HomeMy WebLinkAboutBLD5952 Utility Storage - BLD Permit / Conditions - 3/5/1980 Albert R. Dameron #5952
3-5-80
Collins Lake Community Lot 67, Division I,
Creek View Road
Go thru Belfair to Belfair State Park; follow
signs to Collins Lake Community
Utility Storage
$5,460.00
BUILDING PERMIT APPLICATION
` MASON COUNTY
P.O. Box 186 Shelton Washington 98584
9 426-5593
DATE ISSUED gV�
X ( Z 3 S PERMIT NO. 6 / 5 0L
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
A�- E i� 1= K, D N A 14 U A W -$7 1-7r Y9 3
DIRECTIONS ("Ot S� KS �0 COIF/al p
TO JOB SITE 13e� Cct i l�
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. C O() 1 it S 1- /F}(e C �y fi d 1 V.• 1 C:heel V ' 6L D
CONTRACTOR
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF
BUILDING
Class of work: W ❑ ADDIT N ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe)work:
U
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
v: Hbb,M C7 ?G ,e, t>
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE [)
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO, OF STORIES BASEMENT I J OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE I I I 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 L; SHORELINES ❑
SEASONAL ❑ FLOODPLAIN I I
Firm
E.D. NO. S.E.P.A. L]
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 in conformance therewith. MOTOR VEHICLE PERMIT
Owner • �(�!/Ila ate.IZ-. 7 MAPITIO C PTE BY PLANS CHECK BY APPROVED FOR IS �fQ AE
PLAN CHECK VALIDATION M.O. CASH PERMIT VALIDATION CK. M.O. CASH