HomeMy WebLinkAboutBLD92-0929 - BLD Permit / Conditions - 9/4/1992 MASON COUNTY
Mason County 'dg. 111 426 , Cedar
P.O Box 186 Shelton, Wasfington 98584
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MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Ilan, Washington hington 98584
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BUThDG PERMIT APPLICATION
PLEA PRINT
#1 Owner
"bo le# 24 `'
Site Addr ss
City r .
Directions toJob Site LienC er q
Zip
'Tale Solder
Address___________________________________________________________
City St
#2 Contractor Name 4,_Contractor Reg#
dress t on to , I /
City St hone
#3 If septic is located on project site, include records.
Connect to Septic? public Water Supply Well
(If residential, proof of potable water may be required)
#4 Parcel N . __. V
tegal Description .
Bu.il '° g Square ' otage: ( stinq sedgy
Est Fl 2nd I. / 3rd 1_ ,
_
Basement I Dew 1 #bedrooms i7 #bat. xro /
arage I O Carport__/_ L (Circle: Attached or Detached?) .
Jf* 3 Other ,q ft
#6 Use of building r , u- ; Leit& escrthe work
#7Type of Job: New d. Alt Repair____ Demolition____
Woodsto a Re-Roof _ Bulkhead____ Other
Model Year Make Model
Leugch Width Serial No.
#8edro #Bachroo pe of Heat
Anywater on or adjacent ct rocercy sal:water lake 'r � _
"e' er _ cn w c'a seasonal u
oche `
Show following OnO the site plan
Lcc Limes - Flood Zones
sting Scturs fences
Structure Setbacks Driveways
water ' nee Shorelines
Drainage Plan Topography
septic Systems Wells
Propo is Easements
Name "` w Street Scale: 3
Name c g Street Date:
- ? IT DRAW S P B
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Tt
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PL DRAw T0POc3RApWf PROtLZ 3ELQW
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.7 *4,,•" Via. ac.i =tea
Vent Syszes X 300.
i9at Basis 6 Ve FsIC 3 .00
N « Bai „ s/C r'es:9C�5.rs
Shower
Water Sr
Ladj Waster
S
loor D
Hai'
Dish skier cc
i _as
Other
C
p Coolers
PermitBasic ee Fire Su p reson
s. c` .,
C cir..
Reloc/Repajr 6.0Q
_Gas Outlets a a-r X 2.00
No, Viiel es Wocdstove
100 K th
_Fu >-..LOOK 3T
" .oar 6 .00 e 3 Fey
Eea TO $NO ,$"
TI : IS ERT BECOMES Nur.L An v9ECOS NULL AND VOIDY WORK OR CONSTRUCrION
AORIZ IS NOT WITRIN 1.80 DAYS, OR IF CONSTRUrrION OR WORK
IS SUSPD OR AONt FOR A. PERIOD OP 180 DAYS AT ANYTIME AFTER WORK
Is coc
t TIFT THAT t m xepT F*0 tlt f tIE ICERTIFY MAT I AM A ItEWTL7 REGISTERED TR
ACT
T % REGt TIQlt LAW *CW 1 .Z7 , AM A 'E IN MIRE STATE a sstcropAFRa I Aid A F TNI
T't o*oiwscE ow TS FO u **cER tR TS AE TING TIEFO aaa
MIS RMtTwIS t TWAT ALL DOsE w1u. it a VWPitt IS I ALL R SILL AE Dt
REWTIh, $0 O4AaS S*ALL $E ME MAMC£ F$fE5+IT$. $O S k.L i
WI t FIRST a TAIRIRIIG AL FR Cm LIRE SUILDI$G wil T FIRST TAIRtNG APPROVAL F*4 tME tRUILOt*O
KAI� OA's"
aet per, . O to: Oeparent o Gera1ar °i
426 Ai. Cedar/ ,0. Box 186, Shelton, PEA 98584 427-9670/1-800-562 -5628
FOR OFFICIAL 17SE C Acoeotad by: Dace
FOR t Z
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fluildq P1a Review
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Other:
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II II I
II II Pl ing Fey I It
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II . II ft I II
II if Ii cc c Fey I II
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II II13il ding a Fees I II