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Home My WebLink AboutBLD27355 Skirt Mobile - BLD Application - 1/11/1991 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED �� ✓�/ PERMIT NO. OWNER NAME MAIL ADDR SS CITY&STATE ZIP EHONE DIRECTIONS TO JOB SITE 2 C12� -J-3 PARCEL 0LEGAL NUMBER Z DESCR. Z b 6L) 'C NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ �2 J WORK DESCRIBE ; P 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 COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SQ.FT. 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 THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATIO W RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREM 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 CON A CE THEREWITH. HANGES SHALL B MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAI G t7tOVAL FROM THE ILD EPARTMENT. 9 APPROVAL FROM THE BUILDING DEPARTMENT. X BY DATE FOR OFFICE USE ONLY DEPARTMENT YES APPROVE NO DEPARTMENT YEAPPROVEDIO BUILDING VALUATION HEALTH - - PUBLIC WORKS FEE PLANNING ��} _ - FIRE BUILDING PERMIT D.O.T. BUILDING Q/< ,(,� �y PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP P-3 PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE J STATESURCHARGE APPLICATION ACCEPTE78YPLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION.''a-' BYE 7?1-9 y� CASH CK MO TOTAL BUILDING PERMIT PLOT PLAN MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. Box 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. AME l AIL ADDRE S CITY&STATE/ p ZIP Q(� P E OWNER /}'Q �q lZ� " �. d K� wi f I S �/I / �: ( O7 ONS TO JOB DIRECTSITE 9 L 3 o,o Dt4 12 Gd-i�c fZ L Q rL>v f o o rf'PARCEL 11EGAL NUMBER I 1 DESCR. Q /� LAJ Indicate below:08 roperty lines and dimensions. O Easements and roads. O Septic, drainfield and reserve area, or sewer. O Septic tank and drainfield setback distances from foundations. O Location of proposed construction on property. O Building & septic system setback distances from all property lines& easements. Indicate North O Well and water line. In Circle O Saltwater, lakes, rivers, streams, wetlands, drainage. O Attach copy of septic system"as built' or septic permit approval. O Indicate to r h ro it o perty n s it ,cture on reverse side. 01 S- .J 4/ Q 3 od Q 171 W � 14 -77 0017 1p M 9rtify that the proposed construction will conform to the dimension7and us s s own above and that no ch will b ade withou st obtaining approval. SIGNATURE OF OWNER(S)OR AUTHORIZED PRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED ,ICT AS NOTED DATE TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE