HomeMy WebLinkAboutBLD11198 Replace Decking - BLD Application - 8/11/1981 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. Z//
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
M!L MD&0LIC, t
DIRECTIONS
TO JOB SITE 4rM jf.,C- kop pjj �� (e�tC�� MA,2 bJ A
LEGAL , � (❑ SEE ATTACHED SHEET)
DESCR. 'flit-/��G t9 , IlIO
CONTRACTOR
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
��?'�'( l ,J j 233-0 - 2E.316
USE OF
BUILDING J
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
Describe work:
REPLINCE
20 KI? 3(00 .�
Valuation of work: a o PLAN CHECK FEE PERMIT FEE
► SPECIAL CO ITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED ❑
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 S
Firm HORELINE
� � /m���K n SEASONAL ❑ FLOODPLAIN ❑
j ��
E.D. NO. S.E.P.A. ❑
By C-L C o ff Special Approvals IN OUT YES APPROVED NO
Lic. No. Date l ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
c ntract or registration law RCW 18.27, and am aware ��
f the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. [nAPPLI
EHICLE PERMIT
MTI �IP�TED BY P NS CHECK BY APPR ED FORISSUANCE
w er Date . ' � 8 �
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIQK CK. M.O. CASH