HomeMy WebLinkAboutBLD N/A Cancelled Garage - BLD Application - 6/1/1991 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED
i
PERMIT NO.
E MAILADDRESS CITY&STATE ZIP PHONE.
OWNER rOHSo•-f .^cl 7Z7?3 O
DIRECTIONS
TO JOB SITE /1` DN C►^2S c.,r1 i
LEGAL 7 IJ R I
DESCR. S Z J�W � Sec �-'--2- '-O t � 1
AME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP
CONTRACTOR �e� fitly on rVC--7o/ v!? �ss�'o� c'-L &L--P A i liv-Go
USE OF ". ,,�pp �.� 11
BUILDING e IL4et,e -Q C PeAl k DOk-• Z.� 3
CLASS OF WORK ✓ NEW ADDITION ALTE TION REPAIR MOVE REMOVE
DESCRIBE kt4Y*AA
WORK Z Z A'
BEDROOMS DECKS AR RT V ILATING OR AIR
TI ¢,
AT TS ARE REQUIRE R PLUMBPNG, HEATING,
BATHROOMS TOT FT. AG CO ZONING.
NO.OF STORIES BASEMENT ATT CHED v
ERMIT BECOME NUCMND VOID IF WORK OR CO T TON AUTHORIZED IS NOT
ENCED WITHK 180 DhS, OR IF CONSTRUCTION ORK I, SUSPENDED OR
TOTALSQ.FT. FIREPLACE ACHED DONEDFORAP ODOF180DAYSATANYTIMEAFT. R ORKISCOMMENCED.
��
PERMANENT SHORELINE � r� ,
SEASONAL
OWNERSAFFIDAVIT CONT�i C SAFFIDAVIT
CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENT OF THE CONTRACTORS I CER FY,'[HAT I AM A CURRENTLY G TERED CONTRACTOR IN THE STATE OF
REGISTRATION LAW RCW 18.27, AND AM AWARE* THE ON COUNTY ORDINANCE AS NGT AND I AM AWARE O TH R INANCE REQUIREMENTS REGULATING THE
REQUIREMENTS FOR WHICH THIS PERMIT IS.ISSUED A D T ALL WORK DONE WILL BE R OR RICH THE PERMIT IS I ED AND ALL WORK DONE WILL BE IN
IN CONFORMANCE THEREWITH. NO C NGES S L ADE WITHOUT FIRST C F RMANCE THEREWITH O C G S SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM THE BUILDI DEP%DA
V THE B IN DEPART ENT.
XOWNER rk, Y DATE l
FOR 004CE USE OK'Y
APPROVED PPROVEp
DEPARTMENT YES No DEPARTMIFkT.';., Es o BUILDING VALUATION
HEALTH PUB VC WO KS FEE
PLANNING BUILDING PERMIT
D.O.T. _ B'UILDI G PLAN CHECK
SPECIAL CONDITIONS * BUILDfVGGROUP PRE-INSPECTION
SHORELINE
PLANNING
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
i TOTAL
BY CASH CK MO
STEPHEN JOHNSON, INC.
0I-MI ION CREEK ROAD
BEIf R,WA 98528
Z . Lo-t- C. P-L)
LXiS'*iv� EX�STih�.
EYJ NbvASe_ Gpol?,
�I
i 9h l
�— -