HomeMy WebLinkAboutBLD0228 FINAL PASS 11.6.84 - BLD Permit / Conditions - 10/9/1984 4 a
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAILJADDRESS CITY 8 STATE ZIP PHONE
Eti S 2 geb&
DIRECTIONS I
TO JOB SITE �t ,Y 7jQ+�ii �,.�5� ��sS "C SO
LEGAL �U / (❑SEE ATTACHED SHEET)
DESCR. (--U S C 2-a� T�vN 2 2 !U 2 Kh6j-
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR r C 6A e4 V �Ak&a 12s 7
USE OF BUILDINGk(:A��-'
Class of work: ❑ NEW X ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
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0tf-
Valuation of work: $ PLAN CHECK FEE PERMIT FEES
O C7 S
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORTvj 7 28 NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE)4
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ sq SEPARATE
AIR CONDITIONING.RE REQUIRED FOR PLUMBING, HEATING, VENTILATING
OR TOTAL SQ. FT. FIREPLACE El THIS
❑
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 ❑
SEASONAL ❑ FLOODPLAIN ❑
Firm
E.D. NO. S.E.P.A. ❑
Special Approvals IN OUT YES APPROVED NO
Lic. o. 'r 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. (/
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANSQHECK BY APPROVED FW ISSUANCE
Owner Date. �p/J B
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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SANDERS, Darrell _ #0228
10-9-84
Gov Lot 2 28-22-1
Hwy 302 just past Victor
Contractor
Raphael Custom Const.
Garage & Carport .
$5,512.00
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