HomeMy WebLinkAboutBLD90-26211 - BLD Permit / Conditions - 7/19/1990 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGT, N 98584
427-9670 DATE ISSUED
PERMIT NO.--Z!2J&-4121-1--1
NAME MAIL ADDRESS
C11 Y&STATE ZIP PHONE
:Z1 6
OWNER -
DIRECTIONS r4) /—
TO JOB SITE
PARCEL �VDESCR.
EGAL 7�9 CX "
,, Zlp PHONE
(�JC�1y/� CITY&STATE LICENSE NO.
NUMBER NA/ O MAIL ADDRESS
CONTRACTOR
USE OF
BUILDING REMOVE
CLASS OF ADDITION ALTERATION REPAIR MOVE
NEW
WORK ,-
DESCRIBE
WORK
CARPORT NOTICE
BEDROOMS DECKS Y OR N TOTAL SQ.FT. SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
DECK GARAGE CONDITIONING,
BATHROOMS TOTAL SQ.FT. TOTAL SQ.FT.
NO.OF STORIES BASEMENT Y OR N THIS PERMIT BE OMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED E NOT
BASEMENT COMMENCED THIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
LIVING AREA TOTALSNTQ. CHECKONE ABANDONED FORA PERIODOF180DAYSATANYTIMEAFTERWORKISCOMMENCED.
TOTAL SQ.FT.
PERMANENT FIREPLACE ATTACHED
SEASONAL SHORELINE DETACHED
CONTRACT RS AFFIDAVIT
OWNERS AFFIDAVIT
I CERTIFY THALAWAR EXEMPT
AND THEUIREMENTS OF THE
THE MASON COUNTY ONTRACTORS I CERTIFY THAT I AM A CURRENTLY ORDIINANCE WASHINGTON AND I AM AWARE OF THEREGISTERED CONTRACTOR IN THE STATE OF
ORDINANCE REQUIREMENTS REGULATING THE
R ISTRATINT
QUIREMENTS 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
CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CON ORMA RCAPPC MTHE BUILDING THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
T.
OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT.
XOWNE �`_4 � C -DATE XBY _— DATE
FOR OFFICE USE ONLY
APP OVED BUILDING VALUATION
APPROVED DEPARTMENT YES No
DEPARTMENT ves No � FEE
HEALTH PUBLIC WORKS
7�—
BUILDING PERMIT
PLANNING FIRE
PLAN CHECK
BUILDING
D.O.T. ,--7)
PRE-INSPECTION
SPECIAL CONDITIONS
BUILDING GROUP _
SHORELINE
WOODSTOVE e
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY ---FAIPI?jROVEqFqfjjSSUANCE PERMIT VALIC ATION TOTAL / 00
1-ci BY — CASH CK MO