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HomeMy WebLinkAboutBLD16741 Repair Bulkhead - BLD Permit / Conditions - 4/25/1985 MUNSON) Richard #16741 4-25-85 Tract 13 34-22-3 807 Lake St. S. #303 Kirkland 98033 828-0754 1 mile past Alderbrook on water (next to big house with tile roof) Contractor Olson Const.Co. Repair Bulkhead $1001 00 3—zzzq S q V'� Shorelines: Setback: Special Conditions: Footing: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: Plumbing: Mechanical: Roof: Exterior: Interior: Final: Stop Work: Mobile Home: Smoke Detector: Remarks: PERMIT T DATE -_B - ---- BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 `- —� DATE ISSUED PERMIT NO. /�/ /- `Y 1 OWNER NA E MAIL ADDRESS CITY 8 STATE ZIP PHONE 7 - 30 i �Z33 848--o 7 - DIRECTIONS TO JOB SITE LEGAL. (❑ SEE ATTACHED SHEET) DESCRSec �Z r -12 &' CONTRACTOR NIMI ADDRESS CITY&ST TE LICENSE NO. PHONE USE OF BUILDING C Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE Describe work: Wemoutc (1AA , G Q // 4� Valuation of work: $A90 / PLAN CHECK FEE IVI.j PERMIT FEE SPECIAL CONDITIONS: BEDROOMS_. I DECKS — CARPORT I ; NOTICE BATHROOMS____ ITOTAL SQ. FT. GARAGE I ATTACHED i_i SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT [: OR AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE f-: DETACHED Ll 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. theth State of Washington and I 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 SEASONAL I FLOODPLAIN Firm E.D. NO. S.E.P.A. i r By Special Approvals IN OUT YES APPROVED NO Lic. No.� � Date ? ZONING PLANNING DEPT. a OWNERS AFFIDAVIT HEALTH DEPT. 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 BUILDING DEPT. (J of the Mason County ordinance requirements for which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT AP ION ACCEPTED BY PLANS CHECK BY APP D FOR ISSUANCE Owner —_ Date . B PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH PLOT PLAN ADDRESS Z' 79 7/ 4, PERMIT NO. f o i v 'TaL 1 3 _/ 3O A/ 1�,3 6L > a o LEGAL DESCRIPTION LOT BLK ADDITION u SITE AREA "06) 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 P"'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. -V INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' i U� C i / IT M I/We certify that the proposed construction will conform to the dirn*nsiOhs and uses shown above and that no changes will be made without first obtaining approval. k-'/�e-1 c NAME(S) OF OWNER(3) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNE i R AU'r'HOFUZED REPRESENTATIVE DO NOT W�R.,II TE BELOW THIS LINE APPROVED r / — DISTRICT AS NOTED "?S DATE GHELTON PWN71N'i