HomeMy WebLinkAboutBLD16535 Final Addition - BLD Permit / Conditions - 8/20/1987 VAN PARYS, Dorothy #16535
2-26-85
Beards Cove Div. 5, Lot 5
P. 0. Box 58
Belfair 98528 275-3036
Larean Lake Blvd to Schooner Loop to Harpoon
Contractor
Self
Addition
$7,360.00
Shorelines: IkX
Setback: e /,
Special Conditions:
F o o t i n g le 2 72 r,- 77
Setback.-
Foundation Walls:
Framing: �-
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:_
Interior: '`1,7io /4 5- 7 -� ^
Final:
Stop Work:
Mobile Home:
Smoke Detector:
Remarks: ��.,
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426 5593 —
DATE ISSUED cal of
Vail /) _v s PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
AW
71
DIRECTI S
TO JOB SITE zrs:i 9 Ar Rz4z ` �P,,�«�_ 4 2 Ae-
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. Y r
of S
CONTRACTOR
NAME MAIL ADDRESSE.0 CITY&ST TE LICENSE NO. PHONE
USE OF low
BUILDING A// 7-/Q
Class of work: )] NEW p ADDITI N ❑ ALTERATION [I REPAIR El MOVE ❑ REMOVE
Describe work: / ,
AeA? R0.1A4 16 /t ?j- T C' D r-
o r- 46 ` to - 3zo N o0
Valuation of work: $ PLAN CHECK FEE PERMIT FEE/milO
SPECIAL CONDITIONS:
BEDROOMS _ I DECKS CARPORT f i NOTICE
BATHROOMS I TOTAL SO. FT. GARAGE Lj
ATTACHED i SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SO. 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 am aware of the FOR OFFICE USE ONLY
ordinance require ments regulating the work for which
the ermit is issued and all work done will be in
CO 0rmance therewith. PERMANEN SHORELINES ❑
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 D
LE
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. 4-.74-a'a Q,P - d
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance t erewith. MOTOR VEHICLE PERMIT
X w J APP TION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Own � Date .S BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS PERMIT NO. f o
z °
n s
D O
O
LEGAL
n
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'
'r
Me
L
K
0
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(S) OF SITE & STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED /.� -?A)6 9S� DATE
DISTRICT AS NOTED /�
GHELTON PRTNTINu tl