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HomeMy WebLinkAboutRemodel - BLD Application - 9/2/1986 BUILDING PERIVI'IT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 426-5593 DATE ISSUED PERMIT NO. OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE 13 70,6- - O c 3 DIRECTIONS / / C 30� S 37 34,/3 TO JOB SITE x /a7 / LEGAL DESCR. Q///SD/) v J iv n 3� P ';I-� Al X�s 4v A-." NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR e� .Same. S a/�ov C/Y5 T-12 _3S `�8373 7 USE OF o76! BUILDING C_-a 6 rr CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK DESCRIBE /I jj WORK �_ 1 J5 - !L'5�7�J rock TCc e Q If e4 0 C44 e- Q a(( r r i A tA TC�o rA A5r © os.e -iv\ ic Stoc ; BEDROOMS`— DECKS CARPN _NO NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS_ TOTAL SQ.FT. �� GARAGE J CONDITIONING. NO.OF STORIES BASEMENT�►` O ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT TOTAL SO.FTo7090 FIREPLACE DETACHED COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. � -- p i XOWNER DATE - 1 X BY. c- �w - DATE 9 FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION r YES NO YES NO _ �. C r r HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE PLANNING PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION TOTAL BY CASH CK MO