HomeMy WebLinkAboutBLD0237 Final Pole Bldg - BLD Permit / Conditions - 7/10/1990 Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:,g f o 6
Mob i lT Hdme:
Smoke Detector:
Remarks:
oot ing: 6�.v.s/� -1.6 7 D <
Setback.
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
r
l TYPE POLE BLDG
Permit No. 0237 No. Floors Sq Ftg 576
Owner BOGUE, Dennis Tel Date 2-28-90
Address 1521 NE Tahuya River Rd Tahuy_ Zip
Contractor Self
Address Zip
Legal Description Tr 5 SE.SW 12-22-3
Direction to project site Hwy 3 to Belfair, left on Old Belfair
Bremerton FW, left on Northshore Rd. Right on Belfair Tahij,ya Rd_ Ieft
on Belfair Tahu a Rd. Lea
Rd-
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck -Carage import
Basement Loft Other
(DU F r)
�I
BUILDING
SPECIAL CONDITIONS BUILDING GI
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. Q ✓
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER / "WAM
DIRECTIONS
TO JOB SITE a � ,! '46
oa h A .4 o -
PARCEL �i J6� DESCRLEGAL. , T/: J�
NUMBER C�CJv 'Z-ZZ--' 3
NAME r- MAIL ADDRESS CITY& SATE_ - f LI SE NO. ZIP PHONE
CONTRACTOR a? —
USE OF
BUILDING 573RAe,,C 94o s✓O S
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK e7;1
BEDROOMS_ DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS_ TOTALSQ.FT. GARAGE CONDITIONING.
NO.OF STORIES -/-- BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SO.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT-A' SHORELINE
SEASONAL
OWNERS A IDAVIT CONTRACTORS AFFIDAVIT
I 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
REQUIREME 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 CONFO MANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAININ PPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X R E AW'OZ 6 `�� X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION 8 �C
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT �C):�C)
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP PRE-INSPECTION
_ Q SHORELINE
WOODSTOVE
C� PLUMBING
MECHANICAL
STATE BUILDING FEE y`j
STATESURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY ;2A- �FOUANCE PERMIT VALIDATIONTOTAL
BYCASH CK MO
r
PLOT PLAN
ADDRESS PERMIT NO. 4 0
= s
n s
LEGAL
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'
eY c
lap
' r I ,
s
(
L
rri
l�
-j
I/We certify that the proposed construction will conform to the dimensidns and uses shown above and that no changes will be made without
first obtaining approval.
NAMES) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REP ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE