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HomeMy WebLinkAboutBLD0264 Roof - BLD Application - 5/22/1990 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED - �v PERMIT NO. G NAME MAILADDRESS CITY BSTATE ZIP PHO E OWNER ti "I AA- DIRECTIONS a. TO JOB SITE PARCEL ` LEGAL NUMBER . DESCR. �� � as �a NAME MAIL ADDRESS CITY 8 STAT&.1, LICENSE NO. ZIP PHONE CONTRACTOR5 � USE OF BUILDING q� CLASS OF --F NEW ` ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE to WORK BEDROOMS DECKS YOR N CARPORT NOTICE TOTAL SQ.FT. DECK GARAGE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTAL SQ.FT. TOTAL SO.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 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SQ.FT. TOTAL SQ.FT. CHECK ONE ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT FIREPLACE ATTACHED SEASONAL 4 SHORELINE DETACHED OWNERS IFFI DAVIT CONTRACTORS AFFIDAVIT I CERTIFY HAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRAt ON LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIRE EN 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 CON RMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTJER G APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. X O DATE X BY FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION YES NO YES NO HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTED BY PLANS CHEC APPROVED FOR I UANCE PERMIT VALIDATION © BY ` CASH CK MO TOTAL -;or ��