HomeMy WebLinkAboutElementary School Remodel - BLD Application - 5/28/1980 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 /
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
DIRECTIONS rr �
TO JOB SITE J7� ''t'tc.��.- Ftf-
LEGAL [ p - --T SEE ATTTACH�^, SHEET)
DESCR. r c3 ! O� / — T p?3 C
NAME MAIL ADDRESS CITY 8 STATE LICENSE PHONE
CONTRACTOR W &() F 7 P(LIZ. W COKSVO_ 4CT10Li 6I6,141% diti,-)AsH \AIN flE -25l5 �It__9
USE OF oc
BUILDING �1�,�,,,,_ S�� Bse_9� C-i
Class of work: ElNEW El ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 1
Describe work:
Valuation of work: $ 0 PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS r I DECKS CARPORT ❑ NOTICE
BATHROOMS {TOTAL SQ. FT. GARAGE ❑
NO. OF STORIES BASEMENT ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ElDETACHED ❑
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 aware of the FOR OFFICE USE ONLY
ordinance requirements th regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT ❑ SHORELINES ❑
\t/ c� (�n c l SEASONAL ❑ FLOODPLAIN ❑
Firm Abs W_KK.oLo �JTQ��T��►^' E.D. N ODPLA. ❑
By ��---" t Special Approvals IN OUT YES APPROVED NO
Lic. No.WA-IDE D6 Date 3 Fl BONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. U
PUBLIC WORKS �, a -Liao
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. 6
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date. BY
C9ns
CLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH.