HomeMy WebLinkAboutBLD8450 Well and Pumphouse - BLD Permit / Conditions - 9/8/1975 Delson Lumber Co., Inc. #8450
9-8-75
Portion NW4, NWµ, SEµ (N. of R.R. ) 24-19-4
Well and Pumphouse
$700.00
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Sec. 24 T'wp, 19 North R. 4 West
County of Mason
14 13 n ,N SCALE 1 CM=BOO F!!T
23 24
.................}.................... ...................... ...................... ................... ...................
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:Private Access Roads
1 -
1 I Mill Site
�-Wel1 Si
�1 Private A ess Road
1
�- N.P. RiLilroad R/W 1
Littl(p Skookum reek------'
McCleajry - Kamil he Road
.....................-....................... ................................... ..--- ... ............................................... -------- .................... -•----•--------.
BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Box 400 Shelton, Washinqton 98584
DATE ISSUED- 7� —
Delson Lumber Co. Inc. PERMIT NO.
OWNER -- -- - - MAIL ADDRESS ---ZIP ----- PHONE
P 0 Box 858 Olympia, Washington 98507 352-7633
DIRECTIONS 1
TO JOB SITE See Attached Map
LEGAL MAIL ADOR[88 - - ZIP-
C]OEL ATTACHED SHEET)
DESCR.
y _ g (N•_ of R.R. Tracks)_SecL 24_. T 19N, R4W W.M.
MAIL ADDRESS PHONE
I CONTRACTOR
I None (To be constructed by Delson Lumber Co. , Inc.)
USE Of MAIL ADDRE33 PHONE LICENSE NO,
BUILDING Well & pump house _ � 2L4- OD- QOO 10
Class of work: IN NEW ❑ADDITION El ALTERATION ❑ REPAIR ❑ MOVE 0 REMOVE
-- -------- - -----
Describe work:
New construction of well and pump house. Concrete foundation, wood framing,
sheet metal siding.
`Valuation of work:$700.00 PLAN CHECK FEE PERMIT FEE $7.00
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY
Type of Occupancy
Const. Group Division
GClc• .t�l
_.�._ _ Size of Bldg. No.of Max.
(Total)Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT Spacial Approvals Required Received Not Required
I Certify that I am a currently registered contractor in the State _NN
of Washington and the County of Mason and I am aware cf the HEALTH DEPT.
ordinance requirements regulating the wcrk fcr which the permit POINLIc WORKS
Is Issued and all work done wi;l be in conformance therewith. PIOA15 DEPT,
Firm
By
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the contract.
or regist ation law RCW 18.27, and am aware of the Mason
County or ante requirements for which this permit is issued and that all wo one wi conformance therewith. N O T I C E
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING. VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
0 w n el Date Sept. 5, 1975 AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC-
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
,.PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
SHELTON PRINTING CO.
PLOT PLAN
Delson Lumber Co. , Inc.
ADDRESS P O Box 858, Olympia, Washington 98507 PERMIT NO. df{�SO O o
Sec 24, T 19N, R 4W (See Attached Map) a o
LEGAL °
DESCRIPTION LOT BLK ADDITION
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS 80 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
)r4
t!.. k
I/We certify that the proposed construction will conform to the dimensions and uses showyWatove and th changes will be made without
first obtaining approval. ��
tom" _ - c - �. ✓<' � -�L 1�
NAME(S) OF OWNER(S) OF SITE & STRUCTURE(S) (PRINT) SIGNATURE OWNER(S) OR AUTHORIZED REPRESE51eATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED r.ti.� /�L �ti +-� 2�/ DATE 7.::5-
I
GHEL-ON PRINTING