HomeMy WebLinkAboutBLD17436 Replace Deck - BLD Permit / Conditions - 5/23/1985 BREWER; Charles F. #17436
5-23-85
W 60' , E660' of Gov Lot 2 34-22-3
(503)
128 Condolea Dr. Lake Oswego, Oregon 97034 615-5700
East on Hwy 106 to E 8231 Highway 106 (3 mi. E of Union)
r
Contractor
Self
Replace Deck
$3,160.00
Shorelines: C
Setback: 2'/
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final:_ek' y �S �=
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
n3l —�3 +��O DATE ISSUED
PERMIT NO.
OWNER NAME- MAIL ADDRESS CITY 8 ST TE ZIP PHONE�b
/2 /5� i0 OW O� S p
DIRECTIONS
TO JOB SITE 4f35T'��/j��p•� �d �y3 f�j�j 3rn 07' ,r�/
LEGAL /D�E / b� / / Y, /' `/ (❑ S E A A HED SHEET)
DESCR. 1�Y�J2IC-�vT' /�T 2 /Y• O�
CONTRACTOR
NAME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE
USE OF /7
BUILDING C�/yJs� �CZC) F� _J/�� `'!�/�%l��Y /yo
Class of work: XNEW ❑ ADDITION ❑ ALTERATION )%PAIR,,Z MOVE ❑ REMOVE
Describe wo
Valuation of work: $ PLAN CHECK FEE PERMIT FEE S v
3:/1610 0 ,q,
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT.G3 2 GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. 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 FORA PERIOD OF 180 DAYS AT ANYTIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I am aware of the FOROFFICE USE ONLY
ordinance re uirements regulating the work for which
the permit s issued and all work done will be in
conform an a therewith. PERMANENT SHORELINES
SEASONAL 7 FLOODPLAIN ❑
Firm
E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT. - $ '529-65 OV—
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.
of the Mason County ordinance requirements for
which this permit is issueq and that all work done will ROAD ACCESS
b in confo ma th ith. MOTOR VEHICLE PERMIT
/ APPLIC TION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owe at •a "��� ,� /� /� sv
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
CHRISTMASTOWN PRINTING
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MASON BUiLU,,, ; I, ��1OR'
5c ot�t' CHANGES SUa.r- T W APPROVAL
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PLOT, PLAN.
ADDRESS �QZ-3/ �J/�,ry�L?//�?y 1� Gj�1 PERMIT NO. a
LEGAL
DESCRIPTION LOT BLK ADDITION SL L 3�/ ��-•� u
SITE AREA 6s�/dd 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 A"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 t no gas will be made wit out
first obtaining approval. /
NAME(a) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AU TH RIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
CHRISTMASTOWN PRINTING