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Home My WebLink AboutBLD4254 SFR - BLD Permit / Conditions - 3/28/1979 Eberhard, Irma #4254 • 3-28-79 Tr. 1 Blk 4 NW 1/4 12-22-3 turn right at Kay corner in Tahuya four mile up the hill Plumbing Permit k�esidence Mechanical Permit $35,000.00 97 M BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 L� Q DATE ISSUED PERMIT NO. ��I OWNER NAME MAI ADDRE S CITY BSTATE ZIP PHONE DIRECTIONS TO JOB SITE ` LEGAL SEE ATTAC D SHEET) DESCR. 1 /► .J \��I CONTRACTOR NAME I SULMAIL ADDRESS CITY&STATE LICENSE NO. PHONE USE OF BUILDING Class of work: NEW ❑ ADDITION ❑ ALTERATION EPAIR ❑ MOVE ❑ REMOVE Describe work: Valuation of work: $ PLAN CHECK FEE PERMIT FEE SPECIAL CONDITIONS: BEDROOMS_ DECKS CARPORT ❑ NOTICE BATHROOMS 9�L TOTAL SQ. FT. GARAGE ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE ' 2.. IDETACHED ❑ 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 I SEASONAL I FLOODPLAIN I I Firm E.D. NO. S.E.P.A. I j By Special Approvals IN OUT YES APPROVED NO Lic. No. Date 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 BUILDING DEPT. of the Mason County ordinance requirements for which this permit is issued and that II work done will ROAD ACCESS be in conformance t rew' MOTOR VEHICLE PERMIT t , LICATION ACCEPTED BY PLANS CHECK BY 1 APP VED FO�S ANCE Ownel✓ Date. B� PL N CHECK VALIDATION CK. M.O. CASH V PERMIT VALIDATION CK. M.O. CASH SITE NG. PARCEL NO. THURSTON-MASON HEALTH DISTRICT DATE BASIS FOR FEE AMOUNT NUMBER DIVISION OF ENVIRONMENTAL HEALTH 2000 LAKERIDGE DR.S.W. FIFTH&BIRCH ST. PHONE 753-8073 PHONE 426-5561 OLYMPIA, WA 98501 SHELTON, WA 98584 APPLICANT ADDRESS PHONE DATE APPLICANT MUST CALL FOR INSPECTIONS LISTED BELOW SITE: ❑ APPROVED ❑ NOT APPROVED SEWAGE' CONTRACTOR BY: NA E F T LOT NO. SEWAGE: El APPROVED ❑ APOPROVED SEC. TOWNSHIP RANGE BY: DESIGNER: TYPE OF NO.OF LOT ,SOIL TYPE BUILDING BEDROOMS SIZE X WATER GARBAGE DEPTH TO WATER TABLE FT. SYSTEM DISPOSAL PERC TESTS INCHES PER HOUR LIQUID WASTE G.P.D. BY DATE PRIMARY NORTH - SITE PLAN AND SPECIAL STIPULATIONS: SEPTIC TANK(S) GAL. PUMP REQ. (INDICATE DIRECTION OF DRAINAGE) DISTRIBUTION TILE TOTAL FEET FILTRATION AREA SQ. FEET QUANTITY OF APPROVED STONE CU. YD. SAND CU. YD. FILL REQUIRED CU. YDS. b SPECIAL SYSTEM REQUIRED SITE COMMENTS i A `f SEWAGE COMMENTS WELL DISTANCE WELL LOG INFORMATION IS GROUND WATER USED AS A DRINKING SOURCE LAND USE DIRECTIONS TO SITE: FINAL INSPECTION REQUIRED BEFORE BACKFILLING TO BE BACKFILLED AFTER INSPECTION �i 2" STRAW -� STONE OOVER TILE F STONE UNDER TILE THIS SITE PERMIT EXPIRES I E CROSS SECTION OF TRENCH Om I� J MASON COUNTY PLANNING DEPARTMENT P.O. Box 186 Shelton,Washington 98584 MECHANICAL PERMIT APPLICATION IMPORTANT- Complete ALL items. Mark boxes where applicable. 1. LEGAL DESCRIPTION Location Of s V N s Building E&side of feet E W from intersection of Sect. Twp. ' No j" T Range 3 co ez t U ,mi NO. DESCRIPTIONS FEE NO. DESCRIPTIONS FEE 1. Forced air or gravity type furnace or burner including ducts 14. For the installation or relocation of each boiler or refrigeration and vents, up to .and including 100,000 Btu's-$4.00 compressor over 50 horse power or each absorption system over 1,750,000 Btu's---$25.00 2. Over 100,000 Btu's-$5.00 15. For each air handling unit to and including 10,000 cubic feet 3. Installation or relocation of floor furnace and vent, suspended per minute, including ducts attached thereto-$3.00 heater, or recessed wall heater-44.00 NOTE: This fee shall not apply to an air handling unit which 4. Installation, relocation, or replacement of each appliance vent is a portion of a factory assembled appliance, cooling installed, not included in appliance permit-$2.00 unit, evaporative cooler or absorption unit for which a permit is required elsewhere in this Code. 5. Repair, alteration or addition to each heating appliance, re frigeration unit, cooling unit, absorption unit, or evaporative 16, For each air handling unit over 10,000 cubic feet per minute cooling system including installation of controls regulated by -$5.00 this code---$4.00 17, For each evaporative cooler other than portable type-$3.00 6. Installation or relocation of each boiler or compressor to and including 3 horse power--$4.00 18. For each ventilation fan connected to a single duct---$2.00 7. Over 3 horse power to and including 15 horse power-$7.50 19. For each ventilation system which is not a portion of any heating 8. Over 15 horse power to and including 30 horse power-$10.00 or air conditioning system authorized by a permit-$3.00 9. Over 30 horse power to and including 50 horse power-$15.00 20, For the installation of each hood which is served by mechanical exhaust, including ducts for such hoodA3.00 10. Installation or relocation of each absorption system to and including 100,000 Btu'"4.00 21. For the installation or relocation of each domestic type in- 11. Over 100,000 Btu's to and including 500,000 Btu's-$7.50 cinerator-$5.00 12. Over 500,000 Btu's to and including 1,000,000 Btu's Commercial or industrial type incinerators-$20.00 _$10.00 22. For each appliance or piece of equipment regulated by this 13. Over 1,000,000 Btu's to and including 1,750,000 Btu's Code but not classed in other appliance catagories, or for which -$15.00 no other fee is listed in this Code-$3.00 3 0 FIELD INSPECTION Basic Fee $3.00 O� Date By Remarks TOTAL d,-�' Name Mailing address -- Number, street, city. and State Zip code Tel. No. Owner 0 Ydz, � 2. Jt®s Contractor 7__pL_ The owner of this building and the u ersigned agree to conform to an applicable laws of MASON C UNTY Sign ture of ap licant Address Application date DO NOT WRITE IN THIS SPACE --FOR/OFFICE USE Appr ea by Permit fee �� Date petmit issued Permit number ,Receipt No. r P� &HELTON PRINTING CO. 1 ~ MASON COUNTY PLANNING DEPARTMENT t P.O. BOX 186 Shelton,Washington 98584 PLUMBING PERMIT APPLICATION IMPORTANT—Complete ALL items. Mark boxes where applicable. Name Mailing address—Number,street,city,and State Zip code Tel.No. q�s Owner 2. 7SS y` Contractor The owner of this building and the undersiglied agree to conform to all applicable laws of Mason County and State of Washingto Signature o applicanyj Address Application date I.EG DES RIPTIO Location Of Building M24 C � v NO. PLUMBING FIXTURES FEE WATER CLOSETS BASINS d�0 BATH TUBS r Q.p / SHOWERS yJ / WATER HEATERS AUTO.WASHERS d ISINKS . FLOOR DRAINS 4 DRINKING FOUNTAINS LAUNDRY TRAYS /7 Connect to City Sewer �- ��►` J DISH WASHER p C� DISPOSAL in URINAL - (Show Street Names & Property Lines) ct'V ` INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER. PERMIT O SKETCH IN SEPTIC TANK$ 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 Receipt No. ao j-''d' 7/ ��s'7 r y PLOD' PLAN ADDRESS � G / PERMIT NO. LEGAL DESCRIPTION LOT / BLK ADDITION SITE AREA v L� / L Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS j� 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"'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 J 1 j J A c 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. e Fle 7 NAME(S) OF OWNER(S) OF SITE & S RUCTURE(S) (PRINT) SIGNATTJRE OF OWN (S) OR AUTHORIZED REP ESENTATIVE 00 NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE GHELTON PRINTING