HomeMy WebLinkAboutBLD91-27363 - BLD Permit / Conditions - 1/14/1991 Plunbing:
Shorelines: Mechanica
Setback: Interior:
Special FINAL:
Conditions: Mobile ome:
Smoke Detector:
Remarks:
ooting:
Foundation p 4"m',
Walls:
Framing:
Fireplace• B= -------
Wood Stove:-------------
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TYPE LJ000ST0\/1
Permit NO-
Ftg
No.No. Floors Sq Tel a Fa65 Date
IFR. �TF\/F
Owner ��I�� K: Zip
Addr es s
Contractor ip
Address
Legal Description
Direction to project Site I r ncc frnm Antr^^ tn
Cherr Park 1 h
Mechanica Sewer Wood VI Stove
P tm ing Deck arage arport
Fireplace Loft Other
Basement
1
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERALSERVICES
P.O. BOX 186 SHELTON, WASHING ON 98584
427-9670 DATE ISSUED
PERMITNO.
NAME MAILADDRESS CITYBSTATE ZIP PHONE
OWNER !cJ � J '
DIRECTIONS
TO JOB SITE i
PARCEL LEGAL ��t1 L
NUMBER " � �f DESCR. lj�f(
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK
BEDROOMS -0 DECKS CARPORT NOTICE
s SEPARATE PERM TS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS 2 TOTAL SQ.FT. GARAGE ✓ CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. r(160 FIREPLACE DETACHED ABANDONED FOR'A PERIOD OF180 DAYS AT ANYTIME AFTER WORK ISCOMMENCED.
PERMANENT f!� SHORELINE
SEASONAL
OWNERSAFFI VIT CONTRACTORS AFFIDAVIT
I CERTIFY THA I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATIO AW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON A D I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREME S FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WH CH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CONFO ANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE ,HEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAININ PPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X OW ER.�,XLia X BY __ DATE
FOR OFFICE USE ONLY
DEPARTMENT YES
PPROVEDJO DEPARTMENT YES DEPARTMENT
rD BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING 4 PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE j cw &710 - v`
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATI N
b CASH CK MO TOTAL