HomeMy WebLinkAboutBLD9366 Final SFR - BLD Permit / Conditions - 12/18/1980 Juno Bilt #9366
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Rainbow Lake Lot 42
Residence Plumbing Permit
$35,900 .00
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• '" PUILD►NG 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
ID,
DIRECTIONS `�
TO JOB SITE Ml4SoN I-K RO ro 1-1�"�CrtC K TVe-N- O
LEGAL `` (❑ SEE ATTACHED SHEET)
DESCR. /�O T (�_ kot I
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR 3 _ S
USE OF
BUILDING Res I & w
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Co 6=1� L 2U
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS: 7`
BEDROOMS 3 DECKS CARPORT I i NOTICE
BATHROOMS___. TOTAL SQ. FT. GARAGE.
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES_ BASEMENT LJ ATTACHED A OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE 11 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 I i
J SEASONAL i , FLOODPLAIN 11
Firm ��U 1/L E.D. NO. S.E.P.A.
By _- - r r / _ Special Approvals IN OUT YES APPROVED NO
Lic. No.ul� ���`�` /� Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. ,s(�
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
of the Mason County ordinance requirements for BUILDING DEPT. O 7
which this permit is issued and that all work done will ROAD ACCESS
be in onf rmance therewith. MOTOR VEHICLE PERMIT
r
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner/ 0'0Date. BY
(9''✓
PLAN CHECK 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 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
Signature of applicant As Application date
ddres
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LEGAL DESCRIPTION
Location
Of
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS !9-+
BASINS !1
BATH TUBS
SHOWERS
WATER HEATERS
AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
(Show Street Names & Property Lines)
oar
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT /;7 04 SKETCH IN SEPTIC TANK& DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved by Permit fee Date pemit Issued Permit number Receipt No.
PLOT PLAN
ADDRESS PERMIT NO. f o
= o
n >
a o
LEGAL /
DESCRIPTION LOT BLK ADDITION �`\ l t/r/�
SITE AREAELS Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS / , 6 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 A14D EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN-
SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA-
TION A"ID 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'
w
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k
Id , • Zvi
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.
0-1 o --
NAMEIS) OF OWNERM OF SITE S STRUCTURE(S) (PRINT) GNATURE OF OWNERS) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINTIN3