HomeMy WebLinkAboutBLD29 Final SFR - BLD Permit / Conditions - 12/18/1980 Juno-Built Homes #29
8-2-79
Lot 43 Rainbow Lk. Subdivision
Residence Plumbing Permit
$28, 578 . 00
W7,9
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 R
DATE ISSUED
PERMIT NO. /
OWNER NAME MAIL ADDRESS CITY&ST TE ZIP PHONE
o_ P 13 ..
DIRECTIONS
TO JOB SITE M N �.A'�C' Rb -lb LI n,En 1 Cr -Fog - li
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. Lo+ 3 IIiC » /N 0 w L S u j),
NAME MAIL ADDRESS CITY h STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: NEW ❑ ADDITI N ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Q 0 0 > ✓V1/
Valuation of work: $ ^ PVAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS 3 DECKS CARPORT ❑ NOTICE
BATHROOMS _7j� TOTAL SQ. FT. GARAGE
ATTACHED Qr+ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES_L BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE tL DETACHED Cl
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
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 [1
/ SEASONAL I ! FLOODPLAIN I 1
Firm v ` E.D. NO. S.E.P.A. I I
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date O�� ZONING
2-11 OD PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. 'e _
PUBLIC WORKS
1 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
(CATION APCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date . BY
c
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. 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 Mailing address—Number,street,city,and State Zip code Tel No.
Owner
2.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Sign re applicantt Address Application date
V
LEGAL DESCRIPTION
Location
Of
Building I l� 4/ L V
NO. PLUMBING FIXTURES FEE
WATER CLOSETS �n
BASINS _ C)
BATH TUBS
SHOWERS n
WATER HEATERS
AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
(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
AZ:, Permit fee Date pemit issued Permit number Receipt No.
s .
PLOT PLAN
ADDRESS ✓v o �Ok y, �!/." f/ PERMITNO. F o
�—
a o
0
LEGAL , (�l�. a
DESCRIPTION ft d a "LOT �]� BLK ADDITION "
SITE AREA SD d Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS S'fSq. 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.
J
--� INDICATE TH IN LE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
i
` 1
48 '
I/We certify that the proposed construction will conform to dimensions and uses shown above and that no changes will be made without
first obtaining approval. to a/
V N 0_ i3 I L�r— nv 6--r
NAME(S) OF OWNER(S) OF SITE h STR CTURE(S) (PRINT) IGNA DO
E OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINTIN3