The URL can be used to link to this page

Home My WebLink AboutBLD9962 Woodstove - BLD Permit / Conditions - 9/23/1982 Pederson, Caroline #9962 , 275-6447 , 9/ 23/82 9-23-1, Tract 19 of SW 1/4, SE 1/ 4 NE 150 Pederson Drive, Belfair Wood Stove Contractor: Self $-- Wood Stove Permit /,I3oq- q3 -Cc I q 0 Shorelines: Setback:_ Special Conditions: Footing: �} Setback: Foundation Walls: Framing: Fireplace: Wood Stove: Plumbing: Mechanical: Roof: Exterior: Interior• _ Final: ` Stop Work:_ Mobile Home: Smoke Detector: Remarks: .BUILDING PERM IT'APPLICATIQN MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426 5593 DATE ISSUED PERMIT NO. OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE DIRECTIONS C TO JOB SITE LEGAL p� { �,�/ p (❑ SEE ATTACHED SHEET) DES 5� _ / / 3 CVIi K101 e-1-�^ NAME MAIL ADDRESS CITY&STATE LICENSE NO. / PHONE CONTRACTOR USE OF BUILDING c Class of work: El ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Valuation of work: $ PLAN CHECK FEE PERMIT FEEr� SPECIAL CONDITIONS: BEDROOMS DECKS CARPORT C NOTICE BATHROOMS TOTAL SQ. FT. GARAGE iJ ATTACHED ' SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT L, OR AIR CONDITIONING. TOTAL SO. FT. FIREPLACE C i DETACHED L 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 FOR A PERIOD OF 180 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. PERMANENT SHORELINES SEASONAL [] FLOODPLAIN C Firm 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 BUILDING DEPT. of the Mason County ordinance requirements for which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT ? _ APPLICATION ACCEPTED BY PLANS. C BY APPROVED FOPISSUANCE Owne Date. 3 2 �� ' 1 BY V {G�—L IL P CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH t BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 oO 1 e?a DATE ISSUED � �T��✓ PERMIT NO. / -6,3 6 2 OWNER NA E MAIL ADDRESS CITY&STA E ZIP PHONE I C.ti i e(STY f SZ� N /`�ebcm e l /c�aa-l/� _Z DIRECTIONS r 0111,6e44 �� r � TO JOB SITE Sin f fium bGIyQj �mll ,6e44 I fir , LEGAL "ct4 (Q�O� — S� �lU S C �l� L�� (�� SEE ACHED SHEET) lei DESCR. ^ p o`23 2tli►1 NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR USE OF �'rq �a j BUILDING Class of work: C-1 NEW ❑ ADDITION 0 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Cv /<3 06 Valuation of work: $ PLAN CHECK FEE PERMIT FEE S'r SPECIAL CONDITIONS: BEDROOMS____ DECKS . __- CARPORT Q NOTICE BATHROOMS TOTAL SO, FT.JOW GARAGE Q ATTACHED L: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO, OF STORIES BASEMENT OR AIR CONDITIONING. TOTAL SO, FTi�a FIREPLACE IDETACHED LJ 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 FOR A PERIOD OF 180 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. PERMANENT SHORELINES C] SEASONAL FLOODPLAIN ❑ Firm E.D. NO.------ S.E.P.A. ❑ By Special Approvals IN OUT YES APPROVED NO Lic. No._ Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. / 4 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. MOTOR VEHICLE PERMIT tCHECKVALIDATION ICATION AC PTED Y PLANS CHECK BY OVED FOR SUANCE ODate CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH ' PLOT PLAN ADDRESS PERMIT NO. F a /q d6 S-c-A 2sn LEGAL a _3 6- lc�G< n ,1 DESCRIPTION OT [.�°' r' / 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-'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' Z. Al 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 h STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DATE DISTRICT AS NOTED • aJ 'i w 1. .. ..�i..o._..... ,a„..u•.:a... ..L:v._a-_6._. .J'•...-tea :.lc...w. _.-A THE GRAIJTORS, Frank Livick and Claudine R.Livick, husband and wifenow and at all times since acquiring title to the within described real estate, for and in consideration of the sum of $10.00 lawful money of the UnitedStatVss in hand . paid, convey and warrant to Les Pederson, a married man, the following described real estate situated in. the County of Masons State of Washington, towit : s� A tract of land situate in the Southwest quarter (SW�, ) of the Southeast uarter ( "E ) of Section nine (9) , Township twentythree (23). North, Range one � 71 ) West, W.M. , particularly described as follows: Commencing at the South one-quarter corner of said Section 9, Township 23 North, Range 1 West,W.M. , and proceeding thende along the south line of said . Section 9 North 89002131" Last 612.11 foot to the Southwest corner of a tract of land heretofore conveyed to the grantors herein by deed recorded in Volume 115 of Deeds,page 477, under Auditor ' s File No. 124014; thence continuing along the South line of said section North 89002121" East 311.26 feet; thence run T:orth, along L-he East line of the tract conveyed to rantors herein, as aforesaid., �85.20 feet, more or less, to the Souther n roadway, and the o initial point of the tract of land erebT described; thence run along the South" erly line of said roadway North 47 36150 ' West 186.23feet,and North 61025110" 1:est .81.56 feet; thence run South, along a roadway, 17 46'30" East 105.43 feet; and youth 18 55'10" West 207.93 thence run North 65004►40" East 237.34 feet, more or less, to the said initial point. Dated this 1LI.th day of Octobgx,1957• ®� l ( SEAL) Frank Livick (SEAL) « Claudine R. Livick STATE OF WASHINGTON, ) SS. COUNTY OFt' a."� ) "' I, the undersigned, a Notary public in and for theState6f Washington, duly commis i oned and s worn, do hereby certify t Iiat on this 14th day of .October,1957., rersonally appeared before me FRANK LIVICK and CLAUDINE R. LIVICK, hiasbm d and wife, to me known to be the individualls described in and who executed the within instrument, and acknowledged that they signed and sealed the same as their free and voluntary act and deed for the uses and purposes herein mentioned. i.•.UiOdr my hand and off ici eO the day and year above written. of ota for the State of E GO. Wash' g on, residingat £�-�:�t rein. yT VASq. REAL ESTAI E EXCISE TA!. fl � -- ...T......... _.. y ,