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HomeMy WebLinkAboutBLD0196 Deck - BLD Permit / Conditions - 7/17/1984 ALLEN, Pearl F. #0196 7-17-84 Tract 6 SW-1/4, SE-1/4 20-23-1 NE 603 Old Belfair Hwy Belfair, Wash 98528 275-2130 8/10 mile North of Belfair on Old Belfair Hwy. 2nd driveway on left hand side ac ross from 4-plex. Contractor Self Deck 1408 $2660.00 Shorelines: Setback: d /L Special Conditions: Footing: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: Plumbing: Kechanical: Roof: ,xterior: Interior: itop Work: Robile Home: imoke Detector: temarks: BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 7 DATE ISSUED PERMIT NO. © � OWNER D, AME /� MAIL ADDRESS CITY 8 STATE ZIP PHONE �tV� A C . 0 I r r- S� � 7.S=02 � o DIRECTIONS g ! ,Znd c�v-ilrewa c)n left ho.K4 s td-- TO JOB SITE 114)Mile } Q r d i r a e ro% y L 6X -r ►r S le LEGAL �L 240 -1 3 (f&SEE ATTACHED SHEET) DESCR. rac l aft �W � S � � E? I r NA MAIL ADDRESS CITY STATE LICENSE NO. PHONE CONTRACTOR USE OF ��^^ BUILDING Class of work: W Gl ADDITIq& ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe o ' , I � � � � Q J` C) Valuation of work: $ / _/ _ PLAN CHECK FEE PERMIT FEE SPECIAL CONDITIONS: (�(� BEDROOMS DECKS—,' CARPORT [] NOTICE BATHROOMS —_— ITOTAL SQ. FTs GARAGE ❑ ATTACHED �; SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT L OR AIR CONDITIONING. TOTAL SQ. FT�W I FIREPLACE C DETACHED i J 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 Celt if, that I am a currently registered contractor in WORK IS COMMENCED. the tate of Washington and I the aware of the FOR OFFICE USE ONLY Informance ance requirements regulating the work for which ermit is issued and all work done will be in therewith. PERMANENT SHORELINES SEASONAL I 1 FLOODPLAIN 1 Fir E.D. NO. S.E.P.A. I i 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 be2' rformance therewith. MOTOR VEHICLE PERMIT APPLICATION ACCEPTED BY PLAN HECK BY APPROVED FOR ISSUANCE Own e � n s�Date BY � PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH PLOT PLAN ADDRESS PERMIT NO. ° 0 n s A O LEGAL n 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' t, 1/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. NAMES) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE SHELTON PRTN7IN3