HomeMy WebLinkAboutBLD4437 Bulkhead - BLD Permit / Conditions - 4/6/1979 Lewis, Wendell #4437
4-6-79
35-22-3 E 50 of W 275 G. L. 3 N of r/w
North 3 1/2 miles of Union one mile before Casa
de Canal
Bulkhead Contractor
TAM
Exemption 4-2-79
$2,800.00
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. Zlel 3
OWNER NAME Q MAIL ADDRESS CITY h STATE ZIP PHONE
ST DoX /
DIRECTIONS
TO JOB SITEI Na �An �' _ , ie ey /
LEGAL S415e. 7((JA• R/QH9. (❑ SEE ATTACHED SHEET)
NAME MAIL ADDRESS CITY 3 STATE LICENSE NO. -PHONE
CONTRACTOR / /7' / A_ _ 1�i-
/7 ooG�
USE OF
BUILDING
Class of work: 21NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
Describe work:
U�
Valuation of work: $ PLAN CHECK FEE /. --e PERMIT FEE e b'
a moo
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ LSEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ 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 ❑ SHORELINES ❑
�/`!.� SEASONAL ElFLOODPLAIN Ll
Firm /Y 11d/T��'rQIPS E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. '�C'��* 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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
LIGATION ACCEPTED BY PLANS CHECK BY PROVED FOR 4ISSUANCEOwner Datel
1 PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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