HomeMy WebLinkAboutBLD12720 Green House - BLD Permit / Conditions - 7/15/1982 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 8
DATE ISSUED
I
PERMIT NO. oZ D
OWNER NAME I MAIL ADDRESS CITY&STATE ZIP I PH yE�
S i �Sg (,
DIRECTIONS I DA, L
TO JOB SITE
LEGAL I0 SEE A ACHED BHE
r 4I
DESCR. z
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR _Al
61J
USE OF /_
BUILDING Gr2EE,v Aw:;r- -TYPE C/A/
Class of work: ❑ NEW ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ P Ly CHECK FE PERMIT FEE
3 So V 5 $�
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT O NOTICE
BATHROOMS TOTAL SO. FT._ GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING,
G, HEATING, VENTILATING
NO. OF STORIES_ BASEMENT ❑ 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 FORA PERIODOF 18o AYS AT ANYTIME 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 US ; ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT 0 SHORELINES
SEASONAL ❑ FLOODPLAIN ❑
Firm L ll E.D. NO. S.E.P.A. ❑
1
ByI I Special Approvals IN OUT APPROVED YES NO
Lic. No.a>=PC-,=1�L_�Y�1d �Y Date ZONI
PLANNING DEPT.
HIf
OWNERS AFFIDAVIT
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHA
contract or registration law RCW 18.27, and am aware UILDING DEPT. .t
of the Mason County ordinance requirements for .
which this permit is issued and that all work done will ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
LICATIO A E T D.BY PUN CHECK BY APPROVED FOR ISSUANCE
Owner Date — ' By
\P CHECK VALIDATION CK, M.O. CASH PE MIT VALIDATION CK.I M.O. + CASH
` EXEMPTION FROM SHORELINE
MANACEMF.NT ACT SUBSTANTIAL
DEVELOPMENT PERMIT REOUIREMFNT
The proposal by � applicant)
to undertake
n�re o
the following development I�Q r ( , D;E 0/— (7�I TI (0)
b�el�s,pe�c. s is i
—- ---upon the following property f f1FY�Sl 11�� J S Ur 1 N c+ > --------
legal description; i.e. , section to the j
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nearest quarter section
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-t: pAssAc�rF
within and/or its associated
name ot water area
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wetlands is exempt not exempt from the requirement of a substantial
develoom.ent permit because the development p6soc'
A-C- -7 3 14 -
(identify exemptions as out mad in HAC -1 - 0
Corps Public Notice Number if available)
i
The proposed development is consistent/inconsistent with:
CHECK ONE
CONSISTENT INCONSISTENT
Policies of the Shoreline Management
t/ Act.
The master program.
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Date (Signature ol Authorize Local Govern-
ment Official)/ c
MU
ate - Expiration
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T�q 5,5 A 6�
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SW 426,6945 Estates, a Dti�. 1
stere lsla"a t at Yeal 1
Hart n, a otor.
stop sl ale Dti� Coast a tf CoSLt nst
on left, E 31 Ye BuY Yeli�'e.EXezvtion ,1
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Swimme, Wayne I \
42676945 I112720
7/15/82
Hartstene Island Estates, Division 2; Tract 22.
Right at stop sign, right at Peale Drive, 3rd driveway
on left, ,E 31 Peale Drive.
'Green House Contractor:
(Sun .Space) Burgdorf Const. 1�
$3,500.00 Shoreline Exemption 1
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