HomeMy WebLinkAboutBLD28678 Addition - BLD Permit / Conditions - 7/24/1991 � � ao �
a
C)
Shorelines: Plumbing:
Mechanica
Setback: Interior:
Special FINAL:
Conditions: Mobile Herne:
Smoke Detector
Remarks:
Footing:
Setback:
Foundation
Walls:
Fr aQning
Fireplace:
Wood Stove:
TYPE ADDITION
Permit No.28678 No. Floors Sq Ftg JZIQ
Te1275-4_685 ale 7/24/ 1
Owner Albert Drouillard p
Address NE 1120 Old Belfair
Contractor erne 1p
Address
Legal Description 20 23 1
Direction to project site Frnri nntn (�lrl RP1 dais
Pr eed
abuts S err tove
um" ing ec anica ar rt
Fireplace Deck arage Po
Loft Other
Basement
OD AS PER SITE PLAN. Old 14'x16' trailer to be
removed.
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 �J
427-9670 DATE ISSUED /
lLIL, // U DCP ECrf�IQ. Ic' PERMIT NO.
E MAILADDRESS CITYBSTAT� _ ZIP PHONE
OWNER %cL�LLA JI L��CI` �-11 � % /�Z A/4, �5�') �75 " Z�'S
DIRECTIONS �`• �- �, _ /�
TO JOB SITE /l�L /�j/fL� �C�QA�� C�4,[U OLp CC -/Q/� `(4� s �t/
I
Y'�.JG E-- 5-OOAJD E0ak2Cr!?c=�Al � L'� S66'rH A'/L 7
PARCEL LEGAL D ,/r- , •' � ) �
NUMBER IJ920-JQ-C/33QQ DESCR. TIl O (� EI Z /�G �`' �lZ V 'V
NAME MAILADDRESS CITY SSTATE LICENSE NO. ZIP PHONE
CONTRACTOR �-Ic As 3c�"=
USE OF _
BUILDING
—t
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCR
WORK IBE k4:—
Ql by 6XI5 i,o,;J� � L
BEDROOMS DECKS _ CARPORT M NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE tiA CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. FIREPLACE N/A DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMANENT ✓ SHORELINES
SEASONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND i AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNER DATE�� X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. I BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
a 1 ` ` / Tl SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE L- ,
STATESURCHARGE
APPLICATION ACCEPTED BY PLANSCHECK& APP E� ISSU PERMIT VALIDATION >
CC TOTAL y�
BY CASH CK MO