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HomeMy WebLinkAboutBLD0555 Final ReRoof - BLD Permit / Conditions - 8/24/1987 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES 7- P.O. BOX 186 SHELTON, WASHINGTON 98584 426-5593 DATE ISSUED PERMIT N OWNER NAME MAILADDRESS CITY&STATE Ms ZIP PHONE DIRECTIONS 7 c13 7 .S- TO JOB SITE PARCEL NUMBER EGAL �/ ��`J.c/ '�-3 ' ��©1 ESCR. I Af/1." Al CONTRACTOR NAME MAIL ADDRESS CITYBSTATE LIC NSENO. ZIP PHONE USE OF ° aI&ORP ','rtw. 3 3 - 3 BUILDING YCSI OLCvl -� Si$j/a CLASS OF WORK ✓ NEW ADDITION ALTERATION REPAIR MOVE REMOVE DESCRIBE WORK BEDROOMS 2- DECKS CARPORT NOTICE BATHROOMS�_ TOTAL SO.FT. GARAGE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. NO.OF'STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT TOT SO-FT.`v� FIREPLACE DETACHED COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PER ANENT SHORELINE ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED. ✓ SEA ONAL O NERS AFFIDAVIT CONTRACTORS AFFIDAVIT I RTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF RE ISTRATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE RE UIREMENTS 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 NFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING AINI�NG JAPPgOVAL FROP T{IE BUILDING DEPARTMENT.&J APPROVAL FROM THE BUILDING DEPARTMENT. WNER & ` e a, ATE _A Z.Z O%7 X BY DATE FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED Yes No YES No BUILDING VALUATION b HEALTH PUBLIC WORKS PLANNING FIRE FEE BUILDING PERMIT la D.O.T. BUILDING SPECIAL CONDITIONS BUILDING GROUP PLAN CHECK PRE-INSPECTION 40 S SHORELINE C WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE APPLICATION ACCEPTED BY STATE SURCHARGE P H 4Y APPROV D F R I DANCE PERMIT VALIDATION BY CASH CK MO TOTAL �a a a� a Shorelines: IV j Plumbing: Setback: Mechanical - Special Interior.- Conditions: FINAL• /<- p Mobile Home: Smoke Detector: 0o in Remarks: g Setback: Foundation Walls: Framing: Fireplace: Wood Stove: TYPE RE ROOF Permit No. 0555 No. Floors Sq Ftg 665 Owner WILLIAMS, Helen Te1775---428 Date 7-21-87 Address E 17293 wy llyn Zip Contractor Holloway Roofing Address 5910 Central Valley Rd NE Bremertoilip Legal Descrip ion N-1/2,s-1/2 SW NW 29-22-1 Direction to projec site Above address um ing MechinicaI Sewer Wood Stove Fireplace Deck Garage Carport Basement Loft Other k