HomeMy WebLinkAboutBLD3200 Fiber Glass over Deck - BLD Application - 10/9/1978 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 C
/� GG DATE ISSUED 9 7a
,39,23J " 3 1 ^ DW O PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OR — M A rJV ry
DIRECTIONS
TO JOB SITE ff f o .J j
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. '7-2 -3__ w u c�F E /ao ' of<ov .`� 3 ,J o 7—, '- . -zrs
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR17 C �� a Ux �40 vith 0 v
USE OF
BUILDING
Class of work: C<NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ /l pc, PLAN CHECK FEE PERMIT FEE /D. j-4
SPECIAL CONDITION :
BEDROOMS DECKS ,CARPORT Li NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE Ll
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT LI OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE LJ 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 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 Ll SHORELINES i
SEASONAL Li FLOODPLAIN
Firm
E.D. NO. S.E.P.A.
By Special Approvals IN OUT YES APPROVED NO
Lic. No. O1-'7)jN Date 0 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.
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 ACCEPTED BY PLANS CHECK BY ROVED FOR ISSU NCE
r Date Ow� . '
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. M.O. CASH