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HomeMy WebLinkAboutBLD10569 Addition - BLD Permit / Conditions - 5/12/1981 SHUMAKER, Rodney L. #10569 05-12-81 New Kirk Road, four house on left corner of river hill Tr. 1 of E1/2 NE1/4 NW1/4 21-23-1 Enclosed Carport - Recreation Room $3,500.00 /z�z� zo�� v�v BUILDING PERMIT APPLICATION MASON COUNTY /Z30 26 6q010 P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED PERMIT NO. ®S OWNER NAME MAIL ADDRESS CITY&STAT ZIP PHONE DIRECTIONS TO JOB SITE I&AD 1Q)vZ 110615.4 0e G,aeW cle- L LEGAL (❑ SEE ATTACHED SHEET) NAME MAIL ADD SS CITY&STATE LICENSE NO. PHONE CON RACTOR 6 _ USE OF BUILDING Class of work: ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE r Describe work: 0 Valuation of work: $ Q© Sa d PLAN CHECK FEE PERMIT FEE SPECIAL CONDITIONS: 7' BEDROOMS {DECKS CARPORT O NOTICE BATHROOMS I TOTAL SO. FT. GARAGE ❑ ATTACHED [7 SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT C OR AIR CONDITIONING. TOTAL SQ. FT. 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 FORA PERIOD OF 180 DAYS AT ANYTIME 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 [Jj FLOODPLAIN [I Firm E.D. NO. S.E.P.A. L] 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 contract or 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 conformance therewit MOTOR VEHICLE PERMIT CATION A PTE BY PLANS CHECK BY A ROVED FORS UANCE Owner •' Date 'N CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. M.O. CASH i f ° r ' 1 i � O 's s*aU1 t �C OPnw ` S%uG ✓lLf oUT� l��� b� Gr=�i-.2 rNo. 2 8 8 0 ESTIMATE OF REPAIRS VERBAL AGREEMENTS NOT BiN�NNcMA MATERIALS FREE Owner Dote Address Phone Est. No. Order No. VEAR - MANE MODEL LICENSE NO. SPEEDOMETER Retain Destroy Parts Ports OUAN. DESCRIPTION OF LABOR OR MATERIAL * PART NO, MATERIAL LABOR TOTAL MATERIAL Old parts removed from cars will be junked unless otherwise instructed. Total Labor The above is an estimate bosed on our inspection and does not cover additional parts or laborwhich"my be required after the work has been opened up. Occasionally after work has started worn parts are discoveredwhichore not evident on first Total Material inspection. Because of this the above prices are not guaranteed. Estimate Estimated By Approved By Tax AUTHORIZED AND ACCEPTED You are hereby authorized to make the above specified repairs. PaidOut-Tow&Storage Sublet Repairs By Owner TOTAL Or AyeRf.. r Date �� H 429 Redif rm *CODE N-NEWI U-USED R-REBUILT