HomeMy WebLinkAboutBLD23225 Final Dock - BLD Permit / Conditions - 7/20/1989 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED IJ 2 1V
PERMIT NO. 1913 OR RS
OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE
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DIRECTIONS
TO JOB SITE s' r19p ifP721vin Oki 4
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PARCEL LEGAL
NUMBER 92 3 0-5--23-C"Oq DESCR. c,/. 15 -
NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR eS eel on U d x/Os-e 6 htF Sr s /!. _5-5-pa q
USE OF
BUILDING
CLASS OF NEW✓ ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE 1
WORK ,��.2. /0, �e U( I A
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SO.FT. 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 SQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERS'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 CO ORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAI ING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X N ER DATE X BY ��Yl DATE
31 FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO / o
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK `JS
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY PLAMS CHECK BY APPROVED FOR ISSUANCE PERMIT TOTAL
VALIDATION z �/
/w' J BY CASH CK MO
PLOT PLAN
ADDRESS /I/r, 7o Lt0 / ii0er LA,101, 6r emt44, , PERMIT NO. o
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LEGAL 11)s
DESCRIPTION LOT BLK ADDITION a
a
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 1 )
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-
TION THEREOF.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"-20'
6
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I/We certify that the proposed corntruction will conform to the dimeraime and was shown above and that no changes will be made without
first obtaining approval.
(A!111'a.r.
NAME(a) Or OWNER(S) OF SITE a STRUCTURE(S) (PRINT) TONTRIFOF O NERIe) OR AUTWORIZZO REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:&!c f,/z z g
Mobile Home:
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE DOCK
Permit No. 23225 No. Floors Sq Ftg 210
Owner TRUEMPER, Willi—am Tel 275-5752 Date l-11-89
Address NE 370 W Tiger Way Bremerton zip
Contractor Lakeshore const
Address P 0 Box 1058 Belfair zip
Legal Description Tr 4 G.L.4 5-23-1
Direction to project site West side of Tiger La,<e turn
onto Tiger Way. Go to end of road. Last house.
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport j
Basement Loft Other
i