HomeMy WebLinkAboutBLD0027 Final Cooler - BLD Permit / Conditions - 3/8/1984 I
r .
. Nwris, Bob #0027
275-4501 5/31/83
Tract 43, N 1/2 of Tract 44, Sam B. Theler Dome &
Garden Tracts
Highway 3, across from Hank's Country Inn, Belfair
Cooler Contractor:
22'x10' Self
$1,001.00
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_ BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATEISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
(308 �1�RRfS' )E as 551 1.luy3 Sa FA/R W►�1 q0 8 ?S-AsoIf
DIRECTIONS 3
TO JOB SITE
LEGAL
/� C ((�� J� �(❑_SEE ACHED SHEET)
DESCR. TR, q-3 ^ x. TR 1+4 �&—I i�. �d0'YI�1G.
NAME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING (f V o J— 4%fi
Class of work: ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
a x to C oo),ER Fop t3E04 'RIe aFS
Valuation of work: $ PLAN CHECK FEE PERMIT FEEo
f, o a
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
I BATHROOMS TOTAL SQ. FT. GARAGE ❑
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ 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 FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
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 ❑
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
B Special Approvals IN OUT YES APP V D NO
Y
Date
Lic. No. ZONING
PLANNING DEPT.
HEALTH DEPT.
OWNERS AFFIDAVIT
I 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. /9'3'
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY L PL/ 1 EC BY APPROVED FOR ISSUANCE
Owner Date_ Yin,/►/J eY
7 P CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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