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HomeMy WebLinkAboutBLD28671 Addition Office and Counter Area - BLD Permit / Conditions - 7/23/1991 Shorelines: Plumbing: Setback: Mechanical: Special Interior: Conditions: FINAL: Mobile ome: Smoke Detector: Remarks: Footing: Setback: Foundation Walls: Framing: L101 ReA�, z Fireplace: Wood Stove: TYPE Addition - Permit No. 28671 No. Floors Sq Ftg e0 Owner yang ,Too Na Tel Date 7Z2�/ql _ Address 11900 Hwy 10, ShPltnn Zip Contractor SP1 f Address Zip Legal Description 12 20 4 Tr 9 of 1,7,1 M1 Ex Direction to project site Ham, 101 north to Shp] ton and Cont. ;past Shelton's main exit for a==rox mateig VZt Wile 2nd the store larafed an ri4f Plumbing Mechanical Sewer Wood Stove Fireplace Deck Car age arport Basement Loft Other BUILDING PERMIT APPLICATION ' MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED r��-Q3 q1 PERMIT NO. c?%q NAME MAILADDRESS CITY&STATE ZIP PHONE OWNER gaw jou I q0 0 WA 0 -Ske Ify hJA rS-0 V26-.2oy7- DIRECTIONS T TO JOB SITE l a e l -j p �vr M v+elq- 3 `S o rl)/e And S�"oie vcaw on RPARCEL I-EttT� % �tr NUMBER 20 DESCR. CONTRACTOR NAME MAILADDRESS Y&STATE LICENSE NO. ZIP PHONE USE OF BUILDING CLASS OF NEW ADDITION X ALTERATION REPAIR MOVE REMOVE WORK ✓DESCR /► 1 WORKIBE Add I � OA S�o r 2. abiq q S r cc 1- X ) r✓ C-0 LA.�tv' NYCo. It 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 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SO.FT.ga— 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 I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION 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 IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING AWROVA'LFM THE B ING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. — NERi�ATE - X BY DATE FOR OFFICE USE ONLY DEPART ENT Y SPPROVEDJO DEPARTMENT YEAPPROVED 0 BUILDING VALUATION ©/ 6 J HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK -42Z„Z SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICAT CE DBY P CH BY lMk_]APPR E FOR SUANCE PERMIT VALIDATION v BY CASH CK MO TOTAL BUILDING PERMIT PLOT PLAN MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. Box 186 SH ELTON, WASH I NGTON 98584 427-9670 DATE ISSUED PERMIT NO. NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE OWNER Toil 4 J0e 001 J1900 Aig 14W / 5J+G 1bA &1A 9/5S0 2 6-2o9' DIRECTIONS � L / TO JOB SITE �i�AIL 2 VV Q A e I� G COI /A v e A r Sl 7 s S A*11I Z - t � t' a /Jp to k 1, 3 1 n• /e 64j71sSale iS on A e K Ll h PARCEL LEGA NUMBER DESCR. Indicate below: O Property lines and dimensions. O Easements and roads. O Septic, drainfield and reserve area, or sewer. O Septic tank and drainfield setback distances from foundations. O Location of proposed construction on property. O Building & septic system setback distances from all property lines& easements. Indicate North O Well and water line. In Circle O Saltwater, lakes, rivers, streams, wetlands, drainage. O Attach copy of septic system "as built' or septic permit approval. O Indicate topography profile of property and structure on reverse side. ri i 1/We certify that the proposed construction will c nform to the dimensions and uses shown above and that no changes will be made without first obtaining approval. SIGNATURE OF OWNER(S)OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED L DISTRICT AS NOTED DATE TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE