HomeMy WebLinkAboutGRD27892 - GRD Permit / Conditions - 5/2/1991 Shorelines: Plumbing:
Setback: Mechanics -.
Special Interior:
Conditions: FINAL:d/C=� /.'ouP!.�
MobileHome:
Smoke Detector:
Remarks:
0o ing:
:Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE GRADING
Permit No. 27892 No. Floors Sq Ftg
Owner CRIMI, CARL J. Tel 373-9015 Date 4-15-91
Address 4060 Hwy 16 W. , Bremerton Zip =
Contractor Self
Address Zip
Legal Description Lake Christine Lot 42
Direction to project site N. Shore rd to Tahuya rd rt to
Haven Way to T turn rt Mt View Rd to first rd rt, It
v'e
um ing Mec anica Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
vur,v u''a P.O. BOX 186 SHELTON, WASHINGTON 98584 /
427-9670 DATE ISSUED 1
PERMIT NO._L2 q M
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER c��L .�` c'p mk
DIRECTIONS
TO JOBt SITE Or,,rf4 rlgilv P 11.4V WA Ga v4 *T`
60 T, IM140, 1- ' 'fa r'Rs` kl> gt jto !�:jn
PARCEL LEGAL
NUMBER Y, Z-Z:3Z 0.,!�-00p0 Z DESCR. 46-74/lZ t4 L— C&(Z is 4iw vocI�AGL�
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTO
USE OF
BUILDING
CLASS OF NEW TADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK iG4- - I' '
AJ AGr
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTALSQ.FT. GARAGE CONDITIONING.
NO.OF STORI ES BASA ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTALSQ.FT. LACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
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 ING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
"'�
OWNER DATE 7 X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT Z
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY ED OR I UANCE PERMIT VALIDATION
BY CASH CK MO TOTAL l�