HomeMy WebLinkAboutBLD0082 Addition - BLD Permit / Conditions - 3/7/1989 Q331 - - aooaq
Shorelines: p i< Plumbing:
Setback: Mechanical:
Special Interior A-, &
Conditions: FINAL:p
Mobile Home:
Smoke Detector:
_ Remarks:
Footing: i
Setback: p
Foundation
Walls:
Franing:
Fireplace:
Wood Stove:
TYPE ADDITION
Permit No. 0082 No. Floors Sq Ftg 592
Owner JACOBS, Stan Tel622-7833 Date 3-7_8g
Address 3811 SW Orchard Seattle Zip
Contractor one
Address Zip
Legal Description Wooten Lake ��o�t��9 & 3D
Direction to project site NE 501 Mountain View Drive
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Tarage Carport
Basement soft Other
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 p.
427-9670 DATE ISSUED 6
PERMIT NO.
NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
OWNER Stan Jacobs 3811 SW Orchard Seattle , Wa. 98126 622-7833
DIRECTIONS TO JOB SITE NE 501 Mountain View Dr .
PARCEL LEGAL
NUMBER 22319/50/00029 1 DESCR. Lot 29 & 30, Wooten Lake Tracts .
E MAIL ADDRESS CITY 8 STATE LICENSE N0. ZIP PHONE
CONTRACTOR 1.6�'y'�
USE OF
BUILDING Residence
CLASS
WORK O✓ NEW ADDITION XX ALTERATION REPAIR MOVE REMOVE
DESCRIBE
WORK Construct a 16 'X20 ' addition onto existing residence .
Construct prox . 300 sq . ft. outside deck.
BEDROOMS DECKS �00� tf t CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.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
SEASONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGI TRATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQ IREMENTS 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 ONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OB INING APP L FROM T BUILDI G DF➢j4RTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X WNER DATE Z X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT 9 v
D.O.T. BUILDING PLAN CHECK S
SPECIAL CONDITIONS BUILDINGGROUP * C PRE INSPECTION
f ?7160 E. lAv = ✓c� LC,- SHORELINE �' CIO
WOODSTOVE
y PLUMBING
//16'X = 2`J' MECHANICAL
3a o _ STATE BUILDING FEE
TATESURCHARGE '
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALI ATION
�2 TOTAL 16�,QQ
�4 BY W14 3 CASH CK MO