HomeMy WebLinkAboutBLD6403 Roof Repair - BLD Permit / Conditions - 5/15/1980 Hillier, James F. #6403
5-15-80
4 mi. east of Union - Highway 106 3s-�a-3
Tr. 6, Government Lot 4
Repair Roof
$1,500.00
-� BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER AME MAIL ADDRESS CITY&STATE i SIP PHONE
DIRECTIONS
TO JOB SITE .¢ IVILtL S Q.ii09
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LEGAL r 1 _ >(❑ SEE ATTACHED SHEE
DESCR. 'T&C ((j �T6v T � �F ^ �)�3 'I_ �rj/ �� -2170
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR � ,` L
USE OF
BUILDING vu WL 0— v �—
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ^REPAIR ❑ MOVE ❑ REMOVE
Describe work: et V�:tK 6 I'1+L V40wt Qom.
Valuation of work: $ I ��d PLAN CHECK FEE PERMIT FEE CJ
1
SPECIAL CONDITIONS:
BEDROOMS DECKS _ CARPORT [ i NOTICE
BATHROOMS TOTAL SO. FT. GARAGE LI
ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT LI OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED U
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 U
SEASONAL I ! FLOODPLAIN 17
Firm E.D. NO. S.E.P.A. I
By Special Approvals IN OUT YES APPROVED NO
Lic. No. 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.
of the Mason County ordinance requirements for
vjtV—c57Ms,permit is issued and that all work done will ROAD ACCESS
e in confo ance therewith. MOO VEHICLE PERMIT
r AP L A N AC BY PLANS CHECK BY APPR9 D FI ISS NCE
Owner �Date� � �� BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIO CK. M.O. CASH
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