HomeMy WebLinkAboutBLD0352 Final SFR - BLD Permit / Conditions - 4/4/1988 TYPE RESIDENCE
Permit No. 0352 No. Floors 1 Sq Ftg 1056
Owner RAUH, Jay T. M.D. P.C. Te1-777-7477 Date 10 3�$�
Address P. 0. Box 767 Belfair Zip
Contractor
Address Zip
Legal Description Beards Cove Div. 8 Lot 12
Direction to project site
MAP ATTACHED
Plumbing X_ Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
I
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Interior:
Final: r:, /l y / K
Mobile Home:
Smoke Detector:
Remarks:
l
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME ADDRESS CITY&STATE ZIP PHONE M IL
DIRECTIONS
TO JOB SITE Sr
LEGAL -/ Q ______WE ATTACHED SHEET)
DESCR. 4�C/s' it1�� ,0/1/ G .�
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING eZL) �V1�
Class of work: >6NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Se); t44 AJe GcJ
Valuation of work: $ PL" CHECK FEE PERMIT FEE
SPECIAL CONDITIONS: < Sv1e� J-0
BEDROOMS _ I DECKS 41 CARPORT [ i NOTICE
BATHROOMS ITOTAL SQ. FT.6 GARAGE []
ATTACHED !_: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT i OR AIR CONDITIONING.
TOTAL SO. FIFAieL I FIREPLACE i i IDETACHED f_:
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 fate of Washington and I the
aware of the FOR OFFICE USE ONLY
ordi ance requirements regulating the work for which
the permit is issued and all work done will be in
cc formance therewith. PERMANENT LI SHORELINES I ;
SEASONALk FLOODPLAIN i J
Firm E.D. NO. S.E.P.A. Li
By Special Approvals IN OUT YES APPROVED NO
Lic. .— Date
ZONING
PLANNING DEPT. 6 85 i;b
OWNERS AFFIDAVIT HEALTH DEPT. `�,xy• wy .GJ n
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. 9?� Yf5
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance t rewith. MOTOR VEHICLE PERMIT
Po,A APPLICATION ACCEPTED BY PLAW CHECK BY APPROVED FOR ISSUANCE
Own _ Date
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
MASON COUNTY
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 e
2.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signature of a plicant ' � Address ^�r � � � Applicatio date
LEGAL 06CRIPTION
Location
B
Building
NO, PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS 0
BATH TUBS
SHOWERS
WATER HEATERS Q�
AUTO.WASHERS O
SINKS 00
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 a Date pemit issued Permit number Receipt No.
$ J ✓ �/
PLOT PLAN
ADDRESS PERMIT NO. f
0
/
LEGAL
DESCRIPTION LOT I/A�BLK ADDITION u
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Z 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 Al"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.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
7
C
1
I/We certify that the proposed construction will confor to the dimensi:t nd uses shown above and that no changes will be made
first obtaining approval.
T.
NAME ) OF OWNERS) O SITE S STRUCTURE(S) (PRINT) IGNATU F R(S) OR AU IZE PRESENTA VE
DO NOT WRITE BELOW THIS INE
APPROVED
DISTRICT AS NOTED DATE
CHRISTMASTOWN PRINTING