HomeMy WebLinkAboutBLD9967 SFR - BLD Permit / Conditions - 8/19/1976 Royce, Delbert #9967
8-19-76
Mission Creek Trks. , Div 1 Lot no. 3
Summer Home
$9,640.00
I'Tocx
o IN
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 93584
DATE ISSUED
PERMIT NO. �! 7
OWNER NAME MAIL ADDRESS CITY&STAT ZIP PHONE
DIRECTIONS
TO JOB SITE ii
e. � � Ian Ct�ek of G2. e
LEGAL _T (❑SEE ATTACHED SHEET)
DESCR. 16-%11 I r at s �t v l �
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR r0 t:} (Z'b ` C e O 3
USE OF 1
BUILDING C5Lk-
Class of work: q,-NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: Q
Valuation of work: $ / PLAN CHECK FEE PERMIT FEE
L 7 ✓
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY, PLANS CHECK BY APPROVED FOR ISSUANCE Type Of Occupancy Division
BY Const. Group u
Size of Bldg. No. of Max.
(Total) Sq. Ft.y 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. S
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 Count ordinance requirements for SEPARATE PERMITS ARE REQUIREDFOR ELECTRICAL, PLUMBING, HEATING,
y VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be i conformance t erewlth. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner Date. WORK IS COMMENCED.
PL CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
. y �
MASON COUNTY PLANNING DEPARTMENT
P.O. BOX 186 Shelton, Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT — Complete ALL items. Mark boxes whrre applicable.
Name Mailingaddress—Number,street,ciiy,and State Zip code Tel.No.
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
Sign of applicant � „/'t Address Application date
LEGAL DESCRIPTI NC,
Location Y L "�
Of
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS , 1
BATH TUBS
SHOWERS
WATER HEATERS
AUTO.WASHERS 4" �t
SINKS J
FLOOR DRAINS
DRINKING FOUNTAINS v
I
LAUNDRY TRAYS
Connect to City Sewer 5
DISH WASHER
DISPOSAL 1
URINAL
(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
i Approved by Permit fee --jDate pemit issued Permit number Receipt No.
1� F/,/�?17 6 "�' z