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HomeMy WebLinkAboutBLD6653 Fuel Storage Tanks and Pumps - BLD Permit / Conditions - 6/16/1980 Mason Co. Fire Dist. #2 #6653-, 6-16-80 Old Belfair Hwy. 1 mi. from Belfair, 1st large bld.g. on right (green) S 1/2 of Tr. 37, NE1/4 of 29-23-1 Fuel Storage Tanks & Pumps $5,000.00 C `- `� BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 �l DATE ISSUED PERMIT NO. � NAME MAIL ADDRESS CITY&STATE ZIP PH OWNER �1! �- UZ' ©'f` / �t/�i,, "a. �85 S- .. DIRECTION TO J O B E ©1� f/' C7 N/cT / //!r. f 5,� Ace i LEGAL -�7 i ! (❑ SEE ATTACHED SHEET) Q� 4 DESCR. 9t{t� 2 ( �"r� � 37 .,� Scc4i 41 Z alwaf_ NAME MAIL ADDRESS pp CITY&STATE LICENSE NO. PHONE CONTRACTOR ' 7 Ce �" `l '�r f 1Xs / DO r_ ;A- a' J C_'#2Z.GZ 6 .Z75"S9W USE OF V� BUILDING FIACC S4c=^Qq - Class of work: 5i(NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: �r Gizl- e!q ". Valuation of work: $ JW PLAN CHECK FEE PERMIT FEY SPECIAV CONDITIONS: BEDROOMS — {DECKS — •CARPORT [] NOTICE BATHROOMS (TOTAL SQ. FT. GARAGE [I ATTACHED ', ; SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT C OR AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE ❑ IDETACHED '._ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER I certify that I am a currently registered contractor In WORK IS COMMENCED. the State of Washington and I the aware of the FOR OFFICE USE ONLY ordinance requirements regulating the work for which the permit is issued and all work done will be in conformance therewith. PERMANENT SHORELINES SEASONA [ I FLOODPLAIN Firm JohnSo � E.D. NO. S.E.P.A. I 6 "�•Q�! �C APPROVED By l/ Special Approvals IN OUT YES NO Lic. No. JAI' SIC- *ZZ6 44 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. of the Mason County ordinance requirements for which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOM VEHICL Pf RMIT AP I TION P D BY PLANS CHECK BY APPROVED FOR ISSUANCE Owner __ Date,_—I BY PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDAT ON, CK. M.O. CASH PLOT PLAN ADDRESS PERMIT NO. � °s o -_ LEGAL s o DESCRIPTION LOT BLK ADDITION 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 P"'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' IT IT o � ` -r a AV i -` P111C E1 E S1.00 © V ' 1z �Z S Y ri n m l 1/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(S) OF SITE a STRUCTURES) (PRINT) SIGNATURE-OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE �) APPROVED (� DATE a DISTRICT AS NOTED 6 SHELTON PRINTING