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HomeMy WebLinkAboutBLD15015 Complete SFR - BLD Permit / Conditions - 12/14/1983 ROBBINS, Leroy M. #15015 12-14-83 36-21-3,Tract 1 of Survey 2-49 West End of North Deer Creek Loop, turn right Contractor Self 491-2635 Complete Residence original permit #10424 $25,000.00 Shorelines: Setback: Special Conditions: Footing: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: Plumbing: Mechanical: Roof: Exterior : Interior: Final: Stop Work: Mobile Home: Smoke Detector : Remarks: PERMIT NULL & VOID BUXEIRATION DXTE BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 1 �1 ,(�t_g DATE ISSUED PERMIT NO. ( So is OWNER NAME MAIL ADDRESS CITY&STATE' l ZIP PHONE DIRECTIONS TO JOB SITE (� K o o �Z Y LEGAL. (O SEE ATTACHED SHEET) DESCR CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE USE OF BUILDING ,E, Class of work: l>1 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Valuation of work: $ Q�_J PLAN CHECK FEE PERMIT FEE Q^'a SPECIAL CONDITIONS: BEDROOMS DECKS CARPORT [] NOTICE BATHROOMS TOTAL SO. FT. GARAGE X ATTACHED X SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT L] OR AIR CONDITIONING. TOTAL SQ. FT, u FIREPLACEX I DETACHED G 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 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 SHORELINES SEASONAL I I FLOODPLAIN I Firm E.D. NO. S.E.P.A. I i By Special Approvals IN OUT YES APPROVED NO Lic. No. Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. PUBLIC WORKS I c tify that I a @mpt from the requirements of the FIRE MARSHAL c ntract or rep' tfi 'ion law RCW 18.27, and am aware f the as my rdinance requirements for BUILDING DEPT. /g which th' pe is issu and that all work done will ROAD ACCESS be in c fo ce rewith. MOTOR.VEHICLE PERMIT LI ATION ZCEPOAY PLANS CHECK BY APPROVED FOR ISSUANCE Owner _ Date ./L/�� tj BY PLAN C ECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH