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HomeMy WebLinkAboutBLD5962 Final Enclosed Swimming Pool - BLD Application - 12/18/1980 ti David F. Allen 3-6-80 refer to permit for legal description - That portion of Gov't. Lot 2, Section 32, T 22N, Range 1 West, W.M., etc. also tidelands of the second class, formerly onwed by State of WA Swimming Pool enclosed by building to be attached to existing house $25,000.00 Quality Pools Inc. I 0 w o � .q � d j BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED PERMIT NO. OWNER NAME MAIL A DRES CITY& TATE ZIP PHONE DIRECTIONS �C) !`f>�.ILA- R,t}10GUL@W TO C fe D C)u0 O KT- 7-o P1k$ 7' Stq, TTO JOB SITEA t:. 1� (r T D 5 G LEGAL ( EE ATTACHED SHEET) DESCR. () L4.Q NAME AIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR 0©CS ODD, + Dtl)A Gl,11, USE OF BUILDING P-0c)L Class of work: NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: ^ SLU t POOL � C�L-O Q B(-t,rL � d f s Valuation of work: $ 0 � U PLAN CHECK FEE E FE t SPECIAL CONDITIONS: i BEDROOMS DECKS CARPORT ❑ NOTICE BATHROOMS TOTAL SQ. FT. GARAGE ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE ❑ DETACHED ❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED CONTRACTOR AFFIDAVIT 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 I `certify that I am a currently registered contractor in WORK IS COMMENCED. the State of Washington and I the aware of the FOR OFFICE USE ONLY ordinance requirements regulating the work for which the permit is issued and all work done will be in conformance therewith. PERMANENT ❑ SHORELINES ❑ SEASONAL ❑ FLOODPLAIN ❑ F' E.D. NO. S.E.P.A. ❑ /� '�"p ' 'y! Q� Special Approvals IN OUT YES APPROVED NO Lic. No. t►�u{,'TL---+� 1 'a-7-i QSDate �.LSLt1 ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. PUBLIC WORKS I certify that I am exempt from the requirements of the FIRE MARSHAL contract or registration law RCW 18.27, and am aware BUILDING DEPT. of the Mason County ordinance requirements for which this permit is issued and that all work done will ROAD ACCESS in conformance therewith. MOTOR VEHICLE PERMIT APPLICATION ACCEPT BY PLANS CHECK BY APP OR A CE O L 9"ate. BY e PLAN CHECK VALIDATION *CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH • PLOT PLAN p . 1 /� n PERMIT NO. a c ADDRESS C �D/V(liL S� ����B 1 �� = s s a LEGAL R DESCRIPTION LOT BLK ADDITION SITE AREA 06 Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS 1✓ 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 P"iD SEWER SERVICE ELEVATION. SHOW 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' R7 00 jEt*"'t -- I'j_ - I I/We certify that the proposed construction will conform to the dimensidns and uses Shown above and that no charges will be made without first obtaining approval i N ME131 OF O Rl 1 SiTE 6 3 R TUREIi) OF (PRINT) iGNAT E OF O R(S) OR AUTHORIZ R P ESENT IVE DO NOT WRITE BELOW THIS LINE APPROVED DATE DISTRICT AS NOTED i Vnm PRINTING