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HomeMy WebLinkAboutBLD94-1066 Final Deck - BLD Permit / Conditions - 9/20/1994 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 iliH API)IF" HE 4/0 LARSON F111.VD H E t-V A I R 9 1)0 f R11SSE.1- 11 FORD 2IS-6917 I il VMS I'M #fV 4 0111! 161� Al fS #4131 of 451.. I A f P 0 ti il I i I ti f YP f A 0 A it 0 f it I f p f I I p I I 1') f Ami'll"I BY A A f f 0 t it (it! f 0 0 '11 11 pp m I RIP c j"4/144 t 1� "I f�I fit 0 if-Ict 1 J� 00 NIP U, 1 tlt fill' I A I i I 1 t 4 t>9 0,1 P A I 1 fit 1, 1`4 11 I Pil 1 1 1 CtN I ri I Fif1i<l I I "j I I A I A I 1 0 k If H I i 1,4 1 1 t I I I tit 1 A I ii I I fir m(1 1) 1 Wk i i I< tit i} I I. i; I tif '- W "*Hf i k P t, t t l 1,A 1 f4 H I f m i f1i I I I t"I 1`4 1 it 111 i It It 1 flilm Ill R 4 of 141 f') fit r If 11 1 1,1 1, 10000 itti. 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III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 f I C MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 Mff P RONyu , MASON COUNTY MIS JUL 15 � LLANEOUS PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 • 427-9670 PLEASE PRINT Q+� b(p #1 Fail r 4/ G �/. d/z Phone # Z ✓- 6 917 yv Fire District# ddress ,AIZ—i �JO 24"a c/ /✓G✓0 City gr1,�,ai2 ddress l�6X Id City EL, 11_1 St Zip 99,rLs` Applicant 64VZAI '11— Phone # Applicant Address City St Zip Directions to Site: ap BeZr�wl'e t/✓,/ 412-�y alL Z2 %D d s_ Ca J p vtl � L 6+ 44 1 2 23 9 O It 'z.f 4`ICA ID �- c�c.F Q._a_O( •- �.�e.�? #2 Parcel No. 3 o o Sz - Legal Description Z6 nzc- f rs/J�lovCa�y�� /.�, #3 Indicate by circling the applicable source if any water is on or adjacent to the property site: saltwater lake river creek stream pond wetland seasonal runoff marsh other #4 Project Start Date X Project Completion Date 24�ne< #5 Use of Buildiing - Describe proposed construction l&Z-7w /&J 'Depending upon the type of permit,a floor plan and plot plan may be required. 'This permit is valid for 180 days from the date of issuance. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED CON- MENTS OF THE CONTRACTORS REGISTRATION LAW TRACTOR IN THE STATE OF WASHINGTON AND I AM RCW 18.27, AND AM AWARE OF THE MASON COUNTY AWARE OF THE ORDINANCE REQUIREMENTS REGULAT- ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT ING THE WORK FOR WHICH THE PERMIT IS ISSUED AND IS ISSUED AND THAT ALL WORK DONE WILL BE IN CON- ALL WORK DONE WILL BE IN CONFORMANCE THERE- FORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITH. NO CHANGES SHALL BE MADE WITHOUT FIRST WITHOUT FIRSTOBTAINING APPROVAL FROMTHE BUILD- OBTAINING APPROVAL FROM THE BUILDING DEPART- ING DEPARTMENT. MENT. X OWNER - / X BY DATE DATE Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Wells Water Lines Shorelines Drainage Plan Easements Septic Systems Name of Fronting Street Indicate directional by Proposed Improvements Name of Flanking Street N, S, E, W etc. PLOT PLAN AREA FOR OFFICIAL USE ONLY:Accepted by: � ©ate DEPARTMENTAL REVIEW FOR OFFICIAL USE ONLY Planning UI �—�'�lxxs YS /L c l'1 c-,�cAI CGU� Se c_c�S APP COND APP HOLD Building Fire Marshal Other OWNER/BUILDER TO ASSUME ALL RESPONSIBILITY IF DRAINFIELD AREA IS ENCUMBERED. Special Conditions Fees Permit Fee $ Z`. 06 Plan Check Other Other State Building Fee �'• 6� TOTAL DUE $ , 1 1 , � 1 1 ya - -_ r � L . I ----- -- --- - - I i _ - _ --- -- - --- 1 1 V I F - �-- _ . r 1 - ---- , r� 1 ' 1 - STRU CURE PROPERZY SETBACKS ✓- 1 ` *Note: For setback requirements on shareline property, please contact a Mason County Shoreline Plarmer. chanter 14.08.180 of Mason County Code Building setback fray property lines, right-of-way, or the closes projection shall be five (5) feet to said line. A variance may be granted to said Line if a hardship can be shown and the adjac--.nt property owner has no objection and is wi 1 I i ng to incunber the deed to his/her property and to be recorded with the Auditor of Mason County a written statement on his property deed as follows: '21e crocerty owner described ( 1 ) Legal, Description and the property adjacent (2) L-eg Esc==Freon has been granted a variance of feet to the Mason CoL-zty property line setback regulations. The u variance -_hall be for the life of said structure or structures so located. Dated this ,' day of _ ,L-C y/ / l/- AD. Signed by property owner(s) . rnz PFRTY LWNhR c_ r-u 1 D r � r' o m AaJAC WI PROPERTY O6vNFR .SIR= ) (n )SS. C=Uy 0 ) On this day personally appeared before me,tome known to be the individuals described in. ana executea the oregoing instrunent, and acknowledged that they signed the same as their free and voluntary act and ded, for the uses and purposes therein mentioned. Given under my hand and official seal this day of 19 SEAL NOTARY PUBLIC in and for the State of Wa.shsington, residing at flirthermore the variance so granted must be recorded on the property deed of that parcel of property and a copy of the Auditor's Receipt returned to the Department of General Services. Reviewed by the Director of Genera( Services Approved by Mason County Commissioners Director Date Date