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HomeMy WebLinkAboutBLD12214 Addition/Decks - BLD Permit / Conditions - 3/31/1982 • BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 a DATE ISSUED 9-3 1- o °Z PERMIT NO. IQQ14 OWNER AME MAIL ADDRESS CITY&STATE ZIP PHON LE Pl �. oo idft Se' 4ye;eTO.✓ J S!)j-5(d DIRECTIONS ^ s t,- TO JOB SITE �67,OVr 41*D , �' O �� !/�1✓,xti� T iGLAP. will 4e 7- 5 Z /r1 LEGAL (❑ SEE ATTACHED SHEET) DESCR. %�. 3 aZ C o() .,q -� NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR USE OF BUILDING .5m e &a.i olice Class of work: ❑ NEW 3eADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Valuation of work: $ C^ a� off© PLAN CHECK FEE ZY, 0.66 �� PERMIT FEE v �J cCoC .S SPECIAL CONDITIONS: BEDROOMS I DECKS O CARPORT ❑ NOTICE BATHROOMS TOTAL SO. FT. GARAGE ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT [_, OR AIR CONDITIONING. TOTAL SC FT. 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 Firm S �ST-crG�%�.� SEASONAL ❑ FLOODPLAIN ❑ E.D. NO. S.E.P.A. ❑ gy Special Approvals IN OUT YES APPROVED NO Lic. No'V5--0/ Date ZONING PLANNING DEPT.- OWNERS AFFIDAVIT HEALTH DEPT. Al PUBLIC WORKS I certify that I am exempt from the requirements of the FIR HAL contract or registration law RCW 18.27, and am aware BUILDING DEP of the Mason County ordinance requirements for $Z which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT AP LIGATION ACCEPTED BY CHECK BY APPROVED FOR ISSUANCE Owner __ Date. � - 1-1:07 e PLA CHECK VALIDATION K M.O. CASH PERMIT VALIDATION K M.O. CASH PLOT PLAN ADDRESS PERMIT NO. f c = s s o 0 LEGAL ' DESCRIPTION LOT BLK ADDITION w 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- SIONS.SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA- TION PII'D 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. INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' I ' 1 1 _ in is,nO I �O EM .fOL L I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without first obtaining approval. NAM E(a) OF OWN (a) OF 3 E S STRUCTURE(j) RINT) SIGNATURE OF OWN R S) OR AU1T ORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE SHELTON PRINTING Spitzer, LeRoy #1L214 (479-5614, Bremerton) 3/31/82 34-21-2, Tract 6, Govt. Lot 2 Hartstene Island, left off bridge, 2.3 miles To Sunset Hill Rd, turn left, see map. Addition/Decks Contractor: (family room)10'xl4' Grams Construction (decks) 204 sq. ft. $5,220.00 Shoreline Exemption e K 1 1 i � .. v .. .° .. u o eou � x .. • 4x -4 aox � oncv " c 4 o O ° .- aia U COai C U O p 0 .4 (n •A •.a •r4 .. 3 w .0 U 41 .a C 8 a) 'O � 4 44 a) a) co 0. r4 CO O � a) O � O 0 H O O U O L L O O p 0 6 o t O a) O $4 -4 O .-4 a) • 4 41 O a) t�+ CnP4rZ44+ 3wZC2W H 4v) Z04 1 I