HomeMy WebLinkAboutBLD21376 Mobile Home Storage - BLD Application - 1/4/1988 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED/- Od
PERMIT NO.-'--7�?/3 376
OWNER NAME MAILADDRESS CIT &STATE ZIP PHONE
DIRECTIONS /
TO JOB SITE A-6 j J�
PARCEL ll�^1 LEGAL �j(c(y �' L( p�C �� ,� e)
N U M B E R � � )C�e� DESCR. ft'r�%
NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR f}!�1 •� S I}A& U e
USE OF
BUILDING L
CLASS OF NEW ADDITION ALTERATION
WORK REPAIR MOVE REMOVE
DESCRIBE / (�
WORK
WIQ�OOMS- DECKS CARPORT TILE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHRO TOTALSQ.FT. CONDITIONING.
NO.OF STORIES SEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180
TOTALSQ.FT. LACE DETACHED ABANDONED FOR AERODOFYBDAYSATOANY TIME AOFrTERWORK ISCOMMENCD OR WORK IS EDOR
PERMANE SHORELINE
S ONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERFD 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
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 COIjPORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAI NG APPROVAL FROM THE BUILDING DEPARTMENT. c APPROVAL FROM THE BUILDING DEPARTMENT.
JOINER'/"), DATE 0 X BY_ DATE
FOR OFFICE USE ONLY
DEPARTMENT PPROVENo DEPARTMENT APPROVED
YES YES NO BUILDING VALUATION ^ /
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HEALTH PUBLIC WORKS FEE
PLANNING L FIRE
BUILDING PERMIT � do
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS /� BUILDING GROUP PRE-INSPECTION
c`>s 1 0 SHORELINE
�� LOWlV11�vC �a� CxYI WOODSTOVE
L Irk' 11r`� U641 ITS PLUMBING
J L) MECHANICAL
L ?�0 LAw
1 C_ STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
IBY CASH CK MO TOTAL �� �j