HomeMy WebLinkAboutBLD5672 Sign, Shoreline Exemption - BLD Application - 8/11/1977 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED J°11177
PERMIT NO. ,6 6' 7---
OWNER NAME MAIL ADDRESS CITY&STATE ii ZIP PHONE
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DIRECTIONS
TO JOB SITE LEGAL (❑ SEE ATTACHED SHEET)
DESCR. _V( l -- ) f_1t Iv j` f.�ir!!l:�*( an+ %: Lr g C�%" c I r '4<-'�t.,' t% ;:.� !L !� > -i. L L1 w.
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR Q
C, p
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR YMOVE ❑ REMOVE
Describe work:
Alder-
Valuationof work: $4 PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
1ADDLICATION ACCEPTED BY PLANS CHECK BY APP ED FOR I SUANCE Type of Occupancy Division
BY t.li ! Const. Group
Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT. _
Firm _ _ PUBLIC WORKS
By
ROAD DEPT.
Lic. No. Date
OWNERS AFFIDAVIT
1 certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
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
Owner �'\ - -Date, WORK IS COMMENCED.
.AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. M.O. CASH
August 10, 1977
Mr. Robert J. Close
St. Rt. 1, Box 103A
Union, Washington 98592
Dear Mr. Close:
The Mason County Board of Commissioners went on record at
their regular Meeting last Monday exempting you from the
requirement of a Shoreline Permit to move the Wooden Frog -
sign from the canopy to a spot located East of the Building
North of the power pole and also remove the canopy which served
years ago as the cover for the gas station when it was the
Waterwheel Grocery.
Enclosed is a copy of an Application for Substantial Develop-
ment Permit which will be required when you drill your well.
Sincerely,
Ruth E. Boysen
Clerk of the Board
cc: Planner
Department of Ecology
Enc.
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