HomeMy WebLinkAboutBLD14246 Retaining Wall - BLD Application - 6/24/1983 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP �jy_`� :CyONEU,r,R
Oq ts 00_'_j%-jjju 0-4EZ orW'4Nc►If 61-c• z 295"-S0G'' rya,
DIRECTIONS y-
TO JOB SITE �/ 3 ELfe�rlt k'5 XT-/d ��'� S/¢�r� 7.g 0-4jV
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. o� �3 - s�L Y y
NAME MAIL ADDRESS Gof CITY 9 STATE LICENSE NO. PHONE
CONTRACTOR Lo4 V GrtE Z_ SAMI'
USE OF
BUILDING 4 r4f oli,o- A L L--
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
2 S r 2` W r¢L.4. 2 r 44 tom(/ L T/AJ
Valuation of work: $/D Q� f PLAN CHECK FEE IfAl PERMIT FEE
Y6
SPECIAL CONDITIONS: / /
/ -s 2,0a /
- 4 _P,9.k 2 - 2 —
BEDROOMS {DECKS CARPORT ❑ NOTICE
BATHROOMS I TOTAL SO. FT. GARAGE ❑
ATTACHED !_: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT I; OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE I_I DETACHED Li
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 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 SHORELINE
SEASONAL L' FLOODPLAIN I 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
of the Mason County ordinance requirements for BUILDING DEPT. 623-�3
which this permit is issued and that all work done will ROAD ACCESS
be in conformance r with. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner ate. �: y y e
I (T(�!2 47- 1
PL CHECK VALIDATION K. M.O. CASH PERMIT VALIDATION ( CK. M.O. CASH
I C'' d
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NVASCN GIRDING 04SPECTOR
CNAINGES SUBJEU TO Al"PR�0M
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