HomeMy WebLinkAboutBLD24827 SFR - BLD Permit / Conditions - 6/30/1989 Sho el ines: /yamc�i
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Conditions: Interior:
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Mobile
Smoke Detector:
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Setback:��
Foundation
Walls:
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Fireplace:
Wood Stove:
TYPE RESIDENCE
Permit No. 23988 No. Floors
Owner KOW 2 Sq Ftg 2184
Address • °hn Tel 3 -p 67 Date 6-3 8o g
Contractor r0° ane Bremer on Zip um ermens
Address S' ver a e
Legal Description r urve _ p
Direction to projects to
E en ah Pass R
Fire lace x c anica
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Basement her import
4 bdrm
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BUILDING PERMIT APPLICATION
MASON COUNTY i.OV 2 111969
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 �r•=atl �?[aB "='
427-9670 DATE ISSUED//- 7-
PERMIT
NO.<:>9'7'" 7
�•_ NArAE (,} MAILADDRESS CITY&STATE ZIP PHONE
OWNER ph L�iU k 1 it Sod
DIRECTIONS From 1 �r� N nN W ;r VaIky _ p f-aor
TO JOB SITE 3 7J-XZ
l s ' reSrd-encL pr, W Si A�
PARCEL
NUMBERp",3 DESCR. I LIla/94 rt R, �I43-�
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR N
USE OF � " ��
BUILDING SL&Ln
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SO.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION A*HORIZED IS NOT
COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNE S AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTI THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIST TION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIR ENTS 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 CON ORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAIN G APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.�1rr �/ �
X W ER Q.V",A,& DATE �/ `7-�1_ X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION O d
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT 9
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE APPLICATION ACCEPTED BY l NS K BY APPROVED FOR ISSUANCE PERMIT VALIDATION /�Cl�//�,///�
BY - ' - CASH CK MO TOTAL
Z,
I
PLOT PLAN
L IL
ADDRESS d V 1 E 6 1 I G _FFs',1 Q A"L PASS PERMIT NO. � �s .>—o
ti z .sc�TloN i�, r(),,,N5HIP ° 3 ��R �-� R c, w �Tf cr i sur2� y
LEGAL y
DESCRIPTION LOT BLK ADDITION
CRGS �
SITE AREA— Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS >�U`' Sq. Ft.
r;
I'I INSTRUCTIONS TO APPLICANT :__V m
7C7 r.
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 AND 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- f
TION THEREOF.
INDICATE NORTH IN CIRCLE
NUY' TbI SCALE-
5 �
70
n V
i
.� FE&C EAL
ICI
1� �f •� c . ��R
s
I/We certify that the proposed construction will oonform to the dimensions and uses shown above and that no changes will be made without
first obtaining approval.
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) NATrU OF OWNERM OR AUTHORIZED REP ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE