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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.