HomeMy WebLinkAboutBLD12983 Final Bulkhead - BLD Permit / Conditions - 1/30/1985 Pearson, V. M. #12983
No Phone Listed 9/13/82
Mading Sunny Shore Addition, #6, Tract 67
E 2901 Mason Lake Drive East
Bulkhead Contractor:
200 Sq. Ft. None Listed
James Excavating
$1,600.00 Shoreline Exemption
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final e .s
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 N ME MAIL ADDRESS CITY TA ZIP CPHONE
DIRECTIONS n- -
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. �j -I%.
CONTRACTOR
NAME&4 MAIL ADDRESS CIfY 8 STATE LICENSE NO. PHONE
USE OF
BUILDING
� 65Wa
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
J � �
i
Valuation of work: $ PLAN CHECK FEE /Y PERMIT F
SPECIAL CONDITION :
BEDROOMS (DECKS CARPORT L' NOTICE
BATHROOMS (TOTAL SO. FT. GARAGE ['
ATTACHED ;_: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT i ; OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ! 1 DETACHED L. 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 the
aware of the FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all w done will be in
4
Conformance is PERMANENT SHORELINES
SEASONAL Cl FLOODPLAIN Li
Irm E.D. NO. S.E.P.A. I l
By Special Approvals IN OUT YES APPROVED NO
Lic. No. �C+ 2 L�Date fa ZONING
PLA G DEPT.
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
of the Mason County ordinance requirements for UILDING DEPT. /3 O
which this permit is issued and that all work done will CCESS
be in conf mance therewith. MOTOR VEHICLE PERMIT
PLICATION CC;PIED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Om ner _ Date
PL N CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.O. CASH
r7�n r C n PLOT PLAN yo i "t000n �.Mom- f
. � S
ADDRESS PERMIT NO. 4 0
LEGA� l` I
114�7
DESCRIPTION LOT BILK 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"'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.
0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
- 4 64
MOWN
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 OWNER(S) OF S1TE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED y
DISTRICT AS NOTED DATE
SHELTON PR!NTINi