HomeMy WebLinkAboutBLD0377 - BLD Application - 2/11/1986VIE
Pennit No. 4>377 No. Floors Ftg
Owner st",fa, Tel ,172_,50) te _1,4-R6
Address 7�� I'lsn,� ak.Rd. NW BrUmertOn Zip
Contractor S ,1
Address
Legal Description Maggie t..;tka, Div.
Direction to project site
Across t. `i40 Lake hore Dr. Y
Plumbing hanical Sewer
Fireplace Deck Garage
Basement Loft Other
Zip
C'
Shorelines:
Setback:
Special Conditions:
ck:
aticri bvalis:
Fireplace:
Stove:
ng:
Mechanical:
Interior:
Final: Fi 4�
Mobile H
ke Detector:
marks:,_ . 6e,
PLEASE MAKE CHECK PAYABLE TO MASON COUNTY TREASURER
BUILDING PER IT APPLICATI
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
OWNER
DIRECTIONS
TO JOB SITE
LEGAL
DESCR.
CONTRACTOR
USE OF
BUILDING
•
Class of work:
NAME.
1
MAIL ADDRESS
k; 4p Lk
MAIL ADDRESS
'E4tn1 eq
y C U c2C'1 ! a .
NEW 12 ADDITION ALTERAtION
Describe work: f/fJI c iV +j
ia Arvi
020
Valuation of work: $
SPECIAL CONDITIONS:
BTTHBC)0 'B
NO OF STORIES
TOTAl SO Ft
Firm
By
EEC No.,
%,-)1 AI Sty. FT
ASEMENT
(REPLACE
ied_—
WOOD STOVE PERMIT
CARPORT'
GARAGE
ATTACHED
DETACHED
CITY 8 STATE
CITY & STATE
REPAIR MOVE
C ej 4'i)) 0ve r_74c^
PLAN CHECK FEE
CONTRACTOR AFFIDAVIT
I cerlhat I am a currently registered contractor in
the State of Washington and I am aware of the
ordinance requirements regulating the work for which
the permit is Issued and all work done will be in
confopnnance therewith
Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the
contract or registration law RCW 18.21, and am aware
of the Mason County ordinance requirements for
which this permit is issued and that all work done will
be in conformance therewith. , 12)
r
C.
Date
DATE ISSUED
PERMIT NO,
/ff
ti
ZIP
SEE ATTACHED SHEET)
LICENSE NO
2 pair
a.52 e514
PERMIT FEE
NOTICE
PHONT
7 -
PHONE
5.00
SEPARATE PERMITS ARE REOUIRE)) FOR PLUMBING, HEATING, VENTILATING
OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR
IZED IS NOT COMMENCED WITHIN 1130 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF ttEl) DAYS AT ANYTIME AFTER
WORK YS COMMENCED.
FOR OFFICE USE ONLY
PERMANENT
SEASONAL
E D NO.
Special pApprovals
ZONING
PLANNING DEPT.
HEALTH DEPT.
PUBLIC WORKS
FIRE MARSHAL
BUILDING DEPT.
ROAD ACCESS
MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY
SHORELINES
FL 00 PP L A IN
S,EPA, i
N OUT
PLANSCHECK BY
YES APPROVED NO
APPROVED FOR ISSUANCE
yf
PLAN CHECK VALIDATION CK. M.Q. CASH
PERMIT VALIDATION
CK M.O. CASH