HomeMy WebLinkAboutBLD0483 ReRoof - BLD Permit / Conditions - 1/13/1987i
TYPE RE-ROOF
Permit No. 0483 No. Floors Sq Ftg
Owner WOODFORD, Gary Tel 275-6255 Date 1-13-87
Address NE 131 McKnight Rd B elfair Zip
Contractor Self
Address Zip
Legal Description .Por N 1001 ,S 2001 , SW,SE 29-23-1
Direction to project site Middle of Belfair, next to cafe
Piumbing c anicSewer hboct Stove .
Fireplace Deck Garage Carport
Basement Loft Other
Re roof house and garage
Shorelines: Plumbing:
Setback: Mechanic
Special Interior:
Conditions: FINAL:
MobileHome:
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing: PERM
Fireplace: NAULL & VOID U Y L-ReUMVI G a�}u
Wood Stove: _� �
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED 3
PERMIT NO. 4 �3
NAME MAILADDRESS CITY&STATE ZIP PHONE
OWNER f�. 1 od• - ,YJ tl /fam ga iFj i . i c ►Y W e�- el -3-75-6 7-5-S
DIRECTIONS ` ))
TO JOB SITE c -P of �; .e I n�r`o- t Fk 't ) dui f2
DESCR.
LEGAL Ce/1iLu�Z�R�/^ / � � � C.
NAME MAILADDRESS I CITY&STATE' LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING ,� t�r.,K� ��
Pv-
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE 'J
WORK
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORI ES _ BASEMENT ATTACH ED 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
OWNERAFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTI Y THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIST ATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQU EMENTS 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 C NFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBT INING APPROVAL FROM THE BUILDING DEPARTMENT. G APPROVAL FROM THE BUILDING DEPARTMENT.
WNER tolv W. &DATE i 3 D X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION o
YES NO YES NO Q.
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK S
SPECIAL CONDITIONS BUILDINGGROUP PRE-INSPECTION
SHORELINE
PLANNING
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE ,
APPLICATION ACCEPTED BY PLANS CH ^BY APPROVED FOR ISSUANCE PERMIT VALIDATION _
/��i t�� BY CASH CK MO TOTAL 5
PLOT PLAN
ADDRESS Jr/��' � �4 t';r A/el l L/ PERMIT NO. `o
0
LEGAL
DESCRIPTION LOT BILK ADDITION'
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.) "U
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.
Iv�
INDICATE NORTH IN CIRCLE r GRAPH SQUARES ARE 5' X 5' OR 1"=20
---" old
sl I I f!
f'�a nd tl A�C�_ rf� •l�Y L- � rI
l e
Al-- - - -
Ft � '
I/We certify that the proposed construction will conform to the dlmensiMs and uses shown above and that no changes will be made without
first obtaining approval.
NAME(S) OFjOWNER(S) OF SITE IN STRUCTUREW (PRINT) SIGNATURE OF OWNER(SI OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED DATE
DISTRICT AS NOTED
I