HomeMy WebLinkAboutBLD9990 Final Enclosed Patio - BLD Permit / Conditions - 8/2/1983 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
` PERMIT NO.
5
NAME MAIL ADDRESS CITY&ST ZIP PHONE
OWNER
�� 22� Y�? 3 l7s- Z 3 ? 3
DIRECTIONS _
TO JOB SITE
LEGAL �/ (❑ SEE ATT HED SHEET)
DES /v f c12 q?
NAME MAIL ADDRESS CITY&S TE ENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ a PLAN CHECK FEE PERMIT FEES
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT :; NOTICE
BATHROOMS TOTAL SO, FT. GARAGE L;
ATTACHED i; SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT Li OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE - 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 FORA PERIOD OF 180 DAYS AT ANYTIME 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. PERMANENTi SHORELINES I i
SEASONAL I FLOODPLAIN Li
Firm E.D. NO. S.E.P.A. I i
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.
441im,
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEP PLANS ECK BY APPROVED FO ISSUANCE
Owner ��! -4 0-�-�✓""`� Date. —e j TED BY ' ' B�y�
P LV
CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
Crosswhite, G. M. #9990
275-2373 1/11/83
Sam Theler's Home & Garden Tracts, North 165' of 27 &
27A, Except 27-F
NE 22680 Highway 3, Belfair
Enclose Patio Contractor:
(Change to Rec. Room) 675 Sq. Ft. Self
$20,250.00
J
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final: a k- B' - �3
Stop Work:
Mobile Home:
Smoke Detector:
Remarks: