HomeMy WebLinkAboutBLD21255 Cancelled Pole Bldg - BLD Permit / Conditions - 1/9/1991 Shorelines: iy A Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:
Mobile ome:
Smoke Detector:
Remarks:
ooting:oK_3
Setback:
Foundation
Walls: P13
Framing: ID rY FYPIRATIQN
Fireplace:
FIB'
Wood Stove: aA _.�.,. ...—�..,.-.�
TE L!—_ -
TYPE PDLE BLDG.
Permit No. 21255 No. Floors 1 Sq Ftg 13172
Owner LITTLE K OKI MILL Te1426-9721 Date 11-24-87
Address 780 W Hwy 108 Shelton Zip
Contractor F & L Pacific
Address 3111 Bailey Centralia zip
Legal Description Por 24-19-4
Direction to project site
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
BUILDING PERMIl APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED / L/
CO PERMIT
OWNER NAME MAILADDRESS CITY BSTATE ZIP PHONE
i ►J A 7-6--0 7 zi•
DIRECTIONS
TO JOB SITE con ( U
PARCEL LEGAL jNE Vb 611�-" / a f n1 W 14 ,hK ' a •%A/ c- iYW 14 ItLA
NUMBER DESCR.k7ee vYP til R4�/ tj&Y4- -7 NSA/�l4
NAME MAILADDRESS CITY BSTATE LICENSE NO. ZIP PHONE
CONTRACTOR ct� I I 1 (� -aauawrl PoL z9 S� 5�� 73�—�zQ,c
USE OF
BUILDING 6T-0v'A&e
CLASS OF NEW T�/ ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK d 07 4 (-78 -C> x Z S -O 6 t,f> �i d t� 1 x� V�U G 1 C71.� Qpf N C'A
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING,
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
r� COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT.>> 1 FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY TH T I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATIO LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENfS 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 C NFOR ANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBT NING PPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING..DEPARTMENT.
X O ER DATE X BX DATE to
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT 33I, oa
D.O.T. BUILDING PLAN CHECK S:
SPECIAL CONDITIONS BUILDING GROUP Al _ PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
ti
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANSCH CKBY APPROVED FOR ISSUANCE PERMIT VALIDATION
'� ��.,If IBY "/ CASH CK MO TOTAL 6 y1��.5