HomeMy WebLinkAboutBLD9743 Addition - BLD Permit / Conditions - 1/3/1980 Ells, Jesse #9743
1-3-80
Tr. b SW NE 36-21-3
wnd house right, N. Deer Creek Loop Road
Addition
$22,500.00
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584 /80
426-5593 /
DATEISSUED
PERMIT NO.
OWNER NA E MAIL ADDRE CITY&STATE ZIP PHONE
DIRECTIONS J, '�
TO JOB SITE -4?1 W
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
CONTRACTOR LNAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF ���`
BUILDING
Class of work: ❑ NEW Dsk%DDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ o� �Q O r-O PLAN CHECK FEE �S— PERMIT FEE/O "!Y
SPECIAL CONDITIONS: /
BEDROOMS I DECKS CARPORT I i NOTICE
BATHROOMS TOTAL SO. FT. GARAGE L]
ATTACHED [L SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE I_] DETACHED Ci
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. PERMANENT I I SHORELINES I 1
SEASONAL I I FLOODPLAIN 1
Firm E.D. NO. S.E.P.A. 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. p
which this permit is issued and that all work done will ROAD ACCESS
e ' conformance there ith MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
0 n Date. BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION C M.O. CASH