HomeMy WebLinkAboutBLD90-25834 - BLD Permit / Conditions - 6/5/1990 OD
Shorelines: Plunbing:
Setback: Mechanica
Special Interior:
Conditions: FINAL:
Mobile Home:
Smoke Detector:
Remarks:
noting:
Setback:
Foundation
Walls:
Framing: _vA
Fireplace: -
Wood Stove:
TYPE RE- OF
Permit No. 25834_ No. Floors Sq Ftg
Owner I RICHARD Tel Date
Address Zip Aaaa
Contractor
Zip
Address
Legal Description 20 Ran e 4 TR30
Direction to project-site t
P um ing Mechanical Sewer Woo tove
Fireplace Deck Gar 4ge Carport
Basement Loft Othe '
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASH IN TON 98584
427-9670 DATE ISSUED
PERMIT NO. ��
iWNER N rLADDRESS ITY&STAT ZIP PHONE
0
)IRECTIONS
rO JOB SITE
PARCEL LEGAL
NUMBER 0/ � DESCR. 7 �7
A4AAME MAI ADDRESS CITY&STATE LICEN E NO, ZIP PHONE
CONTRACTOR X) f 5 o 7
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK
BEDROOMS DECKS YOR N CARPORT NOTICE
TOTAL SQ.FT.
DECK GARAGE SEPARATE PE MITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. TOTAL SQ.FT. CONDITIONING
NO.OF STORIES BASEMENT Y OR N THIS PERMIT E COMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
LIVING AREA BASEMENT COMMENCED ITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. TOTAL SQ.FT. CHECK ONE ABANDONED ORA PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMANENT FIREPLACE ATTACHED
SEASONAL SHORELINE DETACHED
OWNERSAFFIDAVIT CONTRAC RSAFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY T T I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTO ND 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 MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FR M THE BUILDING DEPARTMENT.
i >
XOWNER DATE XBY DATE � 5
FOR OFFICE USE�ON LY
APPROVED 7
DEPARTMENT YES No DEPARTMENT YESP ROVE NO BUILDING VALUATION t ;_—
HEALTH L(i PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING— PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
AoC-r2,L)c fi CIO lea: i_«i / .;l'rr WOODSTOVE
'' PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY AAPROVtAFOR SSUANCE PERMIT VALIDATION ' ��n_,y i✓
TOTAL
?_ ' BY CASH CK MO `