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Home My WebLink AboutBLD0352 Carport - BLD Application - 3/12/1991 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED 3-1 2 'y� PERMIT NO.Oc?S OWNER ME TAILQDDRE$$ / CITATt ZIP /ENE /1 //��j(J� 1/C—J C/Ji qJ V,j o/E ONS TO JOB DIRECTSITE �V I I p_ CYIII __`` e Q PARCEL LEGAL MeblI& heimb NUMBER f9330 -22 -Oek.5() DESCR. L07- I Or-- AM MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR ��,� USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE WORK BEDROOMS DECKS CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTALSQ.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 TIMEAFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CE/ING AT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGN LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQS 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 ANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. XOWNERI �la"l DATE : - Jo- 9 XBY DATE FOR OFFICE USE ONLY DEPARTMENT YESPPROVE NO DEPARTMENT YESPPRovENO BUILDING VALUATION J y��a — HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT j Gi D.O.T. BUILDING F'3 PLAN CHECK may' f SPECIAL CONDITIONS BUILDINGGROUP PRE-INSPECTION G SHORELINE pl//0 WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE STATESURCHARGE ICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION C 3�� Il BY :3' 9/ CASH c MO TOTAL ( / PLOT PLAN SS PERMIT NO. o w s s o 0 A 'n {CRIPTION LOT BLK ADDITION ,•. TE 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 AND 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' N or 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(a) OF SITE \ STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(SI OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE BUILDING PERMIT PLOT PLAN MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. Box 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. NAM MAIL ADDRESS( Q TTY�&�STT TE i Zl PHONE OWNER 1 i �.Q . lit f�'�'it�17/c�i (i0�, f/ri �% 7. `(�2--( � DIRECTIONS f / /Y ,,/ "' TO JOB SITE Vl W S1( 0 l�yd— leocO"Az f , i .� � , p 4 PARCEIJ LEGAL ✓�raf-) l7?G��t�P� 6ul NUMBER DESCR. Indicate below: O Property lines and dimensions. O Easements and roads. O Septic, drainfield and reserve area, or sewer. O Septic tank and drainfield setback distances from foundations. O Location of proposed construction on property. O Building&septic system setback distances from all property lines& easements. Indicate North O Well and water line. O Saltwater, lakes, rive rsistreams,wetlands, drainage. In Circle O Attach copy of septic system"as built" or septic permit approval. O Indicate topography profile of property and structure on reverse side. Nov .2 Q- -9 Pi s ! X7 A! 1/ I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changeswill be made without first obtaining approval. SIGNATURE OF OWNER(S)OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE • f v � 'o