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HomeMy WebLinkAboutBLD25058 Final Pole Bldg - BLD Permit / Conditions - 12/20/1989 Shorelines: Setback: Plumbing: Special Mechanics Conditions: Interior: FINAL: Mob i le home: G--ram-- Smoke Detector: Footing: Remarks: Setback: Foundation Walls: Framing: 3 �� - Fireplace. Wood Stove: TYPE POLE BLDG. Permit No. 25058 No. Floors Owner Sq Ftg 1200 Address CEO L ic�erin Te1777-728 DateT-77-797— Contractor 1e nn Zip Address Self Legal Description G.L. I 1P 9-20-2 Direction to project site Right off Hwy 3 on Pickering Rd to Hartstene "Y" sta on Pickerin 1 mile left at ut i sign Plumbing Mechanical Fireplace Deck Sewer Wood Stove Basement gage carport Loft Other i BUILDING PERMIT APPLICATION 4 MASON COUNTY DEPARTMENT of GENERAL SERVICES aa0&1^ -J-1 "00636 P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. 2) OWNER ME G AILADDRESS CITY&STATE ZIP PHONE DIRECTIONS TO JOB SITE NUMBER Q � Q DESCR. L * -;�D NAME' MAIL ADDRESS CITY&STATE LICENSE NO. ZIP : Pf10N CONTRACTOR SE�� USE OF BUILDING CLASS OF NEW ;�q ADDITION ALTERATION REPAIR MOVE REMOVE ✓WORK DESCRIBE / L WORK G' -5©X L4 Q BEDROOMS DECKS CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTAL SQ.FT. GARAGE 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 SO.F . A90 FIREPLACE DETACHED r ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANE ✓ SHORELINE SEASON OW/NEAFFIDAVIT CONTRACTORS AFFIDAVIT I CETHAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQENTS 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 RMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBT APPROVAL FROM THE BUILDING DEPARTMENT. 'J �JAPPROVAL FROM THE BUILDING DEPARTMENT. OR DATE '0`�D — U� X BY DATE FOR OFFICE USE ONLY DEPARTMENT YESPPROVENo DEPARTMENT YESPPROVENO BUILDING VALUATION Q u HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE rReco ds of septic system not located. Missing info .VNOODSTOVE oration may affect future projects. Owner notified PLUMBING C MECHANICAL STATE BUILDING FEE v� STATE SURCHARGE APPLICATION AC!iqPTED BY PLANS CHECK BY kA- V OR ISSUANCE PERMIT VALIDATION TOTAL 17B — CASH CK MO �/�' PLOT PLAN ADDRESS Q� PERMIT NO. = o LEGAL 0 '7 7 ' d /� o DESCRIPTION��o y//.T LOT / 719/A / � o BLK ADDITION SITE AREA 1a G0 Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS I Sq. Ft. INSTRUCTIONS TO APPLICANT THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"-20' ARE 3 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 AND 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. "d INDICATE NORTH IN CIRCLE Vv GRAPH SQUARES ARE 5' X 5' OR 1"=20' �G o r � I S �► p D < 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(al OF SITE \ STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REP14ESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE J , I. 1 �ETi¢L 00 o ! � • I :t f---- -- -- --- yo' m r I J� i s toll tip4 . . , c1 Ova 9 1 date P� 1 � �.