HomeMy WebLinkAboutBLD0540 ReRoof - BLD Permit / Conditions - 6/2/1987 Shorelines: 414 Plumbing:
Setback: Mechanical :
Special Interior:
Conditions: FINAL:
MobileHome:
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing
Fireplace: NULL & VOID BY EXPIRAf10s
Wood Stove•
6 BYE
TYPE REPLACE ROOF
Permit No. 0540 No. Floors Sq Ftg
Owner DUBIAK, Daniel Tel 275-5815 Date 6-2-87
Address NF 481 Old B lfai Hwv RPlfair Zlp
Contractor Self
Address Lip
Legal Description Tr 1 Nw,NE 29-23-1 (Tr B S/PI/ 898)
Direction to project site
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426.5593 DATE IS LIED
PERMIT 140. 416
NAME MAILADDRESS CITYBSTATE ZIP PHONE
'R DANLEL UBiA.K E 0 oLD BC1-Fhip, Atuy gGLFAI Zg 2-7SS9IS
(IONS
3 SITE
ia• TRItCT of w E T2bc:T OF 5 Ptfr 89g
NAME MAILADDRESS CITY S STATE LICENSE NO. ZIP PHONE
VTRACTOR
OF
LDING l{
ASS OF NEW ADDITIO ALTERATION REPAIR MOVE REMOVE
3RK
_SCRIBE
ORK
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HE TING, VENTILATING OR AIR
BATHROOMS TOTALSO.FT. GARAGE CONDITIONING.
NO.OFSTORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSI RUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION DR WORK IS SUSPENDED OR
TOTAL SO.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTE I WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OW N ERS AFFI DAV IT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CON RACTOR IN THE STATE OF
REGISTRATION LAW ROW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS FOR 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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MACE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X OW N E DATE X BY DATE
FOR OFFICE USE ONLY
AD DE A MENT YESPPROVENo DEPARTMENT YES APPROVED
BUILDING VALUATION aQ� c/
HEA H PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT 1
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
PLANNING
PLUMBING
MECHANICAL
STATE BUILDING FEE 5 b
STATESURCHARGE
APPLICATION ACCEPTED BY I PLANSC �BY APPROVQF'pR ANCE PERMITVALIDATION
BY CASH CK MO TOTAL 3 y o o