HomeMy WebLinkAboutBLD19516 SFR - BLD Permit / Conditions - 10/27/1986 TYPE RESIDENCE
Permit No. 19516 No. Floors 1 Sq Ftg 1078
Owner SHELTON CONSTRUCTION Tel 426-1600 Date 10-27-86
Address E 1451 Anthony Rd Grapeview Zip
Contractor Self
Address Zip
hgal Descrlptlon Rainbow Lake I,o 10
Direction to project site Hwy 3 to Mnsnn Lk gd,lefr ro
McEwen Prairie, left to lst lot on left
Plumbing X Mechanical Sewer Wood Stove X
Fireplace Deck Garage 484 Carport
Basement ,oft Other
3 bdrm
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED �o
PERMIT NO.
OWNER NA E MAIL ADDRESS e CITY&STATE ZIP PHONE
C. O �� at' -/ Ga
DIRECTIONS
TO JOB SITE t 04
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. 4D
CONTRACTOR
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF
BUILDING
c �
Class of work: ANEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
r � O
Valuation of work: $ PLAN CHECK TEE PERMIT FEE v
v 416 c7
SPECIAL CONDITIONS:
BEDROOMS_ DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGExQ
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. O STORIES BASEMENT ❑ ATTACHED) / OR AIR CONDITIONING.
TOTA SO. FTzg& 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 [ ) SHORELINE DV
S
/ SEASONAL ❑ FLOODPLAIN ❑
Firm<_A10 ALA /y`01 E.D. NO. S.E.P.A. 1-1By f^ G Special Approvals IN OUT YES APPROVED NO
Lic. No. L^J�.2I9OP/ Date Zn' �S�O� ZONING
PLANNING DEPT. Q�
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. ?c li ✓
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 ISSUANCE
Owner Date . - BY
41
PLAN CHECK VALIDATION K. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
CHRISTMASTOWN PRINTING
MASON COUNTY
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 LA
z.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Si ure of applicant Address J Application date
/ �-4' •/7
GAL DESCRIPTION
Location
Of 0
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINSAA
,
BATH TUBS
SHOWERS
WATER HEATERS
AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
(Show Street Names & Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT O 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.
$ �/. moo
CHRISTMASTOWN PRINTING
PLOT PLAN
ADDRESS PERMIT NO. f ;
LEGAL
DESCRIPTION LOT BLK ADDITION
SITE AREA C, ?O �� Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS f-1 — Sq. Ft.
f:
INSTRUCTIONS TO APPLICANT
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE r�
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 A
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN-
SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA-
TION Al"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'
r
1/We certify that the proposed construction will conform to the dimensiclns and uses shown above and that no changes will be made without
first obtaining approval.
f
i
NAME(S) OF OWNER(S) OF SITE d STRUCTURE(S) (PRINT) _9I`1SN3,TLjRIE7OF OW R(SI OR AU TNORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
CHRISTMASTOWN PRINTING