HomeMy WebLinkAboutBLD6052 Storage - BLD Permit / Conditions - 3/19/1980 ` Wegner, A. G. STey,) #6052
3/19/80
Beards Cove 3-16.
Sandhill Roadd off No. Shore Road. 1st left
Beards Cove (gravel Road) follow around Rt.
AximiHgxxp driveway up green white brn house
Utility Storage Shed
$4,880.00
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• BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 (/
/DATE ISSUED
PERMIT NO. 6105 Q
NAM MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER �-. TEX (.t)e P2 �O�oK 75 �1�'ilk f clN. eSafl �7S- a-9
DIRECTIONS TO JOBS IT E _rW- / QI Q /Lj�
I/ /1a i OFh 4o.jitlee k<,J, 'Leff• ,en (/t�l ?: lv .M •�.l/ �r✓.cd
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR L
USE OF
BUILDING S on ,e
Class of work: Ga-NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: J
rLd 14T/lf T
Valuation of work: $ dO PLAN CHECK FEE PERMIT FEg
J�
SPECIAL CONDITIONS:
BEDROOMS — (DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE [1
ATTACHED Cl SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED 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 [ I SHORELINES I
SEASONAL ❑ FLOODPLAIN I i
Firm E.D. NO. S.E.P.A. C:
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 o registration law RCW 18.27, and am aware BUILDING DEPT. v
of the son County ordinance requirements for /9 D
which thi permit is issued and that all work done will ROAD ACCESS
be in for therewith MOTOR WEHICLE PERMIT
APPLICA VOY"ACCEPT BY PLAN CHECK BY APPR A C
Owner Date~�g BY
PLAN CHECK VALIDATION C M:O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS' �'S PERMIT NO.
= o
� o
0
LEGAL
DESCRIPTION ^ LOT L` BILK ADDITION u
SITE AREA ") d 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'
1
3 2 /
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 RE RESEN ATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED C
DISTRICT AS NOTED DATE