HomeMy WebLinkAboutBLD26988 Final SFR - BLD Permit / Conditions - 12/31/1991 2•�•-
Shorelines: Plumbing:;,;
Setback: Mechanica k�;�_
Special Interior:
Conditions: FINAL:
Mobile Home:
Smoke Detector:mit:. �K yE
Remarks:
Footing: L
Setback:
,- 41
Foundation Z V
Walls:
Framing:C));,
Fireplace:
Wood Stove: ,
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TYPE RESIDENCE
Permit No. 26988 No. Floors 2 Sq Ftg 4500
Owner WILS N-HOSS, R. Tel 426-2999 Date10-25-90
Address E 170 Bal ,lantrae Shelton Zip
Contractor self
Address Zip
Legal Description 4-21-3
Direction to project site R at Dartmoor R at Woodbridge Ln
_across from Balbriggan E. 211 Woodbridge Lri
Plumbing xy c anica xX ewer -Stove
Fireplace Deck 700 age 1550�rport
Basement �nnn��oft Other
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BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES !0
`0?
.5
10
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED �i W %
PERMIT NO. �(? /j C)O
NAME MAILADDRESS CITY B.STATE ZIP PHONE
OWNER L)&oN SS �, l"1 D W_�/J ct8"S9 4" 144
DIRECTIONS
TO JOB SITE �-,. �, �oy7(� Lakl-C ac re)Ss
&4m B W o o d 6►;�. (ten
PARCEL I ODo60DDESCR
LEGAL
NUMBER . �I -4p Plah
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. ZIP PHONE
CONTRACTOR sc( f_
USE OF
i�Jeo-Ge-
BUILDIDING {
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓ F►P16T
DESCRIBE
WORK
BEDROOMS DECKS YOR N Y CARPORT NOTICE
TOTAL SO.FT.
S DECK '^,,� GARAGE ( SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS
TOTAL SO.FT. J SCSI TOTAL SO.FT. 5 5� CONDITIONING.
NO.OF STORIES �- BASEMENT Y OR N THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
LIVING AREA BASEMENT COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. Soft TOTAL SQ.FT. 2000 CHECK ONE ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMANENT FIREPLACE ATTACHED
SEASONAL SHORELINE DETACHED
WNERS 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
GISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
QUIREMENTS FOR WHICH THIS PERMIT IS ISSUItD AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
I CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
O TAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
XOWNER ftk "" '3'" DATE 1011 jib XBY DAT
FOR OFFICE USE ONLY G
DEPARTMENT YES APPROVEDJO DEPARTMENT YES DEPARTMENT BUILDING VALUATION �r
OAeo.
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING �vk PLAN CHECK
SPECIAL CONDITIONS
BUILDING.GROUP - /�-� PRE-INSPECTION
G,E S- m` T! = //6Jj1�Gye r 'f' SCV&S ',jj& SHORELINE
WOODSTOVE /
PLUMBING ,
MECHANICAL
STATE BUILDING FEE 0
STATESURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
y TOTAL
1 BY�tlq,, � CASH CK MO
PLUMBING & MECHANICAL PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
OWNER NAME ' c MAIL ADDRESS 0k , * & CITYSTA � T r H G
7 G—. �'1 D R., �-l.K O J Y 7
DIRECTIONS II
TO JOB SITE G �( JR a� WotJ 6 d f LYE ►-nrS
C3wl br► . -�. w od 6►-►`
LEGAL
DESCR.
CONTRACTOR NAME(� MAILADDRESS CITY BSTATE LICENSE NO. ZIP PHONE
USE OF I
BUILDING l�e✓1
PLUMBING FIXTURES MECHANICAL FIXTURES
NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE OF FIXTURE FEE
S WATER CLOSETS /!, FORCED-AIR/GRAVITY TYPE FURNACE 6.00
BASINS FLOOR/SUSPENDED FURNACE 6.00
JAI BATH TUBS BOILER/COMPRESSOR 6.00
SHOWERS REPAIR/ALTERATION 6.00
WATER HEATERS 2___ REFRIGERATION COMPRESSOR SYSTEM 6.00
AUTO.WASHER 2. AIR HANDLING UNITS 7.50
1 SINKS HEAT-PUMPS
FLOOR DRAINS �_ EACH GAS PIPING SYS.2.00 PER OUTLET
DRINKING FOUNTAINS �_^ VENT.FAN SYS.3.00 PER UNIT ec
LAUNDRY TRAYS WOOD STOVES 5.00
CONNECT TO CITY SEWER WOOD FURNACE 5.00
DISHWASHER 2 r
DISPOSAL
URINALS
PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00
TOTAL s' -�� TOTAL 17-
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 FIRglk,1OL4�4 �ATE
BTNGG APPROVAALFFOMTHE UILDINGDEPAR MENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT.
XOWNER X BY DATE
FOR OFFICE USE ONLY
APPLICATION ACCEPTED BY TPLANS/CHECK BY BUILDING GROUP APPROVED FOR ISSUA CE PERMIT VALIDATION
[� �J7 BY /�(��C O �� CASH CK MO
-�� l l R�
PLOT PLAN
ADDRESS L • )1-I I J�J(,008P ItD66 L4}IJ & PERMIT NO, o
N E 1(c� n� i(1 W�� �� 5.3�-� j Ll (J. 3 Y� /�or�lt of GG✓►kr�l✓u D� uG��.rg r oa c! o
LEGAL
DESCRIPTION LOT BLK ADDITION M
pRop&5 eD
SITE AREA259i and Sq. Ft. AREA OF SITE OCCUPIED BY/BUILDINGS �co 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 AND 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.
2 l '2>20
INDICATE NORTH IN CIRCLE 4F6t _ -
IN
1
Ajof
rn
I b ho e f' a
' ,$e-s
6 3 0 3 �` � - r5
l
We certify at the pmpoesd construction will conform to the dlmensidns and uses shown above and that no changes will be made without
first obtaining th approval.
NAME(S) OF OWNER(C OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REP ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W. CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
OWNER ME 1�) MAILADDRES IT &STA�E, �;Jj _ZIP PH01�2`ny
�y{`lJ�fl
DIRECTIONS
TO JOB SITE
PARCEL LEGAL y
NUMBER DESCR. VJ.
r
NAME MAIL ADDRESS CITY&STATE ZIP PH NE LICENSE NO.
CONTRACTOR
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION' REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK Vk'l4=�lC�t�l�E � -
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE SgFt STORIES SHORELINE❑ CONDITIONING.
BASEMENT SgFt BEDROOMS PRIMARY RES.❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS $ Ft BATHROOMS SEASONAL RES.❑ COMMENCED WITHIN 180 SAYS, 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❑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. APPROVAL FROM THE BUILDING DEPARTMENT,
X OWNER (bkl(/4_)D(&�� �"DATE 5I('1 I� X BY _ DATE
FOR OFFICE USE ONLY
DEPARTMENT YESPPROVEDJO DEPARTMENT YES DEPARTMENT BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE MARSHAL BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
- ' SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
APPLICATION ACCEPTED BY I PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
TOTAL
BY CASH CK MO
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
A E11 MAILA RES CITY STATE / ZIP PHONE
OWNER 1 ,��
DIRECTIONS
TO JOB SITE
PARCEL LEGAL
NUMBER DESCR. (
NAME MAILADDRESS CITY&STATE ZIP PH NE LICENSE NO.
CONTRACTOR
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK
AREA:12c'u NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE SgFt STORIES SHORELINE❑ CONDITIONING.
BASEMENT SgFt BEDROOMS PRIMARY RES.Cl THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS S Ft BATHROOMS SEASONAL RES.0 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.
APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNER CL.A DATE 51l X BY _ DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION 1
YES NO YES NO )`
HEALTH PUBLIC WORKS FEE
PLANNING FIRE MARSHAL BUILDING PERMIT Z. :;0
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
APPLICATIO ACC ED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
r BY CASH CK MO TOTAL
1
PLUMBING & MECHANICAL PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
OWNER A MAILA ESS nl C TiTE
DIRECTIONS
TO JOB SITE
LEGAL
DESCR.
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 FIRE SUPPRESSION 5.00
CONNECT TO CITY SEWER WOOD FURNACE 5.00
DISH WASHER
DISPOSAL
URINALS
PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00
TOTAL I I 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 OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNER DATE X BY DATE
FOR OFFICE USE ONLY
APPLICATION ACCEPTED BY PLANS CHECK BY BUILDING GROUP APPROVED FOR ISSUANCE 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 DATE ISSUED
PERMIT NO.
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER ifw% ?O 5*1-1W Z
DIRECTIONS
TO JOB SITE s
•
i
fijW SA110r, AAAP%
PARCEL LEGAL
NUMBER Z/0 0000 DESCR.
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.r
0 O Location of proposed construction on property.
O Building& septic system setback distances from all property lines& easements.
Indicate North O Welland waterline. ✓
In Circle O Saltwater, lakes, rivers, streams,wetlands, drainage.✓
O Attach copy of septic system"as built" or septic permit approval. ✓
O Indicate topography profile of property and structure on reverse side.
01
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.
SIGNATURE OF OWNER(S)OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
r
TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE
All that portion of the Northeast quarter of the Northwest quarter of Section 34,
Township 21 North, Range 3 West, W.M., in Mason County, lying northerly of the
centerline of the existing road running in a Northeasterly direction across said
land.
EXCEPTING therefrom road rights-of-way.
Parcel No. 32134 2100000.