HomeMy WebLinkAboutBLD18187 Cancelled Addition - BLD Permit / Conditions - 1/9/1991 TYPE ADDITION
Permit No. 18187 No. Floors Sq Ftg 126
Owner FOWLER, Russell Tel 426-3184 Date 12-17-85
Address P. 0. Box 601 Shelton Zip
Contractor (Leffler)
Address Zip
Legal Description Rainbow Lake Lot 44
Direction to project site Left on Rainbow Dr.
Plumbing Mechanical Sewer stove
Fireplace Deck Garage Carport
Basement Loft Other
Has 6 months from this date to bring his septic system
into compliance. Started out to be another bedroom.
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Interior:
Final:
Mobile Herne:
Smoke Detector:
Remarks:
PERMIT
NI1LL R Voin RY FXPIRATIO N
DATE .!'9'9/ BY
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. 1�Ie?7
OWNER NAME MA R CI�+&STAT ZIP PHONE
uS P tI 01 P/ o-yt S ( - /
DIRECTIONS e
TO JOB SITE
LEGAL Li (❑ SEE ATTACHED SHEET)
DESCR.
E MA ADDRESS CITY 8 ST LICENSE NO. PHONE
CONTRACTOR O GO ` I le
USE OF W
BUILDING
Class of work: ❑ NEW DI ION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
A rdll
,Zjfj�A
Valuation of work: $ PLAN CHECK FEE PERM T FEE
f
SPECIAL CONDITIONS:
T 'TO 6E
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
NO. OF STORIES BASEMENT ElATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
OR AIR CONDITIONING.
TOTAL SQ. FTLay, 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 tha I am a currently registered contractor in WORK IS COMMENCED.
the Stat of Washington and I am aware of the FOR OFFICE USE ONLY
ordina a requirements regulating the work for which
the p rmit is issued and all work done will be in
con rmance therewith. PERMANENT SHORELINES
SEASONAL C1 FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A.
By Special Approvals IN OUT
YES APPROVED NO
Lic. NY Date ZONING
PLANNING DEPT. -X
OWNERS AFFIDAVIT HEALTH DEPT,
PUBLIC WORKS
I certify that I a exem from the requirements of the FIRE MARSHAL nn
contra or r g' rat aw RCW 18.27, and am aware BUILDING DEPT. �d1f7-of e o ordinance requirements for
w t i ' ued and that all work done will ROAD ACCESS
b i erewith. MOTOR VEHICLE PERMIT
Owne Date APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
r .
PLAN CHECK VALIDA ION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
CHRISTMASTOWN PRINTING
i
PLOT PLAN
ADDRESS O f 10 P P RMIT NO. 4 0
LEGAL
DESCRIPTION LOT Y_BLK ADDITION
ll u
SITE AREA �d 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 WATE SEWER, GAS AND ELECTRICAL
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF ACH BUILDING AND MAJOR OR-
TION THEREOF.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' 5' OR 1"=20'
1,000
)
i
L 11 - f
I/We certify that the proposed construction will conform to the dimensions an7shob be made without
first obtaining approval.
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) t I A URE QP OWN R(S) I U ORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
CHRISTMASTOWN PRINTING