HomeMy WebLinkAboutBLD11801 Deck - BLD Application - 12/2/1981 BUILDING PERMIT* APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED /'ag
PERMIT NO. 116f 1,10//
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
rat G v �� V Z6
DIRECTIONS I / 7 72
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. r— S— A S
CONTRACTOR NAME MAIL ADDRESS CITY 6 STATE LICENSE NO: PHONE
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ 113 � = PLAN CHECK FEE PERMIT FEE -G
SPECIAL CONDITIONS:
BEDROOMS (DECKS CARPORT ❑ NO ICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT ❑ SHORELINES ❑
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
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 BUILDING DEPT.
of the Mason County ordinance requirements for / Q
which this permit is issued and that all work done will ROAD ACCESS
be in. nformanc h rewith. M TOR VEHICLE PERMIT
�J (CATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date. BY�
Ot..
PL CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. M.O. CASH