HomeMy WebLinkAboutBLD N/A Walkway to Floating Dock - BLD Application - 4/5/1982 t �
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
UT `� � PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITE
LEGAL rr (❑ SEE ATTACHED SHEET)
DESCR. Trgc� *1k7 of �ave►� �-a�CC aS V �ecorA#A IPL Vol. �� o� T1, �a �3�
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING �egSuYe.
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
/'�' Iva l kwa o a / 8 `x IA' SW
Valuation of work: $ AN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. 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 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 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 ❑
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT. S`�Z
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. 2
of the Mason County ordinance requirements for
which this permit is ' sued and that all work done will ROAD ACCESS
knrnform Ike erewith,. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date. �3 �" �� BY
PLAN CHECK VALIDATION CK.. M.O. CASH PERMIT VALIDATION CK. M.O. CASH