HomeMy WebLinkAboutBLD10727 Final SFR - BLD Permit / Conditions - 12/30/1981 KRUEGER, Rick #10727
06-05-81
North Shore Rd. , right on Sand Hill Rd. , left 4/10 mi.
on Larson Blvd. , right 2/10 mile on MiCleary Rd.
Beards Cove, Div. 4, Lot 16
Contractor
Rick Krueger
Residence
Plumbing Permit
$26,728
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SITE INSPECTION CHECK LIST NO
" ,Check ev ace y q p
s :1• a7y acceptable feature. Leave ever questionable or unacce table
�bature. bAapk. Explain every blank in the space for remarks.
Item Applicable Regulations
Soil in holes -describe layers & depth Art. VI Sect. 3.5 (a) VII 3.3, 3.7, & 10.2
Existing sewage systems
3 Existing structures - check use VI 3.5 VII 4.1 & 4.2:
!% 4�Existing wells - check construction VI 2.1 (b) VII 4.1
of fill VI 1.8 VII 3.6
6. soil been re VI 2.1 (c.) 2.4 3.5 (f) VII 4.1
Salt water "
.. Lake "
River "
Creek "
Stream- Pond "
yI3 .Swam ► S
P
4 41isc. surface water "
Property VI 3.5 (f) VII 4.1
6 $anks or cuts VI 3.5 (e) VII 4.1 VII 3.7
_Distance to public sewer VI 3.5 (g) 9.2, 10.2, 10.3 & 10.4
r718 Water table - Record depth VI 3.5 (d) VII 1.4
49v -Slopes VI 3.5 (e) VII 3.7 & 4.1
: Driveways and roads VII 4.2
Drainage patterns VI 3.5 (e) VII 4.1
. Interceptor drains VII 3.8
423,�_
8
Culverts
�. Water lines VII 2.6 & 4.1
Flood Control Zones VII 4.4
2 Roof drains VII 3.2
-.�r7. Vegetation VII 3.2
REMARKS
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RY
DATE
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED-
PERMITJ �] �]
NO. �/ o
OWNER NAME p MAIL ADDRESS CITY 8 ATE ZIP PHONE
\lzRtts D �Fftclz A- 2 ?S-"
DIRECTIONS
TO JOB SITE � �rQ 'Ut � �(M,.� �1�1 KC• �'Ci' � �j� Y�.�SOtiB)�+�-• ICI r� 1' 1.
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. RoS �t)E Dtl)• ui1 �Io e��� It0�-l1LE Din 2kLey�
CONTRACTOR
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
,/�����_
USE OF 1� l CAL
BUILDING1 j Dc C Pk L__
Class of work: Ck<EW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ ` p' PLAN H CK F PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT.,2O0 GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIESBASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ DETACHED ❑
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 FOR A PERIOD OF 180 DAYS AT ANY TIME 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 SHORELINE
SEASONAL ❑ 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
I certify that I am exempt from the requirements of the FIRE MARSHAL
co tract or registration law RCW 18.27, and am aware BUILDING DEPT.
he Mason County ordinance requirements for
hi h this permit is issued and that all work done will ROAD ACCESS
e n onfor nce therewith. MOTOR VEHICLE PERMIT
AP ;TION
ACCEPTED BY PLAN; BY APPROVED FOR ISSUANCE
Owner Date .� �
a.L La-sc
AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIO CK. M.O. CASH
PLOT PLAN
ADDRESS _ PERMIT NO. f o
i o
' a o
a
DESCRIPTION ��. LOT l JG 1"Itc Qf�LK� ADDITIONLEGAL
u
SITE AREA S`— 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"'D 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.
0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
Wo
71
1/We certify that the proposed construction will conform to the dimensi s a uses shown above and that no changes will be made without
first obtaining approval. I Aj � - L,---__'
NAME(S) OF OWNER(S) OF SITE d STRUCTURE(S) (PRINT) TORE OF OW R(S) OR A THORIZED REPRESENTATIVE
DO NOT WRITE BEL0 THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINTING
1
MASON COUNTY PLANNING DEPARTMENT
P.O. BOX 186 Shelton,Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT— Complete ALL items. Mark boxes where applicable.
Name Mailing address—Number,street,city,and State Zip code Tel.No.
Owner
2.
Contractor
The owner of is ilding and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signature of a p cant Address Applic ati n date
l C I�
'LEGAL DESC IPTION
Location
Of
Building
NO. PLUMBING FIXTURES FEE
t WATER CLOSETS
BASINS
I
' BATH TUBS a d
SHOWERS
WATER HEATERS
AUTO.WASHERS
1 SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
— — (Show Street Names & Property Lines)
--- INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT SKETCH IN SEPTIC TANK & DRAIN FIELD LOCATION OR SUBMIT
-- ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved by Permit fee Date pemit issued Permit number Receipt No.