HomeMy WebLinkAboutBLD6719 Cabin - BLD Application - 6/24/1980 s% BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. Ty
OWNER NAM MAIL ADDRESS ITY&STATE ZIP PHONE
DIRECTIONS D Lt�i9 iy' d — -rw, v '6^v
TO JOB SITE //�s fA-7—� Ll IC/ilts/t l��� 4je-' _IfTi @L
LEGAL / w {� SEE ATTACHED SHEET)
DESCR. 14r v L�14 ekl.j/Ti✓- F!�S 1—",0i7JDU 20, ' W M
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF � RA44A//--)dY` IAVA E /A-/
V)
BUILDING A 6 A47 DA/ e- —BIA1 _ S" E/Ht
Class of work: ❑ NEW 4"DDITION ❑ ALTERATION ❑ REPAIR MOVE ❑ REMOVE
Describe work: A-Ppr- -q
li
XIA
Valuation of work; $ PLAN CHECK FEE PERMIT FEE
am K low
SPECIAL CONDITIONS:
BEDROOMS DECKS _ CARPORT 1 1 NOTICE
BATHROOMS 2— TOTAL SQ. FT.�_ GARAGE [
ATTACHED I i SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT [) OR AIR CONDITIONING.
TOTAL SO. FT. 3 FIREPLACE I I DETACHED I;
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 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 1] SHORELINES I i
SEASONAL I I FLOODPLAIN i
Firm E.D. NO. S.E.P.A. i
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 Coun ordinance requirements for BUILDING DEPT.
hic s permit is ' ued and that all work done will ROAD ACCESS
n nfor a erewith. M91OR VEHIC E YERMIT
Q� A P ICATION AC TED BY PANS CHE BY APPROVED FOR ISSUANCE
Own " Date V D '" BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH