HomeMy WebLinkAboutBLD23167 Final Addition - BLD Permit / Conditions - 6/25/1989 Shorelines: y,g Plumbing:
Setback: Mechanica :
Special Interior:
Conditions: FINAL:
Mobile Home:
Smoke Detector:
Remarks:
Footing: ,<
Setback:,,'/,('
Foundation
Wal I s:e,e'
Framing: r
Fireplace:
Wood Stove:
TYPE ADDITION
Permit No. 23167 No. Floors Sq Ftg 480
Owner SCOTT, Robert Tel 275-4079 Date 12-22-88
Address 460 Schooner LP NE Bel aim r- zip
Contractor Earl Green
Address 2018 Yukon Harbor Dr Pt.Orchard zip
Legal Description Beards Cove Div , Lot 5
Direction to project site NE 430 Schooner Lp
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
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ou BUILDING PERMIT APPLICATION
MASON COUNTY ; - s cro ks
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED/ , PERMIT NO. `��
OWNER J NAME MAIL ADDRESS CITY 8-STATE ZIP PHONE
p cq GO SC w �� 2 -0-29
DIRECTIONS 15'/fAV/1/f'LC. /700 7-0 t 17 q 3VA" t_T only t,170 3n9/Y 7- 0 SC1/oC') e'f I-p
TO JOB SITE C p� � /1 L l �U (r
LEGAL C / /� /� (❑ SEE ATTACHED SHEET)
DESCR. L.0 7... J }� �C��/ � �U(��
NAME MAIL ADDRESS CITY&STATZ LICENSE NO. PHONE p
CONTRACTOR MIA Lt- �Irv4-! $�//O
USE OF ff
BUILDING �y71
Class of work: NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
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'exi JS �
at
Valuation of workj PL
a
SPECIAL CONDITIONS: 00. b^
BEDROOM I DECKS CARPORT ❑ NOTICE
BATHROOS S TOTAL SQ. FT._ GARAGE []
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF DRIES BASEMENT ❑ ATTACHED I ; OR AIR CONDITIONING.
TOT.AL FT. FIREPLACE I 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 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 a SHORELINES I I
Firm SEASONAL 1 1 FLOODPLAIN I i
y��L�L— L J��f
E.D. NO. S.E.P.A. LI
By Special Approvals IN OUT YES APPROVED NO
Lic. No��'/JL L G Date
ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner _ Date . BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS PERMIT NO. 0 o
= s
n �
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0
LEGAL
DESCRIPTION LOT BLK 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.)
FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE, AND SETBACK OIMEN-
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'
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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(3) OF OWNER(S) OF SITE ! STRUCTURE(!) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED RED ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE