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Home My WebLink AboutBLD2256 Log Frame Over Basement - BLD Application - 7/3/1979 ' BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 r r�Q DATE ISSUED /7 PERMIT NO. 02 OWNER NAM MAIL AD SS Z rk I CITY& A E ZIPCPU PHONE 44 DIRECTIONS )Co 0 A l 0 7 / d � �d Qd-VVJ -d TO JOB SITE d Q P LEGALA ' �+G (❑ SEE ATTACHED SHEE11 DESCR. /V E ,V4 NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR -t--1 / ..� USE OF BUILDING S e 'f/� Class of work: KNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: l , (' fl` ao 9 s 9 53 Valuation of work: $ PLAN CHECK FEE PERMIT FEE OD Q$� SPECIAL CONDITIONS: Ae APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Type of Occupancy Division BY Const. Group Size of Bldg. No. of Max. (Total) Sq. Ft. Stories A- Occ. Load 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 requirements 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. d 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 of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIREDFOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. which this permit is issued and that all work done will be In conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZF" IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK 10 SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME 0 Owner ate. WORK IS COMMENCED. PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. SITE NO. ,�(, . -MASON COUNTY HEALTH DEPARTMENT FOR DEPARTMENT USE ONLY ENVIRONMENTAL HEALTH SECTION DATE BASIS FOR FEE AMOUNT RECEIPT 428 WEST BIRCH STREET • SHELTON, WA. 98584 NUMBER PHONE (206) 426-5561 APPLICANT SIGNATURE ADDRESS PHONE NOT SITE: APPROVED ❑ APPROVED PROPERTY OWNER BY: ADDRESS PHONE DESIGNED SYSTEM REQUIRED SEWAGE SEWAGE NOT CONTRACTOR DESIGNER SEWAGE: ❑ APPROVED ❑ APPROVED LEGAL DESCRIPTION BY: SOIL TYPE TYPE OF NO. OF LOT BUILDING BEDROOMS SIZE X DEPTH TO WATER TABLE PERC. RATE SINGLE FAMILY ❑ PUBLIC WATER NAME SEPTIC TANKS GAL. PUMP REQ. WATER SYSTEM SYSTEM ( ) COMMERCIAL ONLY LIQUID WASTE G.P.D. DISTRIBUTION TILE TOTAL FEET DIRECTIONS TO SITE: FILTRATION AREA SQ. FEET QUANTITY OF APPROVED STONE-CU. YD. SAND-CU. YD. FILL REQUIRED CU. YDS. FINAL INSPECTION REQUIRED BEFORE BACKFILLING DEPTH OF BACKFILL 2"STRAW OR PAPER STONE OVER TILE PIPE SIZE < STONE SITE PLAN AND SPECIAL STIPULATIONS UNDER TILE (INDICATE DIRECTION OF DRAINAGE) CROSS SECTION OF TRENCH APR 10! 1979 REGIONAL PLANNING COMMENTS: THIS SITE PERMIT EXPIRES O� I -Ij v, Yla MASON COUNTY PLANNING DEPARTMENT P.0. Box 400 Shelton, Washington 98584 PLUMBING PERMIT APPLICATION IMPORTANT —Complete ALL items. Mark boxes where applicable. 1. LEGAL DESCRIPTION Location Of N S -_-- N S-- --- --- --- Building E W side of - _ feet E W from intersection of -_ Sect. _._ _ TWp. — Range NO. PLUMBING FIXTURES FEE NO. GAS APPLIANCES FFE GAS PLUMBING WATER CLOSETS AV 400 EACH UNDER 60 MBTU SEWER SEPTIC TANK BASINS o d EACH 60 TO 120 MBTU BATH TUBS p EACH 120 TO 200 MBTU SHOWERS d EACH 200 TO 500 MBTU WATER HEATERS a, EACH OVER 500 MBTU AUTO. WASHERS O G SINKS C,1 FLOOR DRAINS 0 DRINKING FOUNTAINS LAUNDRY TRAYS Connect to City Sewer SERVICE CONNECTION DISH WASHER DISPOSAL URINAL Distribution System By Special Permit (Show Street Names & Property Lines) INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR GAS AND WATER. SKETCH IN SEPTIC TANK & DRAIN FIELD LOCATION OR SUBMIT ON OTHER SKETCH. PERMIT 12-3 PERMIT FIELD INSPECTION Date By Remarks _ 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 Signature of applicant Address Application date klr;4�,z t�Z Lal&zL2 DO NOT WRITE IN THIS SPACE — FOR OFFICE USE _ Approved by Permit fee ,'^ Date permit issued Permit number JReceipt No. $ V{/✓ �� i�� PLOT PLAN ADDRESS �� ( � PERMIT NO. f o o > ' x o LEGAL DESCRIPTION LOT BLK ADDITION u SITE AREA-3 AM + ,�• 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 P"'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. 0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' IrA Ail 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. NAME(S) OF OWNERW OF S1TE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE GHElTON PRINTIN3