Loading...
HomeMy WebLinkAboutBLD N/A Rip-Rap Bulkhead - BLD Application - 7/31/1991 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES 426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. OWNER �N�+ME MAILADDRESS CITY&STATE ZIP PHONE DIRECTIONS t. �^ i l_ -'"� // - TO JOB SITE I'1 O r+k On o W fie-I ra. r 'T bra i3e-lx f- C_me-k PARCEL LEGAL NUMBER I)-3 Db 1d O 1 OZ3 DESCR. E �� N(n'r�{ SeG, (� ), �3 (�. 2 1 L Z NAME MAIL ADDRESS CITY&STATE ZIP PHONE LICENSE NO. CONTRACTOR <>e USE BUILDING r'l CLASS OF NEW ✓ ITION I AL ERATION A REPAIR MOVE REMOVE WORK r y WORK DESCRIBE �h ru t ro AREA: NUMBER OF: oPtl�E CATE: NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR RESIDENCE SgFt STORIES S ELINE❑ CONDITIONING. BASEMENT SgFt BEDROO PRIMARY RES.O THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT DECKS Ft BA 0000, SEASONAL RES.❑ COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. CARPORT SgFt JREP CE IS CARPORT/GARAGE GARAGE SgFt ATTACHED O DETACHED 0 OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENTS 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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. XOWNE ^ - �a`�-DATE -7 731-91 XBY DATE FOR OFFICE USE ONLY DEPARTMENT YES APPROVEDJO DEPARTMENT YES DEPARTMENTBUILDING VALUATION HEALTH PUBLIC WORKS FEE PLANNING FIRE MARSHAL BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE APPLICATION ACCEPTED BY I PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION TOTAL BY CASH CK MO BUILDING PERMIT PLOT PLAN MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. Box 186 SHELTON, WASHINGTON 98584 P��MIT NO. NAME NlAiLA 0 SS C I T Y d S iA t C ZIP PHONE.• OWNER I r� w✓1 i�u WC 29'0 Imo. Br-e4'ne*4f-.)n , 4(�'r c`e3f Z f OIRECT1oN5 101oes ; rltx'} �,. ©(� el�G;r ���� Oyi ellear Cteek- ahe Z-75�go(c�'� " w�► 10 �,+k Mai PARCEL LEGAL P•��{he. L,k NUMHEP 112 ,06 So 010A oESC;,. It�JE Y4 P-),kYl sel., �,'1.23 M I Indicate below: r Proper;• line- and dimenssnrs. O Easements and roads. O Septic, drainfield and reserve area or sewer. O Septic tank and drainfield setback distances fron foundations. O Location of proposed construction on property. 0 O Building & septic system setback distances from all property lines & easements. Indicate North O Well and water fine. O Saltwater, takes, rivers, streams,wetlands,drainage. In Circle O Attach copy of septic system"as built"or septic permit-approval. O Indicate topography profile of property and structure on reverse side. loo I ( 1 III I I I I II T-ITI 1 111111 I 1 1 I I I ! I I I I I l i � i I � I � I � I ! ► 1 II I I I I I I I I { I I I l I I inl I I I i l I I I I I I I I I I I I I FT1 i 1 1 1 1 I. 1 1 1141 Ilo�� I I I I I I I I I I I I I I I I I I I I i l l l i I I I I I I I I/`V3 CBrZi� :1a::�d J .J�id� .^r. „:J «' -`Jr� _r •/ s: JJ� . _ Z^S•Zr•s anC us2s S:.Jon ato-±.l.'..:.1it ni r!v*;ts will Se•'a•_a•�•:1w:::.'ir5:Jb.3i::�'S 3�