HomeMy WebLinkAbout421 - BLD Inspections - 5/14/1992 Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:QC,t��
Mobile
Smoke Detector:
Foot ing• .l �j/
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE HELIGOPTER PAD
Permit No. 421 No. Floors Sq Ftg
Owner Mason out nty�ire Dist 3 Te1�4483 Date 973
Address PO .Box 142 Grapeview Zip
Contractor ;
Address Zip
Legal Description 8 21 1
Direction to project site Next to Fire Station Grapaide
LT) Rd E 4350
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck arage Zarport
Basement Loft Other
BUILDING PERMIT APPLICATION
MASON BOUNTY
DEPARTMENT of GENERAL SERVICES
426 W.CEDAR/P.O.BOX 186 SHELTON,WASHINGTON 98584 q
427-9670 DATE ISSUED
PERMIT NO.49 X Z Z
OWNER NAM MAILADDRESS CITY&STATE ZIP PHONE
10
s j 9
DIRECTIONS
TO JOB SITE 3
PARCEL LEGAL
NUMBER .Z JO DESCR. �' r
NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE LICENSE NO.
CONTRACTOR ✓ s
USE OF
BUILDING
CLASS OF NEW t7ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE / p
WORK 0j 2 e0/
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE SgFt STORIES SHORELINE❑ CONDITIONING.
BASEMENT SgFt BEDROOMS PRIMARY RES.O THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS BATHROOMS SEASONAL RES.❑ COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
CARPORT SgFt FIREPLACE IS CARPORT/GARAGE
GARAGE SgFt ATTACHED O DETACHED❑
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS 1 CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND 1 AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS 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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROJA THEE LDING PARTMENT. Q APPROVAL FROM THE BUILDING DEPARTMENT.
AllX OWNER DATE gf X BY DATE
FOR OFFICE USE ONLY /
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION �- V
YES NO YES NO DD
HEALTH All PUBLIC WORKS FEE
PLANNING FIRE MARSHAL BUILDING PERMIT
D.O.T. BUILDING ®1 PLAN CHECK y
SPECIAL CONDITIONS BUILDING GROUP f2j-/ PRE-INSPECTION
= 6 Yoo SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
PLICATION ACCEPTED BY I PLANS CHECK SY APPROV D FOR ISSUANCE PERMIT VALIDATION
9 3 ii TOTAL 6�
BY 3' CASH CK MO