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HomeMy WebLinkAboutBLD23253 Replace Four Wood Pilings - BLD Application - 1/20/1989 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. �� OWNER AME A/ (),#AJ13aC=U MAILADDRESS CITY&STATE ZIP PHONE T DIRECTIONS TO JOB SITE / 2 ci�l V .✓, W d 1 ILEGA NUMBERPARCEL 9 DESCR. J J- p23 CONTRACTOR , NAME MAILAD RESS CITY&STATE LICENSE NO. ZIP PHONE 0133 -oZ3 -licoz`i USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR ✓ MOVE TRiMOVE WORK ✓ DESCRIBE , WORK /� (,� Dlll- W l BEDROOMS DECKS CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTALSQ.FT. GARAGE CONDITIONING. NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE J� SEASONAL OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT 1 AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGIS RATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQU EMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN IN C NFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBLNING PPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. X DATE X BY _ DATE FOR OFFICE USE ONLY DEPARTMENT YES NO DEPARTMENT YesPPRovEINO BUILDING VALUATION HEALTH PUBLIC WORKS FEE ' PLANNING FIRE BUILDING PERMIT yG� D.O.T. BUILDING GC.�� PLAN CHECK . SPECIAL CONDITIONS BUILDING GROUP iozL F PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE r� APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FORZTA PERMIT VALIDATION TOTAL '-- BY M< CASH CK MO J f MASON COUNTY DEPARTMENT of GENERAL SERVICES Courthouse Annex 2 N. Fourth & W. Cedar P.O. Box 186 Shelton, Washington 98584 (206) 426-5593 building environmental health maintenance parks&recreation planning sewer&water Zw t1U Re;114Campbel -While Marina Bi 1 N Hwy 101 Hoodsport, Wash. 98548 Re: Building Permit to Replace Pilings Dear Mr. Campbell : Some time ago you made application through this office to obtain a building permit. Please be advised the permit is ready to be issued and can be called for at this time. If you are unable to call in person, a check in the amount of $ 70.25 can be sent to us and we will return your permit by mail. This permit becomes null and void if not called for within 180 days of the date of application. We hope to hear from you soon. Sincerely, Evelyn Fuller Receptionist �J eXL � I u i JAN 0 1999 GENERAL SERVICES yf, DAVIES HOMES AND _ o ES GENERAL CONSTRUCTION -/ PAUL8 A9 52 RESIDENTIAL • COMMERCIAL P.O.BOX 444 HOODSPORT,WA 98548 N1sc wq �� I IS b () 0 1W 04 APPROVED MASON BUILDING INSPECTOR C}! NG SUBJECT 'rO APPROVAL DA-VI-EH 198BK 2 Gig �-o l�G 8�.CZ-L7ez II �. r1osc�s� nE�U �4ddc�sS 877 - Q1 ZZ i O �! - - f' © O O � � I !fy i I l./i bvf s4ce-;,�X- 064 PLOT PLAN ADDRESS PERMIT NO. o 0 / /L -ins a o LEGAL 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. 2LINDI� NORTH IN CIR LE "O H SQUARES ARE 5' X 5' OR 1"=20' k- I/We certify that the proposed construction will conform to the dimensiclns and uses shown abo and that no changes will be made without first obtaining approval. It NAME(S) OF OWNER(S) OF SITE h STRUCTURE(S) (PRINT) SIGNATURE OF OWNERS) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE SHELTON PRINTING