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BLD12311 SFR - BLD Permit / Conditions - 4/20/1982
I � I PErndt No. 12311Type ResidenceIb. Floors 1 Square Footage 864 Oaw Amundson, Angela N. PFEr-9 2 6-3 5 8 rate 20 82 PaIfE�E 21 Do wood Place Shelton Zip 98584 C171 Sal f FrrM Ad�asS Zip Plan D. Fawver Shoreline- �- AFplicant's plot plat as to�a'- regdir i , D. F awv e r Legal Descripticn: Lake Limerick, Di vision 4- Lot- 225 Direction to project site: Lake Limerick, right on Old Lyme Road, in about 3 blocks on left. Fee Paid: Plan Check Bamt d Wood Z�rort �— Irspectims: II Ftxa daticn: Fill ' Fireplace fpotixg ForTE cv A sJ-r bolts FtX]lC3at1(11 wall & re" r _ Pier Sorg Baswent vmll & reLar VEnts & crawl smoe Fbtai nirg %,all & rd)Er Soil-,cod claaarm III Ftamrq: Bloc" s & posts a�idgirq Joist size & cam SLh floor type Span Qa�b & Nailing Walls Material Qade Dcterior Siding (71 Bracing Nailing cs Ceiling height Fbof �3 ty� Fhrric.-ti-- clips t% — Rafters Rrlir�gs� RP B Vall Blsoddrg aWlicaticn Nailing 'Type P &ps ceilings O Rrnaae dicts — Sha.kr calls Stair jacks Dtgg3ed ciailings Main electrical b�m Fbof Fbles ply Firred-oLt calls 06jers Stairs Pdser & 'Neal Headroom Width Stair Jacks L xdirgs HaTk-ails Inspections: ! I a1 Ib. of fluas J Q Fla§Am El 0Ft: SoffitsMFPFM—l Soffit _ CloBd Ride VEnt s 8 Cathedral Winioas & Doors DTact t cn He -ler Srm s ppm.r-q; - InsaTatim Sill Height C a ldm Attic Ve—t-ilation �--1 ❑ Awass [] ❑ IV PluTh Pco� S & Jacks Pipe Rm Trays Bathroom Facilities Clean cuts Hmli.cEp Facilities Hot WatEr Pry Valve Mechanical --- F t & Fzth Clothes Dry' Vent 1m�F & D s O uct St we vast Inailatiaz Floors Ceil�ir-q Exterior Doa__-s V Interior OxEr F F °er=:s Q ❑ Finishsl WallsType -- ❑ ❑ Nailirx� � ❑ Decks, Balconies & Eofts _ GLurirails ❑ ❑ Struct Rpmrt �- Fire Protecticn 9ncke Tx-tecbor Firev ails & Cbilin q Wood Stx� Finial. & Omipffv Ppxujed. Date : PERMIT II III T:6N IV ©ATE RY V _ BUILDING PERMIT'APPLICA TION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED PERMIT NO. OWNER NAME MAIL ADDRESS CITY&STAT ZIP PHONE E. 1,.: Ci S 4 y - DIRECTIONS TO JOB SITE 3 a }(' CIA LEGAL (❑ SEE ATTACHED SHEET) DESCR. NAME CONTRACTOR MAIL ADDRESS CITY&STATE LICENSE NO. PHONE USE OF BUILDING Class of work: !A NE ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: 0 Valuation of work: $ '� PLAN CHECK FE PERMIT FEE SPECIAL CONDITION . BEDROOMS DECKS CARPORT[',. NOTICE BATHROOMS— TOTAL SQ. FT.—&WL GARAGE I ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT CJ OR AIR CONDITIONING. TOTAL SO. FT. y FIREPLACE DETACHED CI 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 SHORELINES SEASONAL ❑ FLOODPLAIN Firm E.D. NO. S.E.P.A. I By Special Approvals IN OUT YES APPROVED NO Lic. No. Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT EALTH DEPT. LIC 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 DEP 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 APP CATION ACCEPT BY PLANS CHECK BY APPROVED FOR ISSUANCE Owner �Le c u��Date. 1--1- 'R A l� - - BY i VyV PV CHECK VALIDATION K M.O. CASH V PERMIT VALIDATION QCK. M.O. CASH 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. 1. Owner 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 applicant Address Application date LEGAL DESCRIPTION Location Of Building NO. PLUMBING FIXTURES FEE WATER CLOSETS BASINS BATH TUBS f SHOWERS WATER HEATERS .2 AUTO.WASHERS SINKS FLOOR DRAINS DRINKING FOUNTAINS LAUNDRY TRAYS Connect to City Sewer DISH WASHER DISPOSAL URINAL ' - I (Show Street Names 8 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. ��s� $ ".5" ---- oo-ems / , 31► + PLOT PLAN ADDRESS PERMIT NO. 4 0 o LEGAL 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"'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' c-1, • i r ' &. 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 d STRUCTURE(S) (PRINT) tIGNATURE OF OWNERS) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED 1 t�� •I� DISTRICT AS NOT21 DATE 6HELTON PRINTIN3