HomeMy WebLinkAboutBLD24572 Cancelled Pole Bldg - BLD Permit / Conditions - 10/12/1989 L�A
:
Shorelines: Plumbing
Mechanics
Setback: Interior:
Special FINAL:
Conditions: Mobile Home:
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing
Fireplace:
Wood Stove:
TYPE POLE BLDG.
Permit No. 24572 No. Floors Sq Ftg
720
_Date 0-12-8
Owner TURNER John M TeShelto Zip
Address E 3033 Brockdale
Contractor Tozier Bros e ton ip
Address 625 S st
Legal Descriptione t site Tbove address P 1305)
Direction to prof
Mec ailSewer Woo Stove
P un ing DeckCar—age arport
Fireplace Loft Other
Basement
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED,
PERMIT NO.C)✓? -
OWNER MA SS CITY ZIP PHONE
hAl-
IL ADD � sF
DIRECTIONS p�^r�'�, 1�.
TO JOB SITE ( "T /�� M(Y-� -(-e
r </ 900 q6 p
PARCEL LEGAL / 4*t jw NUMBER DESCR. 5��� r- 7rrc�ltis}t(P ,Z�
AME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR �2 LJOJ W -r J Ig2-s7 'f"-Z4l
USE Q
BUILDING7:57
�
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
WORK DESCRIBE l.� �7 2`i-J` k '
n �w� Rw V-'- ZI-- L S ��"1 %I
boo-p_ I h w
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTALSQ.FT. GARAGE CONDITIONING.
NO.OF STORIES I— BASEM ENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. �zo FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERS A FIDAVIT CONTRACTORS AFFIDAVIT
1 CERTIFY T AT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATI LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREM TS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CONF MANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAININ APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM BUILDING DEPARTMENT.
1 _
X R DATE X BY DATE/U
FOR OFFICE USE ONLY
DEPARTMENT YES
PPROVENo DEPARTMENT YES No
BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT 6' ...5'tD
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
Y PLANS CHECK BY APPROVED FOR ISSUANCE PER
APP TI N ACCEPTED B MIT VALIDATION
BY P hf CASH CK MO TOTAL ���
�► PLOT PLAN
ADDRESS CJTJ �'� FjIG(�GI� �+�(� l�N PERMIT NO. 4 e
0(— .SFv—t PL,+7T 13OS /jam
E&L/q CI F 5 :P— 11,4 S C-C -a j -24 AAC/If—WA- car fsv
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 DIMEN-
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'
1 "
VG \t�ALA
_ a
- TI
I
I
e � �
I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without �L1!',/
first obtaining approval.
NAME(S) OF OWNER(S) OF SITE b STRUCTURE(S) (PRINT) NATU E OF OWNER 1 OR AUT IZED REP ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE