HomeMy WebLinkAboutReconstruct Fire Damaged School - BLD Application - 5/8/1989 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
kwp A sciAcot. pisT. ii i TO 8 Tl -910,0
DIRECTIONS
TO JOB SITE 10 NkLF- O O S TaK i i-4A/ ICOe iof
PARCEL
NUMBER p(� o{ 3� l�J�/� DESCR.LEGAL 5`1h SC Si/�
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR RAFT1 >, CAN -f: 22 Ntc1ceiZSk'0 7i'Z t
USE OF `-eATrLe w A
BUILDING F0Q ' Di,1 K- $
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE
WORK i .cc'�Ns�TRi1G?' AC�n�^l tSk I�D T1 O� p%p�e t:5V L.
BEDROOMS DE94S CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TO SQ.FT. 9AR#AE CONDITIONING.
NO.OF STORI ES ` BASEMENT A CH ED HIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
OMMENCED N 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT.2i FIREPLACE DETAC ABANDONED ORAP OD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMANENT _� SHORELINE
SEASONAL
OWNERS AFFIDAVIT CO OR AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I A A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I A AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH T PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWI H.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OB:�N�E
AL FROM T ARTMENT. APPROVAL FROM THE BUIL ING DEPARTMENT.
X TE OS X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YES
PPROVEDJO DEPARTMENT YES DEPARTMENTBUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY I PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
TOTAL
IBY CASH CK MO