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HomeMy WebLinkAboutBLD0055 Bulkhead - BLD Permit / Conditions - 7/12/1983 N in ul O� rt o %C) tad hw.+ m I m w O W FJ N m C)D W ►w" rf p.h art K o 0 � vJ m a m w o 0 0 CA m rt rt rr I 0ovi w a+ o a N x x m Iv a o 0 \8 8 0 � mo rrtt Ln w w n °D rr rr w m n o a n m .. rt o b � rr Shorelines: Setback: Special Conditions: Footing: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: Plumbing: _ Mechanical: Roof: Exterior : Interior : Final: ' Stop Work: I Mobile Home: Smoke Detector: Remarks: -YiULL R VOID B BUILDING TERMITAPPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED PERMIT NO. Ind 5 5 OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE 'q - /V 324-, xm- DIRECTIONS TO JOB SITE ` LEGAL (❑ SEE ATTACHED SHEET) DESCR. VT S /M 0 oy p- # NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR C 1YE 12 Yll 4W SAOd' !' USE OF BUILDING Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: 4C Valuation of work: $ 6DOO,v9 PLAN CHECK FEE PERMIT FEE A SPECIAL CONDITIONS: BEDROOMS DECKS-- CARPORT ❑ NOTICE BATHROOMS TOTAL SQ. FT. GARAGE ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING. TOTAL SO. 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 which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT APPLICATION ACCEPTED BY PLANS HECK BY APPROVED FO ISSUANCE Owner �� -Date. 7 �z - BY CHECK ALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O.