HomeMy WebLinkAboutBLD0282 Final Deck - BLD Permit / Conditions - 10/11/1990 I \
Shorelines: Plunbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL: 4V 16
Mobile Home:
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE DECK
Permit No. 0282 No. Floors 1 Sq Ftg 588
Owner CHARNFII , gUSSELL Tel 275-0522 Date 7-31-90
Address 221 Chinook Dr NE Belfair Zip 98528
Contractor none
Address Zip
Legal Description 32-23-1 Tr 9 GL 3
Direction to project site go toward Belfair -State Pk turn
P un ing Mechanicai Sewer Wood Stove
Fireplace Deck _ 7,age import
Basement Loft Other
BUILDING PtRMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 j
427-9670 DATE ISSUED t r
PERMIT NO. 0 2_'K
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER I.
C' �C I �ZS�G��Z
DIRECTIONS ( I I
TO JOB SITE fd 1U i Y Z f 1 P l L�� 14Y 1L YI
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NA M B E R O —QL1tJ% SCL. pe �t biJ I/ 40T o6,
NAME MAILADDRESS Y&STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING r p .e_
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK
BEDROOMS DECKS YORN CARPORT TOTAL
NOTICE
TOTAL SQ.FT.
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
DECK GARAGE
BATHROOMS TTOTAL SQ.FT.5 TOTAL SQ.FT. /IAAn CONDITIONING.
NO.OF STORIES BASEMENT Y OR N THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
LIVING AREA I I) h BASEMENT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. l `�lJ TOTAL SQ.FT. CHECK ONE ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMANENT FIREPLACE l ATTACHED
SEASONAL— SHORELINE `Z DETACHED
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
le
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
REGgISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
R VUIREMENTS 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
I. CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
BTAINING APPROVAL F M THE BUILD G DEPARTMENT. AAPPROVAL FROM THE BUILDING DEPARTMENT.
X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YESPPROVENo DEPARTMENT YESPPROVENO BUILDING VALUATION
HEALTH PUBLIC WORKS FEE 1
PLANNING FIRE BUILDING PERMIT 1?
D.O.T. BUILDING (i PLAN CHECK C)
SPECIAL CONDITIONS BUILDING GROUP J�- r' PRE-INSPECTION G Z S
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE .S
/J STATE SURCHARGE
APPLICATION ACCEPTED BY PLANSCHE` BY APPROVEQFD5 ISSUANCE PERMIT VALIDATION
TOTAL
BY CASH CK MID �`
PLOT PLAN
ADDRESS ( � ClQ I VI Da Ur' PERMIT NO. c
01 ev w
d`{" Cx o
R >
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LEGAL CJ ` A
DESCRIPTIONn 1 Z� c QOT 10.� 1 BLK ADDITION 00
SITE AREA �7 Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS R� 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'
i�
F�
�D
S
I
0
I/We certify that the proposed construction will conform to the dimensions end uses shown above and that no changes will be mode without
first obtaining approval.
NAME(e) OF OWNER(a) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(!) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
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