HomeMy WebLinkAboutBLD28937 - BLD Permit / Conditions - 8/30/1991Shorelines:
Setback:
Special.
Condit ions:
Foot in
Setback:
Found a t ion
Walls:
Framing:
I' i replace:
wood .
ve:
Flunbi.ng:
Meehan ical
Interior:
FINAL:
Mob i Home:
Smoke Detectorr:
Revsirks:
TYPE Ft.)t.N[)ATI (.)N
Permie5Nd7 289.37 No. Floors S1 Ftg
Owner Michael Prtrowsl.;i Tei426-7.1(,"3 Date /30/9i
Address G 4570 CIcx ()qua Lip
a I � t�:k �c� : he l ton ! t
Contractor
Address
Legal. Desc r. i pt icon 2 10 4.
Direction to project site
on C: Loqun1. [urn Rd. V corner. ..qu l.lum and 'hod ton
Vol ley Cutoff Rd
P1uinbi.ng Mechanical Srewer Wood Stove
Fireplace Deck GarageCarport
basenent C ;.)ft Other
4.5 n
lip
f hr
L I
I
T
OWNER
DIRECTIONS
TO JOB SITE
PARCEL
NUMBER
CONTRACTOR
USE OF
BUILDING
CLASS OF
WORK1.
_ .
DESCRIBE
WORK
A
ASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W. CEDAR/P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670
MAO ADOHESS
k t! 5" .7r
5%+c
. .✓tl
LEGAL
'f/110.,1 -t .Z 0c 30 DESCR.
NAME MAIL ADDRESS
RESIDENCE t
BASEMENT SgFt
DECKS SgFt
CARPORT
AbE ScFt
OWNERS AFFIDAVIT
NUMBER OF: PLEASE INDIC
STORIES __ I SI" NE
PRIMARY RES:J
5 SEASONAL RES. J
FIREPLACE IS CAR• ►" GARAGE
ATTACHED J DETA
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF 1HE CONTRACTCRS
REGISTRATION LAW RCW 18.27. 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- NO CHANGES SHALL BE MADE WITHOUT FIRST
OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT,
X OWNE
DEPARTMENT
HEALTH
PLANNING
D.O.T,
SPECIAL CONDITIONS
irk A
APPLICATION ACCEPTED BY
DATE
APPROVED
YES NO
PLANS CHECK BY
I
FF
:DEPARTMENT
PUBLIC WORKS
FIRE MARSHAL
BUILDING
BUILDING GROUP
APROD
YES
APPROVED FOR ISSUANCE
C1'Y ESTATE
EPAtP
OTICE
'IHIE PF4I'MPI
dC1M44FN:: F:I :L�' HI
ARANUONFA
DATE ISSUED
PERMIT NO.
HEATING, VENT+LATi R AIR
S NULL AND VOID IF WORK OR CONS
(I DAYS. OR IT' CONSTRUCTI
F IF40 DAYS AT ANY T
CONTRACTORS A# AVIT
<CERTIFY {q?
W ASH=NO TON
WORK F'OR
CONFORM
APPRO
Y.
ION AUTHORIZED IS NOT
R WORK IS SUSPENDED OR
AFTER WORK IS COMMENCED
M A CURRENTLY REGISTERED CONTRAC wY IN THE STATE OF
I AM AWARE OF THE ORDINANCE REQUIREMENT "' GULATING THE
THE PERMIT IS ISSUED AND ALL WORK DON ILL BE IN
TH NO CHANGES SHALL BE MADE WITHOUT FIR STYF'#TAINING
ISO DEPARTMENT
PERMIT VALIDATION
ND
CASH CK MO
DATE ____.......„
Y
BUILDING VALUATION 1p
BUILDING PERMIT
PLAN CHECK
PRE INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
TOTAL
FEE
F