HomeMy WebLinkAboutBLD11841 Barn - BLD Application - 12/14/1981 ` �- - BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. �v
OWNER NAME MAIL ADDRESS CITY&STATE ZIP 47'?5-,? PHONE
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DIRECTIONS o v* to 7-3 J — '7 I
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
NAME MAIL AD115RESS CITY 3 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: W ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
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6X ao d4 16 0/67 Y10
Valuation of work: $ f G Cy PLAN CHECK FEE PERMIT FEES to
SPECIAL CONDITIONS: 'Ot�, O�V '
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
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 FORA PERIOD OF 180 DAYS AT ANYTIME 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. PERMANENT ❑ SHORELINES ❑it
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. 14-I3e"¢/ '2•IY� t7
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in con1prmaryee therewith. MOTOR VEHICLE PERMIT
(/ AP ICATIO A EPTED BY B PLANS CHECK BY APPROVED FOR ISSUANCE
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Owner Date. -
� v
N CHECK VALIDATION CK.. M.O. CASH ERMIT VALIDATION CK.) M.O. CASH