HomeMy WebLinkAboutBLD4198 Visual Final SFR - BLD Permit / Conditions - 2/8/1980 Sande, Carl L. #4198
` 1-12-77
Collins Lake, Div. 3 Lot 21
Plumbing Permit issued
Residence
$5,600.00
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• - BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED �2
PERMIT NO.
OWNER ^NAME J MAIL ADDRESS CITY&STATE ZIP PHONE
DO JOB SITE 1
ONS
T 7�//�hf' JEcG yC/o emu. 8 .. 1 L L kr�
LEGAL / (❑ SEE ATT. .ACNE,D SHEET)
DESCR. 1 n ]� i r/ Cb N s /�/!� Z[J-/s��7 97 9
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF
BUILDING �� I a� Q�.5"C1, A
Class of work: 'g NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
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SPECIAL CONDITIONS:
APPLICATION A EPT D BY PLANS CHECK BY APPROVED FO ISSUANCE Type of Occupancy Division
� BY Const. Group
'e
Size of Bldg. No. of Max.
(Total) Sq. Ft. Z p-� Stories ` Occ. Load
CONTRACTOR AFFIDAVIT O
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 0 T I C E
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
which this ermit i ued a d that all work done will
OnC the eWl THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
/ IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
7 SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner Date. WORK IS COMMENCED.
P HECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
Li
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.
Viz, w.�. qs � )-:7s �
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
Sig ur of pllcant Address Application date
LEGAL DESCRIPTION 1
Location
Of
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS d-'U
BASINS
BATH TUBS
/ SHOWERS
C
WATER HEATERS
�o
AUTO.WASHERS
SINKS �Lt
FLOOR DRAINS
DRINKING FOUNTAINS C
I
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
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
ApprovedAy Permit tee Date pemit Issued Permit number Receipt No.
- � $ /3 04 ZI 2/7 7