HomeMy WebLinkAboutBLD4433 Final Tool Shed - BLD Permit / Conditions - 12/24/1979 Gallagher, Robert M. #4433
4-5-79
20&21-23-1 Tr. 28 E 1/2 NE 1/4 & W 1/2 NW 1/4
1 mile north of Belfair on Newkirk Road.
Tool Shed
$960.00
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` ~ BUILDING PERMIT APPLICATION
MASON COUNTY 1z-3&166 3 2,9b
P.O. Box 186 Shelton, Washington 98584
426-5593 , / p
DATE ISSUED
MIT NO.
OWNER wobNAME 1, /'{ A I LTRES CTY STATE ZIP PHONE
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DIRECTIONS / U 4 '� ` UV a o- +°
TO JOB SITE
LEGAL _ (❑ SEE ATTACHED SHEET)
DESCR. — j � 4, Niv
CONTRACTOR AME MAI �DDRESS CI 6 STATE LICENSE NO. PHONE
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USE OF T6 '` I
BUILDING V
Class of work: NEW ❑ A DTION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: cl T 0
Valuation of work: $ /may PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE Ll
NO. OF STORIES BASEMENT []
ATTACHED I I SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 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 LI SHORELINES f
SEASONAL [] FLOODPLAIN L]
Firm E.D. NO. S.E.P.A. L]
By Special Approvals IN OUT YES APPROVED NO
Lic. No. 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 4 thareutith MOTOR VEHICLE PERMIT
6 Ow APPLI ATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
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17 P,
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BY A4 l0 t� i
PL N CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN �Z.�ZQ/QQ 32
ADDRESS PERMIT NO. i o
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LEGAL
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DESCRIPTIO OT y _ (� ��BL/� 1 ► ADDITION / u
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS
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.
0 INDICATE NORTH IN CIRCLE G, C) w 1 GRAPH SQUARES ARE 5' X 5' OR 1"=20'
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All
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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. I
Nti
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTEDl'C DATE
1 SHELTON PRTNTIN