HomeMy WebLinkAboutBLD N/A Storage - BLD Application - 3/24/1991 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER �� A,/ ) eK7 C'
DIRECTIONS
TO JOB SITE
xi seY
PARCEL LEGAL `5` tt L r h E
NUMBER �� 7 DESCR. 111 F c
NAME MAILADDRESS CITY&STATE ZIP PHONE LICENSE NO.
CONTRACTOR
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK /
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE �&qFt STORIES SHORELINE❑ CONDITIONING.
BASEMENT SgFt BEDROOMS PRIMARY RES.Ik-' THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS S Ft BATHROOMS I SEASONAL RES.❑ COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
q ABANDONED FOR A PERIOD OF 189 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
CARPORT SgFt FIREPLACE N I IS CARPORT/GARAGE
GARAGE��SgFt ATTACHED 0 DETACHED❑
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNER DATE X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YESPPROVENo DEPARTMENT YESPPROVENo BUILDING VALUATION
HEALTH PUBLIC WORKS
PLANNING FIRE MARSHAL BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
PERMIT IS FOR THE STORAGE ONLY OF MOBILE HOME. NO OCCUPANCY SHORELINE
NO HOOK UP TO ANY UTILITIES. PERMIT EXPIRES ON 3-24-91 and WOODSTOVE
WILL BE REQUIRED TO BE RENEWED. AT THE END OF 1 Yr a LUMBING
of residential or storage unit must be made or mobile is to be MECHANICAL
moved. A permit for designation will be requ' _d. Placement of STATE BUILDING FEE
obile must meet all ��': - l�
APPLICATION ACCEPTED BY I PLANS CHECK BY rAPPROVED FOR ISSUANCE
—TOTAL
CASH CK MO