HomeMy WebLinkAboutBLD9427 Fianl ReRoof - BLD Permit / Conditions - 1/3/1980 Peake, Mark A. #9427
10-16-79
Portion SE 1/4 9-23-1
1 mile south of Kitsap County line on Old Belfair
Hwy.
Re-roof
$19125.00
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BUILDING PERMIT APPLICATION
MASON COUNTY M�
P.O. Box 186 Shelton, Washington 98584 ��
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE lifirCli ZIP�r8a��p PHONE
G 1 :C/
DIRECTIONS / .fit( c ,� ✓/ a� L�
TO JOB SITE
LEGAL (❑ SEE ATTA ED SHEET)
DESCR.
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF Ir
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION EPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ " PLAN CHECK FEE PERMIT FEE
&—_
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT L1 OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE I_I 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 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 Ll SHORELINES ❑
SEASONAL ❑ 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
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
Owner Date
ICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
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PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH