HomeMy WebLinkAboutBLD0035 Deck - BLD Application - 9/22/1988 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
OWNER NAME MAI
Ke-NNE -L
1lA E. ODQ D"DES T2(6 ?JiP �CAQ UASN W. 1 S 2 L5 S CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITE
PARCEL 1232I.sl_00020 DESCR. Lx> 20 cc= �-1 0�NUMBER Rt%)eAwu.— .- v.
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
USE OF
BUILDING Derj<_
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE
WORK
BEDROOMS DECKS � Z . CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTALSQ.FT. GARAGE CONDITIONING.
NO.OF STORI ES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SO.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CE IFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGI RATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQ REMENTS 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 NFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBT INING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
WNER?YQdst �� -/L DATE 8' l 6'$� X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT Y SPPROVE NO DEPARTMENT YES NoBUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING GchC PLAN CHECK /
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
* 0-Cp qr` � �� PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE ,
APPLICATION ACCEPTED BY P CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION � A O�
��c.NcHQ- BY"UK 4-1 "0� CASH CK MO TOTAL