HomeMy WebLinkAboutBLD4666 Final SFR - BLD Permit / Conditions - 12/18/1980 Juno Bilt' Homes #4666
5-14-79
Rainbow Lake Lot 73
Residence Plumbing Permit
$28,578.00
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- RUILDING PERMIT APPLICATION
Y
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 - p
DATE ISSUED ✓ /L`a/"7/
PERMIT NO. �� r
OWNER AME MAIL ADDRESS CITY&S ATE ZIP PHONE
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. �f>% I�As.�S L�4fG� S-��f0, Z I 1 tj(.)
CONTRACTOR NAME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE
USE OF
BUILDINGClass of of work: XNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ oQ, PLAN CHECK FEE a PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS ; TOTAL SQ. FT. - — GARAGE Ci,-'
ATTACHED �� SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES_ BASEMENT I I / OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE 60 DETACHED ❑
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 [l
SEASONAL [I FLOODPLAIN [_J
Firm L., V
E.D. NO. S.E.P.A. I1
By nn ) Special Approvals IN OUT YES APPROVED NO
Lic. No. 2�� I.�D Date / —`/ ' ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
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.
which thi permit is issued and that all work done will ROAD ACCESS
be in o ormance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PL C ECK BY AP VED FOR NOE
Own Date. , B
c
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ry
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. /Ju
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signatur plicant Address Application date
LEGAL DESCRIPTION
Location
Of
Building
NO. PLUMBING FIXTURES FEE
2 WATER CLOSETS
3 BASINS
` BATH TUBS
f SHOWERS 2-
WATER HEATERS U�
AUTO.WASHERS
1 SINKS 2ocr
v FLOOR DRAINS
Q DRINKING FOUNTAINS 1 (44..D t
C-D LAUNDRY TRAYS
() Connect to City Sewer y
' DISH WASHER ? P
DISPOSAL i
URINAL
lu
•
-- ---- -----— — (Show Street Names & Property Lines)
--- INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT _— 7� SKETCH
IN SKETCH.
TANK & DRAIN FIELD LOCATION OR SUBMIT
OTHERON
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved Permit fee Date pemit issued Permit number Receipt No.
PLOT PLAN
ADDRESS PERMIT NO. 0 o
= o
n >
A O
LEGAL
DESCRIPTION LOT _3 BLK ADDITION
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS 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 AII'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'
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i
A 4
9
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1/We certify that the proposed construction will conform to tha dlrt»midns and uses shown above and that no change will be made without
first obtaining approval.
—1—LJn40 --0 11. ! /-4y-..
NAME(S) OF OWNER(S) OF SITE 6 SYRUCTURE(S) (PRINT) IGNA OWNE (S OR AUTHORIZEO REPRESENTATIVE
O NOT WRITE SELO HIS LINE
APPROVED DATE
DISTRICT AS NOTED S 7�
6MELT ON PRINTING