HomeMy WebLinkAboutBLD11428 Siding - BLD Application - 9/16/1981 BUILDING PERMIT APPLICA.TI®N
MASON COUNTY -
P.O. Box 186 - Shelton, Washington 98584
426-5593
DATE ISSUED _
PERMIT NO. l
I
OWNER NAME MAIL_ADDRESS CITVBSTATE ZIP - PHONE
t . C. 9S r.DIRECTe vt $
ONS IL I-L NeL
TO JOB I SITE
LEGAL - - - JE SEE ATTACHEDSHEET)
DESCR. 7_.� -
NAME, - MAIL ADDRESS CITY&STATE - LICENSE NO. PHONE }
CONTRACTOR - -
USE OF
'-1UILDING
`Elass of work: ❑ NEW ❑ ADDITIO ALTERATION ❑ REPAIR ❑ MOVE", 11 REMOVE-
Describe work:,. .
_ . '
Valuation of work: 3 �. o ,PLAN CHECK FEE PE MIT FED b 1
v(
SPECIAL CONDITIONS
BEDROOMS - IDECKS `CARPORT ❑ _.
NOTICE
BATHROOMS ' TOTAL SO FT. GARAGE❑ '
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FORT PLUMBI G,. HEATING VENTILATING
NO* OF STORIES BASEMENT ❑ OR AIR CONDITIONING
TOTAL SQ. FT. FIREPLACE 0 DETACHED ❑ N R MIT �V
" THIS PER BECOMES NULL ANDOID IF WORK CONSTRUCTION OR ONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IFCC NSTRUCTION OR WORK IS
- SUSPENDED OR ABANDONED FOR A PERIOD OF"180 AYS AT ANY TIME AFTER .
"I certify that,I am a,c6rrBntly�registered'contra6tor'in WORK IS COMMENCED.
the State of Washington and I am aware of :the. FOR OFFICE, IUS .ONLY
'ordinance requirements regulating the work for which
the;permit is issued and all work done,will be in
'conformance therewith - PERMANENT ❑ 'SHORELINES ❑
"SEASONAL ❑. FLOODPLAIN El -
Firm . .. -:-.. - E.D: NO .,w . S.E.P.AI7 - .. .
- BY Special Approvals IN ;+ OUT... YES APPROVED..NO. .
Llc. No: Date ZONING
'. :.. - PLANNING DEPT.. '.
OWNERS AFFIDAVIT HEALTWDEPT. -
PUBLIC WORKS -
I certify that lam.exempt from the requirements of the FIRE.MARSHAL- -
Contract or registration,law RCW 18.27, and am aware BUILDING DEPT.
of 'the .Mason County ordinance requirements for
which this permit is issued and that all work"done will ROAD ACCESS':
be in conforman a therewith MOTOR VEHICLE PERMIT
- /� P/ PP CATION A EPTE BY - PLANS,Q BY APD FOR ISSUANCE
�no Dale o
e I
P ECK VALIDATION CK. M.O., CASH PERMIT VALIDATION CK. M.0 CASH