HomeMy WebLinkAboutBLD19638 SFR - BLD Permit / Conditions - 12/5/1986 TYPE RESIDENCE
permit No. 19638 No. Floors 2 SI Ftg 2
Tel 877-9872 Date 12-5_-86
Owner STRAATMAN John — Zip
Address P 0 Box 68 Lilliwaup -
contractor Self Zip
Address
Legal Description Lilliwaup Falls Bl. 26, Lots 1,17121
Direction to prof si e
road South oPi f Post Office in Lilliwau
ing x Mechanical S..—F—%bod Stove x
Fireplace Deck 1400 Garage 624 carport
Basement Loft Other
2 bdrm
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED/
PERMITNO.
OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE
Ac
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DIRECTIONS I,
TO JOB SITE d c;. ��+ L%: c: t= i t IS 7 C Pal
LEGAL _ o j
DESCR. I is-Tip 0 ! �i/
NAME MAILADDRESS CITY&STATE LICENSE NO ZIP PHONE
CONTRACTOR .n
USE OF
BUILDING
CLASS OF WORK ✓ NEW ADDITION ALTERATION REPAIR MOVE REMOVE
DESCRIBE
WORK :t =tlk-% S7
BEDROOMS ;Z DECKS CARPORT NOTICE
BATHROOMS_ TOTAL4t2020�LLff SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
GARAGE `} CONDITIONING.
NO.OF STORIES -2_ BASEMENT 0 ATTACHED THIS PERMIT BECOMES NULL AND VOI IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOT'AT, FIREPLACE DETACHED ABANDONED FOR A PERIOD OF180 DAYS ATANYTIMEAFTERWORKISCOMMENCED.
PERMANENT k SHORELINE Al c
SEASONAL
OWNERIS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTI . THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTL REGISTERED CONTRACTOR IN THE STATE OF
REGIST _ION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF T E ORDINANCE REQUIREMENTS REGULATING THE
REQUIR ENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT 1 ISSUED AND ALL WORK DONE WILL BE IN
IN CO '! MLNCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHA GES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAI G APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X O E �"- #)ATE X BY DATE
FOR OFFICE USE ONLY
APPROVED APPROVED BUILDI G VALUATION
DEPARTMENT DEPARTMENT /
YES NO YES NO SG.7%4..
HEALTH PUBLIC WORKS FEE
PLANNING i FIRE BUILDI qG PERMIT 3,
D.O.T. BUILDING PLAN GHECK
SPECIAL CONDITIONS BUILDING GROUP '� PRE-INSPECTION
SHORELINE
PLUMBING Cj
MECHANICAL
STATE BUILDING FEE ,
STATE SURCHARGE ;
APPLICATION ACCEPTED BY PLANS C K BY APPROVED FOR ISS NCE PERMIT VALIDATION
1ITOTAL
� BY CASH CK MO