HomeMy WebLinkAboutBLD20112 Alterations - BLD Application - 4/16/1987 Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:
MobileHome:
Smoke Detector:
Remarks:
Doting:
Setback.-
Foundation
Walls:
Framing: _
Fireplace: --�'B;��EYp1i�ATE�ti1
Wood Stove: U LE a
DATE - 9_qBy
Typg ALTERATIONS
Permit No. 20112 No. Floors Sq Ftg
Owner FOWLER, Larry Tel 275-3375 Date 4-16-87
Address NE 170 Riverhill Rd Belfair Zip
Contractor A A & E Inc
Address P 0 Box 730 Belfair Zip
Legal Description 28-23-1 Tr 6 NW,SW (Tr C SIP #178)
Direction to project site Belfair Center Quick Pack
Plumbing Mec is Sewer Wood Stove
Fireplace /Z 3 2 IF �2 �16vcaC)
Basement J-"LU Vu1C1 -
Remove 1 window, change door, replace window
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 _
426-5593 DATE ISSUED to 52
07
PERMIT NO. 02e!!57���
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
DIRECTIONS 641,
TO JOB SITE iv Q G xL 0 /p
PARCEL LEGAL �'�,Jf ���)
NUMBER �/ Q DESCR. ��3-- l Ti: 6 NLU
NAME MA DDRESS CITY BSTATE LICENSE NO. ZIP PHONE
CONTRACTOR ,ya lv( o f� G Ih �
�,; O'�
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATIO
WORK r REPAIR MOVE REMOVE
DESCRIBE q �� 6v r
WORK ✓�,.e ?
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SO.FT. GARAGE CONDITIONING.
NO.OF STORIES 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 SQ.FT. FIREPLACE DETACHED ABANDONED FORA PERIOD OF180 DAYS AT ANY TIME AFTER WORK ISCOMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERS FIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY HAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRA ON LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIRE NTS 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 CON RMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAIN G APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
NER DATE X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO 3.000,
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING g? PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP Z PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY MHECK BY g APP D F R I PERMIT VALIDATION / DO
9 7 BY V7 CASH CK MO TOTAL a,