HomeMy WebLinkAboutBLD0029 Swimming Pool - BLD Application - 5/31/1983 BUILDING PERMIT APPLICATION. ,
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. O 0 '
OWNER NAME MAIL DRESS CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITE
LEGAL � (❑ SEE ATTACHED SHEET)
DESCR. Y
NAME MAIL ADDRE r CITY&STATE LICENSE NO. PHONE
CONTRACTOR P L c—, j� VUC Kr6C4 I W
USE OF
BUILDING
Class of work: KNEW ❑ AD ION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe wor
Valuation of work: $ D PLAN CHECK FEE PERMIT FEE
/en �a .
SPECIAL CONDITIONS:
BEDROOMS (DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE
ATTACHED C SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT L OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED o
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 SHORELINESA/9t;
SEASONAL [-] FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. II
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
be in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLAN HECK BY APPROVED FOR ISSUANCE
Oxuner /J !✓L Dates 3 (, G BY
PLV CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH