HomeMy WebLinkAboutBLD92-0293 Shingle Siding - BLD Permit / Conditions - 5/14/1992 BUILDING PERMIT
APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. J-2
ZIP PHONE
MAIL ADDRESS NAME CITY BSTATE
it (� Z7.5�"Z S_>Z•-52 ,.
OWNER 'G
DIRECTIONS Utz t4l Lt 'q 1�
TO JOB SITE � f'yl!- S � Lb�,� ��� �
-&.7� Al 2- S�C�Lf£ l I p� €�.f--r t S h LEI ,f�
v
LEGAL ! �—Lryi Sc7Aiy� C i7�
PARCEL DESCR. �}
y 7/S ��~ ucENSENo.
NUMBER NAME MA ZIP PHONE
IL ADDRESS CI TY8STATE {�
CONTRACTOR fZi ��? z7 =Sid %� "'JCua p`Y. c>.' t
USE OF
BUILDING MOVE REMOVE
CLASS OF NEW ADDITION ALTERATION REPAIR
WORK r
DESCRIBE "j
WORK A)C(,J 5-- NOTICE'
AREA: NUMBER OF: PLEASE INDICATE: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE SgFt STORIES
SHORELINE❑ CONDITIONING.
BASEMENT USPENDEED OR
SgFt BEDROOMS PRIMARY RES.O THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED NOT
COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS S
DECKS SgFt BATHROOMS SEASONAL RES.❑ ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
CARPORT SgFt FIREPLACE IS CARPORT/GARAGE
GARAGE SgFt `D'Au% ATTACHED❑DETACHED❑
CONTRACTORS AFFIDAVIT
OWNERS AFFIDAVIT HE
I NTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
CERTIFY THAT I ARCW 8 PTAND FROM
THE
REQUIREMENTS
OF THE MASON COUNTYOORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQU REMENTS REGULAT NG THE
REGISTRATION LA
REQUIREMEN S FO WHEREW THIS
PERMIT
R ICIS HANGESD AND SHALLHBEAMADE WITHOUT WILL
FIRST CONFORMANCE HEREWITH NO CHANGES SHALL BE MADE WFOR WHICH THE PERMIT IS ISSUED AND ALL ITHOUT RK OFIRST NE VOBTAINING
IN CONFORM APPROVAL FR THE BUILDING DEPARTMENT.
OBTAINING APPROV FROM THE BUILDING D PARTMENT.
� DATE
X BY �'�'Q � Y DATE
XOWNE
FOR OFFICE USE ONLY
APPROVED BUILDING VALUATION z
APPROVED DEPARTMENT YES NO
DEPARTMENT YES NO FEE
HEALTH L PUBLIC WORKS
FIRE MARSHAL BUILDING PERMIT
PLANNING PLAN CHECK
BUILDING
D.O.T. PRE-INSPECTION
�3
SPECIAL CONDITIONS BUILDING GROUP SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE 4(• O
NCE PERMIT VALIDATION `
RoveD S TOTAL
APPLICATION ACCEPTED BY PLANS�CHECK BY CASH CK MO
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