HomeMy WebLinkAboutBLD4139 Add Basement - BLD Permit / Conditions - 2/13/1979 Hoeffle, Jim #4139
2-13-79
Madrona Morning Side Beach Tracts Tr. 26 & T.L.
Sisters Point, Tahuya
Addition and Alteration, Add 10 feet to rear
structure and add basement.
$18 000.00 Plumbing Permit issued
., ORILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
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DIRECTIONS
TO JOB SITE A �J
LEGAL M q OV9 �d7/Q V//9 G+ ��� C'A1 IV G T.S) (❑ SEE ATTACHED SHEET)
DESCR. 'P�C.r Z6 L
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING lv-9 "6 c51TZ`A-7c-15-
Class of work: ❑ NEW ADDITION XALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
9na o ' zc-
Valuation of work: PLAN CHECK FEE -- PERMIT FEE a-d
000
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
NO. OF STORIES BASEMENT!z�
/ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ DETACHED El
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I 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 IJ SHORELINES L)
SEASONAL [] FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. Ll
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
,be in conformance the with. MOTOR VEHICLE PERMIT
F APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner 6L Date —�J BY
PLA CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
MASON COUNTY PLANNING DEPARTMENT
P.O. BOX 186 Shelton,Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT—Complete ALL items. Mark boxes where applicable.
P PP
Name Mailing address—Nu r,street,city,and State Zip code Tel.No.
C� t
Owner Of
r
2.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Si ure of applicant Address Application date
LEGAL DESCR PTI N
Location ~
Of
Building
NO. PLUMBING FIXTURES FEE
r WATER CLOSETS rOk9
BASINS
BATH TUBS
SHOWERS
WATER HEATERS
AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
(Show Street Names & Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
F7 PERMIT SKETCH IN SEPTIC TANK & DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved by Permit fee Date pemit issued Permit number Receipt No.
PLOT PLAN
ADDRESS PERMIT NO. �'3� 0 0
z °
n a
LEGAL : a
DESCRIPTION LOT BILK 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 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'
/ o
.I
/We certify that the proposed construction will conform to the dimensions and us shown above and that no changes will be made without
irst obtaining approval.
NAME(S) OF OWNER(S) OF SITE & STRUCTUREIS) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED,,,( � _-5
L��I.STRICT AS NOTED ,/6�rL ���L/�c� DATEr-ie�TON raN-•,.�