HomeMy WebLinkAboutBLD15887 Concrete Footing and Steel Bldg - BLD Application - 7/25/1984 CON r-"T",
.,"o mow^II BUILDING PERMIT APPLICATION
MASON COUNTY
9-7 Z. P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED�a�- _
PERMIT NO. 1 4eZ
OWNER AM MAIL ADDRESS CITY&STATE ZIP P?HONE
S u E tom. o Q 2DIRECTIONS "Tb M QC FX CU70 7r C� L
TO JOB SITE �,.GL.
LEGAL ./ �I EE ATTACHED SHEET)���,f/�j
DESCR. �) L�I
NAME MAI ADDRESS CITY&STAT LICENSE NO. PHONE
CONTRACTOR 1�1TL �4 6� ' 071.
USE OF
BUILDING C�4�i1
Class of work: X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN C H E CK FEE q`��i PERMIT FEE v
coo►
SPECIAL CONDITIONS:
BEDROOMS_ I DECKS CARPORT ! NOTICE
BATHROOMS_ TOTAL SQ. FT. GARAGE L 1
ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT [I OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE I ' DETACHED L
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 Aat I am a currently registered contractor in WORK IS COMMENCED.
lea of Washington and I the
aware of the FOR OFFICE USE ONLY
e requirements regulating the work for whichit is issued and all work done will be in
nce therewith. PERMANENT L i SHORELINES i
SEASONAL I I FLOODPLAIN I
Firm E.D. NO. S.E.P.A. iJ
By Special Approvals IN OUT YES APPROVED NO
ZONING
Lic. No. Date
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. a o
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract r re is r law RCW 18.27, and am aware r
of the a o oun ordinance requirements for BUILDING DEPT.
hich thi mit is issue n tall work don will ROAD ACCESS
in orm a therew MOTOR VEHICLE PERMIT
r PLI ION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
40 Date. I BY
ECK ATION CK. M.O. CASH PERMIT VALIDATIC CK. M.O. CASH