HomeMy WebLinkAboutBLD19903 Pole Bldg - BLD Application - 3/4/1987 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. �J
OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
h m � rl t-' 3o(p
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. lJ Dad
NAME MAIL ADDRESS , �� CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR ^ Gt7 D
smg, iLof�67 S M 145Z► e 7¢3Iss-+
USE OF V
BUILDINGCYCL e
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: 1 -
pote -IL
Valuation of work: $ PLAN CHECK FEE---,.- PERMIT F,l3E
1275
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT [,
NOTICE
BATHROOMS E I TOTAL SQ. FT. GARAG ^
ATTACHED I� SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT Li OR AIR CONDITIONING.
TOTAL Q. FT. FIREPLACE Cl 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 am 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 I-i SHORELINES I
C SEASONAL CI FLOODPLAIN l
F _� J
E.D. NO. S.E.P.A.
By Special Approvals IN OUT YES APPROVED NO
Lic. No. TOWIVGS 9�blt 1Z7Date 'Z=Z�—S,f 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. 3 Y v
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS 1 jtIECK BY APPROVED FOR ISSUANCE
Owner --- Date . � /J BY�
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
ImTOWN & COUNTRYSTEEL BUILDINGS Quality: Our future depends on it."
DIVISION Of
1171MU-MY IndwMer,Inc.
(206)743.1556 16521 Highway 99•Lynnwood,WA 98038 SITE P L.A N
PLEASE SHOW:
Property dimensions Septic and drainfield Main road with name
Existing buildings Sewer lines Access to proposed building
Proposed building Setbacks of proposed and Lot size
existing building Elevation of property
Job Name gticp l Address
Tax # � N
-- - ---- -- - -
_7777--
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