The URL can be used to link to this page

Home My WebLink AboutBLD4548 Final Concrete Block Wall and Gas Tank - BLD Permit / Conditions - 2/5/1981 Rest, A While 4548 7-16-79 31-23-3 Tr 2 & TL. 2'2 Mile north of Hoodsport Concrete Block Wall $501 . 00 r �� f + I ANDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED �7— PERMIT NO. OWNER M IL DRESS CITY&ST TE IP P ONE DIRECTIONS , TO JOB SITE LEGAL � � � � (❑ SEE ATTACHED SHEET) DESCR. 3/ _�� 1f CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE USE OF BUILDING Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: 7 / - Valuation of work: $ rQ/ PLAN CHECK FEE PERMIT FEE j SPECIAL CONDITIONS`:: 'P BEDROOMS DECKS CARPORT ❑ NOTICE BATHROOMS TOTAL SO. FT. GARAGE ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING. TOTAL SC 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 L1 SHORELINES I SEASONAL fl FLOODPLAIN C; Firm E.D. NO. S.E.P.A. F1 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 of the Mason County ordinance requirements for BUILDING DEPT. which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT AP CATION ACCEPTED BY PLANS CHECK BY AP ROVED FOR ISSUANCE Ow r ate. PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK M.O. CASH #4548 31-23-3 Tr. 2 & TL 6��y $501.00 3R 531 -a3 -9002y ---r nXS Cj--+ ,�,�, r • : " - _ -BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED 9 PERMIT NO. ys�� OWNER NA MA A R / I &ST T;.E�/Cfi/t ZIP/J^� PHONE / DIRECTIONS ma`s TO JOB SITE S � LEGAL (O SEE ATTACHED SHEET) DESCR. 3�_ 3�� di, 2 4-7 Z- CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE USE OF BUILDING Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: /V'Ie Valuation of work: $ PLAN CHECK FEE PERMIT FEE lee �� !• • SPECIAL CONDITIONS: BEDRO MS lo CKS CARPORT U NOTICE BATHROOMS TOTAL SQ. FT. GARAGE ❑ NO. OF STORIES BASEMENT ❑ ATTACHED [ I SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. TOTAL SO. FT. I 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 [] SHORELINES [; SEASONAL L] FLOODPLAIN [] Firm E.D. NO. _ S.E.P.A. L] 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 C contract or registration law RCW 18.27, and am aware of the Mason County ordinance requirements for BUILDING DEPT. which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. �J MOTOR VEHICLE PERMIT / APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Owne Date. l BY PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH PLOT PLAN ADDRESS C PERMIT NO. 0 o = v a c LEGAL I 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 A"ID 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' I , I V I/We certify that the proposed construction will conform to the dimensidns and uses shown above and that no changes will be made without first obtaining approval. NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF WNER(S) OR UTHORI ZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE SHELTON PRINTIN3