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HomeMy WebLinkAboutBLD12355 Cancelled Satelite Antenna - BLD Permit / Conditions - 1/9/1991 Olympic TV Cable #12355 871-4043, Port Orchard 5/3/82 North 75' of Tract 13, of Sam B. Theler's Home & Garden Tracts Off Highway 3 on east side, 2 power poles south of Bel- fair Comm. Baptist Church. Sattelite Receiver Antenna Contractor: Owner $4,000.00 �I� Shorelines: - - - - - - - - - - - - - - Setback: Special Conditions: Footing: Setback:_ Foundation Walls: Framing: Fireplace: Wood Stoves _ Plumbing: Mechanical: Roof: Exterior: Interior: Final: Stop Work: Mobile Home Remarks: PEPMIT- DATE /'9_9/ BY 2 BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 _3- Q_,, DATE ISSUED U PERMIT NO. # a 3,5_ OWNER NAME L M ©DRESS CITY&STATE �3 _ PHONE 3 DIRECTIONS GAFF /��y 3 , /3�/ ,r LJa,� 0/Q J''G's7` Sf.Je o A4c,,l 3. 0 owe- ps/e-J TO JOB SITE So LEGAL T (❑ SEE ATTACHED SHEE ,„, DESCR. SPA _�_r4.CA01�11 _e=5 e 75- ,8 NAME MAIL ADDRESS CITY&STA / (LICENSE NO. CONTRACTOR USE OF BUILDING Class of work: > NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: a G h? rt- S c �"c .V �Gh Valuation of work: $-4avo " PLAN CHECK FEE PERMIT FEE ' ��.•SQ SPECIAL CONDITIONS: BEDROOMS &e a {DECKS N A CARPORT [! NOTICE BATHROOMS_f,L 1 (TOTAL SQ. FT._kA GARAGE [] ATTACHED L] k � SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES&& BASEMENT L: �� OR AIR 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 FOR A PERIOD OF 180 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 SHORELINES SEASONAL FLOODPLAIN [ Firm E.D. NO, S.E.P.A. I I 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. s 3 8 of the Mason County ordinance requirements for which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT 4�'�" / �3— ,Z APPLICATION C E TED AY PLAN�'ECK BY APPROVED FOR ISSUANCE Owner Date, PLj#fi CHECK VALIDATION CK. M.O. CASH PE MIT VALIDATION CK M.O. CASH PLOT PLAN ADDRESS PERMIT NO. f ; ivo '7s 3 0 -1 ti. /3 7_Aa/e`i-'1 /fonu 4 LEGAL 5 l �Eu.-cjr� `'� {�t3I, f 0-/" DESCRIPTION LOT BLK ADDITION u SITE AREA l2�� Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS 00 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. 1 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' Ali L FIE, w 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. NAM (S) OPP OWNERS) OF SITE Q STRUCTURE(S) (PRINT) SI NATURE OF O W AUTHORIZED REPRESE ATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE SHEL.TON PRINTIN3