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HomeMy WebLinkAboutBLD11043 Bulkhead - BLD Inspections BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98684 DATE ISSUED ` —�/ PERMIT NO. 11O 3 NAM MAIL ADDRESS ii CITY STATE ZIP PHONE OWNER ,� ohrllSv IQ ,®(i� T&CO)-r/tCcz•2�1 DIREC TO JOB SITE 0Vi6w — c1t. Vt C�t.T 2 -e C1 C Lt.(-We,-Scr- LEGAL r"rstf�Cct� A ACHED SHEET) DESCR. �2' NAME MAIL ADDRESS CITY d STATE I LICENSE NO. S PHONE CONTRACTOR L a 40 9 3 S a USE OF BUILDING Class of work: NEW ❑ ADDITION'' ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: i 00i, < < r Valuation of work: $ ©� PLAN CHECK FEE PERMIT FEE SPECIAL CONDITIONS: 1 TION A CEPTED Syl PLANS CHECK BY APPROVED FOR ISSUANCE Type of Occupancy Division 7'n Const. Group Size of Bldg. No. of Max. (Total)Sq. Ft. Stories Ooc. Load CONTRACTOR AFFIDAVIT PERMANENT SEASONAL E.D.NUMBER I Certify that I am a currently registered contractor in RESIDENCE the State of Washington and I am aware of the MOBILE HOME ordinance requirements regulating the work for which the permit is issued and all work done will be in Special Approvals Required Not Required conformance therewith. ZONING HEALTH DEPT. Firm PUBLIC WORKS By ROAD DEPT. Lic. No.��n^ 1✓' lg-o`' Date 7 Z3 OWNERS AFFIDAVIT I certify that I am exempt from the requirements of the N O T I C E j contract or registration law RCW 18.27, and 8m aware SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING. which this permit is issued and that all work done will be in conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WO&Off STRUCTION AUTHORIZED IS NOT COMMENCED.WITHIN 12D DAYS, OR IF CO=TRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER /wner Date. WORK IS COMMENCED. PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH KV2MIK, Llloyd M. #11043 7005•Johns;on rd. NE, Tacoma 07-22-81 Grapeview Rd. , take Rauschart Rd. to water, end of cul-de-sac, Lot #12, Mountain Shores Bulkhead Contractor - Johnson Bulldozing $3,200.00 Shoreline Exemption i i �' ii 4 1- �' I � � f i