HomeMy WebLinkAboutBLD0414 Retaining Wall - BLD Permit / Conditions - 6/24/1986 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 4 6
DATE ISSUED
PERMIT NO. y 7
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
it e .
DIRECTIONS %'zw-AiCL prn f��a2•}h S4o �.
TO JOB SITE
LEGAL �' G-!/7/'�/ �J ` �GL_� (❑ SEE ATTACHEDSHT)
DESCR. iv_ W -0 VJ Z,D U 6 60
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR F
USE OF
BUILDING}��•� i
Class of work: ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
` i 1 r f_J /•���
Valuation of work: $ PLAN CHECK FEE PERMIT FEE S p
av oc> 00
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. 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.
jFirm
State of Washington and I am aware of the FOR OFFICE USE ONLY
ance requirements regulating the work for which
permit is issued and all work done will be in
ormance therewith. PERMANENT ❑ SHORELINES �
SEASONAL ❑ FLOODPLAIN ❑
E.D. NO. S.E.P.A. ❑
Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
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 DEFT.
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 PLANS ECK BY APPROVED FOR ISSUANCE
Owner ) , ak�/�UI� Date . BY
C�u 2�
PLAN CHECK VALIDATION CK,. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
CHRISTMASTOWN PRINTING
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