HomeMy WebLinkAboutBLD18612 Expansion,Addition Gable and ReRoof - BLD Permit / Conditions - 5/8/1986 TYPE EXPANSION & ADDITION
Permit No. 19612 No. Floors Sq Ftg
Owner FOSTER, J,C. Tb1 275-6270 Date
Address NE 991 Old Belfair Hwy Belfair Zip
Contractor Cornerstone Cont,
Address 1445 Russell Ave. Pt.Orchard Zip
Legal Description 20-23-1 N-1 2,SE-1
Direction to project site
NE 991 Old Belfair Hwy
Plumbing Mechanical. Sewer Hood Stove
Fireplace Deck Garage port
Basement Loft Other
Add Gable & re-roof 27 add. to bathroom
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Shorelines: Pluu biipg:
S Special r/�
Interior:
Conditions: FINAL:
Mobile Home:
Swke DetectUr
Remarks:
Footing:
Setback:
Foundation
galls:
Framing: o e Yh e,
Fireplac . ILAN
Wood Stove:
BUILDING PERMIT APPLICATION
MASON COUNTY
pTie /paP DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED'_'- V_ggli'
PERMIT NO. lz&ZA
OWNER NAME' MAILADDRESS CITY SSTATE ` ZIP PHONE
DIRECTIONS // r
TO JOB SITE
Z
LEGAL / ,�`
DESCR. �d — 3 / %Yd�74/� C� f Gv = Sr ejoelU{A,: ley CK 2-3
NAME MAILADDRESS CITYBSTA E LIC S NO. ZIP PHONE
CONTRACTOR r oat �dy j t o7. YY �u d C lrncC (11Y,
USE OF
BUILDING
CLASS OF NEW ADDITION 6",/- ALTERATION REPAIR MOVE REMOVE
WORK so,
DESCRIBE
WORK
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES 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
TOTALSQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
V
FIDAVIT CONTRACTORS AFFIDAVIT
T I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND i AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
S 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
NCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
PROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.DATE X BYX DATE �U
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION A
YES NO YES NO � CDO
HEALTH PUBLIC WORKS FEE
PLANNING / FIRE BUILDING PERMIT 3-,;) 5- o
D.O.T. BUILDING PLAN CHECK J61
:2 S
SPECIAL CONDITIONS BUILDING GROUP _3 PRE-INSPECTION
SHORELINE
PLANNING
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION `J
J� TOTAL
BY CASH CK MO ` /1
PLOT PLAN
ADDRESS PERMIT NO.
0
= o
a o
LEGAL °
DESCRIPTION LOT BLK ADDITION
SITE AREA 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 P"'D 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'
1/We certify that the proposed construction will conform to the dimensiolu and was shown above and that no changes will be made without
first obtaining approval.
NAME(S) OF OWNER(S) OF SITE ! STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
iNCLTON PRIN TINO
THIS PARCEL
INCLUDES
PLANS, BLUEPRINTS
OR OVERSIZE
IMAGES
LARGE FORMAT
IMAGES HAVE BEEN STORED IN
FILE CABINETS) UNDER
PARCEL NUMBER
PARCEL # IZ310 - ql - 06010
CASE #