HomeMy WebLinkAboutBLD7429 SFR - BLD Application - 9/18/1980 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. 71
OWNER NAME MAIL ADDRESS CITY 6 STATE ZIP PHONE
&/G O G /�iC/�// O rp 9,fit!' W, _
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. ��1p�i(/lJ' //,r/�t/� �.�fc>.��G ,4' 7 '4
CONTRACTOR
NAME MAIL ADDRESS CITY 3 STATE LICENSE NO. PHONE
USE OF
BUILDING
Class of work: El NEW ❑ ADDITION ALTERATION EPAIR ❑ MOVE ❑ REMOVE
Describe work:
lif/PB.41, 1-4114(
Valuation of work: $ �O HECK FEE PERMIT FEE
� a5�
SPECIAL CONDITIONS:
17
Q�
s
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
N0. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SQ. 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. PERMANEN SHORELINES I
SEASONAL i FLOODPLAIN I 1
m E.D. NO. S.E.P.A. I
Special Approvals IN OUT YES APPROVED NO
No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
P S
i 1 certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT.
of the Mason County ordinance requirements for
iwhich this permit is issued and that all work done will ROAD ACCESS
�' onformance t wi . MOTOR VEHICLE PERMIT
i ' �" A ICATION ACC TED BY PLANS CHECK BY APPROVED FOR ISSUANCE
er Date. ( '� _ v
N CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION C M.O. CASH