HomeMy WebLinkAboutBLD N/A Mobile Storage - BLD Application - 1/9/1992 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W. CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED
GSA,r` _`��2 -� PERMIT NO.
A)AE �' MAILADDRESS CITY&STATE ZIP P ON
OWNER L� �c7o' 1).��v�,� 7-5 y9
DIRECTIONS , ,)
TO JOB SITE l\ �) /KO 9
PARCELLEGAL
NUMBER .,C 1 � DESCR.
NAME MAIL ADDRESS CITY&STATE ZIP PHONE,Z L N'E NO.
CONTRACTOR jL
USE OF
BUILDING G
CLASS OF NEW �/ ADDITION ALTERATION REPAIR MOVE REMOVE
WORK
DESCRIBE /
WORK / i /!J `7 - % N L-
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE, .ZO SgFt STORIES�_ SHORELINE❑ CONDITIONING.
BASEMENT✓ 'SgFt BEDROOMS PRIMARY RE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS --'SgFt BATHROOMS SEASONAL RES.❑ COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
CARPORT SgFt FIREPLACE IS CARPORT/GARAGE
GARAGE --` SgFt ATTACHED O 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 1
REQUIREMENTS 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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREW .NO CHANG SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM THE BUILDZ4G DEPARTMENT. APPROVAL FROM TH 8 I T.
XOWNER V v DATE _ /- e-�L
- XBY_ _ DATE /� �✓ �Z
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO
-IEALTH PUBLIC WORKS FEE
LANNING FIRE MARSHAL BUILDING PERMIT
O.T. BUILDING U4PLAN CHECK
ECIAL CONDITIONS BUILDING GROUP m_ PRE-INSPECTION
STORAGE ONLY---DO NOT HOOK UP WATER SHORELINE
SEIIIER, ELECTRICITY. DO NOT OCCUPY. WOODSTOVE
EXPIRES 7/9/92 . X PLUMBING
MECHANICAL
STATE BUILDING FEE
ION ACCEPTED BY PLANS CHECK BY rVED FOR ISSUANCE PERMIT VALIDATION
�' ``> CASH CK MO TOTAL