HomeMy WebLinkAboutBLD29438 Garage - BLD Application - 10/31/1991 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.
OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE
I
DIRECTIONS
TO JOB SITE (�
PARCEL LEGAL
NUMBER d—�10 DESCR.
NAME MAILADDRESS CITY&STATE ZIP PHONE LICENSE NO.
CONTRACTOR
an
USE OF f ,�K 099DI✓
BUILDING
CLASS OF NEW ADDITION FALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE L`
WORK auildr
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 Ft COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
`SQ BATHROOMS SEASONAL RES.O ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
CARPORT SgFt FIREPLACE IS CARPOR RAGE
GARAGE:74�2�SgFt ATTACHED O 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 Y DATE/6 —(�
FOR OFFICE USE ONLY
DEPARTMENT -YES
SPPROVENo DEPARTMENT YES No
BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE MARSHAL BUILDING PERMIT DS v
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP I PRE.INSPECTION
SHORELINE
G WOODSTOVE
PLUMBING
MECHANICAL -
STATE BUILDING FEE
APPLICATION ACCEPTED BY PLANS CHECK BY APP D ISSU N I PERMIT VALIDATION
TOTAL —�
BY SH CK MO