HomeMy WebLinkAboutMIS97-00143 Replace Sign - BLD Permit / Conditions - 3/20/1997 will
03/14/97 FRI 11:56 FAX 3604277798 MASON COUNTY BLD 8 id001
MIS
MASON COUNTY <
MISCELLANEOUS PERMIT APPLICATION a
426 W.Cedar/P.O.Box 186.Shelton,WA 98W 427-9670 y4j
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#1 net
ite Address C'Ity f 1=F A R
Mall Address
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Applicant Address t R St w# 3 to q83 3
City k �L�k
I& ZIP
Directions to Site:
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�galescription
#3 Inling the applicable source if any is on or to the�pe�ty site:
��Mratorrarer creek stream po an s run �. tither
#4 Project Start Date Project Completion Date
#5 Use of euildiing Describe proposed construction l�K a pow n
P�1S-tt �G �1t,t� + �£_ c w ►`rW Nf w �X10� (abut3tt t=Ac%
t, L Vt.w^,_ i4Tt C RA I C T.
•tkpendno upon the type of permit.a Soar plan and pot plan+may be wMred.
`This permit i9 vaN far t 8o days trom the dale of -
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE-. I CERTIf-Y THAT t AM A CURRENTLY REGISTERED CON-
MENTS OF THE CONTRACTORS REGISTRATION tAW TRACTOR IN THE STATE OF WASHINGTON AND I AM
RCW 1827, AND AM AWARE OF THE MASON COUNTY AWARE OFTHE ORDINANCE REQUIREMENTS REGULAT-
ORDINANCE REQUIREMENTS FOR WHICH THIS PEOM1T ING THE WORK FOR WHICH THE PERMIT IS ISSUED AND
IS ISSUED AND THAT ALL WORK DONE WILL BE IN ALL WORK DONE WILL BE IN CONFORMANCE THERE-
FOR4OUTFI THEREWITH. AP RO ALFR EBBE E WTrH. NO OBTAINING AAPPROVVAL FROM THE BUILDINHALL BE MADE G DEPART-
UT FIRST
ING NING MEf+IT.
DEPARTM 7.
X OWNER X BY
DATE "Q7 DATE
10 002
03/.14/97 FRI 11:56 FAX 3604277798 MASON COUNTY, BID S
Show following on e site plan
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Lot Dimensions Flood ZonesFences
Existing Structures Wells
Structure Setbacks Shorelines
Water Lines Drainage Plan Easements Indicate directional by
Septic Systems Name of Frording Street; N, 8, E, W etr.
Proposed Improvements Name of Flanking 811" -
PLOT PLAN AREA ,
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FOR bpFiC1AL SE ONLY .�'
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Buildiri�- (,J�1 •
Fire Marshal
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pecial Conditions
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Permit Fee l K-
Plan Check
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- Other
- State Building Fee
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N•M•CHAMBER OF �pM
TOURIST INFpRMATIpN
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING Attic OTHER
Groundwork date by
date by WALLBOARD NAILING
D.W.V.
date by date by
Water Line FINAL INSPECTION
date by date f 3 _ gi, by (� date by
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