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HomeMy WebLinkAboutBLD11562 Utility Storage and Shoreline Exemption - BLD Permit / Conditions - 10/12/1981 Cothary, Walter G. #11562 10/12/81 Cothary Beach Tracts #2, Block 2, Lots 23 & 24 10 miles from BelfAir on North Shore Road (St. It. 2, Box 580, Belfatt) Utility Storage Contractor: Self i $1,632.00 Shoreline Exemption j A i i i BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426.5593 ' DATE ISSUED PERMIT NO. , I OWNER E MAIL DDRE S CITYd TAT ZIP PHONE OIRECTIO S ,�55 TO JOB SITE//""��!//ffJS -yrh'j/.O /�jp DESCRLEGAL. t; o/�C//- �CQG.0 �llGf �f GlG� 2.3 swz/ OCEE�A'-') MEET) NAM MAIL ADDRESS%%% CITY d STATE LICENSE NO. I PHONE CONTRACTOR 1S�P G0�5. C��4�1 USE OF //// �s�vf�rye GG1'>•!,l 7DO�S BUILDING T Class of work: ANEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: r '&/ Valuation of work: S J /3� PLAN CHECK FEE PERMIT FE� SPECIAL CONDITIONS: BEDROOMS DECKS CARPORT CI NOTICE BATHROOMS TOTAL SO. FT.__ GARAGE ❑ ATTACHED O SEPARATE PERMITS ARE REOUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING. I TOTAL SO. FT FIREPLACE ❑ DETACHED ❑ THIS PERMIT BECOMES NULL AND VOID IF WORK ORCONSTRUGTION 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. ih nlate of Washington and I am aware of the FOR OFFICE USE ONLY ordia equirementS regulating the work for which the permit I Led and all work done be in conformance there PERMANENT ❑ SHORELINES ❑ SEASONAL ❑ FLOODPLAIN ❑ Firm E.D. NO. S.E.P.A. ❑ By Special Approvals IN OUT YES APPROVED NO Li o. 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 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 Owner�/r Date APPLICATION ACC EPTED BY PLANS CHECK BY I APPROV�D,.F—OR ISSUANCE JIXIrt�Uu P N CHEC VALIDATION K. M.O. CASH ERMIT VALIDATION CK. I M.O. CASH i EXEMPTION FROM SHORELINE MANAGEMENT ACT SUBSTANTIAL DEVELOPMENT PrE�RMIT REQUIREMENT & (name and address of he applicant) The proposal by SrNYIP/ to undertake (name -of applicant the following development cons fruC c P (be specific) I - upon the folowing property c(9Jh4t j RP, Tr-ad-c- ( legal des iption; i .e. , section to the nearest quarter section) within qov4 Cn afs� and/or Its associated (name of wate area) wetlands is exempt from the requirement of a substantial development permit because the development IS nnpfpr-L- ai21 t ciGTti �r? ti rh r7 c - qrl '7 ( identify exemptions as outlined In WAC 173-14-040) (Corps Public Notice Number if available) The proposed development is consistent or Inconsistent with: CHECK ONE CONSISTENT INCONSISTENT Policies of the Shoreline Manage ent Act. The guidelines of the Department of X Ecology where no master program has been finally approved or adopted by the department. 1 The master program. 4I,2/,I/ (date) (SignaTiFre of Authorize al Govern- ment Official ) I I • , !/ MIN . . ■■■■■■■■■■!■■�'■r2ZJ►tl'�'lC- ■t■■■■1■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■ri�i!'�ili1■i■ ■■vG'Gie■■■■■■■