HomeMy WebLinkAboutBLD10037 Cantilever Deck - BLD Application - 2/10/1981 BUILDING PERM ITAPPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
6�1 426-5593
DATE ISSUED /,
PERMIT NO. Z& ,3
OWNER NAME MAIL ADDRESS CITY 8 STAT ZIP PHONE
�, Aor IF � -z 3
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
NAME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE
CONTRACTOR VC
USE OF l
BUILDING
Class of work: X NEW XADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ 00 PLAN CHECK FEE PERMIT FEE
(7Q �. ao
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ IDETACHED
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 1 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
SEASONALII FLOODPLAIN ❑
Firm
E.D. NO. S.E.P.A. ❑
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.
e Mason County ordinance requirements for
whi rewith c this p it is issued and that all work done will ROA4 CCESS
b n conf m nc the MOTOR EHICLE IT
//� Q APP TION AC E E BY PLANS CHECK BY APPROVED FOR ISSUANCE
O Date . C� V BY
i
i
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH