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Home My WebLink AboutBLD4396 Final SFR - BLD Permit / Conditions - 12/18/1980 ' Koroch, Ben, #4396 3-30-79 RAinbow Lake Lot 69 Residence Plumbing Permit $35,986.00 �� _ �� D� S—d —�y,�.9, � ��,/�>�• � L 5'�3 •7y 12�,..e a°.��7/.3./s o � �� -BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED PERMIT NO. 1&911 OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE �i DIRECTIONS TO JOB SITE LEGAL / (❑ SEE ATTACHED SHEET) DESCR. L� T' 6 l c' CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE Ju yc..irs3 -3 T J /G j / c�/r/G� �D / c9 9 7 /1/J.r!!lC �l� !vim Y��3"7/ USE OF BUILDING S/�✓�L6> � -�/G� /Z`5�/„��-�/Gt Class of work: NEW ❑ ADDITION 0 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Valuation of work: $,36� PLAN CHECK FEE �� PERMIT FEE SPECIAL CONDITIONS: ' (2211 BEDROOMS , DECKS CARPORT ❑ NOTICE BATHROOMS TOTAL SQ. FT. GARAGE X / ATTACHED'( SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT ! OR AIR CONDITIONING. TOTAL SO. FT. 2- FIREPLACE 1,4 DETACHED F1 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 Firm �� SEASONAL i 1 FLOODPLAIN �d' E.D. NO. S.E.P.A. By — Special Approvals IN OUT YES APPROVED NO Lic. No. ,V -IVA'-AI3 ` -2//130 Date 3 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 of the Mason County ordinance requirements for BUILDING DEPT. ,,?" - 3 -,,2 -- which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSU Own r __ Date BY P - PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CAS 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 GTel.No. O 6f !,7 � Yj# L-C✓I� s�-.p� !Q 6-3 71 Owner 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 Address Application date c�. / c9 V 7 v i4 LGc fO LEGAL DESCRIPTION Location `Of Building NO. PLUMBING FIXTURES FEE Z WATER CLOSETS 3 BASINS BATH TUBS SHOWERS WATER HEATERS , AUTO.WASHERS SINKS FLOOR DRAINS DRINKING FOUNTAINS LAUNDRY TRAYS Connect to City Sewer DISH WASHER C'V DISPOSAL URINAL -- (Show Street Names & Property Lines) INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER. PERMIT 97) SKETCH IN SEPTIC TANK & DRAIN FIELD LOCATION OR SUBMIT ON OTHER SKETCH. DO NOT WRITE IN THIS SPACE — FOR OFFICE USE Approv d by ` Permit fee Date pemit Issued �y Permit number Receipt No. T� r. PLOT PLAN ADDRESS PERMIT NO. O o f o z n s D O O LEGAL _DESCRIPTION LOT BLK ADDITION /y 11-4.0 "u 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 Pl"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. c R' INDICATE NORTH IN CIRCLE GRAPHSQUARES ARE 5' X 5' OR 1"=20' -�1 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. ,y NAME(S) OF OWNER(S) OF SITE & STRUCTURE(S) (PRINT) GNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE 6HELTON PRINTIN3