HomeMy WebLinkAboutBLD0180 SFR - BLD Permit / Conditions - 6/19/1984 MASON COUNTY DEPARTMENT OF GENERAL SERVICES II lW1C.C��
Legal Description: Section /fJ Township oQ 3 North, Range _c-_ West, W.M.
Project.
Date Received
Address of Project
Owners Name _ oeh
,;�^�_ _--�^+►
Address
Phone,,
Directions to Project Site
A i` -) C��lp�i,fair «r . Ta��=��L>_n..�•
�i�.l�>>��Q� t» sl i yr�j/f �r•�� r� 7cl Z�Z.7
HEALTH Fee Paid 75t)6 Receipt No. Date Received •�� -�S'f
Plot Plan ✓ Type of Septic System _ ,
Tank Size n OD gallons; Drainfield Length, feet; Approved for
_ -2_
bedrooms ; Septic System Site Approved tJ-,3d -,5y Final Approved ^�
Contractor ,�,,-y��J _ _ Phone —
Inspected By _ Completion Date
Water Supply Approv d �—
PLANNING Fee Paid _ T Receipt No. Date Received J�G
Residen�cf Commercial Plat _
SEPA d 1)A Final Declaration EIS Required
Shoreline Exempt i Shoreline Permit — — --- -—
Local Decision �`7
Appeal Final Decision
Preliminary Plat Date Final Plat Date —
Contractor _ Phone
Project Engineer Phone - — —
By 7C�
BUILDING Fee Paid ac,?�p � Receipt No. Date Received
Plan Check: Approved — Denied with the following c rrections
Conditions -~ _—� -+ --- ----+-� -l--
-41
Approved: Property Line Setback Footings Foundation Walls _
Framing _ Fireplace- Wood Stove Plumbing
Mechanical Roof _ Exterior _ Interior
Final Stop �Work
Mobile Home Smoke Detector
Pemarks ���
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Additional Comments
J
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER Ci ST W 7 •) Ili
DIRECTIONS I Fo1 -r cJyY '��, k,'e ern aaro �.rCrecftS,f`'"re ,+��(-S ,r;�
TO JOB SITE �I-e-K S r...� L. j��G1 tliaC'rs MFPr0X Iw��(-c �' (-Joy rc,(•e{'r f K31. qt yC((o:�s '1 Pas1S
LEGAL f 0 Z� 'Z 'Z. TO �ACt I Z S�ru y 5/1.3? (� SEE ATTACHED SHEET)
DESCR. c�
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR S C G
Bra � 373 7)(v
USE OF /
BUILDING !
Class of work: EW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
o
�?7, '2 90, 0
6 o)s, o a �
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT : I NOTICE
BATHROOMS ITOTAL SO. FT. GARAGE
// ATTACHED � '. SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIESJ�r BASEMENT X H� OR AIR CONDITIONING.
TOTAL SO. FT. E`er I 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
/th
ify that I am a currently registered contractor in WORK IS COMMENCED.
State of Washington and I the
aware of the FOR OFFICE USE ONLY
ance requirements regulating the work for whichermit is issued and all work done will be in
rmance therewith. PERMANENT SHORELINES
SEASONAL f 1 FLOODPLAIN I
Firm E.D. NO. S.E.P.A.
Byk Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. mom,
PUBLIC WORKS
1 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 all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLAN CHECK BY APPROVED FOR ISSUANCE
Owner. Date. �4
PLAN 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.
1.
Owner
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 applicant Address Application date
LEGAL DESCRIPTION
Location
Of
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS C-0
BASINS C,'
BATH TUBS �t
SHOWERS p fl
/ WATER HEATERS C C)
/ AUTO.WASHERS - 0 0
SINKS Q
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 f� 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 issuedd / Permit numb/err Receipt No.
$ � � OLD - lqo �/
PLOT PLAN
ADDRESS PERMIT NO. i o
= a
n >
A O
O
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"'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'
7
I/We certify that the proposed construction will conform to the dimensims and uses shown above and that no changes will be made without
first obtaining approval.
�F OWNERW OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
AS NOTED DATE
-INS