HomeMy WebLinkAboutBLD9760 Storage Bldg - BLD Application - 4/12/1978 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584 LL//
DATE ISSUED 7dy
i
PERMIT NO.
OWNER NAME MA D E S CITY& ATE f` ZIPg��� t PHONE
DIRECTIONS V
TO JOB SITE
...
LEGAL SEE ATTACHED SHEET)
CONTRACTOR NAI MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
r
Valuation of work: $/15,, U PLAN CHECK FEE PERMIT FEE B Q
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BYl PLANS CHECK BY APPROVED FOR ISSUANCE Type of Occupancy Division
n BY Const. Group /
V
Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories ! Occ. Load
CONTRACTOR AFFIDAVIT — —
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 1 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,
VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be I ormance therem4kth. . THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
NOT
OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner Date..6�//i//nr WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH