HomeMy WebLinkAboutBLD27188 Final Addition and Repair - BLD Permit / Conditions - 6/5/1981 Nordstrom, Lloyd #4159
2-16-79
E 125' Tr. 16 S of r/w State Hwy 106 33-22-3
5th house east of Alderbrook Inn, water side
Addition and Repair (addition only 6'x20')
Repairs to remove rotted box will mud plate and
some floor joists.
Contractor
$10,000.00 D.A. Construction
U�
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
OWNER Nb1E M-AILADDqESS
CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITE ��� C)
PARCEL LEGAL
NUMBER - - ) DESCR.
NAME ��ti/l-9
CONTRACTOR MAIL ADDRESS CITY64STATE LI ��� l
S^�t'L 9�S1 i 7 ZIP PHONE
USE OF -
BUILDING
CLASS OF
WORK r NEW ADDITION ALTERATION REPAIR MOVE REMOVE
DESCRIBE
r
WORK C'>j 2
BEDROOMS DECKS CARPORT NOTICE
BATHROOMS TOTAL SQ.FT. GARAGE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
TOTAL SQ.FT. FIREPLACE DETACHED COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
PERMANENT
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED,
SHORELINE
SEASONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY T4SLFOR
I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATIOAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREME WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CONFO ANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAININ APPROVAL FROM THE BUILDING DEPARTMENT,
APPROVAL FROM THE BUILDING DEPARTMENT.
S
X OW R DATE X BY
��'� DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED
YES No YES No BUILDING VALUATION ���
HEALTH PUBLIC WORKS
PLANNING FIRE FEE
'®�L BUILDING PERMIT
D.O.T. BUILDING (_ PLAN CHECK 01
-7 f>
SPECIAL CONDITIONS BUILDING GROUP o<
Z-s PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
APPLICATION ACCEPTED BY PLANS CHECK BY STATE SURCHARGE
ED F SSUANCE PERMIT VALIDATION
I-2 BY CASH CK MO TOTAL / •'�_ �