HomeMy WebLinkAboutBLD17892 Final SFR - BLD Permit / Conditions - 2/18/1986 TYPE RESIDENCE
Permit No. 17892 No. Floors 1 Sq Ftg 774
Owner SHELTON CONSTRUCTION Tel 426-1600 Date 9-4-95
Address E 1451 Anthony Rd. Grapeview Zip 98546
Contractor Self
Address Zip
Legal Description Rainbow Lake Lot 19
Direction to project site
Plumbing x Mechanical Sewer Wood Stove
Fireplace Deck Garage 264 Carport
Basement Loft Other
Shorelines: A-
Setback:C IC-
Special Conditions:
Footing:,
Setback:
Foundation Walls:
Framing:e'/('
Fireplace:
Wood Stove:
Mechanical:
Interior:
Mobile Home:
Smoke Detector:
Remarks:
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 _ /
DATEfSSUED �/ !
PERMIT NO. f 71z _
OWNER NAM MAIL ADDRESS CITY&STATE zip PHONE '
/ Owl! ! _ Dn/ zr kl J 1 d
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. 0 / c/ R',i/+/.jOcJ f
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR S.
- "i
USE OF
BUILDING P
Class of work: ,K,NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
0
Cz� S o i"
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
In :;?6-5 O /7 S�
SPECIAL CONDITIONS:
7-
BEDROOMS DECKS CARPORT [I NOTICE
BATHROOMS / TOTAL SO. FT. GARAGE.1 �6 ZI
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES / BASEMENT [ ] ATTACHED)( OR AIR CONDITIONING.
TOTAL SQ. FT. 7-1 FIREPLACE [J DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
he 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 q—A—
�� SEASONAL [IFLOODPLAIN ❑
Fi Ow ti
E.D. NO. S.E.P.A. 11
By Q Special Approvals IN OUT
YES APPROVED NO
Lic. No.. _.�-� �6 D PT ZONING Date `�
PLANNING DEPT.
OWNERS AFFIDAVIT
HEALTH DEPT. i �.�` �S-
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
APPLIC ION Owner Date ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. 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.
(f Name Mailing address—Number,street,city,and State Zip code Tel.No.
Owner
2.
Contractor
The owner of this buildin nd the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Si net of appli nt V Address Application date
AL DESCRIPTION
Location
Of
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS
BATH TUBS aQ
SHOWERS
f WATER HEATERS eo
AUTO.WASHERS
/ SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
4 6-
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 Date pemit issued Permit number Receipt No.
I
PLOT PLAN _
f/ ,` PERMIT NO
ADDRESS F/1/.'$1 )06� �/ �Ui .
' a o
LEGAL
DESCRIPTION LOT / C2 BLK ADDITION di'/iL'���ti
SITE AREA 7 7 Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq.Ft.
INSTRUCTIONS TO APPLICANT Z-
1
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.
r�
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
J
y
J �
44
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.
)�F //off ( DAL �� //L (�• 4� 0
NAME(S) OF OWNER(!) OF SITE 6 STRUCTURE(S) (PRINT) IGN T RE O AZUTHORIZ D REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON P"TNTIN^u