HomeMy WebLinkAboutBLD11111 Carport - BLD Application - 7/29/1981 �- BUILDING PERMIT APPLICATION
• MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 �--
DATE ISSUED-
PERMIT NO.
,OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
S _ o 4C 940. o.v W — y -
DIRECTIONS
TO JOB SITE C O S Rv&D PROM P JWh S" A P084 G A Q C Ar
LEGAL � 4dd (❑ SEE ATTAC ED S EET)
DESCR. Q ,� ! 'VCa4_1 .4 oxakr
NAME MAIL ADDRESS CO8 STATE LICENSE NO. PHONE
CONTRACTOR SELF
USE OF
BUILDING O Sr
toX 46
O C A g y Ae A �^
Class of work: ❑ NEW W ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOV
Lv dllC � 10
Describe work: v
Valuation of work: $ _�1 PLAN CHECK FEE ' f Ij PERMIT FEE�� S
SPECIAL CONDITIONS: w
BEDROOMS I DECKS CARPORT X NOTICE
BATHROOMS TOTAL SQ. FT.__ GARAGE ❑ %70
�I
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ElATTACHED X OR AIR CONDITIONING.
TOTAL SO. 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 ANY TIME 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. P E R M A N E SHORELINES ❑ 0200
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
BY Special Approvals IN OUT YES APPROVED NO
Lic. No. Date 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. „? 71.2
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
e in conformance therewith. MOTOR VEHICLE PERMIT
a PLI TI N A PTED BY PLANS CHECK BY APPRO ED FOR ISSUANCE
`} OwAnr Date.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O CASH