HomeMy WebLinkAboutBLD92-0501 Signs - BLD Permit / Conditions - 7/7/1992 MASON COUNTY PIERMiT
Mason County Bldg, 111 426 W. Cedar NULL VOID BY EXPIRATION
r --
&ja
By
P.O. Box 186 Shelton, Washington 98584 DATE `
13 IIJ I 1 14 q r-41 f IF 1f. 4,t. 01 1 1 (0
ME 23791 HWY 3 _ _ .
OWN F i,' SAMOY ' S 01FLI. MARI . I t4C (INK
CONIkAf 101; TU8F ART 223-1122
11 11 A I is ti of IF St I's 16716
k - 440401 p'y DAII RUJIf''! I VPF By 04if k v c F I p I
I: (;kol)p . tit 06 [4 r_- T61( I 7t 54 OJI 4111119" 33846
N 131 R L P 1, A t:f: ## 113K #1141I41
ki I- 1 (1 A 1) 0 WO 0 0 -,1 OVE 41 14'
li N I T Cri PARKING SPA! 0
I (.)N A kt-A I 'S 110 R f. 1, 1 N U,
0 f +It 1. k tq p M It I i I t I ft 11 t
0 t,t: fiATH I`IA';I.N'., 0
0 t t, ti A'I f I 1-0 H
S T 1; 1 Of 1. 't If 014F P 0 r llfZN toot, b 111 0
oft. WA I F k )4 f.A T f. 11 0 V 0 R N ( 01� t�, 10 to 10
Aft c 1 0 1'HE :� WA 1'),14 F p 0 V URN F 1 1101 0 0
ARE A - K, I I c H f:N �)I N 1( o 0 14 FA I P1)Mll
1: 1, 0 0 k t;it A I N 0 vF 1`4 j I,y I-'. I'I m
0 1 V tit, s 11111 1 rf#A I If 0
t 0 1 0 f DR I N K r N fi F()U N T 0 VIN f I A 1`4 11 fill ls 0 IA 01 H, 0
H A t 0 f I. AlINI)R Y T RAY', 0 00ME. I No. I i-4 0 V t I Al If
Of,f 13 1, 11 W AS H F R A j 1? IU4ml)l 1"6 11N.f i ")mmt INI. I NJ 0
6 111 0 [3 1) 1 p 0 A 1 0 0 0 0 0 c I sit 0 PF1 01 /PC V A 1 R 0
0 R I N A 1 000 c:in1 0 0 I'lil' h ilN.1 1 0
m'It 01] 1 1 1 1 0
pop"677(T
19,1111T 10111`1001:iANOY3 011.1 NARI AT of 23191 lily A IN B(If4t1;
FHjq pffioil 8frolls #Ott AND VOID If WOO[ OR (40544(11411 A111THORIJI) i) NOT (61111fliff8 WITHIN 160 DAY%. 01 if IAN'-1Rtl( 11AN (4 QbR1 11 `;11".PfI101`11 foli A Pffloft
Of 104 AT 311Y IIII( kfTFR 900t fS (41111fiff.ffi, FVIDIN(f Of 10116118ATION Of VOWf 1S A fiqfipfsS 114tcligo WITHIN for 1811 DAY PTE(OR IIIIAI 111%PFC11011 MOST PF
APPRf%J1 btfARt ?P11.0116 (AN 81 Of(OPM,
OWNF it 46ENI , 0A I t
'A
MOM
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
D W WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
i
I
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED( j
PERMIT NO.
NAME MAILADDRESS CITY&STATE ZIP PHONE
OWNER '--o Q�L
DIRECTIONS
TO JOB SITE / 4,616 111V 7� S ��
D S -39 l E i k�) 3 �C- rili
PARCEL _ J LEGAL
NUMBER �,� .Z.� 4 � ���!�U DESCR.
NAME MAILADDRESS CITY&STATE ZIP PHONE LICENSE NO.
CONTRACTOR7V4 'USE OF
`
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK
DESCRIBE
WORK I �/�� .��-L_ �� �' ��/�. ��'�71L�itJ ��ibiu� I'/I•l
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE SgFt STORIES SHORELINE❑ CONDITIONING.
BASEMENT SgFt BEDROOMS PRIMARY RES.❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS S Ft BATHROOMS SEASONAL RES.❑ COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
g ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
CARPORT SgFt FIREPLACE IS CARPORT/GARAGE
GARAGE SgFt ATTACHED Q DETACHED❑
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL F E ILDIN DEPARTMENT.
XOWNER DATE XB � �� DATE -� �J�
FOR OFFICE USE ONLY
DEPARTMENT YES APPROVEDJO DEPARTMENT YES DEPARTMENTBUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE MARSHAL BUILDING PERMIT
D.O.T. BUILDING Qo 1,?z �' PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
APPLICATION ACCEPTED BY PLANS CHECK BY APP D FOR ISSUANCE PERMIT VALIDATION
CASH CK MO TOTAL (�,I�