HomeMy WebLinkAboutBLD10988 Wood Shed - BLD Application - 7/13/1981 r '
BOIL®ING PERMIT APPLICATION ` i
MASON COUNTY
P.O. Box 186 Shelton, Washington,98584
426-5593 z
DATE ISSUED
_ �� V I �,. W J� ✓'O r . PERMIT"NO. I
PHONE
ZIP
MAIL ADDRESS CITYB STATE I- ' I
OWNER NAME
E T.. Z S> �l.TD IJ W
. DIRECTIONS -
TO.'JoB SITE AC
� c' ^
G �j [,{/ (❑ SEE A CEET)
LEGAL
EGCR. ' �.J l,.�. /' / �W �D ` 'LICENSE NO PHONE
AIL ADDRESS .CITY 6 STATE
NAME-
CONTRACTOR �
USE OF
BUILDING �t; E ''
lass of work: NEW ❑,ADDITION ❑ .ALTERATION LJ REPAIR O MOVE Li REMOVE
Describe work: L(J M B E wl �T bF ou '
PE MIT FEEL
-PLAN CHECK FEE
Valuation of work: $
(0 7
SPECIAL.CONDITIONS:, ,.
BEDROOMS DECKS
CARPORT ❑° NOTICE.
HEATING,
BATHROOMS ' TOTAL SO FT._— GARAGE
' SEPARATE 'PERMITS ARE -REQUIRED FOR PLUMBING, VENTILATING
BASEMENT ❑ ATTACHED Or OR,AIR CONDITIONING.
NO. OFT STORIES - :DETACHED ❑ `
TOTAL SO FT FIREPLACE ❑ THIS'PERMI7 BECOMES NULL AND VOID IF WORK OR CONSTRUCTION WORKAUTHOR-
CONTRACTOR AFFIDAVIT [ZED IS NOT COMMENCED.WITHIN 180 DAYS,ORIF ONSTRUCTION ORWORKIS.
SUSPENDEDoR ABANDON ED FOR A PERIOD OF.18 DAYS AT ANY TIME AFTER
WORK IS COMMENCED.
I certify that I am."a currently registered contractor in FOR OFFICEi 'US I�Y
the 'State of Washington and 1 am aware 'of the
ordinance requrements regulating the work for which. ,
. the.permit is issued, and all ,work 11 don e..will ,be. in PERMANENT SHORELINES JJ
conformance therewith ;SEASONAL I7 FLOODPLAI ❑
E.D. NO. . .S E.P A ❑ I' AP^
Firm - ' OUT . PROVED N�_
Special Approvals IN J.
By. ZONING I.
'Lie. No. Date PLANNING.DEPT: 1`
Ii EALTH.DEPT
OWNERS AFFIDAVIT PUBLIC WORKS '
I certify IhatI am exempt from the requirements of the FIRE MARSHAL
contractor registration'Iaw RCW 18.27, and am aware BUILDING DEPT.7/•j � �fj n'
of the:. Mason County.ordinance requirements for
ROAD:ACCESS'.
which this permit Is.issued,and that all work done will VEHICLE PERMIT `I �•.
begin conformance-iherew,dh.'
— � � /—� � ppPLI TI N EPTED Y EC AP
PLANS CH K BY
OVED FO ISSUANCE-
Date
Ow er
.
PERMIT VALIDATION CK: M.O. CASH
eTION CASH
CK. ' ` M.O I1