HomeMy WebLinkAboutBLD9103 Shed - BLD Permit / Conditions - 11/24/1980 Abad, Mark #9103
11-24-80
Corner of Mason Blvd. & Larson Lake Rd.
Beard's Cove - Div. 4 - Lot 58 - Belfair
Shed
$1,632.00
_! BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 �j��
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STAT ZIP PHONE
b _
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE A ACHED SHEET)
DESCR. ' —D 1V
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ v " PLAN CHECK FEE PERMIT FEE
16 3 -�-
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT ❑ NOTICE 1
BATHROOMS TOTAL SQ. FT. GARAGE U
SEPARATE RE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED ❑ OR AIR CONDITION CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS AT ANYTIME 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 Cl SHORELINES ❑
SEASONAL [] FLOODPLAIN ❑
Firm
E.D. NO. S.E.P.A.
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 BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will R ACCESS
tps conforman e t ith. OTO VEHICLE PE IT
PP I ATION ACCEPT PLANS CHECK BY A ROVE FOR IS U E
Owner Date . B
U
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
'.��j I,- 14
PLOT PLAN
ADDRESS ���<j �`:`1� I ).V ](� PERMIT NO. � F a
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a o
0
LEGAL a n
DESCRIPTION LOT BLK ADDIT
ION u
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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'
4'
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.
� r
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) PR T) IGNATUR F (S) OR AUT I E REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRiNTIN3