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Home My WebLink AboutBLD10717 SFR - BLD Permit / Conditions - 7/29/1981r WARREN, Larry D. #10717 P. 0. Box 733, Belfair 07-29-81 Up Effendal Pass - nelt to Lake Wotten Lot 11 - Lake Christine Development Residence Contractor - Self $24,102.00 Plumbing Permit F�Y- v� �,(��/may/r i �, �/� i / , �� i . I Y BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED PERMIT NO. D /7 NAME MAIL ADDRESS CITY 8 STATE ZIP, PHONE. OWNER ,. _ DIRECTIONS I TO JOB SITE "` �� '.`-�: 5 - �� •� �L�� LEGAL 1. (❑ SEE ATTACHED SHEET) DESCR. Zi\ NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE CONTRACTOR V" USE OF BUILDING Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ ❑ REMOVE -N Describe_wo(k: jN_ _.�� OD 0v Valuation of work: $ i PLAN CHECK FEE PERMIT FEE S� 0 v?.S SPECIAL CONDITIONS: BEDROOMS I DECKS CARPORT ❑ NOTICE BATHROOMS (TOTAL SQ. FT. GARAGE ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES� _ BASEMENT ❑ OR AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE Pj DETACHED ❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- /12 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 SHORELINES/ SEASONAL ❑ FLOODPLAIN ❑ Firm E.D. NO. S.E.P.A. ❑ By Special Approvals IN OUT YES APPROVED NO Lic. No. Date ZONING OWNERS AFFIDAVIT HEALTH DEPT. I certify that I am exempt from the requirements of the FIRE MARSHAL contract or registration law RCW 18.27, and am aware f the Mason County ordinance requirements for BUILDING DEPT. hich this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT , 1`\`k',�\ LIC ION PTED Y PLANS CHECK BY APPROVED FOR ISSUANCE lj BY Own r , _Date.` PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIO CK. .O. CASH PLOT PLAN ADDRESS ` :_UX �.� �� `�a- \� PERMIT NO. 0 a = a 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 G 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 V 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"ID 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 , G PH SQUARES ARE" 5' OR 1"=20' VV 1 � i r C X-11 I I/We certify that the proposed construction will conform to the dimensions end uses shown above and that no changes will be made without first obtaining approval. -- NAME(S) OF WN ER(S1 OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED 'oL � DATE 6HELTON PRINTIN3 let 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. LN �JK J3 Owner 2. o�� 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 plic t Address Application date LEGAL DESCRIPTION Location Of Building NO. PLUMBING FIXTURES FEE / WATER CLOSETS Is BASINS BATH TUBS SHOWERS WATER HEATERS O% d AUTO.WASHERS t ` SINKS — FLOOR DRAINS DRINKING FOUNTAINS LAUNDRY TRAYS Connect to City Sewer DISH WASHER DISPOSAL y URINAL tp -- / (Showy Street Names & Property Lines) :.c —— --- — INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.' PERMIT 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.