HomeMy WebLinkAboutBLD Pre-Inspection SFR - BLD Application - 7/26/1985 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED_?7(o Z
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
X -?- OO JRwC 11,1EwAR. 5I —L e a/ 9373 ter,
DIRECTIONS 4627- 7¢A-2)
TO JOB SITE O�ARA �7 d -,Rem AcGFi9/ T /.3/// NO,Sff d
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. L.0 f5 31 }< 3Z lmo4ONA A'/O/e�t//v/ j pe /gC T 's
CONTRACTOR NAME MAIL ADDRESS CITY R STATE LICENSE NO. PHONE
USE OF o
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR MOVE ❑ REMOVE
Describe work:
GvE PL A41 `7' o E' /9/// f149 615 71 Loi
19171 I/a e le , /.6/// Wq:5 doll r .c%al IAI / 7L -./ d-j/fEPi Fa ADp,v.
NSrJ L A"T/oAJ A/ F 00/2 Y C deoe, Neav IVOoVC 0
gE CCA.IS' v 0 r6d F?'EX- �SE�✓i /S o s
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS: n�,y!✓ fNe v l i I► h —
k
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS L TOTAL SO. FTAJC0 GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SQ. FT.L9l:e0 FIREPLACE X DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
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
conformance therewith. PERMANENT Cl SHORELINES
SEASONAL ❑ FLOODPLAIN Ll
Firm E.D. N0. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT. 7- i-8S -3i-e
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in c of ance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner 6d' Date. 7 By
PLAN CHECK VALIDATION K. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
CHRISTMASTOWN PRINTING