HomeMy WebLinkAboutBLD17915 Pole Type Bldg - BLD Application - 9/11/1985 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593DATE ISSUED �J
PERMIT NO.
OWNER NA.LrME MAIL ADDRESS CITY STATE ZIP PHONE
r. z u; -r k CT 3 -�3
DIRECTIONS
TO JOB SITE
LEGAL TTACHED SHEET)
DESCR. ?0/, G �. ZeI7 —�
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR
USE OFJ 5,63te
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
ALL G
r
,4e',1 -7-11-26
1pl.iinq 5i-te, i%aspecr ,q6 f 72Zr6 F.EtJ
Valuation of work: $ r„ PLAN CHECK FEE w PERMIT FETE
7 l, / -
SPECIAL CONDITIONS: '
1 rLt' , q
-
7 / v e <" Z' 6ti `� i L v �'�t� r, .� C_Q
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BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES I BASEMENT ❑ 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
/thetate
at I am a currently registered contractor In WORK IS COMMENCED.
of Washington and 1 th aware of theFOR OFFICE U E ONLY
equirements regulating the work for which is issued and all work done will be in
e therewith. PERMANENT ❑ SHORELINES
C4, SEASONAL ❑ FLOODPLAIN ❑
Firm
E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. ILA" i"C' jsgir Date ZONING
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.
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
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date. BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH