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HomeMy WebLinkAboutBLD0387 Addition - BLD Permit / Conditions - 4/29/1986 TYPE ADDITION Permit No. 0387 No. Floors 1 Sq Ftg 1056 Owner STEGMAN, Robe rt K. Tel 377-4668 Date 4-29-86 Address 1541 9th St. B remerton Zip Contractor Self Address Zip Legal Description Mission Cr-ek B1. 2, Lot 8 Direction to project site 210 Rainbow Lane NE Belfair Plumbing _x _ Mechanical Seer Wood Stove Fireplace Deck Garage Carport Basement Loft Other Add living room, laundry, kitchen Shorelines: ��� Plunbing: Setback: Mechanic Special Interior: Conditions: FINAL: Mobile Home: anoke Detector: Remarks: �� Footing: le _ 1-4 Setback: Fbundation Walls: Framing: o ,e f,> 10 F? ,-e Fireplace: Wood Stove: 3 . DATE / -y-t/ EY R , BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 A? c� DATE ISSUED PERMIT NO. G 3� NA — MAIL ADDRESS CITY&STATE ZIP PHONE q OWNER �� � / r C C Gt� O - G DIRECTIONS TO JOB SITE ILEGAL Q p (❑ SEE ATTACHED SHEET) DESCR.I.Z/ o /�fi/.,/,goo/ /"19//(:,, �L' • (G� //��- Cs��f ZO �� lJ L "G/� )Vl j;,5,k64LCe NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR USE OF BUILDING Class of work: ❑ NEW %ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Valuation of work: $ �O PLAN CHECK FEE _ PERMIT FEE —� SPECIAL CONDITIONS: 3 116 go BEDROOMS DECKS CARPORT ❑ NOTICE BATHROOMS_ TOTAL SO. FT. GARAGE ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES_ BASEMENT ElATTACHED ❑ OR AIR CONDITIONING. TOTAL SO. FT./J✓rlrs FIREPLACE ❑ IDETACHED ❑ 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 c tify that I am a currently registered contractor in WORK IS COMMENCED. the" th State of Washington and I aware of the FOR OFFICE USE ONLY ordinance requirements regulating the work for which t,Ve permit is issued and all work done will be in conformance therewith. PERMANENT SHORELINES 1_1 SEASONAL ❑ FLOODPLAIN ❑ Firm ]� E.D. NO. S.E.P.A. [I By 1 Special Approvals IN OUT YES APPROVED NO Lic. No. Date 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 BUILDING DEPT. 6 6 of the Mason County ordinance requirements for which this permit is issued a that all work done will ROAD ACCESS be in conformance therew' MOTOR VEHICLE PERMIT aeACHECK BY APPLICATION ACCEPTED BY PLANS CH APPROVED FOR ISSUANCE Owner C Q ���� ate_ ./ BY .C�d� PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH CHRISTMASTOWN PRINTING PLOT PLAN ADDRESS /n /`/I��/C7���/ `'/i �� / ' !•.Iv-� /lJ�/L�'l� PERMIT NO. f g 11 D LEGAL DESCRIPTION LOT BLK ,( ADDITION /`� ��� C/l'F" - 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. I INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' /T 'I Fir, �I y -t< , N all O r L,b ' Lc A PF 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 OWNERS) OF SITE 6 STRUCTURE(S) (PRINT) tIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE CHRISTMASTOWN PRINTING