HomeMy WebLinkAboutBLD6525 Alteration - BLD Permit / Conditions - 6/2/1980 I�
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Lepers, Don #6525
6-2-80
Across from Belfair Elemenatary School
N 1/2, Tr. 22of Theler's Home & Garden Est.
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Alteration
$2,200.00
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BUILDING PERMIT APPLICATION
MASON COUNTY �l
�I P.O. Box 186 Shelton, Washington 98584 v
426-5593
DATE ISSUEDeat �
V PERMIT NO.
NAME & n MAIL ADDRESS BF)L CITY i S�TE tO IJ � I�P-.� PHONE
OWNER �'() � /��• P I H r � r1 Q��t,(,7
DIRECTIONS AC.,�os s FRDr-� �3 L FA IlQ L. NFll7T�leY `'"' `0
TO JOB SITE �/ r /� A �,/
LEGAL /lJ D TTl 1 C•T�pP.(, D ?M�J� /C s D�1 (❑SEE ATTACHED SHEET)
DESCR. GARPEO &S!/ rr_5 G c a D
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR �Q �4 Aio fil S
USE OF 7-
BUILDING p N r R
j Class of work: ❑ NEW El ADDITION
ALTERATION El REPAIR ❑ MOVE El RE
Describe work: Iq 7 A/ G FIRIMPIC E
WV,F TWO WAt,1 5 ?O 2�—N1.iq � 6�' R�C�PTID� ARE
Valuation of work: $ 0 / PLAN CHECK FEE PERMIT FEE 8 55
SPECIAL CONDITIONS:
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BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE El THIS
El
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in
WORK IS COMMENCED.
the State of Washington and I am 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 ❑
L I�/ SEASONAL El FLOODPLAIN ❑
XFlrm_�L g?0 E.D. NO. S.E.P.A. ❑
Special Approvals IN OUT
By YES APPROVED NO
Lic. No. ��L- '�Gl)�r�.�IsDate '3�I8`0 ZONING
I PLANNING DEPT.
s
HEALTH DEPT.
OWNERS AFFIDAVIT 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. kMORVEHICLE PERMITTIO D BY NS CH BY APPROVED FOR ISSUANCE
Owner
Date. BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIO CK. M.O. CASH