HomeMy WebLinkAboutBLD25379 Alterations - BLD Permit / Conditions - 4/2/1990 qqL0 X-G.9 ob 5 a
Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:
Mobile cme:
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE ALTERATIONS
Permit No. 25379 No. Floors Sq Ftg 1272
Owner FIRS HU H F TD Tel 2�- 226 Date 4-2-90
Address 1113 Shelton Springs Rd Shelton Zip
Contractor Self
Address Zip
Legal Description Tr 3 NW,NE (Tr 2 S/P 908) 12-20-4
Direction to project site Corner of Springs Rd & Island Lk Dr.
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
LUa.yr�� ra ��s�J BUILDING PERMIT APPLICATION
Jar) d MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. _h
NAME
f LLI MAILADDRESS -C STATE PHONE
OWNER p -- D Sf 4• /
y
DIRECTIONS /
TO JOB SITE �i(Je� P� S�/Q/� S /pd 1 d . -S�.1"4)� C ,�r/ C o i^
PARCEL // /� l GAL -r ti
NUMBER '7` v �GY-�� -�a ESCR. • X,,) OF a." ;0
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR s-
USE OF
BUILDING
CLASS OF NEW ADDITION O1V� REPAIR MOVE REMOVE
WORK
DESCRIBE �; ,� / S
WORK / / /a,v (A
'#911 l��� , A�7 /c2a/D/7S Q/e 76 SiO�FJ
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORI ES _ BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 JAYS, 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 FFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY HAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRA ON LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIRE NTS FOR 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 CON RMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINI G APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
3
X W R ATE X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION 1�( 2 i 1
YES NO YES NO \ .Z L
HEALTH 7�" PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT I oLA , S O
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP 7_3 PRE-INSPECTION
r',e_ �� � SHORELINE
f d G a G L WOODSTOVE
1!9-a PLUMBING
�( O )5 MECHANICAL
STATE BUILDING FEE
STATESURCHARGE
APPLICATION ACCEPTED BY I PLANS CHECK BY VE FOB ISSUANCE PERMIT VALIDATION
BY CASH CK MO TOTAL
PLOT PLAN
ADDRESS � JC/°6' ���'"S ^��- PERMIT NO. f
LEGAL
DESCRIPTION LOT BLK ADDITION
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 AND 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.
4) INDICATE NORTH IN CIRCLE GRAPH c Ileocc � � no �•_7a
It F-11-
I/We certify that the proposed construction will conform to the dlmertsiOns and uses shown above and that no changes will be made without
first obtaining approval.
NAME(S) OF OWNER(a) OF SITE ! STRUCTURE(S) (PRINT) SIGNATURE OF OWNERIS) OR AUTHORIZED REP ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
4' 3'
r
ATI
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cGo
STORAbE in
6"RAISED
0
PLATFORM I I•fi
16' To12' SANCTJARY
OFFICE
:o
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SE i_ ;; 'gT SE
e� ON t r- it .. _. C r r Gev6t D6.DR. _
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r
° FOYER ~
m
\ N
4s'-D" .WALK•` ' . .
EXISTING
I
SPRING ROAD CHAPEL
PROJECT- REMODEL APT-
INTO NEW SANCTUARY
3-11-g0 it.DALIY