HomeMy WebLinkAboutBLD28263 Final Bulkhead Repair - BLD Permit / Conditions - 6/4/1991 Shorelines: Plumbing:
Setback: Mechanica
Special Interior:
Conditions: FINAL��
Mobile Hame:
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE BULKHEAD REPAIR
Permit No.28263 No. Floors Sq Ftg
Owner Theodore Jacobs Te157T-7I;5 Date
Address ox acoma 98401 Zip
Contractor ame zip
Address
Legal Description 0 is View Tracts
Direction to project site Hartstene Is an to Bergen y R
right to mial boxes follow signs to Local 313 Trans-
fers-project is on their south boumda ' tove
um ing ec anica ewer
Fireplace Deck Tar—agearport
Basement Loft Other
DUPLICATE CARD?
,F
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED PERMIT NO. cg-X424103-
OWNER NAME MAILADDRESS CITY BSTATE ZIP PHONE
DIRECTIONS
TO JOB SITE L A 4 o
PA*EL LEGAL
NUMBER 2?.425� �►j DESCR ' /*Oc .!i
NAME MAILADDRESS t CITY&STATE LICENSE NO.. ZIP PHONE
CONTRACTOR '
USEOF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE
WORK
Aflele'v eCd I
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.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 SO.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
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
RIQISTRATION 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 18ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
lit'C°ONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
01�4'AINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
'_--ter
NEc ".�T� '�Z+� X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YES APPROVEDJO DEPARTMENT YES DEPARTMENTBUILDING VALUATION 10
HEALTH AA PUBLIC WORKS FEE
PLANNING A3 FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK O
SPECIAL CONDITIONS BUILDING GROUP INSPECTION
SHORELINE
77
5 WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE -ISO
STATE SURCHARGE
` APPLICATION ACCEPTED BY PLANS CHECK BY E ISSUANCE PERMIT VALIDATION
m TOTAL
=t� Isa CASH CK MO
Shorelines: Plumbs
Setback: Nechanica :
Special Interior:ter �T
Condit ions: FINAI. / Jy '3 5l��'J1
Mobile :
Smoke Detector:
Remarks:
00
Setback:
toundat ion WON i
falls:
ftami :
!`fireplace:
'Mod Stove:
TYPE BULKHEAD REPt�11IR
F
wit No. 28263 No. Floors Sq Ftg
QglactOr
4EWWWW" zip
Descr pt on
lIIs"tion to proJect site Hartstene Is to Bug ndy
Wd rt to mail boxes righf follow signs to local 313 to` -+;
sters Project is on gouth bouyQEY
Plumbing Mechanical r Wood Move
Fireplace Deck arage —rport
Basement soft —Other