HomeMy WebLinkAboutBLD18776 Mechanical - BLD Application - 6/12/1986 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY 6 STATE ZIP PHONE
e l-ci t �E' i �! 70 P cl 0 19 �)S -
DIRECTIONS
f0 JOB SITE I. y M, l r r a 5 8 e �a �- /,'"r f t,,J d 0 ,� (3r f1c I C. rd�t
LEGAL (❑SEE ATTAC ED SHEET)
DESCR. f�r r'� Al 4 s�� c��c� t' T,P13 1e9 l 0 kJ y1
:ONTRACTOR NAME t MAIL ADDRESS CITY A STATE LICENSE NO. PHONE ��
K o o c 4 4 -F0 3 x-3 t,
SE OF
iUILDING ems.t ctg ;ram -e
:lass of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
)escribe work:
/' ) ,t. d el- ,A t e al i P c ku c-
k
s ell. '%-�7a_ Xf 1
7 f 15/-, /2 Q eJ
,&19, CY-
/aluation of work: $ PLAN CHECK FEE PERMIT FEE
iPECIAL CONDITIONS:
;EDROOMS DECKS ` >C CARPORT❑ NOTICE
,ATHROOMS_ TOTAL SO. FT. 3p-1- GARAGE ❑
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
O. OF STORIES. BASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
OTAL SO. FT. 3 FIREPLACE ❑ DETACHED ❑
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 certif�'that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I am aware of the FOR OFFICE USE ONLY
ordinb the requirements regulating the work for which
the/permit is issued and all work done will be in
co formance therewith. PERMANENT Cl SHORELINES ❑
SEASONAL ❑ FLOODPLAIN ❑
rm 4 LL Vry "I r s
E.D. NO. S.E.P.A. ❑
Special Approvals IN OUT YES APPROVED NO
c. No. T Date Cr
( ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. f
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. b Z=
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY I PLANS CHECK BY APPROVED FOR ISSUANCE
vner Date. BY
AN CHECK VALIDATION CK.. M.O. CASH PERMIT VALIDATION CK. M.O. CASH