HomeMy WebLinkAboutBLD20054 Produce Stand - BLD Permit / Conditions - 1/9/1991 Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:
Mobile Home:
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing: PERMIT
Fireplace: N111 1 R VUIC? BY EXP1114,40117P N
Wood Stove:
T
TypE PRODUCE STAND
Permit No. 20054 No. Floors Sq Ftg 1400
Owner HOHMANN, Leonard Tel275-6473 Date 4-3-87
Address P 0 Box 107 Allyn Zip
Contractor Self
Address Zip
Legal Description S m Theler H
Direction to project site H,,,, 1, belfair, hPtL.1P PTl
Laundromat & Belfair Auto Parts
Plumbing Mechanical Seer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 p+y
426-5593 DATE ISSUED ] O
✓' -�!3 •J� U�/�O PERMIT NO.O�����f
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER 4EOrF>AI?0 Z 7> --ii� 7
DIRECTIONS ,(
TO JOB SITE
PARCEL LEGAL
NUMBER DESCR p f'LEP G 2D itJ
NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR 0
USE OF
BUILDING -PtI/7 S 7.
CLASS OF NEW �/ ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r !�
DESCRIBE
WORK C ON TUB V e 350e
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.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. /4c��a FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERSAFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTI Y THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIST ATION 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
OBTAI ING AP AL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
r
X NE DATE 3���® 7 X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK S'
SPECIAL CONDITIONS I BUILDINGGROUP PRE-INSPECTION
j _ SHORELINE
n WOODSTOVE
�A -
l'n PLUMBING
W 4 MECHANICAL U�
V0 6 STATE BUILDING FEE
G �(� STATE SURCHARGE
APPLICATION ACCEPT D BY PLAN§CpeK BY APPROVED FOR ISSU NCE PERMIT VALIDATION
/L ^�' BY CASH CK MO TOTAL /� ��
1
PLOT PLAN
ADDRESS h<<�hlGvr�Y ^� >�L /4/.� PERMIT NO. o
LEGAL
DESCRIPTION LOT :L. BILK ADDITION U
SITE AREA f3� % Sq, Ft. AREA OF SITE OCCUPIED BY BUILDINGS / t� 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'
0
g C
1,1 `
OIL
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.
� 411p�vl awe'
AMEISI OF OWNE (S) OF SITE k STRUCTURE(S) (PRINT) _F1_GNAjtURE OF OWNFR(S# OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE