HomeMy WebLinkAboutBLD11022 Garage - BLD Permit / Conditions - 7/21/1981 WHITCOMB, Jerry #11022
P. 0. Box 869, Shelton ".
�-- 07-16-81
Red house on left on Walker Park Rd.
Lot 3, Block 3, W1/2 of Lot 4 of Block 3,
Walker Park Addition
Garage Contractor - Lumbermen's
$3,360.00 Shoreline Exemption
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED 7' j,` J
PERMIT NO. 1//v
OWNER NAME MAIL ADDRESS CITY STATE ZIP PHONE
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DIRECTIONS (�
TO JOB SITE
LEGAL. /
DESCR �. � /� /� (❑ SEE ATTACHED SHEET)
GGG C- l.,
NAME MAIL.ADDRESS ` CITY 8 STATE LICENSE NO. PHONE ��(
CONTRACTOR - C S� t�Z� Z�X
iY W i u
USE OF (`
BUILDING �_
Class of work: ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
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Valuation of work: $ PLAN CHECK FEE PERMIT F 3'J
SPECIAL CONDITIO S:
BEDROOMS I DECKS CARPORT ❑ NOTICE
BATHROOMS (TOTAL SQ. FT. GARAGEt
ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NQT 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
Firm
SEASONAL ❑ FLOODPLA LJ
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E.D. NO. S.E.P.A. L
By Special Approvals IN OUT YES APPROVED NO
Lic. No. hl ✓J t' ULJ ?,-1U1Date 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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
P ICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date BY
PLAN CHECK VALIDATION CK, M.O. CASH PERMIT VALIDATION K. M.O. CASH
PLOT PLAN
_ADDRESS � .;t J y PERMIT NO Wo o
4 0
= s
s o
LEGAL Y�1� r' o
DESCRIPTION LOT `
Y S A BLK ADDITION �+ \ 2g � ►� o
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 (L
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN-
SIONS.SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA-
TION A"ID 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.
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INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
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I/We certify that the proposed construction will conform to the dimensi0ht and uses shown above and that no changes will be made without
first obtaining approval.
NAME(S) OF OWNER($) OF SITE R STRUCTURE(S) (PRINT) IGNA UR OF OW R(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED A l
DISTRICT AS NOTED DATE
BHELTON PRINTING