HomeMy WebLinkAboutBLD15443 Final Deck - BLD Permit / Conditions - 8/28/1984 PAULUS, Albert _ -• #15443
4-25-84
E200' , S-1/2 SW-1/4, NW-1/4 13=22-3
NE 2021 Tahuya River Rd.
Tahuya, Wash. 98588 275-4713
Follow riv er road up 2 miles from canal (Northshore)
Contractor
Self
Deck 12x20
$1,200.00
�aa�3 --IQ3 -Ono 10
Shorelines:,e/L-
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing: _
Mechanical:
Roof:
Exterior:
Interior :
Final:
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426 5593 �
DATE ISSUED
PERMIT NO.
OWNER I NAME MAIL ADDRESS CITY&STATE ZIP PHONE
r, 7- P/1 j U 1/t )-ozl 7-AHO A iVram HU A w e Frs 8-f ,Z7S'q>/
DIRECTIONS
TO JOB SITE %% cJ /r141 r R 0 A -Z / df f -/Q 0 Yh C'R 0?c
LEGAL �/ �1, (❑ SEE ATTACHED S T)
DESCR. �� s � s� •/7� �1�L� �� cal Q-13
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING p F CA-
Class of work: IxNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: /
i
(j Dec
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS_ I DECKS ^^ CARPORT i' NOTICE
BATHROOMS__ TOTAL SO. F C, GARAGE
ATTACHED I SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT G OR AIR CONDITIONING.
TOTAL SO. FIZ14497 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 that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I am aware of the FOR OFFICE USE ONLY
or inance requirements regulating the work for which
t e permit is issued and all work done will be in
nformance therewith. PERMANENT SHORELINES
SEASONAL i FLOODPLAIN i 1
Fir
E.D. NO. S.E.P.A. I ;
By Special Approvals IN OUT YES APPROVED NO
Lic. — Date ZONING
PLANNING DEPT. ZU
OWNERS AFFIDAVIT HEALTH DEPT.
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
u S_C�/ LICAT N ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner —Date, / 0 / .0 /'//lxe � B
t �� irfv
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS PERMIT NO. o i
= v
n >
LEGAL z
DESCRIPTION LOT BLK ADDITION u
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 A"0D 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.
NINDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
e
t' Y
L ,
�1
I -
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.
NAME(S) OF OWNERS) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
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