HomeMy WebLinkAboutBLD23894 Garage - BLD Application - 6/16/1989 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO
OWNER NAME MAIL DRESSi CITY&STATE ZIP PHONE
lC�
DIRECTIONS
TO JOB SITE
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PARCEL U2�� D 3 006�0 LEGAL.
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DES
NUMBER CR
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP NE
CONTRACTOR 0,0 Q �26 7&&
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK .-
DESCRIBE
WORK Oc
� I
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 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
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I CERTI THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS 1 CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTR ION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIR ENTS 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 ORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFOR ANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAI G APPROVAL FROM THE BUILDING DEPARTMENT. APPROV L FROM THE BUILDING DEPARTMENT.
X ER DATE X B DATE����
FOR OFFICE USE ONLY
DEPARTMENT YESPPROVE NO DEPARTMENT YESPPROVENQ BUILDING VALUATION
HEALTH vLl�� PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
�� �L 7r ✓y 7 LL SHORELINE
WOODSTOVE
PLUMBING
z MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY PLLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
L�J�� �� BY�L��e K/6 CASH CK MO TOTAL �7,
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