HomeMy WebLinkAboutBLD15469 Deck - BLD Permit / Conditions - 5/1/1984r
COPELAND, Mike #15469
5-1-84
Mading Sunny Shore Div 6, Lot 72
221 Monty-Elmard
Montesano, Wash 98565 249-5689
1 mile North of Mason Lake Marina on Mason Lake Drive E.
Contrator
Roger Denny
Deck
$4,100.00
i
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final:
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
Niftt ;& VOID By I�
ATE ;-F-91 BY 0,/- _
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
/ICF (°0kraly 221 1 eb019XJ ,v�SRNu wA 5-6 5- 2 V?_5bY`1
DIRECTIONS
TO JOB SITE / ,4 At/
LEGAL (O SEE ATTACHED SHEET)
DESCR. �/ V tf L 72
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
{/I eACK,0K e
USE OF
BUILDING e
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: /
C 1`1 z FCK UN N7 oF / i 48t c- c' G rr/A[/C z,✓A
/� 06 f 67 ivAcX c4,4 f/T.y J/,CIF (goo O)wc / crx
! - -
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
n a
SPECIAL CONDITIONS:
BEDROOMS I DECKS----- CARPORT Cl NOTICE
BATHROOMS ITOTAL SQ. FT. GARAGE [ '
ATTACHED I SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT i] OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE Li 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
jii't,01/
ertify that I am a currently registered contractor in WORK IS COMMENCED.
State of Washington and I am aware of the FOR OFFICE USE ONLY
inance requirements regulating the work for which
permit is issued and all work done will be in
conformance therewith. PERMANENT Ll SHORELINES I 1
Y0 AGOI�/A/P�G�i�II�N� SEASONAL [ FLOODPLAIN iL�E.D. NO. S.E.P.A. C1
-L� Special Approvals IN OUT YES APPROVED NO
Lic. No."A&Pl 92 S 7 Date y-173
ZONING
PLANNING 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 BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CAS'
PLOT PLAN
ADDRESS ZZI /Yl0 Uy-�ZL�1/� �PD /�7�.1�Jl�ry!P�U L�iN �fDf PERMIT NO. f o
Z o
n 1
407
LEGAL
DESCRIPTION LOT BLK ADDITION u
I
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.
7j INDICATE NORTH IN CIRCLE Gfj�API�SQUARES ARE 5' X 5' OR 1"=20'
�'
� ,,� U yl
14'
IA St iL
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 SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER ) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
6HELTON PRINTIN3