HomeMy WebLinkAboutBLD12116 SFR - BLD Application - 3/10/1982 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMITNO. IR' I (O
NAME _ MAIL ADDRESS CITI&STATE / ` ZIP PHONE
OWNER -- 2,32" S?o Ptr/iU� �t/S J W' 3?O 29"
DIRECTIONS j WW-29&y4'i"
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. ,� a?-3-02 4c.� I sur✓e / - �?.2,
NAME MAIL ADDRESS TY&STATE LICENSE NO. PHONE
CONTRACTOR
4>ti�
USE OF ^ w00 2� )
BUILDING C(
Class of work: >0NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
zzoolq ' C� Sr Oo
J
Valuation of work: $ PLAN CHECK,,PEE 0 PERMIT�,FEEG
SPECIAL CONDITIONS:
BEDROOMS_ DECKS CARPORT LI NOTICE
BATHROOMS TOTAL SQ. FT32t2_ GARAGE i--i— _%/7
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES"3� ,�-_�_ BASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
TOTAL SQ. FT.Zk2iX) 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 FORA PERIOD OF 180 DAYS AT ANYTIME 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 OFF ICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT L4011, SHORELINES 90 4.1
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNIN_r nFPT.
HEALTH DEP
OWNERS AFFIDAVIT
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE M AL
contract or registration law RCW 18.27, and am aware
of t ason Count _o�dina ce requirements for BUILDING DE ji$� / ga
w c h s permit is ued and t at all w k done will ROAD ACCESS
e in onform ce t e; ith. MOTOR VEHICLE PERMIT
�i
3 ts2 APPLICATION A CE TED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner BY
PLA CHECK VALIDATION CK M.O. CASH PERMIT VALIDATION CK M.O. CASH
;_A
1
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 N S N S
Building
E W side of feet E W from intersection of
Sect. Twp. Range
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 y 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-$4.00
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 / a
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 hood-$3.00
10. Installation or relocation of each absorption system to and
including 100,000 Btu'sl--$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 Lno other fee is listed in this Code--$3.00
FIELD INSPECTION Basic Fee $3.00
Date By Remarks
TOTAL
Name Mailing address - Number, street, city, and State Zip code Tel. No.
t. t- 7- S e 14 -w---Z /N QSs3-70 7'7Y-yJ
Owner
CZ S ,16 0
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
CV'Y,7 e c�,s n G/'I V�e �J /997
DO NOT WRITE IN THIS SPACE - FOR OFFICE USE
Approved by Permit fee Date permit issued Permit number Receipt No.
eN6LTON PRINTING CO.
A-�
PLOT PLAN
ADDRESS PERMIT NO. f o
A D
D O
O
LEGAL 1
DESCRIPTION LOT / BLK ADDITION u
_ w
SITE AREA -5,,c e BeTfF' 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 p
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.
�G INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
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.
NAMES) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED �_ /
DISTRICT AS NOTED 2 Z DATE
SHELTON PRINTING
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.
Owner
[� C
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
/4" JGr Z
LEGAL DESCRIPTION
Location
Of
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS
BATH TUBS ✓
SHOWERS
WATER HEATERS
AUTO.WASHERS i
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER ^�
12
DISPOSAL
URINAL
r^
(Show Street Names 8 Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT SKETCH IN SEPTIC TANK 8 DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved by Z Permit fee Date pemit issued Permit number Receipt No.