HomeMy WebLinkAboutBLD27396 Final Concrete Ribbons and Tiedowns - BLD Permit / Conditions - 1/29/1991 Shorelines: Pltmbing:
Setback: Mechanics :
Special Interior:
Conditions: FINAL:
Mobile Home: '
Smoke Detector:
noting: Remarks:
Setback:
Foundation
Walls:
Framing
Fireplace:
Wood Stove:
TYPE -CONCRETE -RfBBOP,tS & TIED01INS
Permit No. 273916 No 7 Floors S Ft
Owner _HEN-N, UVID Tel ?75-Y2 q Date-
Address NE 81 D�vQy J00Pc 21 Relfair Zip
Contractor 1
Address
Legal Descri tion 1p
p _Beards _Q (�i� l of 4�
Direction to project site RPlfalr makP I at Nnrthqhnrp p
d
R At CandHi 1 l R(i I at Anrhnr 14 i at
o a uoy—
P um ing Mechanfca ewer Wood Stove
Fireplace Deck Varage arport
Basement Loft Other
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
'-\ PERMIT NO.
NAME MAIL ADDRESS CITY I TATE ZIP PHONE
OWNER '/i
DIRECTIONS 1
TO JOB SITE �� - lE 'r (\Q(� 3/� y "l
(r T
PARCEL rr�� LEGAL
NUMBER 0 - DESCR.
NAME MAIL ADDRESS CITY 3 STATE LICENSE NO. ZIP PHONE
CONTRACTORLa V L r� $` `
USE OF
BUILDING
vvxylo-
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS�_ TOTAL SQ.FT. GARAGE \ CONDITIONING.
NO.OF STORI ES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
p� COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FIT. g FIR LACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMANE '� SHORELINE
SEASON
OWNE AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIF THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTR TION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIR ENTS 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 ORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINI GAP PR A L FROMUILDIN EP RTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNER O`C 1RATE c tI I X BY DATE
FC�R OFFICE USE ONLY
DEPARTMENT YESPPROVE NO DEPARTMENT YES No
BUILDING VALUATION
HEALTH NX ak PUBLIC WORKS FEE
PLANNING ` FIRE BUILDING PERMIT �.
D.O.T. BUILDING (-tx PLAN
SPECIAL CONDITIONS BUILDING GROUP �" "' f ¢S PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE -
APPLICATION_ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
L�� BY WIC <`Z44-4j CASH CK MID TOTAL Z