HomeMy WebLinkAboutBLD6751 Addition - BLD Inspections - 6/27/1980 I
Olsen, Irving L. #6751
4Q4-O a--$ 6-27-80
S.E. end-bf Treasure Island
W 1/2 Lot 27 & all of Lot 79, Treasure Island
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Addition O�
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$12,500.00.
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NULL & VOA IBY EXPIRAT@ - ---- -- - --
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PLOT PLAN
ADDRESS /JPERMITNO. o
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LEGAL �EAs�
DESCRIPTION—r LA/Vj) LOT ''�Y ak f BLK ADDITION a
SITE AREA C Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS V Sq.Ft.
INSTRUCTIONS TO APPLICANT
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"-20' ARE
FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.)
FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN-
SIONS.SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA-
TION P"'D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR-
TION THEREOF.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
sit S.
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0
001 IT 00
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in,
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I/We certify that the proposed construction will conform to tM dlmensim and uses shown above and that no changes will be made without
first obtaining approval.
4
A16NIA
ME(S) OF OWNERS) OF SITE 6 STRUCTURE(S) (PRINT) SIOXYTURE OF OWNE 7
S) OR AUTHORIZED R P ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED DATE 6 C
DISTRICT AS NOTED
SHELTON Pn?NTINO
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED �
PERMIT NO.
NAME MAIL ADDRES$r CITY&STATE ZIP PHONE
OWNER bl�u►h!'� .C)C `` fU 3Za��19s'1'. t- " ..—f(?G`/ftF'1 �f> - � C,
DIRECTIONS I
TO JOB SITE S� E C p,. Sl.� .. .. ,i-1�S 0A.,, Ce, H AsT
LEGAL / c` .�+ s ,r� (❑SEE ATTACHED SHEET)
DESCR �C+F L. Off" 7`/7�L OF "! /r E/ 5 A;)C J..S�i
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR g )
USE OF ,y /'�`
BUILDING 1,''a'1/�'�M �R .
Class of work: ❑ NEW KADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: `
C�
Valuation of work: $ / .� �.-��p �G PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS_ TOTAL SO. FT. GARAGE ❑
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES&— I BASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ IDETACHED ❑
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. PERMANEN SHORELINES ❑
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. Q
PUBLIC WORKS
certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT. ,Z
of the Mason County ordinance requirements for
which this permit is issued and that all work done will R9PQ ACCESS
betconformance;her T R VEH CL RMIT
/ //6
Aa
ATION TED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owne ate u 4 BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATI CK. M.O. CASH