HomeMy WebLinkAboutBLD17863 SFR - BLD Permit / Conditions - 8/28/1985 TYPE RESIDENCE
Permit No. 17863 No. Floors 2 Sq Ftg 2400
Owner PENTONY, Mark Te1426-3381 Date 8-28-85
Address E 1052 Mason Lk. Dr. W GraDeviewZip
Contractor Self _
Address Zip
Legal Description Por NW-1/4 SE-1 /4 17-20-4
Direction to project site%L 7 mi. E on Dagtnn/Matlnr•k Rd_
From Dayton Cut-over Rd turn N @ Timberline_4000' on
right is driveway.
Plunbing x Mechanical Sewer Wood Stove
Fireplace x Deck 1An Garage Carport
Basement Loft Other
Shorglines: A1,4-
Serb ack:_e 1-k'_
Special Conditions:
Foot ing: < c
Setback:
Foundation Walls: c -4c--
Framing: CV
Fireplace:
Wood Stove:
Plumbing: / �2 IleIVY'
Mechanical:M�e- 2/io 9�
Interior:
Final: -.< axK
Mobile Home:
Smoke Detector:
Remarks:
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426 5593
DATE ISSUED
PERMIT NO. ` 71:5 6 17
OWNER NA MAIL ADDRESS CITY 8 STATE ZIP PHONE
e. E At, G - 38/
DIRECTION IF r' 3�9
TO JOB SITE .7h; oa �la 1o„�Mu7' l� Fi�,,.t &a 0., c.11'ooer Ra),TurN N� 'f;M�er 1;,ue �cro M% Q;j�'T' ;s �r;or �
LEGAL ���� (❑ SEE ATTACHED SHEET)
DESCR. D S�
CONTRACTOR NAME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE
USE OF c l
BUILDING
Class of work: X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: t
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
7oc, 9� s-a ASS c' c)
SPECIAL CONDITIONS:
r
BEDROOMS DECKS CARPORT LJ NOTICE
BATHROOMS TOTAL SO. FT��Q GARAGE ❑
NO. OF STORIES BASEMENT ElATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
OR AIR CONDITIONING.
TOTAL SO. FB21W 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 FOR A PENIOD OF 180 DAYS AT ANY TIME AFTER
I Certify that I am a Currently registered contractor in WORK IS COMMENCED.
th State of Washington and I the
aware of the
o FO OFFICE USE ONLY
finance requirements regulating the work for which
t e permit is issued and all work done will be in
onformance therewith. PERMANENT SHORELINES
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. Li
Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT. 7$5 ^K7-$ f3
OWNERS AFFIDAVIT HEALTH DEPTt!� r 9'
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for BUILDING DEPT. 1y �•�
which this permit is issued and that all work done will ROAD ACCESS
be in conform ce therewith. MOTOR VEHICLE PERMIT
0�.
Z7 _ APPLICATION ACCEPTED BY PLANS HECK BY APPROVED FOR ISSUANCE
Owner Date. 7!�98 r BY
t;L_=
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
CHRISTMASTOWN PRINTING
PLOT PLAN
ADDRESS PERMIT NO. o
f °
LEGAL ' °o
DESCRIPTION LOT BLK ADDITION
u
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 Al"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,
0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
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.
AME S) OF OWN ER(S) OF E 6 STRUCTURE(S) (PRINT) IGN TUBE OF OWNERIS) OR AU ZED REPRESENTATIVE
DO NOT WRITE BELOW 1S LINE
APPROVED
;TRICT AS NOTED
DATE
RISTMASTOWN PRINTING