HomeMy WebLinkAboutBLD9982 Final Deck - BLD Permit / Conditions - 11/4/1982 Kiecaid, Robert & Vera #9982
275-4742 11/3/82
30-23-1, Tract 1 of Govt. Lot 4 EX R/W
1 mile down Mission Creek Road on right
Deck Contractor;
10'x26' Jesfield Const.
$1,300.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior: _
Interior:
Final:
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
r
BUILDING PERMIT APPLICATION
` MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED Q
PERMIT NO.
OWNER AME / ,/ MAIL,ADDRESS CITY&STATE 21P PHONE
DIRECTIONS
TO JOB SITE (. i 14 e Lf0 eEl t2d 0 u
LEGAL 1 (❑ SEE ATTACHED SHEET)
DESCR. C' 2 T Y'Q G / D // �'/
NAME MAIL AD15RESS CItY&STA E LICENSE NO. PHONE
CONTRACTOR Re
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�y r•6
USE OF —J /
BUILDING �L IZ u.)-e
Class of work: NEW ❑ ADDITION ❑ ALTERATION 6 REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ e^ PLAN CHECK FEE PERMIT FEE
�u aa. o �
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT 17 NOTICE
BATHROOMS TOTAL SO. FT. GARAGE LJ
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED
Ll THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS AT ANYTIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT i i SHORELINES I]
SEASONAL C, FLOODPLAIN ❑
Firm
E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
1 certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT. // Q
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
bey' c nformanc herewith. MOTOR VEHICLE PERMIT Q'2
�Q f APPLIC CEPTED BY PLANS CRE6�BY /DPP E R ISSUANCE
Owner Date,�Q��—(1 j /l BY
P N CHECK VALIDATION CK M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS PERMIT NO. F o
z �
n D
D OO
LEGAL
DESCRIPTION LOT BLK ADDITION u
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.)
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 A"ID 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'
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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(SI OF SITE d STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRIN7IN3