HomeMy WebLinkAboutBLD10534 Final Carport - BLD Permit / Conditions - 4/28/1982 i
McGOWAN, Ken #10534
05-06-81
Take road Just before bridge before entering Allyn -
go right to water
32-22-1, NE 1/4 NW 1/4
Contractor
Jerry H. Wright
Carport Shoreline Exemption
$3,850.00
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BUILDING PERMIT APPLICATION
MASON COUNTY IZ2321,� ,OZI?C
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. d`�
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
Z-6,20
DIRECTIONS TO JOB SITE
LEGAL lag (❑SEE ATTACHED SHEET)
DESCR.
CONTRACTOR —22—
NAME M IL ADDRESS CITY&STATE LICENSE NO. PHONE
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USE OF A,
BUILDING
Class of work: KNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: PLAN CHECK FEE ,t PERMIT KfE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ DETACHED ❑
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 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
SEASONAL ❑ FLOODPLAIN ❑
Firm ( J lI A. �w19�.;�312 E.D. NO. S.E.P.A. ❑
By e
Special Approvals IN OUT YES APPROVED NO
Lic. No. ` ^'/,l Date rO_ ZONING
3Sv fC r 6 PLANNING DEPT. (10
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. MOTOR VEHICLE PERMIT
APPLICATION ACCEPT D BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date. 2�3BY
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LAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN IZ,SZ 1 - V L�
ADDRESS G��D + l.TG 4.4 mac.G "t PERMIT NO. � c
= s
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LEGAL '
DESCRIPTION A Z LOT 4 IVG! %_BLK ADDITION n
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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 t"=ZO' 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 Pl"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.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X '�O 1"=20'
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I/We certify that the proposed construction yvill cgnform to the dimensions and uses shown above and that no changes will be made without
first obtaining approval
NAME(S) OF OWNERS)OF SITE a STRUCTURES) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT IN /TE BE OW TNIS LINE
APPROVED (� �� Nez
DISTRICT AS NOTED DATE
•HELTON PRINTING