HomeMy WebLinkAboutBLD11798 Garage - BLD Application - 12/1/1981 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. //-79F
NAME MAIL DRESS CITY&STATE ZIP PHONE
OWNER I 3 IA 6L
DO JOB F T4re- S
(❑ SEE ATTACHED SHEET)
LEGAL l n rJ 3S gi
DESCR. � S $ V 2,
MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
NAME +/
PClass
ACTOR /� 7' S �Y S C ��� (�_G D— ,V ' O
F �T je
NG �q l X
of work: VAEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: J / /'C
re 1� p
Valuation of work: $
PLAN CHECK FEE PERW F
� � Q
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑ =SEPARATERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ ITIONING.
TOTAL SQ. FT. FIREPLACE ❑ 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 FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER
WORK IS COMMENCED.
I certify that I am a currently registered contractor in
the State of Washington and I am aware of the F p R OFFICE USE ONLY
ordinance requirements regulating the work for which M
the permit is issued and all work done will be In PERMANENT ❑ SHORELINES ❑
conformance therewith.
11,,rr SEASONAL ❑ FLOODPLAIN ❑
Firm �r�� �� S� E.D. NO. S.E.P.A. El
s , APPROVED NO
g Special Approvals IN OUT YES
Y n l
Lic. No. W'Cn-u.A10_IP_ -Date L/ e egg/ ZONING
PLANNING DEPT.
HEALTH DEPT.
OWNERS AFFIDAVIT 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.
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
APPZV
CCEP ED.BY PLANS CHECK BY APPROVED FOR ISSU NCE
Owner Date:P N CHECK VALIDATION CK. M.O. CASH
PERMIT VALIDATION CK M.O. ASH