HomeMy WebLinkAboutBLD11739 Bulkhead - BLD Inspections - 11/17/1981 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED 'J v
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP fFFAME
— 8 Z
DIRECTIONS / I
TO JOB SITE 4 V c OTC L /!rr Ir✓ d
LEGAL '7-- (❑ SEE ATTACHED SHEET) IL
DESCR. S � Z — -7`"2Z Z — O ..z O / �� .la� I►
Noy
NAM MAIL ADDR SS CITY&STATE Li6G►ICG#IAr• PHONE
CONTRACTOR /� ( Z Z 75W
USE O1
BUILDINGNG
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
Describe work:
e
00,
G < o
Valua ion of work: $� O PLAN CHECK FEE PERMIT FEE
is—
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
NO. OF STORIES BASEMENT ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED El
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 ❑
Firm S(� �.,( SEASONAL ❑ FLOODPLAIN ❑
4H`�r�c�J�S
E.D. NO. S.E.P.A. ❑
YES APPROVED NO
By Special Approvals IN OUT
Lic. No. C— ?�Z�r�ate 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 / g
of the Mason County ordinance r iaements for BUILDING DEPT. �7
which this permit is issued at all work done will ROAD ACCESS
be in conformance t with. MOTOR VEHICLE PERMIT
APPLICATION ACC P ED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date. BY
A4Aft
P HECK VALIDATION CK. M.O. CASH PLVRMIT VALIDATION CK. M.O. CASH
i
I
I
I
Barnard, Morley 0. #11739
'(275-2195#* 11/17/81
32-22-1, Portion of Tract 10, Gov. Lot 1, NE 1/4 of
j Nw 1/4.
l
Grapeview Road, 1/2 way between store & Sherwood Bri
dge. , Rt. 1, Box 172, Allyn.
Bulkhead Contractor:
**B & D Contractors
$2,375.00 Shoreline Exemption
ta93a • (p-d 100
z