HomeMy WebLinkAboutBLD0032 4500 sq ft - BLD Application - 9/27/1988 ` BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED
PERMIT NO. 412253-2,'
OWNER NAME MAILADDRESS CITY SSTATE ZIP PHONE
DIRECTIONS
TO JOB SITE �Jc11G'i !J/ 41 C. .i cJ
WPARCE?L LEGAL
NUMBERzzlgah�� DESCR. f� Sa) CJa`" / 0 Ear
NAME MAILADDRESS CITYaT,STATE LICENSE NO. ZIP PHONE
CONTRACTOR &USE OF
�O
BUILDING L .5 :fA!LERA
CLASS OF NEW � ADDITION TION REPAIR MOVE REMOVE
✓WORK
DESCRIBE
WORK f 'W
11007
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 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SO.FT. .W FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTERWORK IS COMMENCED.
PERMANENT X SHORELINE
SEASONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY 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 CONFORMANC.E THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBT INING APPR AL FROM THE B ILDING DEPARTMENT. �( APPROVAL FROM THE BUILDING DEPARTMENT.
\X v X BY(,L-111 LA,) LA —DATE�CI
FOR OFFICE USE ONLY
DEPARTMENT YESPPROVENo DEPARTMENT YESPPROVENo BUILDING VALUATION f,Z,
HEALTH PUBLIC WORKS FEE '
PLANNING FIRE BUILDING PERMIT 5-'eO,
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE ,
1PPLICATION ACCEPTED BY PLA S CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION '
BYGUk �Z{�' CASH CK MO TOTAL dwelpl j �