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HomeMy WebLinkAboutBLD21092 Bulkhead - BLD Permit / Conditions - 1/9/1991 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 426-5593 DATE ISSUED�Q' G, PERMIT NOC OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE vV C— .57 2-+0 Pcwl 70 Z 2-75— 7-10 DIRECTIONS W �� TO JOB SITE PARCEL NUMBER 1 Z233 SO o00� ESCRLEGAL. !t'tf"ILS f}o2E T2- 2. NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR -&kR T _ S *AW BUILDINGUSE OF PQ.evmv►r �m-r' e)"X-- pQ �1E7502, 95b�O-03'7-7 CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE WORK ►.�Li L©(7 BEDROOMS DECKS CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTA�LSQ.FT. GARAGE CONDITIONING. NO.OF STORI ES B SEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SQ.FT. IREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORKIS COMMENCED. PERMANENT SHORELINE SEASONAL OWNERSAFFI AVIT CONTRACTORS AFFIDAVIT I CERTIFY THA I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION W RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMEN 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 CONFOR ANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING PROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. X OW DATE X BY DATE FOR OFFICE USE ONLY AD DEPARTMENT Y SPPROVENo DEPARTMENT YES No BUILDING VALUATION ;25 515 HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT 5,0 D.O.T. BUILDING PLAN CHECK . SPECIAL CO DITIONS BUILDING GROUP PRE-INSPECTION ,� OO SHORELINE WOODSTOVE PLUMBING MECHANICAL I STATE BUILDING FEE 1 STATE SURCHARGE APPLICATION ACCEPTED P R N PERMIT VALIDATION j BY CASH CK MO TOTAL �3� Shorelines: Plumbing: Setback: Mechanical: Special Interior: Conditions: FINAL: Mobile Smoke Detector Foot : Remarks: Setback2 to- : Foundation Walls: Framing: Fireplace: ul Wood Stove: DA►T -,;,��.�..� ly n TYPE BULKHEAD Permit No. 21092 No. Floors Sq Ftg Owner CROW, Leroy Te1275-3247 Date10-20-87 Address E 5720 Hwy 302 Belfair Zip Contractor Japhet Bulkheadin Address 2121 Summit Lake Shore RdNW 1p Legal DesCrlptlon Olympic Shore Tr 2 Direction to project site Same address as above Plumbing c anicasewer Woo tove Fireplace Deck Garage Carport Basement Loft Other