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HomeMy WebLinkAboutBLD15852 Replace Bulkhead with Concrete - BLD Permit / Conditions - 7/18/2002 OEHRLING, W. L. #15852 7-18-84 Burgandy Fruit Tracts, Lot 10 P. 0. Box 125 Tracyton, Wash 98393 377-6372 Harstine Is. Location So.West (9 mil. S. of bridge) . South rd. to N.S. continue S. to Burgandy Rd. Last lot on Burgandy Rd. Contractor Self Replace wooden Bulkhead with concrete � 2 GV •• aO.i �. N U O () 9 •• x O41 1 ' p •• •• •• -i •• U O bD U H H H ','L'• a) •• t F bO aG 4J bO co A -H O O O A W u co u to C . cn •� r.i •,-� •� •• 3 a� (1) co --4 v4 CO b v, O. p co •• H H .i rl a) H H .0 u " a G a) b = W a a) co ts.4-1 4d = G) a °O aL) o w -H 00 r-4 aui 00 X 0 •H 41 o 0 cncncn Gr4cn4444443w+ Z134WH44cnZcnW BUILDING PERMIT APPLICATION f MASON COUNTY U I P.O. Box 186 Shelton, Washington 98584 1426-5593 _ DATEISSUED — PERMIT NO. 1 ' > 7 OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE DIRECTIONSi4E':, f 1,TJF /� - ti-L)c 1r,r,- �i ,; r cf 2i 't��. ,:.y s� 1 TO"JOB SITE Af0jetP^...0tvt ' LEGAL (❑SEE ATTACHED SHEET) j DESCR. NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE 4 CONTRACTOR USE OF ?�c� c� � C@ CI© f /) "�'✓ / t BUILDING ,� � LC // ��r�C/ �C.- �t:RfJ�'r �T F.l Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION )K REPAIR ❑ MOVE ❑ REMOVE I j Describe work: I 1 -- Valuation of work: $ !" PLAN CHECK FEE PERMIT FEE.. SPECIAL CONDITIONS: / ,•' 0 i BEDROOMS {DECKS CARPORT❑ g NOTICE BATHROOMS TOTAL SQ. FT. GARAGE ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE❑ DETACHED ❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- CONTRACTOR AFFIDAVIT [ZED 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 f1 certify that I am a currently registered contractor in WORK Is COMMENCED. the State.of Washington`and I am 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 PERMANENT ❑ SHORELINES conformance therewith. 4�r SEASONAL FLOODPLAIN ❑ E.D. NO. S.E.P.A. ❑ Y Special Approvals IN OUT YES APPROVED NO ZONING L o Date PLANNING DEPT. T/ �,, HEALTH DEPT. I OWNERS AFFIDAVIT PUBLIC WORKS I I certify that I am exempt from the requirements of the FIRE MARSHAL contractor registration law RCW 18.27, and am aware BUILDING DEPT. ' of r the .Mason County ordinance;` requirements for which this permit is issued and that ail work done will ROAD ACCESS be in_conformance tfierewith. MOTOR VEHICLE PERMIT P LIC'ATIAN A�(aE ED BY PLANS CHECK BY APPROVED FOR ISSUANCE Ow Date / 1 �r �. r By_' d PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH PLOT PLAN I ADDRESS? PERMIT NO. 1 o LEGAL I DESCRIPTION• LOT BLK ADDITION u SITE AREA Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq.Ft. I INSTRUCTIONS TO APPLICANT j i 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 K PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN- SIONS SHOW EASEMENTS, FINISH.CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA- TION P.ND`SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR- TION THEREOF: r V -� INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' { O I (`t1 a.,�. i 1� � 1 I V � s C i . V G � i E t I I/We certify that the proposed construction will conform to the dimensiMs and uses shown above and that no changes will be made without first obtaining approval. f NAME(S) OF OWNER(S) OF SITE A STRUCTURE(S) MR INT SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DATE DISTRICT AS NOTED I SHELTON PRINTIN3