HomeMy WebLinkAboutBLD8755 Retail Grocery - BLD Application - 12/31/1975 BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Box 400 Shelton, Washinqton 98584
DATE ISSUED A-L11- T� —
PERMIT NO. '7$`�
—'—T— ---- MAIL ADDRESS ------- --_-ZIP PHONE —
OWNER ,�.,-21�.�1jlY�, T�.�J _ �4�� 6 � �)_ �3d d
f DIRECTIONS I
TO JOB SITE �/ N_ � __
LEGAL //-- MAIL ADDREaf ZIP (QSEE ATTACIitDH *,✓ .� ,,,_ /
DESCR. .modJ .516OWC•r- �J )76 '
--------- MAIL ADDRESS PHONE _
CONTRACTOR 99W ,
MAIL ADDRESS PHONE LICENSE NO.
L-6U-SOF g�NG �C eyAd
Class of work: 2<EW ❑ADDITION 0 ALTERATION '0 REPAIR 0 MOVE ❑REMOVE
Describe work:
Valuation of work:$ T G PLAN CHECK FEE !/ PERMIT FEE /8,f O o _
SPECIAL CONDITIONS: 2
APPLICATION ACCEPTED BY PLANS CHECKED By APPROVED FORISSUANCE BV Type Of OC CUP
ancy
l,Cost. n Group F Division Z
Size of Bldg. No.of Max. p
(Total)Sq.FtZ9V0 Stories Dec.Load T
CONTRACTOR AFFIDAVIT Special Approvals Required Received Not Required
r
ONING
I Certify that I am a currently registered contractor in the State H EALTH DEPT.
of Washington and the County of Mason and 1 am aware of the t 3
ordinance requirements regulating the wctk for which the permit 11111090C W014RO
is issued and all work done wi;l be in conformance therewith. DIMPT.
Firm
By _
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the contract
or registration law RCW 18.27, and am aware of the Mason N O T I C E
County ordinance requirements for which this permit Is issued
and that all work done will be in conformance therewith. SEPARATE VPERMI TS TINGRE RA RUIREDCON FOR O ELECTRICAL, PLUMBING,
H .AUTHORIZED ISENOTHIS PERMIT T�COMMENCED WITH NES NULL AND VOIDi120 DA SWORK ,ORC FNSTRUCTION CONSTRUC-
� 120NDAYS AT ANY S TIME PAF ERD WORK OR BS CDONEDOMMENCED.FOR A PERIOD OF
Owner . � Date fL�/�"Z>�
J PERMIT VALIDATION M.D. CASH
PLAN CHECK VALIDATION CK. M.O. CASH CK.
SNELTON PRINTING CO.