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HomeMy WebLinkAboutBLD5033 SFR - BLD Permit / Conditions - 10/1/1976 Baxter, James A. #5033 10-1-76 Rt. 2 Box 148, Shelton SW4 NE4 36-21-3 Plumbing Permit issued Residence $23,680.00 3a-1 3(o- [3- 96a3 I ,4- J /3 y BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 DATE ISSUED�.20,424 3 1) 74 PERMIT NO. OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE DIREC I NS TO JOK SITE LZF jUIA-je3 a et LEGAL SEE ATTACHED SHEET) DESCR. IsO :gT �(�I/A O 0 & 3JrCl/OIY V&' Ar CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE USE OF BUILDING 0 Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Valuation of work: $ PLAN CHECK FEE av PERMIT FEE ,l SPECIAL CONDITIONS: APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED F9R ISSUANCE Type of Occupancy Division BY 1 Const. _ Group Size of Bldg. No. of Max, (Total) Sq. Ft. Stories r Occ. Load C, CONTRACTOR AFFIDAVIT PERMANENT SEASONAL E.D.NUMBER I certify that I am a currently registered contractor in RESIDENCE the State of Washington and I am aware Of the MOBILE HOME ordinance requirernents regulating the work for which the permit is issued and all work done will be in Special Approvals Required Received Not Required conformance therewith. ZONING HEALTH DEPT. ( 33 Firm PUBLIC WORKS By ROAD DEPT. Lic. No. Date OWNERS AFFIDAVIT I certify that I am exempt from the requirements of the N O T I C E contract or registration law RCW 18.27, and am aware SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING. which this permit is issued and that all work done will be ' conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED 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 Own v Date. WORK IS COMMENCED. PL CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 7 1N0. PARCEL NO. RECEIPT THURSTON-MASON HEALTH DISTRICT DATE BASIS FOR FEE AMOUNT NUMBER DIVISION OF ENVIRONMENTAL HEALTH 529 WEST FOURTH 110 W.K ST P.O.BOX 746 PHONE 753-8073 PHONE 426-4407 OLYMPIA, WA 98501 SHELTON, WA 98584 OWNER P.O. PHONE DIRECTIONS TO SITE: TOTAL FEES 'SEWAGE CONTRACTOR ADDRESS OR LOCATION NAME OF PLAT LOT NO. SOIL TYPE TOWNSHIP RANGE SEC. DEPTH TO WATER TABLE FT. WATER ❑PUBLIC ❑ PRIVATE SOURCE PERC. TESTS: INCHES PER HOUR TYPE OF LOT BY: DATE BUILDING BASEMENT SIZE X NO.OF NO.OF GARBAGE PRIMARY SECONDARY BL'DROOMS BATHS r DISPOSAL SEPTIC TANK (S) GAL. AERATION GAL. SPACE RESERVED FOR DISTRIBUTION TILE TOTAL FEET REPLACEMENTS DISTRIBUTION FIELD SQ FT. NORTH - SITE PLAN AND SPECIAL STIPULATIONS: TRENCH BOTTOM AREA SQ. FEET QUANTITY OF APPROVED STONE CU. YD. SAND CU. YD. FILL REQUIRED CU. YDS. OF THE BUILDING SEWER SHALL BE SUCH THAT THk@VATION XIMUM DEPTH OF THE DISTRIBUTION TILE SHALL BE BE- WEENTO SEP 28 i9 6TOP OFITILENCHES UNLE S OTHERWISEAND 36ESTIPUO ATEDIBYETT ERADE HEALTH OFFICER. IF THE ELEVATION OF THE BUILDING SEWER IS TOO LOW TO MEET THESE ELEVATIONS,A SEWAGE EJECTOR MAY BE REGIONAL PLA RED. TION STANDARDS FOR PRIVATE WATER SUPPLIES: BETWEEN WELL AND TANK OR ANY PART OF THE TILE FIELD, 100 FEET FOR SINGLE RESIDENCE, MOBILE HOMES, DUPLEXES AND MULTIPLE DWELLINGS. NO DRAINFIELD WITHIN 100 FEET OF ANY WELL, FRESH WATER LAKE OR STREAM)00FEET FROM ANY SALT WATER BODY. I ! g • NOTE: "FOOTING DRAINAGE, DOWNSPOUTS, WATER SOFTENER AND ANY i OTHER WASTE WATER NOT DEFINED AS SEWAGE SHALL NOT BE CONNECTED r TO OR DISCHARGED INTO THE SEPTIC TANK SYSTEM OR THE SEWAGE DISPOSAL AREA". ALL SEWAGE, INCLUDING SINK AND LAUNDRY WASTE, MUST BE CONNECTED TO THE SEPTIC TANK. FINAL INSPECTION REQUIRED BEFORE BACKFILLING OFFICE USE ONLY TO BE BACKFILLED AFTER INSPECTION DATE APPLICANT MUST CALL FOR INSPECTIONS LISTED BELOW 12" TO 24" NOT SITE: u) APPROVED APPROVED � 2" STRAW BY: �(Z "G�J �a �,r � —� h � STONE NOT + O OVER TILE SEWAGE: ❑ APPROVED ❑ APPROVED BY: tc STONE WATER: ❑ APPROVED ❑ NOT BY: - UNDER TILE APPROVED I I > E � CROSS SECTION OF TRENCH ©M �/