HomeMy WebLinkAboutBLD2856 Addition - BLD Permit / Conditions - 8/17/1978 Strumberg, Rudy #2856
8-17-78
Ayock Beach Lot 12 Blk 1
Contractor
Peter Straatman
Addition (relocate bedroom and new rec room)
$10,000.00
BUILDING PERMIT APPLICATION
i
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATEISSUED o /
PERMIT NO.
OWNER W gy'6 AkA yr AIL ADgRES CITY&STATE ZIP PHONE
A 0 C a15 DUIVIA00. �S`S
DIRECTIONS
TO JOB SITE N)6/i WA y 101 , 11 L T Yfl f^I OF TO A Yllo Kf3 eA L. - -
LEGAL (❑ SEE ATTACHED SHEET)
I
DESCR. 11YULOt ( dr
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
PtrLtlq, S S T!PoA l
USE OF
BUILDING 2 _ M
Class of work: ❑ NEW 19 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
N�
Valuation of work: $ 20 PLAN CHECK FEE PERMIT FEE e-0
>0 mod.
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT [ ] NOTICE
BATHROOMS TOTAL SO. FT. GARAGE 1
[1 SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES ATTACHED
BASEMENT LlOR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE [l DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I am aware of the FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conf r ance therewith. PERMANENT ! SHORELINES
SEASONAL I I FLOODPLAIN 11
Firm AM,gvlolrzC E.D. NO. S.E.P.A. I
By Special Approvals IN OUT YES APPROVED NO
d _�
Lic. No. ST�Am►[/i--A C —3O�I ,I G Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT. /�� ��'"T
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCED BY PLANS CHECK BY PROVED FOR ISSUANCE
Owner Date.
ACCEPTED J
PLA CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH