HomeMy WebLinkAboutBLD0456 ReRoof - BLD Permit / Conditions - 3/17/1992 horelines: Plumbing:
etback: Mechanical•
special Interior:
:onditions: Final:
Mobile Home•
Smoke Detector•
Remarks
Footing:
setback:
Foundation
Walls:
raming:
'fireplace:
�Voodstove:
kREA: #1 - FAWVER TYPE: RE-ROOF
)wner: JOHNSON, JACK Tel: 275-5400 Date: 03-17-92
address: P.O. BOX 1119, BELFAIR 98528
'ermit #: 0456 Floors: Sq Ft: 6 SQ
"ontractor: SELF
?'hone:
4gal Description: 1-22-2 TR 8 NW NW
)irection to job site: APPROX 1/2 MILE PAST BELFAIR STATE
."ARK ON RT SMALL WHITE HOUSE. ACROSS FORM
.ROVER FLUERYS GARAGE
Plumbing Mechanical Woodstove
1 fireplace Deck Garage
"arport Basement Loft
-onditions:
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. ( "t 5i�;
OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITE t _ � ( r
cJ over
r G
PARCEL LEGAL
NUMBER DESCR. -f� a� /.,W VW �� u � E, Ib -4Z
CONTRACTOR
NAME MAIL ADDRESS CITY&STATE ZIP pHoNe LICENSE NO.
w►S G — �
7
USE OF
BUILDING y
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK 6 s t4 ctiJ140 S Ftz
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE SgFt STORIES SHORELINE❑ CONDITIONING.
BASEMENT SgFt BEDROOMS PRIMARY RES.O THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS SgFt BATHROOMS 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 FIREPLACE IS CARPORT/GARAGE
GARAGE SgFt ATTACHED O DETACHED a
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 F M THE BUILDING DEPARTMENT. ^ APPROVAL FROM THE BUILDING DEPARTMENT.
XOWNER DATE I�_ �v(0 � XBY / DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION 1
YES NO YES NO
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 5Ln
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION 0
r �5
�t 17 1 t BY_ / — I- r CASH CK MO TOTAL
SITE INSPECTION CHECK LIST NO d
Chec1: every acceptable feature. Leave every questionable or unacceptable
feature blank. Explain every blank in the space for remarks.
Item Applicable Regulations
1. Soil in holes-describe layers & depth Art. VI Sec. 3.5 (a) VII 3.3, 3.7, 10.2
2. Existing sewage systems
3. Existing structures - check use VI 3.5 VII 4.1, 4.2
4. Existing wells - check construction VI 2.1 (b) VII 4.1
5. Presence of fill VI 1.8 VII 3.6
6. Mas soil been removed VI 2.1 (c) , 2.4, 3.5(f) VII4.1
7. Salt w�_ter it
8. Lake if
9. Piver If
10. Creek IT
11. Stream if
12. Pond if
13. Swamp
14. T,iisc. Surface water
15. Property VI 3.5 (f) VII 4.1
16. Banks or cuts VI 3.5 VII 4.1, 3.7
17. Distance to public sewer VI 3.5 (g), 9.2, 10.2, 10.3 &
10.4
18. Water table - Record depth VI 3.5 (d) VII 1.4
19. Slopes VI 3.5 (e) VII 3.7,4.1
20. Driveways and roads VII 4.2
21. Drainage patterns VI 3.5 (e) VII 4.1
22. Interceptor drains VII 3.8
23. Culverts
24. Water lines VII 2.6, 4.1
25. Flood control zones VII 4.4
2.6. Roof drains VII 3.2
27. Vegetation VII 3.2
P.EPIARKS