HomeMy WebLinkAboutBLD9368 Shop - BLD Permit / Conditions - 1/27/1981 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED �
PERMIT NO.
MAIL ADDRESS CITY 8 STATE ZIP PHONE
OWNER NAME y
Lake Cushman i a �TL I'c` .�
DIRECTIONS
TO JOB SITE Follow signs to Pro Golf Shop lst driveway on left past Pro Shop
(❑ SEE ATTACHED SHEET)
LEGAL
DESCR. Lot 206 Div 8 Lake Cushman
MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR NA
USE OF
BUILDING Golf course maintenance shop.
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
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scribe work:
1 story framestructure with concrete foundation and floor and aluminum roof.
FEE ~
Valuation of work: $ / �; PLAN CHECK FEE PERMIT
C7(/e 4�O•
SPECIAL CONDITIONS:
BEDROOMS {DECKS CARPORT ❑ NOTICE
BATHROOMS (TOTAL SQ. FT. GARAGE ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
5�0(�0(�
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
WORK IS COMMENCED.
I certify that I am a currently registered contractor in
the State of Washington and I am aware of the FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done be in PERMANENT i J SHORELINES 1_
,,__. , nformance therewith.
SEASONAL ❑ FLOODPLAIN ;
Firm E.D. NO. S.E.P.A. ;-
APPROVED
Special Approvals IN OUT YES NO
By
ZONING
Lic. No.— Date
PLANNING DEPT.
HEALTH DEPT.
OWNERS AFFIDAVIT PUBLIC WORKS
/be
tify that I am exempt from the requirements of the FIRE MARSHAL
ract or registration law RCW 18.27, and am aware BUILDING DEPT.
he Mason County ordinance requirements for
h this permit is issued and that all work done will ROAD ACCESS
n conformance therewith. OR VEHICLE PERMIT
i 7 A ATION ACCE E BY PLAN" CHECK BY BYPROVEDFORISSUANCE
Owner 1� Date . ( � ? j�`
``
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS t PERMIT
o
LEGAL Division u
DESCRIPTION LOT 206 BLK4�cusin{� 8
SITE AREA 1350000 apX Sq,Ft. AREA OF SITE OCCUPIED BY BUILDINGS 1500 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 THEION
PROPOSED CONSTRUCTI NVIDE AND EXIST NG IMPROVEMENTS.E S.SHOW BUILD NGPS TE,AND ET ACKINFORMATION IN THE SACE BELOW: TDIMENF `
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 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 changes will be made without
first obtaining approval.
Take Cushman Maintenance Co. `- '�---
NAME(S) OF OWNER(S) OF SITE S STRUCTURE(S) (PRINT) -SIGNAYUKE OF OWNERS) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED
6MELTON PRINTING
Lake Cushman Maintenance Co. #9368
1-27-81
Lake Cushman, Lot 206, Div. 8
Golf course maintenance shop
$21,000.00
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