HomeMy WebLinkAboutBLD21951 Carport and Deck with Shed - BLD Application - 5/12/1988 PLOT PLAN (Ia4
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PERMIT NO. °
ADDRESS s a
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LEGAL BLK ADDITION a
DESCRIPTION LOT
SITE AREA Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq.Ft.
INSTRUCTIONS TO APPLICANT
THIS
ED WITH PERMITOAPPLI APPLT BE USED ICATION.( SCALEEN PLOT PLANS DRAWN TO
EACH BUILDING S TE MUST HAVEA SEPARATE P OT PLAN.OF NOT LESS THAN 1""20' ARE
FILED
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.
INDICATE NORTH IN CIRCI,E GRAPH SQUARES ARE 5' X 5' OR 1"-20'
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I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no charges will be made without
first obtaining approval.
NAME(f) OF OWN[R(f) Or f1T[ i fTRUC TUREIf) (PRIN TI I N TUR r OWNER(S) OR AU TM I D FtE N I
DO NOT WRITE BELOW THIS LINE
APPROVED DATE
DISTRICT AS NOTED
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 � O
427-9670 DATE ISSUED J
PERMIT
OWNER NAME MA CITY&STATE ZIP PHONE
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DIRECTIONS
TO JOB SITE 512 le'-- 4/0 0-0
PARCEL LEGAL
NUMBER Q DESCR. idWAI A.A- /►�
NAME MAILADDRESS CITY BSTATE LICENSE NO. ZfP PHONE
CONTRACTOR 'At.-
USE OF
BUILDING
CLASS
WORK O✓ NEW ADDITION ALTERATION REPAIR MOVE REMOVE
DESCRIBE
WORK (;
4 �
BEDROOMS DECKS CARPORT3L— NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTALSQ.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 SOFT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK ISCOMMENCED.
PERMANENT SHORELINE
SEASONA /?G'
O/IFY
AFFIDAVIT CONTRACTORS AFFIDAVIT
I CHAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
ON LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFOR THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APP AL F THE BUILDING DEPARNT.
XOWNER DATE B DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO S ��• O
HEALTH PUBLIC WORKS FEE
PLANNING FIRE UILD!N P 3S y�0
D.O.T. BUILDING �, f PLAN
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
40 SHORELINE
W,2 k-- 8. 1,/ WOODSTOVE
PLUMBING
MECHANICAL
_ STATE BUILDING FEE S U
STATE SURCHARGE
APPLICATION ACCEPTED BY I PLANS CH CK BY APPROVED FOR SSUANCE PERMIT VnlDAONATOTAL d`). VBY CASH MO