HomeMy WebLinkAboutBLD11868 Farm Bldg - BLD Permit / Conditions - 12/21/1981 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 G_
DATE ISSUED
J( / PERMIT NO. ��O 1t70
NAME MAIL ADDRESS
OWNER - T aTYasTATFJ, zlv PHONE
DIRECTIONS
TO JOB SITE w., ��. '
< < ciG
LEGAL i I�' $EE ATTACHED SHEET)
DEscR. �,;�., l��.l - �c -- Y '� ',t. 't it ;t �� li-t
NAME `. MAIL ADDRESS CITY 8 STATE LICENSE NO. - PHONE
CONTRACTOR -�.r _ ,
USE OF - "-
BUILDING � � /j DJ / • ' -
Class Of v Ork ANEW ❑ ADDIPON ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: --
AR
Valuation Of work: $ PLAN CHECK FEE ol�/l PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS _ _ (DECKS_ - _ CARPORT L: NOTICE
BATHROOMS_. TOTAL SO. FT. GARAGE '.
NO. OF STORIES BASEMENT ( . ATTACHED : SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
—— OR AIR CONDITIONING.
TOTAL SO. FT. _ FIREPLACE -1 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 FORA PERIOD OF 180 DAYS AT ANYTIME 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
C_o,gformance therewith. PERMANENT _ SHORELINES
Firm IZ�.t�._- '�" r SEASONAL r, FLOODPLAIN
E.D. NO._ S.E.P.A, i
By Special Approvals IN OUT YES APPROVED NO
..
Lic. No._.__ Date ' C / . ;� ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MAR
contract or registration law RCW 18,27, and am aware
of the Mason County ordinance requirements for BUILDING DEP
which this permit is issued and that all work done will ROAD ACCESS
be Ip cpn(ormance therewith. t MOTOR VEHICLE PERMIT
t/
'r ED BY PLANS CHECK BY APPROVED FOR ISSUANCE
APPLICATION ACCEPT
Date
Own �f-"i -� - `
I , ✓- BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
Johnson, Jack #11868
12-21-81
Sam Theler's Home & Garden Tracts 35, 36, 36A, & 37
Hwy 106/ Left at Golden Bell Trailer Court, Down on
flats.
Farm Bldg.
$1,530.00
0
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