HomeMy WebLinkAboutBLD0206 Addition - BLD Application - 10/31/1989 Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL
Mobile Hcme:
Smoke Detector:
Remarks:
noting: ,5-
Setback:
Foundation
Walls:
Framing: 7K,3 77 ZEE
Fireplace:
Wood Stove:
TYPE ADDITION
Permit No. 0206 No. Floors Sq Ftg 247
Owner HOLST, William Te1275-6702 Datel0-31 -89
Address NE 330 RiverhillDr Belfair Zip
Contractor None
Address Zip
Legal Descr ip ion Ir - z, z, of B S P 900 '
Direction to project site W on Old Belfair Hwy, turn rt o
Newkirk, turn left on Riverhill to NE 330. On right side.
Plufibing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement ---Loft tether
BUILDING PERMIT APPLICATION 1
` MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAME MAILADDRESS CITY SSTATE ZIP PHONE
OWNER William S Ernestine Hoist - NE 330 Riverhill Dr. ,Belfair,WA 98528 206/275-6702
DIRECTIONS West on Old Belfair Hwy, turn right on Newkirk, turn left on Riverhill to NE 330 on
TO JOB SITE Fight side
PARCEL 12321-20-90101 LEGAL Recorded 7 July 1980,
NUMBER DESCR(Lot B of Short Plat #900,
Alldit-r-s File
MAIL ADDRESS CITY SSTATE LCENSENO. ZIP#372 53 PHONE
CONTRACTOR N ne
USE OF s-id ence
BUILDING
CLASS
WORK O✓ NEW ADDITION X ALTERATION REPAIR MOVE REMOVE
DESCRIBEAdd space to Dining Area
WORK
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTALSQ.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 SQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL /- ,
OWNERS FIDAVIT CONTRACTORS AFFIDAVIT ,Z y S�
I CERTIFY AT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATI N LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
IEQUIREM TS 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 CONF MANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAININ APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
a�
X OW R DATE T X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT Y SPPROVEDJO DEPARTMENT YEAPPROVEDIO BUILDING VALUATION
HEALTH PUBLIC WORKS 0 FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING v✓1t, PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP - -* PRE-INSPECTION
P SHORELINE
WOODSTOVE
T Of - Gtjf PLUMBING
MECHANICAL
TATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY PLA CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
1 , TOTAL
( 1�- p CASH CK MO
PLOT PLAN
ADDRESS N. E. 330 Riverhi11 Dr . , Belfair, Wa 98528 PERMIT NO, °s
0
= s
w s
LEGAL Lot g of Short Plat #900, Recorded 7 July 1980, Auditors File #378532
DESCRIPTION LOT BLK ADDITION
w
SITE AREA 61 ,840 Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS 2,879 _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 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.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
3 7
__t-jAjZA(3&t lees
int-w0t4
Ul
i 11 (
I/We certify that the proposed construction will conform to the di"nsicns and uses shown above and that no changes will be made without
first obtaining approval.
William Holst and Ernestine Holst L�-�
NAME(SI OF OWNER(al OF SITE i STRUCTURE(SI (PRINTI -� SIGNATURE OF NER(SI OR AUTHORIZED R P ES T TITI V�E��T
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
Courthouse Annex I N. Fourth & W. Cedar
P.O. Box 186 Shelton, Washington 98584
(206) 427-9670
building environmental health maintenance landfill parks&recreation fair/convention center planning sewer&water
1 0-4-)V%i 71
CHECKLIST FOR PROPOSED CONSTRUCTION
No Yes
C L,T< ] Within 200 feet of designated shoreline or wetland
C ] Proposed construction on/over/in wetland
[ C ] Proposed construction within floodplain
Commercial Development ( Parking Standards , Sign
Ordinance, Public Works Review, other applicable
agencies )
C L ] Mobile Home and/or R. V. Park
What Type Of Construction Is Being Proposed?
C a C ] Exempt from building permit application
C ] C 9-- Exempt from S.E .P.A . process (WAC 197-11-305,
WAC 197-11-800 )
C ] C ] Meet all requirements (Which section ( s ) of
S .M.P. does proposed construction pertain to? I1 �
1
C ] C ] Variance or Conditional Use Permit required
C ] C ] Exempt from Shoreline Substantial Development�,l � /�
Permit process (WAC 173-14-040
C ] C ] Exempt from Substantial Development but within
Army Corp. jurisdiction (WAC 173-14-115
Printed 3/89
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