HomeMy WebLinkAboutBLD19363 Final Retaining Wall - BLD Permit / Conditions - 11/13/1986 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED 57`2^1-51C2
PERMIT NO. �yQ• �' '�
OWNER NA MAILA RES ;MA
ZIP PHONE
DIRECTIONS `2
TO JOB SITE
LEGAL
D SCR. dA:774r)J
NAME MAILADDRESS CITY BSTATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE / '
WORK /
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTALSQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
a
OWNER AFFIDAVIT CONTRACTORS AFFIDAVIT
I
I CE1,, ER
THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGTION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQENTS 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 RMANCE THEREWITH. NO CH ES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTG APPROVAL FROM THE BUILDI EPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X O DATE X BY DATE
�09 OFFICE USE ONLY
APPROVED APPROVED
DEPARTMENT DEPARTMENT
YES NO YES NO � / (/BUILDING VALUATION - '7 / eel
HEALTH PUBLIC WORKS FEE
PLANNING /� FIRE BUILDING PERMIT 5(, s 0
D.O.T. I BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP �'�- PRE-INSPECTION
VC / SHORELINE
PLANNING
PLUMBING
MECHANICAL
STATE BUILDING FEE Q
STATESURCHARGE '
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
p TOTAL
BY V' CASH CK MO
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TYPE RETAINING WALL
Permit No• _19363 No. Floors Sq Ftg
Owner —SOT.TT. TN , Bob Tel 275-4477 Date 9-25-86
Address P. o. Box 767 Belfair Zip
Contractor Self
Address
zip
Legal Description Sam Theler Home & Gar Tr Por Tr 29-
Direction to projec t site B
NE 22580 Hwy 3
Plumbing Mechanical Sewer Tnbod Stove
Fireplace Deck Garage Carport
Basement Loft Other
Shorelines: Plumbing:
Se
tback: Mechanic
Interior:
Conditions: FINAL:
Mobile Home:'
Smoke Detector:
Remarks:
Footing: G
Setback:
Foundati
Walls:
Framing:
Fireplace:
Wood Stove: