HomeMy WebLinkAboutBLD0052 Addition - BLD Permit / Conditions - 11/8/1988 13A I
Shorelines:
Setback: Plumbing:
Special Mechanics ;
Conditions: Interior:
FINAL:
Mobile Home:
Smoke Detector:
Footing; Remarks;
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE ADDITION
Permit No. 0052 No. Floors 2
Owner SKOGLUND, Robert Sq Ftg 156
Address NE Tel Date 11 8
New 1r R Bel aii
Contractor A A & E Inc Zip
Address p 0 Box 730
Legal Descri tion Bel Zip
P S-1 2 W-1 2 W-1 2 NE SW 21-23-1
Direction to project site
Follow to 2nd dirt drive Old Belfair Hwy to Newkirk Rd.
ast Riverhill Rd.
Plumbing Mechanical
Sewer Wood Stove
Fireplace Deck
Basement Garage Carport
Loft Other
�( BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON WASHINGTON 98584
427-9670 DATE ISSUED
P
ERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
'06ekKE GrnOkLUMD NE 3,S4 Aj W IQIC O OPLEA1112, wk 98S26
DIRECTIONS
TO JOB SITE Ke CW t3ejr_4jtz ... Wwy To 0ewI4IejL 120. FOLLMAJ -(-p
5- b Pkt POUP , f T IU 2 040
PARCEL LEGAL
NUMBER 2 I 3ZIDESCR. W I w ( 1/f CA_) ( _
NAME MAIL ADDRESS CITY&STAT L CENSE NO. ZIP PHONE
CONTRACTOR A vl C. Mr'oie cv,4
USE DI n^,A AAT txj6- , 1,36DK-- Z BUILDING +�(�I(�, , T"+�T 7S`4m(o
CLASS OF NEW ADDITIO [ALTERATION REPAIR MOVE REMOVE
WORK r
ESCRIBE
WORK ftio Pike c ta- /a,Yn r
sq
P s cA6,00 e _ O
BEDROOMS DECKS �— CARPORT PO NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS 3 TOTAL SQ.FT. GARAGE e� CONDITIONING.
NO.OF STORI ES fi BASEMENT t? 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
�u
TOTAL SQ.FT. Z � FIREPLACE PO DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT Wt> SHORELINF,-�
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
REGI$TRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REO IIREMENTS 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 ONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THERE .NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBT INING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM T BUI D NG DEPARTMENT.
)VIVNER DATE X DATE-1 -
FOR OFFIC ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION / no
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT S ��
SL.
D.O.T. BUILDING PLAN CHECK 12 S ecj
SPECIAL CONDITIONS BUILDINGGROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY I PLANS CHW BY APPROVED FOR ISSUANCE PERMIT VALIDATION
Q TOTAL
L L��/ BY CASH CK MO %./f