HomeMy WebLinkAboutBLD2021 Storage - BLD Permit / Conditions - 4/21/1978 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED /70
PERMIT NO.
r ,NAME I MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER
DIRECTIONS
TO JOB SITE
(❑ SEE ATTACHED SHEET)
DESCR.
NAME � MAIL ADDRESS P CITY 8 S ATE LICENSE NO. PHONE
CONTRACTOR �'/
USE OF
BUILDING
Class of work: C NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
/4
Valuation of work: $ C PLAN CHECK FEE Ir PERMIT FEE
SPECIAL CONDITIONS:
PLICATION ACCEPTED BYl PLANS CHECK BY APPROVED FOR ISSUANCE Type of Occupancy Division
' BY A r Const. i�� Group
Size of Bldg. No. of Max.
(Total) Sq. Ft. �j 6 Stories f 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 I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be In C nformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
y IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
A SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner Date_ WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. M.O. CASH