HomeMy WebLinkAboutBLD19670 Cancelled Carport - BLD Permit / Conditions - 1/9/1991 TYPE CARPORT
Permit No. 19670 No. Floors 1 Sq Ftg 1080
Owner POLLARD, Roy rrel 275-4123 Date 12-11-86
Address NE 81 Saber Dr Belfair Zip
Contractor Lais Const
Address 5568 Wilson Cr Rd Zip
Legal Description Beards Cove Div 8. Lot 30
Direction to project Site Same address ns nhove
Pl unbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
3 stall 30x36
Shorelines: PluTbing:
Setback: Mechanical: - -
Special Interior:
Conditions: FINAL:
mobile Home:
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing:
Fireplace: PERM
Wood Stove: NULL =" .
DATE L-TYT BY -�...
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED
PERMIT NO.
OWNER E MAILADDRESS CITYBST ZIP PHONE
DIRECTIONS
TO JOB SITE
LEGAL
DESCR. �O T D/
NAME /! MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR Al ""TOac-rJO lJ �S' LUl�.kyJ�1 �< 3G(c
USE OF L,AI$C g7GQ
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK 44&6z /Q /LT' / J7 /
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. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANE OS� SHORELINE
SEASON
OWNE AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTI THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIST TION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUI MENTS 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 CO FORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
O TAI NG APPROVAL FROM THE BUILDING DEPARTMENT. p APPROVAL FROM THE BUILDING DEPARTMENT.
X NER ATE X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YES
PPROVE NO DEPARTMENT YES
PPROVENQ BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT 5'(
D.O.T. BUILDING , PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP _ PRE-INSPECTION
SHORELINE
PLANNING
PLUMBING
MECHANICAL
STATE BUILDING FEE S'L
STATESURCHARGE
APPLICATION ACCEPTED BY I PLAN CHECK BY APPROVED FOR ISS NCE PERMIT VALIDATION
�v I"� ITOTAL
BY CASH CK MO
PLOT PLAN
ADDRESS PERMIT NO. F
0
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LEGAL
a
DESCRIPTION LOT BILK ADDITION u
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 Al"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'
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A rl >
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6 �
I/We certify that the proposed construction will conform to e 1 nsi s a u shown above and that no changes will be made without
first obtaining approval.
NAME(S) OF OWNERS) OF SITE h STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
CHRISTMASTOWN PRINTING