HomeMy WebLinkAboutBLD0373 Storage Addition - BLD Permit / Conditions - 5/14/1991 1
Shorelines: Plunbing:
Setback: Mechanica
Special Interior:
Conditions: FINAL:
Mobile Hcane
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Fran ing
Fireplace:
Wood Stove:
TYPE STORAGE ADDITION
Permit No. 0373 No. Floors 1 Sq Ftg 38_ 4 _
Owner S M. Tel 275-0822 Date 5-14-
Address 4700 Davis St. SW Bremerton Zip
Contractor Self ip
Address
Legal Description Collins Lake Blk 3 lot 53
Direction to project site Lot 53 Collins Place at
Collins Lake
P tm ing Mec a-- Sewer vWbood Stove
Fireplace Deck arage arport
Basement —Loft Other
L
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED '.)
/
PERMIT NO.0 '3 73
NAME MAIL ADDRESS CITY B STATE ZIP j,� PHONE Z
OWNER S / T, �" 9 2 %Ji �Pi
DIRECTIONS
TO JOB SITE
PARCEL -.S;2 LEGAL.IC 61-,41 rIS 41(% 5 64K J'07 v~_y
NUMBER DESCR.
NAME MAILADDRESS CITY BSTATE LICENSE NO. ZIP PHONE
CONTRACTOR 15115 4�:
USE OF
BUILDING 5.7- R
CLASS OF NEW ADDITION�j ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE r D
WORK „�U 1 Z
F
BEDROOMS DECKS CARPORT /_41 NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS /VO TOTAL SQ.FT. GARAGE _ V ( _ 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 Art 6 ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL f!!7:�
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
REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS 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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
XOWNER 1 , DATE '` ! XBY _ — DATE
FOR OFFICE USE ONLY
DEPARTMENT YES APPROVED
JO DEPARTMENT YES NoBUILDING VALUATION 3
HEALTH S� PUBLIC WORKS FEE
PLANNING 4,4 FIRE BUILDING PERMIT y s v
D.O.T. BUILDING 0111- S -JY y PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP//--/ PRE-INSPECTION
OS/ !` iElQ �i9X. SHORELINE
07 y = 3 S 'y J = 3a� `� WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE
PLICATION ACCEPTED BY PLANS CHECK BY APPR D F R ISSUANCE PERMIT VALIDATION
TOTAL
BY CASH C MO
BUILDING PERMIT PLOT PLAN
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. Box 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAME MAIL ADDRES CITY ZIP _ PHONE
OWNER S'7' ? 4 od A.9 y 'PRrp.ti��.�'
DIRECTIONS
TO JOB SITE
PARCEL LEGAL
NUMBER DESCR.
Indicate below: 0 Property lines and dimensions.
e Easements and roads.
6-Septic, drainfield and reserve area, or sewer.
O Septic tank and drainfield setback distances from foundations.
O Location of proposed construction on property.
O Building &septic system setback distances from all property lines& easements.
Indicate North O Well and water line.
In Circle O Saltwater, lakes, rivers, streams,wetlands, drainage.
O Attach copy of septic system as built or septic permit approval.
O Indicate topography profile of property and structure on reverse side.
� � I
IL
.1
V '
s
r
-
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.
SIGNATURE OF oWNER(S)OR AUTHORIZED RE ESENTATIVE
DO NOT WRIT4 BELOW THIS LINE—
DISTRICT AS NOTED ��( yl DAT —/
TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE