HomeMy WebLinkAboutBLD6378 Deck - BLD Permit / Conditions - 5/12/1980 Leggett , Ed #6378
5-12-80
To Union (5-6 mi. to So. Shore) right hand side of rd.
Little Paris Tracts 5 & 6 - SE of right-of-way
Deck
$707.00 (bid price)
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 —/Z_ �l
DATE ISSUED O y
>�• Lr-GGf PERMIT NO. 4�-,o79 _
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITE ' _� 0�� ��
LEGAL Z; J// � (� (E] SEE ATTACHED SHEET)
DESCR. /—f/,L Lr; 4S " a+ � w
CONTRACTOR[,,:.,NAME MAIL ADDRESS CITY 8 TATE LICENSE NO. PHONE
USE OF
07,'1 6_3
BUILDING
Class of work: 59 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ �01-1 CCU PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS _ .CARPORT II NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE 1 1
ATTACHED 17 SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE I I DETACHED u
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. PERpAANENT I SHORELINES
Firm
/� `� SEASONAL [ ] FLOODPLAIN
n E.D. N0. S.E.P.A. I
By Special Approvals IN OUT YES APPROVED NO
Lic. No�Zy`�A-�L rA40 a-7J Date a 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 therewith. MOT VEHICLE PE MIT
AP P TION AC E BY PLANS CHECK BY PR ED FOR ISSU E
Owner Date . Y
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. UY
I
PLOT PLAN
3 7F ADDRESS PERMIT NO. f o
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a OO
a
LEGAL
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"ID 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'
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M_JA3 I-IF
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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.
t- -L j _
NAME(S) OF OWNERS) OF SITE & 3TRUCTUREM (PRIN IGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
NAME(S) OF OWNERS) OF SITE & 3TRUCTUREM (PRI�O T WRITE
B H LINE
APPRO D �7
DATE
DISTRICT AS NOTE �t cac
SHELTON PRINTIN3