HomeMy WebLinkAboutBLD18949 Cancelled Addition - BLD Permit / Conditions - 7/10/1986 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATEISSUED
PERMIT NO.
OWNER NAME MAIL DDRESS CI^TY 8�l ATE ZIP PHONE
� Iry �� z7s�4
DIRECTIONS
TO JOB SITE
LEGAL (❑SEE ATTACHED SHEET)
DESCR. eSAA We Z ,
NAME CONTRACTOR MAIL ADDRESS CITY 3 STATE LICENSE NO. PHONE
USE OF
BUILDING , /�/�//'J
Class of work: ❑ NEW ❑ ACPTION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
Describe work:
o
Valuation of work: $ PLAN CHECK FEE PERMIT FEE D
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF ST RIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL S . FT. ¢10 FIREPLACE ❑ DETACHED ❑ 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 FORA PERIOD OF 180 DAYS AT ANYTIME 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 ❑ SHORELINES ❑
SEASONAL ❑ FLOODPLAIN ❑
FI 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.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
• APPLICATION ACCEPTED BY PLAN QHECK BY APPROVED F R ISSUANCE
Owner gQ n?'t 0wle�"Date. BY
PLAN CHECK VALIDATION CK,. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
CHRISTMASTOWN PRINTING
PLOT PLAN
�f Eli F►h 0AS' inrj0OW
ADDRESS •c OQ 1 RrC Wxq 985l 8 PERMIT NO. 0 o
A0y_/$ of 5"78:711� �X /vXoA1Ar.skD Gig-Ade-'V r'4 4ey1r o
LEGAL sp"ys' 3/
DESCRIPTION z3F� R LOT ,t7,��p,l/ r'0dnr'Ttf 4l�BLK ADDITION
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 �\
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK.DIMEN- VG�V
SIONS.SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA-
TION A•ID SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL O ice`
TON SECE LINES.RVI
SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR-
Aw to y,G Go >z As
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' E OR 's=20'
i y 13
h '7
O 0 I
i aF
µ
.Ir pig im
Y
0
1 a
1 3
.� L I
A
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I We rtify that the proposed construction will conform to the dimensions and uses shown above and th�+�no changes Drill made thout /�,
f taining approval. !j o6 ALt+,+T#-k jVi4 rAtA1- h dA-Cdlr /5 19 Qs F bfi h1 wA
Lwr44 s oey So FAAM
p�I�e>� •
!�D QlK'�i �
NAMEM OF OWN[ lfl OF 417E 6 T CTUREIf) (PRINT SIGNATURE OF OWNERM OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
TRICT AS NOTED DATE
TMASTOWN PRINTING
No. pioors 1 Sq �'Gg 480
7-10-96
Permit 18949 te
y OF GODTel275 —
owner BBL ,,,., 6315 Belfair p
Address
Contractor IF r.
Address ar en Tr.
�� DeSCr p�lpn Sam. Theler Home. &
t Direction to project site
Ng 23001 H 3
Belfair
Seer stave —
Gara9e Carport
Fireplace Deck r
t soft ��
Hasem� —
16x30 Addition of 2 bdrms•
Shorelines:
setback:
1� Interior:
Conditions: FIIRL:
Mobile Home:
Smoke .
lnarks:�
�z -� OF
elation
.
Framing
Fir .
Wood Stove: