HomeMy WebLinkAboutBLD11070 Bulkhead - BLD Inspections - 7/23/1981 it
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BERGER, Jack. L. #11070
13817-115th NE, Kirkland 07-23-81
MOUntain Shores, Track 11,
Bulkhead Contractor - Daves Construction
$1,200.00 Shoreline Exemption
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 —a3--o
DATE ISSUED
Jac k
{r er PERMIT NO.
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OWNER NAME M ADDRESS CITY 8 STATE ZIP PHONE
^/,� 92 9�� 3 SxI-3v2
DIRECTIONS r It
TO JOB SITE L n r(/a ll - �. i •� G' i !c [�
(❑ SEE ATTACHED SHEET)
LEGAL
NAME ~MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR j 0G -r SZ' 33 Sv 4,c/ f"n Ala:d
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: i
,4 d 5
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A -� N f-/ � /H-
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
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SPECIAL CONDITIONS: IreG C
5> : w e s
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BEDRO S {DECKS CARPORT ❑ NOTICE
BATHROOMS 1 TOTAL SQ. FT.__ GARAGE ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ 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 am aware of the F p R OFFICE S E ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in SHORELIN S
conformance therewith. PERMANEN
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SEASONAL ❑ FLOODPLAIN ❑
Firm 10or.y'G ,s cr '• E.D. NO. S.E.P.A. ❑
)�� �e, �j1, Special Approvals IN OUT YES APPROVED NO
By
Lic. No. 1-14`V� -5-C Date y yr—�-- ZONING
PLANNING DEPT.
HEALTH DEPT.
OWNERS AFFIDAVIT PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
co tract or registration law RCW 18.27, and am aware BUILDING DEPT. ?
of the Mason County ordinance requirements for7- 1
ich this permit is issued and that all work done will ROAD ACCESS
e in conformance therewith. M VEHICLE PERMIT
PPLICA O A PAPTEDBY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date. B
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH