HomeMy WebLinkAboutBLD6088 Garage - BLD Application - 3/24/1980 BUILDING 1 APPLICATION
� G PERMIT A P LI C
• MASON COUNTY
PYB ;—t�ton shington 98584426� 93
DATEISSUED� J + ����� PERMIT NO. Q�
OWNER f A E L M L ADDRES CITY 3 STATE
ZI� PHONE
DIRECTIONS �+� ` 1 �` L 6
TO JOB SITE I&r ph i r1C r / ,--) �7� 0t I v17
LEGAL �--
` � 2 TrkJ
r v �� I/ (❑,SE� CHEDSHEET)
DESCR. I J `� '/'�iJ�
NAME /� /� MAIL AD773
/� CITY 8 STAGT,E l LI EN E NO. /PHHONE
CONTRACTOR "C /T �.Lc� <' / , 2O " S' e ! Gl.t�t� 7 '
USE OF J
BUILDING j
Class of work: 9CNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: �
u� c% k 3o'2 qaraqe wi on c rec 4-
�Oo r
c� X
Valuation of work: $ / (y PAN CHECK FEE IVA PERMIT FEE dF--
SPECIAL CONDITIONS: `
BEDROOMS I DECKS CARPORT i J NOTICE
BATHROOMS TOTAL SO. FT. GARAGE X
ATTACHED f SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT a OR AIR CONDITIONING.
TOTAL SQ. 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 IJ SHORELINES i
SEASONAL I i FLOODPLAIN I
Firm E.D. NO. S.E.P.A. I i
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. f
Icwhich this permit is issued and that all work done will ROAD ACCESS
be i conformance there ith. MON VEHICLE PE MIT
Q AP IqN D Y PLANS CHECK BY APP R I UANC
Owner Date.v v BY
PLAN CHECK VALIDATION M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS �" 13 51) 6 lAt PERMIT NO.
� o
a •�� �� 3f �1 � J a o
LEGAL
DESCRIPTION LOT K J "� Aq6ITj6N u
SITE AREA Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq. Ft. (`f,
INSTRUCTIONS TO APPLICANT 1
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE `hl
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-
TI
ON 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.
J
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' \�
G
o
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 h STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED �` Y
DISTRICT AS NOTED DATE�G�
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