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HomeMy WebLinkAboutBLD21240 SFR - BLD Application - 11/23/1987 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 2 426-5593 DATE ISSUED ? / J 7 PERMIT NO. � y� NAME MAILADDRESS CITY BSTATE ZIP PHONE OWNER j - r DIRECTIONS TO JOB SITE L PARCEL LEGAL 3 1 NUMBERSC�•� �:� ESCR.L']r sS� 7�L��F fC see- NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR �r V iir J ,; iC USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE WORK BEDROOMS DECKS jakq�a_ CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTAL SQ.FT. 41L GARAGE CONDITIONING. NO.OF STORI ES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SO.FT. 17O!;�__ FIREPLACE14�7" DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN IN CONF�DRMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING 0BTAINI G APPROVAL FROM THE BUILDING DEPARTMENT. APPROVA FROM THE BUILDING DEPARTMENT. i X OW[ DATE X BY DATE FOR OFFICE U O LY DEP TMENT YESPPROVENo DEPARTMENT YESPPROVENQ BUILDING VALUATION 0 G) HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT 242.%'D D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP — PRE-INSPECTION SHORELINE -3 5 `0 WOODSTOVE Q pp PLUMBING 0-0X cj Z O MECHANICAL / 3, OD STATE BUILDING FEE ol 50 ` STATE SURCHARGE S) C APPLICATION ACCEPTED BY APP F U PERMIT VALIDATION 4 TOTAL CASH CK MO PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 426-5593 DATE ISSUED PERMIT NO. NAME MAIL ADDRESS CITY&STATE ZIP PHONE OWNER L S=Z � �f` � DIRECTIONS TO JOB SITE f LEGAL �^ ,` Vol-, ~ b iu- DESCR. Lo / 46/a �.eZK �. • / CONTRACTOR NAME MAILADDRESS CITY SSTATE I LICENSE NO. ZIP PHONE BUILDING ei D�'kee �77,y= s'� 4 5/ PLUMBING FIXTURES MECHANICAL FIXTURES NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE OF FIXTURE FEE WATER CLOSETS FORCED-AIR/GRAVITY TYPE FURNACE 6.00 BASINS 14-m FLOOR/SUSPENDED FURNACE 6.00 I BATH TUBS OO BOILER/COMPRESSOR 6.00 f SHOWERS REPAIR/ALTERATION 6.00 WATER HEATERS REFRIGERATION COMPRESSOR SYSTEM 6.00 AUTO.WASHER 2, AIR HANDLING UNITS 7.50 SINKS HEAT-PUMPS 6.00 FLOOR DRAINS —T EACH GAS PIPING SYS.2.00 PER OUTLET DRINKING FOUNTAINS VENT.FAN SYS.3.00 PER UNIT LAUNDRYTRAYS WOOD STOVES 5.00 CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISH WASHER DISPOSAL �-- URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL a k.00 TOTAL .©G SPECIAL CONDITIONS: NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED 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 WORK IS COMMENCED. OWNERS AFFIDAVIT: I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF CONTRACTORS AFFIDAVIT: I CERTIFY THAT I AM A CURRENTLY REGISTERED THE CONTRACT OR REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON CONTRACTOR IN THE STATE OF WASHINGTON AND 1 AM AWARE OF THE ORDINANCE COUNTY ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL REQUIREMENTS REGULATING THE WORK FOR WHICH THIS PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. WITHOU IRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. X OWNER DATE X BY �' t DATE /In FOR OFFICE U O APPLICATION ACCEPTED BY PLANS CHECK BY BU N; V R I/P APP ED U NCE PERMIT VALIDATION CASH CK MO