HomeMy WebLinkAboutBLD10639 Storage - BLD Permit / Conditions - 5/26/1981 '?,HODES., %. G. #10639
Rt. 4, lox 77, Shelton 05-26-81
Hwy 3 (Bayshore Rd.)
Sec. 35, Twp 21 N, Rge 3 W
Equipment and StorageShed
$4,992.00
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED-
PERMIT NO. lO((✓�/
OWNER NAME IL ADDRESS CITY STATE ZIP PHONE
c-S 1 ��X '7 ,4 Zpzo k r, a 1 ?
DIRECTIONS
TO JOB SITE
LEGAL SEE ATTACHED SHEET)
DESCR. �t�'e C.
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF l_
BUILDING 7" re R ff 9cd e CAVAJd
Class of work: ,►'NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
LviT�
Describe work:
.sc. z Try s e e T-r
Valuation of work: $ 9 92 v0 PLAN CHECK FEE ` PERMIT FEE-*
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED E5'
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 L_i SHORELINES i J Q
SEASONAL ❑ FLOODPLAIN F,
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 ROAD ACCESS
be in conformance/thf�e�IrBwith. I" MOTOR VEHICLE PERMIT
��HECKOwner /�-• Date� ��/-CJ / AP TI N A BY APPROVED FOR 1 S ANCE
N CHECK VALIDATION C1 M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
4ESS �/ /�i�.�/V% �t L� C{ S PERMIT NO. ° o
= o
,/
TALCS~ /Y
SCRIPTION LOT BLK ADDITION a
,ITE AREA—�` 441` i --.. AREA OF SITE OCCUPIED BY BUILDINGS Sq.Ft.
INSTRUCTIONS TO APPLICANT
i 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-
TIO
9N TH REOF. � ,�J
' .b�tM
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
N
( a
N �
Q
N � R
1l use
l7'
r
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 ' ✓/ P i �`-r --
NAME(S) OF OWNERM OF SITE d STRUCTURE(S) (PRINT) IGNATURE OF OWNER(S) OR AUTHC'RIZE� REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED r_
DISTRICT AS NOTED �,ZG J,tr/ DATE
6HCLTON Pr'tIN7IN3