HomeMy WebLinkAboutBLD9347 Gamble Roof - BLD Application - 1/22/1981 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
i DATE ISSUED �— � `� _f
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
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DIRECTIONS D h d BA Ir /�a--A,a r,[
TO JOB SITE l ( { / a Lt n NJ Rdr—a ; ,� , Q
LEGAL (❑ E TTACHED SHEET)
DESCR.
CONTRACTOR NAME MAIL ADDRESS����� 3._ CITY S STATE LICENSE NO. PHONE
USE OF Rr
BUILDING V
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: / O
14
Valuation of w rk: $ 960 LAN CHECK FEE PERMIT FEE 3
SPECIAL CONDITIONS:
BEDROOMS I DECKS e00WORT X R Y Po r NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE C
ATTACHED [J SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED O
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 a SHORELINES E
SEASONAL [J FLOODPLAIN G
Firm E.D. NO. S.E.P.A. [I
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
ntract or registration law RCW 18.27, and am aware
f the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance th rewi h. MOTOR VEHICLE PERMIT
r CATION BY PLANS CHECK BY APPROVED FO ISSUANCE
Owner ,r Date.4Z //
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH