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HomeMy WebLinkAboutBLD9269 Storage Shed - BLD Application - 1/19/1978 BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 J DATE ISSUED PERMIT NO. FDE NER 1 NAME MAIL ADDRESS CITY&STATE ZIP PHONE ..a S't'-c'r , ( Ib R ' NcL-Tom uu A q%S a ya -1os 6 ECTIONS JOB SITE L©-r a 4- E),V L" L-j A46Q IC AL (❑ SEE ATTACHED SHEET) CR. SAM C— CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE USE OF BUILDING Class of work: ❑ NEW )0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: But Lb A U 11.E 'Kai SA el) FOR -Ta 1 Ec Valuation of work: $ PLAN CHECK FEE PERMIT FEE SPECIAL CONDITIONS: APPLICATION ACCEPTED BY PLANS CHECK BY PROVED FOR ISSUANCE Type of Occupancy Division A Const. Group Size of Bldg. No. of Max CONTRACTOR AFFIDAVIT (Total)Sq. Ft. Stories Occ. Load PERMANENT SEASONAL E.D.NUMBER I certify that I am a currently registered contractor in RESIDENCE the State of Washington and I am aware of the MOBILE HOME ordinance requirements regulating the work for which the permit is issued and all work done will be in Special Approvals Required Received Not Required conformance therewith. ZONING HEALTH DEPT. Firm PUBLIC WORKS By ROAD DEPT. Lic. No. Date OWNERS AFFIDAVIT I certify that I am exempt from the requirements of the N O T I C E contract or registration law RCW 18.27, and am aware of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, which this permit is issued and that all work done will VENTILATING OR AIR CONDITIONING. be in conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED 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 OwnerQ 1 Date_ WORK IS COMMENCED. PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH