HomeMy WebLinkAboutBLD6921 Garage - BLD Application - 7/18/1980 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. t16
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
�'A �?s' o[o% IzIAe.
DIRECTIONS
TO JOB SITE ,�p i+•G//. IS -La 8e
LEGAL )<SEE ATTACHED SHEET)
DESCR.
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
1
USE OF
BUILDING
Class of work: /�eN@W ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: 4
1
Valuation of work: $ �O �O PLAN CHECK FEE �rI PERMIT FEE
SPECIAL CON ITIONS:
GG .�
BEDROOMS— DECKS CARPORT 1 1 NOTICE
iiY BATHROOMS TOTAL SO. FT. GARAGE
ATTACHED C! SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT L:- OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE [�J DETACHED
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. PERMANEN SHORELINES
SEASONAL I ] FLOODPLAIN f 1
Firm E.D. NO. S.E.P.A. Li
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
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. — 7 1
which this permit is issued and that all work done will ROAD ACCESS
b nformance therewith. MOTOR VEHICLE PERMIT
ICATION EP PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date. BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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