HomeMy WebLinkAboutBLD0174 Replace Deck - BLD Application - 9/19/1989 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. C.
OWNER NAME MAILADDRESS CITY aSTATE ZIP PHON
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PARCEL LEGAL �y
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NAM MAILADDRESS CITY BSTATE -tiOENGENep ZIP PHONE
CONTRACTOR _ .Q. /f. — G c.'— a ' Z7l
USE OF j� �
BUILDING 0aqi`-G -.5"Oomwc-e
CLASS OF NEW ADDITION ALTERATION REPAIR x MOVE REMOVE
WORK ✓
DESCRIBE �y /
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BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTALSQ.FT. GARAGE CONDITIONING.
NO.OF STORI ES 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
TOTAL SQ.FT. FIREPLACE I DETACHED ABA NDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL �c� cga Z-ZG Q
OWNERS FIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY AT 1 AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRAT N LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIRE TS 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 CONF MANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINI APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
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X W ER` „ AT X BY DATE
No FOR OFFICE USE ON I)V--1
DEPARTMENT YES APPROVEDJO DEPARTMENT YESPPROVENO BUILDING VALUATION J D
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT CIO
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE �j U
STATE SURCHARGE
APPLICATION ACCEPTED BY P N H K'� APPROVE OR ISS CE =PERMITDATIONBY CK MO TOTAL S