HomeMy WebLinkAboutBLD N/A Bulkhead - BLD Application - 9/21/1982 ■
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BUILDING,PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
PHONE
MAIL AD'Df ESS CITY 8 STAT ��
OWNER ,yAMyK�'G1 �a07r —�
DIRECTIONS �// r 7 Y
TO JOB SITE /V O. ✓ /�'` ' ` / (p SEE ATTACHED SHEET)
LEGAL. ���-�
ESCR.� LICENSE NO. PHONE
NAME
MAIL ADDRESS CITY 8 STATE
CONTRACTOR
USE OF
BUILDING REPAIR ❑ MOVE ❑ REMOVE
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION
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Describe work: /�`
mew / ,
PLAN CHECK FEE
PERMIT Efg
Valuation of work: $
J
S s— — gs
SPECIAL CONDITION
CARPORT ❑ NOTICE
BEDROOMS— DECKS VENTILATING
TOTAL SO. FT. GARAGE ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING,
BATHROOMS ATTACHED ❑ OR AIR CONDITIONING.
NO. OF STORIES BASEMENT ❑ DETACHED ❑
TOTAL SO. FT. FIREPLACE ❑ 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
WORK IS COMMENCED.
I certify that I am a currently registered contractor in FOR OFFICE USE ONLY
the State of Washington and I am aware of the
i ordinance requirements regulating the work for which SHORELINES
the permit is issued and all work done well be in PERMANENT ❑
conformance therewith. SEASONAL ❑ FLOODPLAIN ❑
S.E.P.A. ❑
E.D. NO.Special S APPROVED NO
Firm Approvals IN OUT
YE
By ZONING
Lic. No. Date PLANNING DEPT.
HEALTH DEPT.
OWNERS AFFIDAVIT PUBLIC WORKS
a
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 ROAD ACCESS
which this permit is issued and that all work done willMOTOR VEHICLE PERMIT
s be in conformance therewith.
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUAN
ate�l '
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH