HomeMy WebLinkAboutBLD6153 Final Foundation - BLD Permit / Conditions - 4/3/1980 R
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY 6 STATE ZIP PHONE
S L —
DIRECTIONS � � ��
TO JOB SITE 6 f ar-293 Sgorcif
L EGCRAL. (❑SEE ATTACHED SHEET) f I�
a
ONTRACTOR
ME MAIL ADDRESS CITY 3 STATE LICENSE NO. PHONE
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USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION jFREPAIR ❑ MOVE ❑ REMOVE
Describe work:
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Valuation of work: 9 PLANK FEE PERMIT FEF,O
SPE IAL CONDITIONS: cS
_BEDROOMS DECKS CARPORT❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
NO. OF STORIES BASEMENT❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, 'HEATING, VENTILATING
TOTAL SO. FT FIREPLACE ❑ DETACHED ❑ OR AIR CONDITIONING.
CONTRACTOR AFFIDAVIT THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 .DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 12D DAYS AT ANY TIME AFTER
I certify that I am a currently registered Contractor In WORK IS COMMENCED.
the State of Washington and I am aware of the ordinance requirements regulating the work for which FOR OFFICE USE ONLY
the permit is Issued and all work done will be In
con rmance therewith. PERMANENT❑ SHORELINES ❑
SEASONAL❑ FLOODPLAIN ❑
Firm
E.D. NO. S.E.P.A. ❑
Special Approvals IN OUT YES APPROVED NO
Lic. yo. .3�.3-d/ Date �v ZONING
aAta< a�+7?t�Ci 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
of the Mason County ordinance requirements for BUILDING DEPT. Q
which this permit Is Issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR EHICLE PERMIT
APPL OV EqfSY PLAN E BY APP ED F I AN
Owner Date. y��- n
Y
PLAN CHECK VALIDATION M.O. CASH PERMIT TION M.O. CASH
j
4/3/80
Star Route 2, "I= 287H, Panorama- Park, Belfair
North Shote; Section 2, Township 22, Range 2,
{ Tract 8 of Gov't Lot 2 & 3, South of right of way
Foundation under existing Building
$1,800.00
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