HomeMy WebLinkAboutBLD12683 Final Repair Dock and Piling - BLD Permit / Conditions - 2/25/1985 Johnsont Bruce M. #12683
564-6739, Tacoma 7/7/82
Mading's Sunny Shore Addition #6, Lot 78
.9 mile north of Mason Lake Marina.
Repair Dock & Piling Contractor:
P.D.B. Pile Driving
$2,346.00 Shoreline Exemption
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final: 7
Stop Work:
Mobile Home:
Remarks:
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 -
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
is C- Joyj Sar1 503 /Ao_yIor DriYe_ cow.a WA 18' G r6Ljr-67.3`7
DIRECTIONS _
TO JOB SITE p �- yt��� Ytest�, cr /V(0.so„ a Q /t/�ar��q
LEGAL ` 1 (❑ SEE AT
�tT,ACHED SHEET)/
DESCR. L—c 1 -1 F /lG�TYI tS Sccnn flore '4"i'ti0t7 No.0 Afrzg-eh Lakz_
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR * r t
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
Describe work:
O e. Q'frr , �i —9 l K 31? , ri
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS {DECKS — CARPORT ❑ NOTICE
BATHROOMS I TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT f] OR AIR CONDITIONING.
TOTAL SC FT. FIREPLACE I i DETACHED 11
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 work done will be in
conformance therewith. PERMANENT ❑ SHORELINES
SEASONAL ❑ FLOODPLAIN ❑
Firm
E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT. 192- -7
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
of the Mason County ordinance requirements for BUILDING DEPT. b(�
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewi MOTOR VEHICLE PERMIT
A LIGATION CE TEQ BY PL NS HECK BY APPROVED FOR ISSUANCE
Owner Date.
PL�fi CHECK VALIDATION CK. M.O. CASH V L43ERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS /4- GC S PERMIT NO. f o
LEGAL
LOT McL9-jng j S�-n� l-o �
r S �e_ Q1Q�tid ' n
DESCRIPTION BILK ADDITION
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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 At"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 1"=20'
o Ft
.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. —�
u-t 9L
NAME(S) OF OWNER(S) OF SITE 6 STRUC TUREIS) (PRINT) SIGNATURE OF OWNERS) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
6HELTON PRINTIN3