HomeMy WebLinkAboutBLD4656 Cancelled Alteration - BLD Permit / Conditions - 1/9/1991 Lee, 'Elvin M. #4656
4-22-77
Lake Christine Lot 45
Alteration & Repair
Plumbing Permit issued
$3,500.00
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PERMIT
NULL & VOID BY EXPIRAT'ON
DATE./ BY �� --
BUILDING PERMIT APPLICATION
MASON COUNTY aa-3 a� ` 0D
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED 2 7 7
PERMIT NO. S �
OWNER NAMEZ=— '� MAIL ADDRESS CITY&STATE �/ ^ZIP �,'/ 373PHONE
DIRECTIONS // �/77
TO JOB SITE 0,yqel S7-
&7 144 H SQ Al LI�r � �
LEGAL ` 1 (❑ SEE ATTACHED SHEET)
DESCR.
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION LTERATION ><REPAIR ❑ MOVE ❑ REMOVE
Describe work:
c� Z2 S' 0w 6 � � e6
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
,APPWCATION ',EPT D BY PLANS CHECK BY APPROVED FOR ISSUANCE Type of % Occupancy Division
BY Const. � Group
Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D. NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT.
Firm PUBLIC WORKS
By
ROAD DEPT.
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIREDFOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPEowner�V%,� / /I` ��__ Date - WORKNSDED OR COMMENCED ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
P}AN 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 Mailingaddress—Number,street.city,and State Zip code Tel.No.
,. I,EE thllAl jo3-
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
-4 -
LEGAL DESC431PTION
Location -----.--
Of ----
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS c
t� BASINS
BATH TUBS
SHOWERS
WATER HEATERS C�
AUTO.WASHERS
✓ SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
' DISH WASHER
DISPOSAL
URINAL
i
(Show Street Names & Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
13.04 SKETCH IN SEPTIC TANK& DRAIN FIELD LOCATION OR SUBMIT
PERMIT — ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
- - -- Permit fee �) Date pemit IWed Permit number Receipt No.
by 7e ����7