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HomeMy WebLinkAboutBLD15668 Pre-Permit Site Inspection - BLD Permit / Conditions - 6/13/1984 LARSON, Douglas _ #15668 6-13-84 Pebble Beach Park Lots 4 & 5 7310 91st Ave SE Tacoma, Wash 98498 3.0 miles East of Alderbrook Inn - Hwy 106 Contractor Self Bring existing bldg. to Code & �� y c� make liveable f�U,W�b�rjG (✓Vl $8,976.00 Shorelines: Setback: Special Conditions: Footing: Setback: Foundation Walls: Framing: ef) eel z�= Fireplace: Wood Stove: Plumbing: ey4� /p 3 A- Mechanical : Root: Exterior- Interior: Final : ele" Stop Work: Mobile Home: Smoke Detector. Remarks• BUILDING PERMIT APPLICA ON MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED / PERMIT NO. OWNER �, NAME GLA5 /� nc^NI MAItDADDRESS} w — CIS-STATE ZIP PHONE MdRe DIRECTIONS V (� LA f�JV 1 .\ `vr'/ DI JOB SITE 3.o Hf asr or LD&A'vwse v4I HIG C LEGAL (❑ SEE ATTACHED SHEET) DESCR. 1 OT,3 4 ' Pe4le -Beam, -Par k NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE CONTRACTOR USE OF 3, BUILDING C4- Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: .00 Valuation of work: $ PLAN CHECK FEE PERMIT FEES-� © O SPECIAL CONDITIONS: BEDROOMS'-- I DECKS CARPORT ❑ NOTICE BATHROOMS TOTAL SO. FT. GARAGE ❑ / ATTACHED L SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING. TOTAL SQ. FT_5 FIREPLACE Ll DETACHED Ll 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 /r — rtify that I am a currently registered contractor in WORK IS COMMENCED. State of Washington and I am aware of the FOR OFFICE USE ONLY nance requirements regulating the work for which permit is issued and all work done will be in ormance therewith. PERMANENT i I SHORELINES SEASONAL FLOODPLAIN Ll E.D. NO. S.E.P.A. i 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 onformance ther ith. MOTOR VEHICLE PERMIT LICAT ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Owne Date . BY PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH MASON COUNTY P.O. BOX 186 Shelton,Washington 98584 PLUMBING PERMIT APPLICATION IMPORTANT — Complete ALL items. Mark boxes where applicable. Name Mailing address—Number,street,city,and State Zip code Tel.No. 1. Owner 2. Contractor The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington Signature of applicant Address Application date LEGAL DESCRIPTION Location Of Building NO. PLUMBING FIXTURES FEE ' WATER CLOSETS I?G C j BASINS '2. o o BATH TUBS SHOWERS v I WATER HEATERS �, C) O ' AUTO.WASHERS �, 0 I SINKS p 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. PERMIT I SAC 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 ��V�7 >'l��iNG!>/4Y �D� PERMIT NO. 0 o a o LEGAL a DESCRIPTION LOT 4 s BLK ADDITION ebb je � u SITE AREA 660 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 Al"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' 17 C U ' 0 - - — — _43 - - -- 7 to S R � L !lid r 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 ! STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE GHELTON PR1NTiN"