HomeMy WebLinkAboutBLD20448 Repair Boat Ramp - BLD Permit / Conditions - 6/18/1987 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 / p
426-5593 DATE ISSUED
PERMIT NO.' ����4
OWNER NAME MAILADDRESS CITY BSTATE ZIP PHONE
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DIRECTIONS
TO JOB SITE
PARCEL 6 0 LEGAL
NUMBER 6qblt IDESCR. _ w
NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR i - r y �
c E E . C (,�.�, r C7r S i c r'ysi 5 3 zs -
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE Al
WORK
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTALSQ.FT. GARAGE CONDITIONING.
NO.OF STORIES 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 ANYTIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL S G n
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT 1 AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION W RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS OR 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 CONFORMA CE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING AP OVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNER DATE X BY DATE
FOR OFFICE USE ONLY
DEPAR T APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO •C'
HEALTH PUBLIC WORKS FEE
PLANNIN FIRE BUILDING PERMIT 5
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY I PLANS Ck ECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
I TOTAL `7 7,
(<f _ Ly4.1r BY 4,1 r CASH CK MO
PLOT PLAN
ADDRESS t 7 Y ��I /1L /'f W Y PERMIT NO.
0
= s
s o
LEGAL
DESCRIPTION LOT BLK ADDITION
`n. T
SITE AREA Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq.Ft. A�
INSTRUCTIONS TO APPLICANT
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"-20' ARE Z)
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 W
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 n. F
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR-
TION THEREOF.
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INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
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8 jNor C
1/We certify that the proposed construction will conform to the dimarniona and uses shown above and that no changes will be made without
first obtaining approval.
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNERS) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
3Da�a - - OaDC) I
Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:
Mobile Hare:
Smoke Detector: _
Remarks:
ooting:
Setback: L
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE REPAIR BOAT RAMP
20448
Permit No. No. Floors Sq Ftg 560
Owner BUECHEL, Richard Tel 898-2487 Date 6-18-87
Address E 4941-1/2 Hwy 106 Union C ZIP
Contractor e
Address �0 Hyland Dr Uninn Zip
Legal Description Plat of Union Bl. 4 Lots 1-2 15-16
Direction to project site
Same as above
Plumbing Mechanic Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other \
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