HomeMy WebLinkAboutBLD14486 SFR - BLD Application - 8/4/1983 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426 5593 �
DATE ISSUED_ /U
M lJ GOOD JR, PERMIT NO. /Y 7" p
OWNER NAME MAIL ADDRESS CITY&STATE ZIP
S1)/V� WE 34-Sa eE w to - +-l� �Pcr,, -RR IA,, l�v'a is&3i z �HONE
3o-Lm
DIRECTIONS
TO JOB SITE Wi WKIRK R p - -0 mtq 1-FON!►9 TO R1 V RNI L,- LANL
LEGAL (❑SEE ATTACHED SHEET)
DESCR. L l 121 P,, I V(,I 1 f I LL
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR S0tiSE- NEST Sfi-mC=.
5im5 c-v,pj� t 73/`'5 g3o-4r(.
USE OF
BUILDING N Vk) S f lJ G L-E k ES!1�1,
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: ^ '^
Valuation of work: $ C)a PLAN CHECK FEE PERMIT FEE d
910
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ �1 NOTICE
BATHROOMS TOTAL SQ. FT.QPW GARAGE /Gg
NO. OF STORIES_ BASEMENT ❑
ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
OR AIR CONDITIONING.
TOTAL SQ. FTJ FIREPLACEX 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 FORA PERIOD OF 180 DAYS AT ANYTIME 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 h ,
Firm
1 14)EST SEASONAL ❑ FLOODPLAIN ❑
E.D. NO. S.E.P.A. ❑
BY Special Approvals IN OUT YES APPROVED NO
Lic. No.S V N;S C W ;K 1 73 K S Date -2 7-3-3 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. ly.i
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
Owner Date
APPLICATION C TED BY PLANS ECK BY APPROVED R ISSUANCE
_ BY
s�
PLAN CHECK VALIDATION CK. M.O. CASH PERMIY VALIDATION CK. M.O. CASH