HomeMy WebLinkAboutBLD337 ReSiding and ReRoof - BLD Application - 9/7/1997 1
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 nn .5.
DATE ISSUED '7" / — ?9
PERMIT NO. 3C3 z
OWNER NA MAIL ADDRESS Cl &STATE ZIP PHONE
I fc 39d 9 S F. e")I fFc 69ek Die. o,ef O'er A . 9836 �7i-sz2
DIRECTIONS `j{f / �.� LA,rx 'Tu,�CC.d L�Ff uQ �¢ �o Mi g 7�4Pr �iEv`gEk%f /S 7OX,E
TO JOB SITE t AS1" A40 'off b ADG�e��rr✓, T � S Ef
T 1 LEGAL "rkAlC7l 0 /fUE 'q '9!5 , �7'— � ,�C i2.ECo4 S�,9� V EglSHEEE
DESCR. E /.s/ /�f-C'a F /i7r4S0lJ o
CONTRACTOR
NAME MAIL ADDRESS CITY&STWE LICENSE NO. PHONE
USE OF n )
BUILDING `CE C iI si/
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Re-siding and Re-roof of cabin9/so Pq tr r- /5'k 26
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
3,000.00 $24.00
SPECIAL CONDITIONS: w/0 / ✓JX?
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS 0 TOTAL SO. FT. 0 GARAGE ❑
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIESBASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. .3 FIREPLACE ❑ DETACHED ❑
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 1 SHORELINES ❑
SEASONAL ❑ FLOODPLAIN
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 County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be ' conform ce therewith. MOTOR VEHICLE PERMIT
J
X/ M� APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANFE
O W n r ����//// CCCC�����"" Date . f� Y
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CAS