HomeMy WebLinkAboutBLD16031 Retaining Wall - BLD Permit / Conditions - 9/4/1984 Bienick, Ed W. #16031
276-4584, Pacific Beach 9/4/84
Madrona Morningside Beach, Tract 2
North ShoreRoad
Concrete Retaining Wall Earl Lincoln
216 Sq. Ft.
$1,836.00 Shoreline Exempt
Shorelines:
Setback: r
Special Condit ns:
Footing:
Setback:
Foundation Walls :
Framing:
Fireplace:
Wood Stove:
Plumbing: _
Mechanical:
Roof:
Exterior:
Interior:
Final:
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 9
DATE ISSUED —
PERMIT NO. 40 31
OWNER NAME MAIL ADDRESS CITY 6 STATE ZIP PHONE
DIRECTIONS
TO JOB SITE 1,71
LEGAL (0 SEE ATTACHED SHEET)
DESCR. C 4 e
NAME MAIL ADDRESS V CITY&STATE LICENSE NO. PHONE
CONTRACTOR f /
f ,C C
USE OF
BUILDING e6j7C.0el`r
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION It REPAIR ❑ MOVE ❑ REMOVE
Describe work:
A;e c a T �,w c'ah c-e T tv
Zor7 .err C Zo 4 0A 5la / k A/ /
Valuation of work: $ �/ PLAN CHECK FEE PERMIT FEE
A: 511 A U
SPECIAL CONDITIONS: hm .u..'Tok c4�_,
BEDROOMS (DECKS CARPORT [] NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE I J
ATTACHED I] SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT C' OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE I 1 DETACHED IJ
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 PERIOD OF 180 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and t the
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 i_i SHORELINES i41`-�
SEASONAL I 1 FLOODPLAIN
Firm_ka,41-/ L!/1e6& C0d..57• Z�7/° . E.D. NO. S.E.P.A. i
By 0,9cy+ Special Approvals IN OUT YES APPROVED NO
Lic. No. 44L 4 2 1-PNC Date 4 / l ZONING
PLANNING DEPT.
/Cnty
FFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that Irom the requirements of the FIRE MARSHAL
contract or re RCW 18.27, and am aware BUILDING DEPT.
of the Masordinance requirements for
which this pe and that all work done will ROAD ACCESS
be in conforith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date . a n 0 BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION C . M.O. CASH
" PLOT PLAN
ADDRESS PERMIT NO. f o
A D
a o
0
LEGAL a
DESCRIPTION LOT BLK ADDITION /�740//"DP4 /(�ICf�i4� S� �'r✓C 1 4C "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 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.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
�s7
jr
f _
q e
1
Cev,e,le;F,
`0 at
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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.
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(5) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REP ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED Q'Lf _�>
DISTRICT AS NOTED DATE ti
SHELTON PRINTING