HomeMy WebLinkAboutBLD0473 Final Carport - BLD Permit / Conditions - 2/18/1987 TYPE CARPORT
Permit No. 0473 No. Floors 1 Sq Ftg 48Q - -_
Owner MATKINSL Harold Tel Date 1242-86
Address P. 0, gn,, 836 Belfair Zip
COxa N C Butterfield
Address Belfair Zip
Legal Description SW NE NW SE 20-23-1
Direction to proj site
1041 NE Old Belfair Hwy
Across from Newkirk Rd
Plumbing - Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
Shorelines: /Yf} Plumbing:
Setback: Mechanic
Special Interior:
Conditions: FINAL: r g g h
Mobile Home:
Smoke Detector:
Footing:
Remarks:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 �7 p
426-5593 DATE ISSUED
PERMIT NO. "�''/Z
NAME MAILADDRESS _ CITY&STATE ZIP PHONE
OWNER C ) 1 � f�
`- !DIRECT
-
TO JOBIONS
SIITE 16 ,11 V U c� -
LEGAL
DESCR. 6w, —
NAME MAILADDRESS CITY&STATE LICENSE YO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASS OF NEW AD ITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK r ,
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
1 CERTI THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIST ATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUI MENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN C FORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBT ING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT,
X O DA��tJ/ - X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION �^1
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING VV FIRE BUILDING PERMIT ��� L'
D.O.T. BUILDING PLAN CHECK �j 1
SPECIAL CONDITIONS BUILDING GROUP M :2- PRE-INSPECTION
SHORELINE
PLANNING
PLUMBING
MECHANICAL
STATE BUILDING FEE Q
STATESURCHARGE
APPLICATION ACCEPTED BY P C CK BY APPROVED/FOR I UANCE PERMIT VALIDATION
i� BY TOTAL CASH CK MO
PLOT PLAN
ADDRESS 16 / / � •�/6 6 / r �w
PERMIT NO. F o
LEGAL
DESCRIPTION LOT OLK 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 A"'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'
0 '
� X
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.
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) IGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
. DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
CHRISTMASTOWN PRINTING