HomeMy WebLinkAboutBLD15382 Final Replace Deck - BLD Permit / Conditions - 6/14/1985 MCDOUGALL, Duane #15382
4-13-84
Madings Sunny Shore Div 6, Lot 68
E 2791 Mason Lake Drive East
Grapeview, Wash.
Contractor
Self
Replace Deck
$2,620.00
Shorelines:
Setback:
Special Conditiods:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final: �=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. �S
OWNER NAME MAIL ADDRESS CITY&STATE / ZIP PHONE
DIRECTIONS
TO JOB SITE
LEGAL /- (❑ SEE ATTACHED SHEET)
DESCR. S Lvih �r�'s'� �7/I �C 6,(' -
NAME MAIL ADDRESS " CITY&STATE LICENSE NO. PHONE
CONTRACTOR 1Du*Ut_- Lc /�%L'1.Lt't2Lj .�L�6i/u ,� 2 E�J�/ �C Jr•�3/�S'7
USE OF
� " 3�-
(�1�-� D c c �. ��/7C i/ �04__BUILDING 'R -
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ErftPAIR ❑ MOVE ❑ REMOVE
Describe work:
R c L,e-c D cz fc - ?vl7p 4/v pi c ) :moo,o ro ro i is 7 X /D
Valuation of work: $ ti C —PLAN CH FEE PERMIT FEE
SPECIAL CONDITIONS
BEDROOMS_ I DECKS CARPORT [I NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE L!
ATTACHED '' SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT!; OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE I] DETACHED Ll
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 St to of Washington and I am aware of the FOR OFFICE US ONLY
ordin ce requirements regulating the work for which
the rmit is issued and all work done will be in
conffr1mance therewith. PERMANENT SHORELINES
SEASONAL i FLOODPLAIN I i
Firm
E.D. NO. S.E.P.A. I
By Special Approvals IN OUT YES APPROVED NO
Lic. Date ZONING .�-
PLANNING DEPT. 9 / :-
HEALTH DEPT.
OWNERS AFFIDAVIT
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
MA in confo�an�ce� th r with. MOTOR VEHICLE PERMIT
/►�lC I,//, •- ? ICAT N ACCEPTED BY PLANSJeHECK BY APPROVE FOR ISSUANCE
Owner `�"� Date" B��'
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ch_< 11.. _
ADDRESS r 2 791 /VJ�FSc>y L' /9Kc 0 c PERMIT NO. f
0
n�
_
LEGAL ��r
DESCRIPTION LOT BLK ADDITION a "
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 AkID 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'
I
i
v
C f (/
- 1
I/We certify that the proposed construction will conform to the dimensims and uses shown above and that no changes will be made without
first obtaining approval.
NAME(S) OF OWNER(S) OF SITE R STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
AD ` DATE
DISTRICT ASS NOTED /� 7 Z.t
SHELTON PRINTIN3