ducts attached thereto-$3.00
heater, or recessed wall heater-$4.00
NOTE: This fee shall not apply to an air handling unit which
4. Installation, relocation, or replacement of each appliance vent is a portion of a factory assembled appliance, cooling
installed, not included in appliance permit-$2.00 unit, evaporative cooler or absorption unit for which
a permit is required elsewhere in this Code.
5. Repair, alteration or addition to each heating appliance, re-
frigeration unit, cooling unit, absorption unit, or evaporative 16. For each air handling unit over 10,000 cubic feet per minute
cooling system including installation of controls regulated by -$5.00
this code--$4.00
6. Installation or relocation of each boiler or compressor to and 17. For each evaporative cooler other than portable type-$3.00
including 3 horse power-$4.00 18. For each ventilation fan connected to a single duct-$2.00
7. Over 3 horse power to and including 15 horse power-$7.50 19. For each ventilation system which is not a portion of any heating
8. Over 15 horse power to and including 30 horse power-$10.00 or air conditioning system authorized by a permit-$3.00
9. Over 30 horse power to and including 50 horse power-$15.00 20. For the installation of each hood which is served by mechanical
exhaust, including ducts for such hoo"3.00
10. Installation or relocation of each absorption system to and
including 100,000 Btu'"4.00 21. For the installation or relocation of each domestic type in-
11. Over 100,000 Btu's to and including 500,000 Btu's-$7.50 cinerator-$5.00
12. Over 500,000 Btu's to and including 1,000,000 Btu's Commercial or industrial type incinerators-$20.00
$10.00
22. For each appliance or piece of equipment regulated by this
13. Over 1,000,000 Btu's to and including 1,750,000 Btu's Code but not classed in other appliance catagories, or for which
-$15.00 no other fee is listed in this Code-$3.00
FIELD INSPECTION Basic Fee $3.00
_ � �Ct
Date By (remarks TOTAL �
Name Mailing address - Number, street, city, and State/ Zip code Tel. No.
Owner e 7 P .� l�G�t So e l �(Ju 9�?Xf" ?Sly-3
2.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of MASON COUNTY
Srgnatur f applicant Address Application date
915-/>9
DO NOT WRITE IN THIS SPACE - FOR OFFICE USE
Approved byM Permit fee Date permit issued Permit number Receipt No.
- PLOT PLAN
ADDRESS PERMIT NO, 0 0
LEGAL ,VL., y "'4 S t ��y S y 7- 1/�fr j f K/ p °n
DESCRIPTION LOT BLK ADDITION N
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS -3 Z Sq. Ft.
INSTRUCTIONS TO APPLICANT
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE
FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.)
FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN-
SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA-
TION A"'D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR-
TION THEREOF.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
.4
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.
N'.ME(S) OF OWNERS) OF SITE & STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
ISTRICT AS NOTED DATE
HE_.'ON PRiN�IN.�