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HomeMy WebLinkAboutBLD11024 Siding - BLD Permit / Conditions - 7/17/1981 6 o YD Manning, Edward E. #11024 7-17-81 E 9110 Hwy 106, Union A Tract of land in G. L. 1 25-22-3 New siding 12x20 deck, sliding Glass door $3,000.00 BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 _ DATE ISSUED AP PERMIT NO. OWNER NA E MAIL ADDRESS CIZ 8 STATE ZIP` PHON DIRECTIONS / TO JOB SITE 1f�SQ vC , — �� dU /0t ON/ 0AJz 9O LEGAL (❑ SEE ATTACHED SHEET) DESCR. %� � o?`S :mil 2 NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR USE OF BUILDING Q/ Class of work: 0 NEW DITION ALTERATION REPAIR El MOVE El REMOVE Describe work: '\ V w l S O Valuation of work: $� 000 DD PLAN CHECK FEE PERMIT FEE, 3g _5 SPECIAL CONDITION BEDROOMS (DECKS CARPORT F NOTICE BATHROOMS TOTAL SQ. FT._ GARAGE [J ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT LI OR AIR CONDITIONING. TOTAL SO. FT. FIREPLACE ❑ IDETACHED ❑ 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 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 L; SHORELINES I I SEASONAL [] FLOODPLAIN I I Firm E.D. NO. S.E.P.A. ❑ By Special Approvals IN OUT YES APPROVED NO Lic. No. Date ZONING PLANNING DEPT. 1 HEALTH DEPT. OWNERS AFFIDAVIT 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. 7 1 k� which this permit is 'ssued and that all work done will ROAD ACCESS conf ewith. MOTOR VEHICLE PERMIT CATION AC PT BY PLA CHECK BY APPROVED FOR ISSUANCE Own r , BY Date a e PLAN CHECK VALIDATION CK. M.O. CASH v PERMIT VALIDATION CK. M.O. CASH 1 PLOT PLAN ADDRESS PERMIT NO. 0 o = o n > s o 0 LEGAL 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 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' ff Ll v v n that no changes will be made without IIWe certify that the proposed construction will conform to the dlrrNMicros and uses shown above and g first obtaining approval. 31 O OWNER(S) NAM OF OWNER(S) OR AUTHORIZED REPRESENTATIVE F ER 3 OF SITE S STRUC TUREl3) (PRIN TISIGNATURE El O ( I DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE SHELTON PRINTING