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Home My WebLink AboutBLD26202 Replace Roof - BLD Application - 7/18/1990 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED Ia3a - PERMIT NO. OWNER NAME *A�-- , - CITY&STATE ZIP PHONE DIRECTIONS TO JOB SITE Q 12 00 Ae= ztJo- i f` PARCEL LEGAL /(/E ,?p/ 044 ,fSsCs'AiiC Fes:�1y NUMBER DESCR. (,f NAME' MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR z, ' - 6 T— USE OF 27,r BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK DESCRIBE WORK A ajLay=!e— '712;A. slall cu BEDROOMS DECKS YORN CARPORT NOTICE TOTAL SQ.FT. BATHROOMS DECK GARAGE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR TOTAL SQ.FT. TOTAL SQ.FT. CONDITIONING. NO.OF STORIES BASEMENT Y OR N THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT LIVING AREA BASEMENT COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SQ.FT. TOTAL SO.FT. CHECK ONE ABANDONED FORA PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED. PERMANENT FIREPLACE ATTACHED SEASONAL SHORELINE 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 EQUIREMENTS 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 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 FROM THE BUILDING DEPART ENT. X OWNER DATE X BY DATE 7 FOR OFFICE USE ONLY DEPARTMENT YESPPROVENo DEPARTMENT YESPPROVENO BUILDING VALUATION L �` ✓ HEALTH ILIPUBLIC WORKS FEE PLANNING L- FIRE BUILDING PERMIT �y D.O.T. BUILDING PLAN CHECK 2 SPECIAL CONDITIONS BUILDING GROUP -4 PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTED BY PLANS CHECK BY kP-P9 OR SUANCE PERMIT VALIDATION CASH CK MO TOTAL