HomeMy WebLinkAboutBLD24999 Garage with Loft - BLD Application - 1/8/1990 BUILDING PERMIT APPLICATION
,v MASON COUNTY
DEPARTMENT of GENERAL SERVICES
\v P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMITNO�"r
OWNER N ME MAILADDRESS CITY&STATE ZIP PHONE
T-) I gel � A oe St S 9',?0J7 64 -ya$S
DIRECTIONS ']� i �,p Nod
TO JOB SITE ( T . T S K"N a Id Q o w TO w �. end J/!V
�Q AT 9,ff6m, // -ftl vou Come 7 1_pr aM 94t �iAE�aqa
PARCEL I I LI rj(Q_ 50.600438 LEGAL
NUMBER DESCR. �F Tt_ n l qj
ME MAI ADDRESS 11 CITY&STAT LICENSE NO. ZIP PHONE
CONTRACTOR �� �/ Se J� EJ/I 0
l1 BfNSA�j) 0� a OO eg
USE OF
BUILDING CIARAqk
CLASS OF
WORK All NEW ADDITION ALTERATION REPAIR MOVE REMOVE
DESCRIBE )J /�
WORK T T X L I - UNh1visbqDi
rrovidt- FIZAmt t rooF t Sim cm
BEDROOMS DECKS CARPORT OTICE
�r PARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SO.FT. �/ GARAGE � CONDITIONING.
NO.OF STORIES BASEMENT---2&_ 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. FIREPLACE DETACHED_ ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANEN _ -SHORELINE LH-
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SEASONAL
9
OWNERSAFFI VIT CONTRACTORS AFFIDAVIT
1 CERTIFY THA I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION W RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMEN 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 CONFOR ANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING PROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X W R DATE X BY ATE /ee '9 89
FOR OFFICE USE ONLY
DEPARTMENT YESPPROVE NO DEPARTMENT YESPPROVENo BUILDING VALUATION
l3. is a _
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT ( kk ,5
D.O.T. I BUILDING �L- PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP f3-2- PRE-INSPECTION
T ZF LjO J C 1aAnl6 L. Sl iA-:s SHORELINE
J /� eUAbli& (Cob' ! a 0 WOODSTOVE
c� iQ PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
i
APPLICATION ACCEPTE712-
LANS CHECK BY A E ISSUANCE PERMIT VALIDATION
TOTAL
�3
�U`"` -2Z B CASH CK MID �` ��