HomeMy WebLinkAboutBLD0464 Remove Old Mezz Area and Replace with Restrooms - BLD Application - 4/7/1992 ` BUILDING PERMIT APPLICATIC�� 2r009
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MASON COUNTY
G
q�o25� DEPARTMENT of GENERAL SERVICES
426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. 2 6
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
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DIRECTIONS
TO JOB SITE I o 5Ft-FATF— '— o" beii Fa -PK4-:tm Jim a a--
PARCEL LEGAL
NUMBER 3 49 c:t P DESCR.
NAME MAILADDRESS CITY&STATE ZIP PHONE LICENSE NO.
CONTRACTOR tk00G+j cb 04W ICI
USE OF l,� M
BUILDING C'Cfefl W Per' STp
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK 6LQ M/l (.0 +
fs t 1.tzGo R-• Z
AREA: IZZs7• NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE SgFt STORIES ( SHORELINE❑ CONDITIONING.
BASEMENT SgFt BEDROOMS A— PRIMARY RES.O THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS Ft BATHROOMS SEASONAL RES.❑ COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
CARPORT SgFt FIREPLACE IS CARPORT/GARAGE
GARAGE SgFt ATTACHED O 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. APPROVA2FM THE BUILDING DEPARTMENT.
X O ER DATE X BY DATE
7 q�
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO ��1[��0
HEALTH PUBLIC WORKS FEE
PLANNING FIRE MARSHAL BUILDING PERMIT 5
D.O.T. BUILDING PLAN CHECK 7-! �6
SPECIAL CONDITIONS BUILDING GROUP ,Z PRE-INSPECTION
lldp SHORELINE
,-iJ On 1 -F* /6 WOODSTOVE
iM�/�1✓� ` CIS �R PLUMBING
MECHANICAL
STATE BUILDING FEE 6 ,
APPLICATION ACCEPTED BY I PUNS CHECK SY APPROVED FOR ISSUANCE I PERMIT VALIDATION
t h 92 BY 7 '� CASH CK MID TOTAL c ��
1
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