HomeMy WebLinkAboutBLD14593 Block Structure - BLD Application - 8/26/1983 MASON COUNTY No $ 8
427-9670 BUILDING DEPARTMENT
ALL PERSONS ARE HEREBY ORDERED TO AT ONCE
STOP
WORK
On these Premises at
This order is issued because
��B
P.M /Z�19 y
Posted /^ of work without permission from the
The failure to stop work, the resuming
�H' G Building Official,or the removal,mutilation,destruction or concealment of this
WA fine and imprisonment.
/� Notice is punishable by
J
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426.5593
DATE ISSUED y
PERMIT NO.
IT 8 STATE ZIP PHO�LE
NAME I,AIL ADDRESS V
op
OWNER ')1, ., n
DIRECTIONS
TO JOB SITE it
(� SEE ATTA ED SHEET)
LEGAL . ! J / IJ
DESCR. .,p J •/' h ITY ST LICENSE NO. PHO
AI AD E
_ ATE
CONTRACTOR
USE OF 1% r
fJ l0 k �' Em� t _. r�✓1 f,'f',
BUILDING _ ¢b jl! d r A .»
Class of NEW C ADDITION ❑ ALTERATION ❑ EPAIR ❑ MOVE ❑ REMOVE
Describe work:
490 ® g
^ PLAN ( FEE PERMIT FEE 44
Valuation of work: $ Q`.1`J\ '
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT Ll NOTICE
BATHROOMS TOTAL SO. FT. GARAGE [' SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING. VENTILATING
BASEMENT ❑ ATTACHED I I OR AIR CONDITIONING.
NO. OF STORIES_TOTAL SO. FT. FIREPLACE ❑ DETACHED ❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
WORK IS
CONTRACTOR AFFIDAVIT SUSPEND DOM
IZED IS NOTC N F DO IEDFIORADPERIOD OF 180 DAYS AT ANYTDAYS OR IF CONSTRUCTIONTIIME AFTER
WORK IS CO IWO.
I certify that I am a currently registered contractor in FOR �OFFICE USE ONLY
the State of Washington and I am aware of the
ordinance requirements regulating the work for which
the permit is Issued and all work done will be in PERMANyENT LJ SHORELINES ❑
conformance therewith. SEASbRIw,p❑ FLOODPLAIN ❑
E.D. NO. S.E.P.A. ❑
Firm IN OUT YES APPROVED NO
Special Approvals
By
ZONING
Lic. No. Date
PLANNING DEPT.
HEALTH DEPT.
OWNERS AFFIDAVIT PUBLIC WORKS
I certify that I am 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 ROAD ACCESS
which this permit is issued and that all work done will MOTOR VEHICLE PERMIT
be in conformance there
APPLICATION ACCEPTED BY PLAN HECK BY APPROVE FOR ISSUANCE
�" Dale . � BY
Own9�—_----_ '
PLAN CHECK VALIDATION CK. M.O. CASH
PERMIT VALIDATION CK. M.O. CASH