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HomeMy WebLinkAboutBLD26681 Garage - BLD Application - 9/11/1990 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON WASHINGTON 98584 r/ 1 yv 427.9670 DATE ISSUED PERMIT NO. NAME MAILADDRESS ` CITY&STATE rev' ZIP PHONE OWNER S R 'M veeiq 7r�ZZ l l Ali'S&A pqV 4 y-f , 2 d� 2 73,FZ 7 DIRECTIONS A1� � �„a A;V / WIla Q�1✓�pp-+`� .�t/to�'it_ TO JOB SITE- 7711�// "mac / ✓ - G�✓wC p.s L d `- C aL►1s ti d'�- -� -vim L PARCEL LEGAL Sj . / NUMBER 2.`3�o jQ ©ooB DESCR. Q' V NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR 5714111, icc'.USE OF ��-� BUILDING CLASS OF NEW �- ADDITION 7ALTERA7TIO�N������ REMOVE WORK ✓ DESCRIBE WORK BEDROOMS DECKS YORN CARPORT NOTICE TOTAL SQ.FT. DECK GARAGE -�n SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTAL SQ.FT. TOTAL SO.FT. �� CONDITIONING. NO.OF STORIES BASEMENT Y OR N THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT LIVING AREA BASEMENT COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SO.FT. TOTAL SO.FT. CHECK ONE ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT FIREPLACE ATTACHED SEASONAL SHORELINE DETACHED OWNER$AFFIDAVIT CONTRACTORS AFFIDAVIT I j THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF RION LAW ROW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCEWASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE RENTS 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 IRMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING O APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. XR /J DATE �5 - �ff X BY DATE FOR OFFICE USE ONLY APPROVED DEPARTMENT APPROVED BUILDING VALUATION DEPARTMENT YES No YES NO HEALTH PUBLIC WORKS FEE PLANNING >>'/ FIRE BUILDING PERMIT Cj© D.O.T. BUILDING PLAN CHECK Z SPECIAL CONDITIONS BUILDING GROUP ( -b-Z PRE-INSPECTION SHORELINE WOODSTOVE �� ��� PLUMBING MECHANICAL S c u l GlW STATE BUILDING FEE )� Or- U1 r-- PEr-m:1 „ STATE SURCHARGE APPLICATION ACCEPTED BY PLANS CHECK BY VE OR ISSUANCE PERMIT VA bQA_Tl.QA TOTAL CASH CK MO Q B PLOT PLAN ADDRESS/' / <",' i /` ''7 � � ��I C-/t � ;cJ� ,�r/IL! ��_ / /1' i PERMIT N0. s o LEGAL DESCRIPTION LOT J�///?� f i�f BLK ADDITION ` t SITE AREA Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS tv 0 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. X s INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' i •,. a- 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. ,AMEW OF OWNER(S) OF SITE 6STRUCTURE(S) (PRINT) SIGiTATURE OF OWNERS) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED "lICT AS NOTED DATE IASTOVVN PRINTING