HomeMy WebLinkAboutBLD N/A Bulkhead and Shoreline Exemption - BLD Permit / Conditions - 12/12/1981 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATEISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
Jack T. King P. 0. Box 64 Tahuya, Washington 98588 275 6792
DIRECTIONS
TO JOB SITE Shorebrook Lot 3
LEGALI (❑ SEE ATTACHED SHEET)
DESCR. Sec. 27 T-22 North Range 3 W. ,W. M.
NAME MAIL ADDRESS CITY S STATE LICENSE NO. PHONE
CONTRACTOR Frank Weisgerber =N. E. Rovewood Dr. F R-A N-K W-C227R0 479-o442
USE OF I 2W9 Itremerton
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑[REPAIR ❑ MOVE ❑ REMOVE
Describe work:
�_ •?� =aov Y %0 e2Bulkhead is above 11 foot einnh tidp_ mark-
Valuation of work: 49 PLAN CHECK FEE /1� PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED Li SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE DETACHED L:,
El
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 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. PERMANENT a SHORELINES ❑
SEASONAL ❑ FLOODPLAIN
Firm / ✓�C/!f/� [�C�i<iso.�/`6C'!` `p/d�/�
T El
E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT
YES APPROVED NO
Lic. No.,�iQANA w C2 Date ��� ��� gl ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIR
contract or registration law RCW 18,27, and am aware
of the Mason County ordinance requirements for BUILDING DEPT. A-I -f/ .?-/y-�'/
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Own i Date ZI�) e
P CHECK VALIDATION v CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
4
EXEMPTION FROM SHORELINE
MANAGEMENT ACT SUBSTANTIAL
DEVELOPMENT PERMIT REQUIREMENT
TO: Ir �G'a �,�.�G�/
(name and addres of the applicant)
The proposal by jotc i T )<< to undertake
(name 6f applicant
the f o I low i ng deve to ment
( e specs is
upon the fol ow i ng property SG,vrc Ate,k
( legal description; i .e., section to the
Z 7 Z Z�r �( -3
nearest quarter section)
within s&../ �. ,��j and/or Its associated
(name of water area)
wetlands is exempt from the requirement of a substantial development
permit because the development y� ;r d t /�� � ;57`,'k�, •�•tyca�
T
123 /y- Va
(identify exemptions as, outlined in WAC 173-14=040)
(Corps Public Notice Number if available)
The proposed development is consistent or inconsistent with:
CHECK ONE
CONSISTENT INCONSISTENT
Policies of the Shoreline Management
Act.
The guidelines of the Department of
Ecology where no master program has
been finally approved or adopted by
the department.
The master program.
7
(date) (Signatu of Aut on Local Govern-
ment Official )
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oF,Du�I(HrAp-f A!rD-/57 1ADOVE .4-a>
P7-�o5ed cr•4Ee (ju(KNca 4ace
/Pv7r005a : Ra/v1ace. A �"Sisflny Dock ,OO(Olead aw floavCara.(/ Pvge&
�vlf(h�C,�,r W th Ca�c-re�e 5our�d 7,�a7�f,v�r4 4p1,7?-ey 4 /P(°-,so�J
�"o ��-event F� oSid� S&460- of Wash, A��lica�io» h�
��J$Cent Pra/��Ty vw7?e�5 jdc t( 7:'/` 1�2y 64x -�y
e-r
��Y 77 7?e- l �'t i n
#Below $1001 Valuation
King, Jack T. 12414/81
(275-6792)
Shorebrook, Lot 3, 27-22-3
Tahuya, Shorebrook
lace & Repair Contractorterber
Bulkhead/Rep Frank Weisg
Shoreline Exemption
$800.00
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