HomeMy WebLinkAboutBLD N/A Demo - BLD Permit / Conditions - 1/9/1981 Pope, Alice J. #- -
1-9-81
Small house behind Thriftway Market in Belfair
29-23-1 - Tract 16, NW SE
o
Demolition - 1 bedroom house
BUILDING PERMIT APPLICATION
' MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED /
PERMIT NO.
�Ni4rr��,E M ILA CRESS ) CITY STATE �. _ / ZIP PHONE
OWNER C UGC E; %"� ` ,�' �G2G'zJ /GL.iI'd 2-
0 /j
DIRECTIONS c
TO JOB SITE zt��-�..G> 14 i. .GLG> i� Lt,�
LEGAL / (❑SEE ATTACH SHEET)
DESCR.
NAME MAIL ADDRESS CI 8 STATE LICENSE NO. PHONE
CONTRACTOR _',/!) �z
USE OF p
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE X'REMOVE
Describe w rJt
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L.
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITION
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BEDROOMS (DECKS CARPORT NOTICE
BATHROOMS TOTAL SQ. 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 ❑
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
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
wh'cKthis permit is issued and that all work done will CCESS
e in conformance therewith. l / OTO VEHICLE PE MIT
A TION AC Ci D Y PLANS CHECK BY APP R ED FOR IS DANCE
0 ner ate.J jjj}}} l BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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