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HomeMy WebLinkAboutBLD22857 Addition - BLD Permit / Conditions - 10/7/1988 Shorelines: Plumbing: Setback: Mechanical : Special Interior: Conditions: FINAL: Mob i 1 e Home: Smoke Detector: Remarks: Footing: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: TYPE ADDITION Permit No. 22857 No. Floors Sq Ftg 264 Owner CRAWF RD, Ran y Tel--gT7-7474 Date-0-7----87- Address P O Box 561 Graham Zip Contractorse-LE Address Zip Legal Description Wooten Lake Tr. 52 Direction to project site South on Hwy 300 past Belfair St. Pk. 1/2 mile, turn right on Tahuya Rd. , go 6.2 miles, turn right at Stop, go 3/4 mile, sign on left Plumbing Mechanical Sewer Wood Stove Fireplace Deck Garage Carport Basement Loft Other BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED/C'�' O� PERMIT OWNER AME AIL ADDRESS CITY BSTATE ZIP PHONE --�, (,�a 83� 8y 7 3117 DIRECTIONS CtY'�p TO JOB SITE 5 d � 300 Ad S.T �1 pa 1C �2 LA�c Ile ✓Li 1C Gu NUMBERC c l9` 5�9 600-5 1 ESCR. Ze,)ee7 /Q,L:f, Tr J NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. ZIP PHONE CONTRACTOR �( USE OF BUILDING CLASS OF NEW ON ALTERATION REPAIR MOVE REMOVE WORK r DESCRIBE WORK BEDROOMS 2- DECKS CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING. NO.OF STORIES It BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SQ.FT./L(a FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL-, r 4 6 OWNERS AFFIDAVIT i 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 REGISTRA ON LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREM NTS 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 CONF RMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAJ VAPPROVAL FROM THE ILDING DEPARTMENT. > APPROVAL FROM THE BUILDING DEPARTMENT. X WN ATE ( ©�7 X BY DATE FOR OFFICE USE ONLY DEPARTMENT YESPPROVE NO DEPARTMENT YESPPROVENO BUILDING VALUATION 0 HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECKg' SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION Cs d 3 0 2 QmKwA 31,61, WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE r STATE SURCHARGE APPLICATION ACCEPTED BY PLANS C CK BY APPROVE FOR ISSUANCE PERMIT VALIDATION TOTAL ,,-? BY CASH CK MO PLOT PLAN ADDRESS PERMIT NO. i o z ° n s s o ' 0 LEGAL DESCRIPTION LOT BLK ADDITION u SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS _Sci. 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 AND 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. r INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' 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. NAME(S) OF OWNER(!) OF SITE a STRUCTURES! (PRINT) AIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE