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Home My WebLink AboutBLD7599 Mobile Home - BLD Application - 2/11/1981 BUILDING PERMIT ,APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED PERMIT NO. OWNER NAME MAIL ESS CITY&STATE r ZIP PHONE . - DIRECTIONS TO JOB SITE LEGAL T r r (❑ SEE ATTACHED SHEET) DESCR. Af kr- NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR USE OF BUILDING A/el (`. Ae) 1 Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Va on of work: i PLAN CHECK FEE PERMIT FEE SPECIAL CONDITIONS: IT EDROOMS DECKS CARPORT ❑ NOTICE BATHROOMS TOTAL SO. FT. GARAGE ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING. TOTAL SO. FT. FIREPLACE ❑ DETACHED ❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- CONTRACTOR AFFIDAVIT IZED 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 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 Ll SEASONAL ❑ FLOODPLAIN ❑ Firm E.D. NO. S.E.P.A. ❑ By Special Approvals IN OUT YES APPROVED NO Lic. No.— Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. PUBLIC WORKS I rtify that I am exempt from the requirements of the FIRE MARSHAL ntract or registration law RCW 18.27, and am aware BUILDING DEPT. f the Mason County ordinance requirements for which this permit is issued and that all work done will E�OT�R ESS be in conformance therewith. HICLE PERMIT AC P Y PLAN CHE-C-K,BYY APPROVED FOR ISSUANCE Owner �Lt .j Date. /� �'� BY PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH PLOT PLAN ADDRESS /` � 0� �' ! PERMIT NO. �� 7 �� 4 (, ° o z o z l %r' ,,V `0 LEGAL DESCRIPTION LOT BLK ADDITION �' 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 A"tD 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 - GRAP SQUARES ARE 5' X 5' OR 1"=20' i r L JI eA Y f C I/We certify that the proposed'cons Yuction will conform to the dimensions and uses shown Love and thpt no changes will be made without first obtaining approval. NAME(S) OF OWNERS) OF SITE h STRUCTURE(S) (PRINT) I NATURE OF OWNERIS) OR THORIZEO REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED / DISTRICT AS NOTED DATE SHELTON PRINTINu BUILDING PERMIT APPLICATION y ` MASON COUNTY Tom• /�� '`P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED y PERMIT NO. OWN AME MA ADDRESS C &SAE ZIP PHONE DIRECTIONS TO JOB SITE otit� tr LEGAL SEES,, D SHEET) DESCR. j V�-+2 / � ✓ X l"V{�� CONTRACT NAME MA DRESS CITY 6 STATE LICENSE NO. PHONE OR USE OF BUILDING //0 Class of work: WNEW ❑ ADDITION ❑ ALTERATIO' IR ❑ MOVE 0 REMOVE Describe work: �J 4 4e. J NZ V:OwF of w r . $ Y 0 PLAN CHECK FEE 9 PERMIT FEE SPECIAL CONDITIONS: BEDROOMS DECKS —o CARPORT ❑ NO E BATHROOMS TOTAL SO. FT GARAGE ❑ ATTACHED ❑ SEPARATE PERMITS ARE REOUI FOR PLUMBING, HEATING, VENTILATING N F STORIES BASEMENT ❑ OR AIR CONDITIONING. 11, TOTAL FT.� FIREPLACE ❑ DETACHED ❑ THIS PERMIT BECOMES faldLL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED CONTRACTOR AFFIDAVIT IS NOT COMMENCWWITHIN 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 a urrently registered contractor in WORK IS COMWIENCED. the State of Washing and I am aware of the FOR OFFICE USE ONLY ordinance requirements regul ' the work for which the permit is issued and all wor ne will be in conformance therewith. PERMANENT ❑ SHORELINES ❑ SEASONAL ❑ FLOODPLAIN ❑ Firm E.D. NO. S.E.P.A. ❑ By \�� Special Approvals IN OUT YES APPROVED NO Lic. No. Date PLANNINd-BFPT. OWNERS AFFIDAVIT HEALTH DEPT. • PUBLIC WORKS I certify that I am exempt frpfn the requirements of the FIRE MARSHAL contract or registration ja* RCW 18.27, and am aware BUILDING DEPT. S `� of the Mason Cou^ ordinance requirements for which this permit ' issued and that all work done will ROAD ACCESS be in conform ce therewith. M R VEHICLE PERMIT f / A CATION ACCEPTE BY PLANAPHECK BY PPROVED FOR ISSUANCE Owne --Date. ` Q — 7—� f� ,/ PL 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 rt 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 ap n Add res Application date LEGAL DESC05TION LocationOf Building NO. PLUMBING FIXTURES FEE 3 WATER CLOSETS BASINS BATH TUBS SHOWERS WATER HEATERS AUTO.WASHERS SINKS O� — FLOOR DRAINS DRINKING FOUNTAINS LAUNDRY TRAYS Connect to City Sewer At DISH WASHER I `' DISPOSAL I 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 Approved by Permit fee Date pemit issued Permit number Receipt No.