HomeMy WebLinkAboutBLD194 Pump House - BLD Permit / Conditions - 8/20/1979 Martin, Elvin #194
8-20-79
act 13 of A Nwk Nek
m'Apoiles down Old Belfair Hwy. (toward Gorst)
on the left.
Pump House
$864. 00
1 i
BUILDING PERMIT APPLICATION
16, MASON COUNTY 123 2(D /Z 6130
P.O. Box 186 Shelton, Washington 98584
426-5593 C
DATE ISSUED
PERMIT NO.
4ESGR
AME MAIL ADDRESS CITY&Mail,
ZIP PHONE
— / &)A j" 9 K7
/ /n l ,� -6 ��� ��, 5 ThL�
:) JOBMr e S �l/ CJc�
a 3 / (❑ SEE ATTACHED SHEET)
!.-NAME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE
Pam P u S C_
:lass of work: KNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
)escribe work:
Valuation of work: $ � � PLAN CHECK FEE PERMIT FEE �t.t
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ , y SEPARATE
NO. OF STORIES BASEMENT El
ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
OR AIR CONDITIONING.
CY
TOTAL SO. FT. FIREPLACE ❑ 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 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 ❑
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
contractor registration law RCW 18.27, and am aware
BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in onform nce th rew' MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date.
BY
t�~"
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. A'