HomeMy WebLinkAboutBLD96-0675 SFR - BLD Application - 7/10/1996 Permit No.
MASON COUNTY oa
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT
#1 O er Phone#
ite Addres 03! �R�Voe .�t��_�re. Fire District# �
City _ j�j ) St GU ft Zip f8<25 y
Directions to Job Site /Q/) �D X!� �/iL7� 7P 2ClCTtf9- lJyU CET,T-rJ/e1�.J
Owner Mailing Address G. E��2e7p PE
City ?
Lien/Title Holders
Address
Clty St Zip
#2 Contractor Name ff7:7Llt.� (� 1�C��2u �t-I �h� Contractor Reg#_n/A60tt 131a
Address ?_0 �Esc'( 3G7, Expiration Date
City_ �L(-(Jl�Dy� c St W4r Phone# YTT2_11 -1/72-0
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply._Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 cel No. a-Da-/ -_s - �Dl
egal Description L.CIr �/ ni2�a2GS
&A:a
#5 Building Square Footage: (existing/proposed)
1 st FIB_/ IQVc� 2nd FI / 3rd FI / Loft /
Basement_. Deck / # bedrooms _/ 3 # bathrooms b / 3 s
Garage / Carport / (Circle: Attached or Detached?)
Other sq. ft. /
#6 Use of building Describe work
#7 Type of Job: New_, Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make Model
Length Width Serial No.
-
# Bedrooms # Bathrooms Type of Heat
Purchase Price $
#9 Indicate by circling the applicable source if any water is on or adjacent to subject property:
River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other