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HomeMy WebLinkAboutBLD14839 Final Sign - BLD Permit / Conditions - 11/20/1987 DOMINGUEZ, Louis #14839 ' 10-20-83 29-23-1, Tract 1 of SEk,SEh Highway 300, Belfair Contractor Self 275-5064 Sign $1,001.00 Shorelines: Setback: Special Conditions: Footing: Setback: Foundation Walls : Framing: Fireplace: Wood Stove: Plumbing: Mechanical: Roof: Exterior : Interior : Final: Stop Work: Mobile Home: Smoke Detector : Remarks: L - J f 4 BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 / _ O DATE ISSUED v PERMIT NO. `f 4 9 2 OWNER NAME MAILyDDRESS CITY&STATE ZIP PHONE ' ^ter' J v 'c o W I� � LL- e ,' �'S' -z� Z;> c V DIRECTIONS I �C/ TO JOB SITE (� LEGAL q 2 l (❑ SEE TTACHED SHEET) DESCR. p� 1 J — I Tlr 2G�t I O� S� �,� I �+ fNAME h MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR L,6r1rg //o/YrVG.evF_ I.—, 5f IYF-- USE OF BUILDING Class of work: NEW ❑ ADDITION ❑ WERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: lGN Valuation of work: $ PLAN CHECK FEE PERMIT FEE D c'� �- SPECIAL CONDITIONS: BEDROOMS DECKS CARPORT ❑ NOTICE BATHROOMS TOTAL SO. FT. GARAGE ❑ ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT ❑ 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 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 SHORELINES I. SEASONAL C i FLOODPLAIN i❑ Firm E.D. NO. S.E.P.A. LJ 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 iD confor er ith. MOTOR,VEHICLE PERMIT a I A o /�_26-_�� CATION ACC T BY PLAN CHECK BY APPROVE FOR ISSUANCE Owner "—``� Date_( M Ida a&I&��r BY PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH