HomeMy WebLinkAboutBLD4082 Cabin - BLD Permit / Conditions - 1/10/1980 Pasquini , Joe F. #4082
12-2-76
Wooten Lake, Lot 68 Contractor
Across from Public Access Joe Pasquini
Tire in tree with Joe & Reeva�� written on it.
6'' 40`4`4 c/" / ""7 Plumbing Permit issued
Cabin
$21 ,500.00
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BUW�NG PERMIT A PPS CATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED 17C
PERMIT NO. S/O 2-
OWNER NA E 1 MAIL ADDRESS CITY&STATE ZIP PHONE
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DIRECTIONS h f,'C A �cuss
TO JOB SITE -as 7— 3 5 r2tP ak � S' rf� 2c J
LEGAL ) (fXSEE ATTACHED SHEET)
DESCR. Lo t J� C Cl` !''a� rJJC► l� "/ p7 �I��) 2 .Q V/
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ / PLAN CHECK FEE �S PERMIT FEE
/
SPECIAL CONDITIONS:
AP ICATION ACY PLACit BY MAPPR � OR SUANCEi Typo of Occupancy Division
Const. Group
r_ f Size of Bldg. No. of Max.
(Total)Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVI
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am av,are 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 1
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 confof Ice therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
_ IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
l , v f y�1 SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner Date f� WORK IS COMMENCED.
PLAN S,HECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
MASON COUNTY PI-ANNRNG DFPAPTNIMIPNT
P.O. BOX 186 Shelton, Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT — Complete ALL items. Mark boxes where applicable.
Name ,/ Mailingaddress—Number,street,pity,and State Zip code Tel.No.
�. e r s i n 1� '1 !O
Owner
z. Joe
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Simtrappli Address Application date
LEGAL DES IPTION
.T lq a e T # (,,(/ o D t-eh �a k>✓ a eG o din to ` h'e V'e v o i'd
Location —r—---n 1i
Of
Building a e p -rr ®, r` @�e
r o u A af- S T 1'e, fJ o ts Pa Q l
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS C'a
BATH TUBS C-O
SHOWERS
WATER HEATERS • (� '
AUTO.WASHERS
SINKS Q t)
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
3. �
(Show Street Names & Property Lines)
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
Appr v by Permit fee Date pemit issued Permit number Receipt No.
171d 00 2
1
PLOT PLAN
ADDRESS r—' r l/lJ �' �` `'�� 7\1�� PERMIT NO.
LEGAL
DESCRIPTION LOT (,"', BLK ADDITION W O[I teo LAC
SITE AREA L 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"ID SEWER SERVICE ELEVATION. $HOW 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'
I
TA
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.
� � r
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNA R OF OWNERS) OR AUTHORIZ P REPRESENTATIVE
DO NOT WRITE BELOW T LINE
APPROVED
DISTRICT AS NOTED DATE
GHEL-ON IRINTINi