HomeMy WebLinkAboutBLD29570 ReRoof - BLD Permit / Conditions - 11/19/1991 Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: Final:
Mobile Home:
Smoke Detector:
Footing: Remarks:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Woodstove:
AREA. TYPE: RE-ROOF
Owner: SHARER, R.W. Tel: 275-2137 Date: 11-19-91
Address: 16950 HWY 39 ALLYN 98524
Permit #: 29570 Floors: 0 Sq Ft:
Contractor: SAME
Address:
Legal Description: 29-22-1 TR 1 PF W1/2 SW
Direction to job site: 16950 HWY 3 BY CAT FISH LAKE
Plumbing Mechanical Woodstove
Fireplace Deck Garage
Carport Basement Loft
Conditions: NONE
i
•T
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W.CEDAR/P.O.BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. a9576
OWNER NAMES MAILADDRESS CITY&STATE ZIP PHONE
4J) /GR
DIRECTIONS
TO JOB SITE
PARCEL LEGAL / 1
NUMBER 'p�q� DESCR.
NAME
CONTRACTOR SIV
MAIL ADDRESS CITYB Ip
TATE ZIP pNE LKEIrBENO.
USE OF IF
BUILDING ,G.•a�•
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE /►
WORK
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 SgFt BATHROOMS SEASONAL RES.❑ COMMENCED WITHIN 180 SAYS, 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 0 DETACHED❑
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
1 CERTIFY THAT 1 AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I 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 I 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 FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNER DATE ��' ��� /^� X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION �/�
YES NO YES NO /00
HEALTH PUBLIC WORKS FEE
PLANNING FIRE MARSHAL BUILDING PERMIT •��
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
APPLICATION ACCEPTED BY PLANS CHECK SY AP ED FOR ISSUANCE PERMIT VALIDATION
�� Y - CASH CK MO TOTAL a3 ��