HomeMy WebLinkAboutBLD N/A Change of Use - BLD Permit / Conditions - 5/14/1979 Fisher, David #####
5-14-79
Star Route 1, Box 9, Belfair
31&32-23-1
Change of use to Professional Office Space
I a 33a - 56 - oco2.
1
'B UIL D ING PERM 1 T A PPL ICA TIO N
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED S /'V- 7
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
Q o fiZ7
DIRECTIONS
TO JOB SITE St }� O I W
LEGAL 11 r, SEE ATTACHED SHEET)
DESCR. LLB 31 �- 3 S Q E. &rden Ir•
CONTRACTOR NAME F MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
�-
USE OF
BUILDING `ASS! a n& i gad
c
Class of work: ❑ NEW ❑ ADDITION W ALTERATION ❑ REPAIR ❑ MOVE REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED Ij
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
I certify that I am a currently registered Contractor In WORK IS COMMENCED.
the State of Washington and I the
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 ❑ SHORELINES ❑
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date 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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance there Ith. MOTOR VEHICLE PERMIT
AP ICATION ACCEPTED BY PLANS CHECK BY A PROVED FOR ISS ANCE
Ow er ��JJJ`���✓✓✓ Date
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH