HomeMy WebLinkAboutBLD11515 Storage Space - BLD Application - 10/1/1981 r BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATEISSUED
PERMIT NO.
NAME AIL ADDRESS CITY&STATE ZIP PHONE
OWNER �[ _ M' ' E
DIRECTIONS J C
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR, p 11
Ih K � 0 oolli s
NAME CONTRACTOR MA L ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF
BUILDING
Class of work: ❑ NEW ERA DIT115N ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work:
$ PLAN CHECK FEE PERMIT FEE d 14
O .'
SPECIAL CONDITION : '
BEDROOMS DECKS — CARPORT[; NOTICE
BATHROOMS TOTAL SO. FT.____ GARAGE II
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT !: ATTACHED OR AIR CONDITIONING.
TOTAL SO. FT.asI FIREPLACE I i DETACHED L l
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 FORA PERIOD OF 180 DAYS AT ANYTIME 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 f i SHORELINES ❑
SEASONAL [] FLOODPLAIN ❑
Firm E.D. NO. E,P.A. I I
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING /0'
PLANNING DEPT. i
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 County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
APP ICATION ACC PTED.BY PLANS CHECK BY APPROVED FOR ISSUANCE
Own Date / B
PIU CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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