HomeMy WebLinkAboutBLD9713 Move House on Property - BLD Application - 7/9/1976 W P-7/rA-
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98W �^
DATE ISSUED
PERMIT NO.
OWNER ` NAME MAIL ADDRESS CITY&STATE ZIP PHONE
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TO JOB SITE Lj, , 4
LEGAL "BEE ATTACHED SHEET)
DESCR.
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF
1' 11DING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR d MOVE ❑ REMOVE
Describe work:
d tor` L t- R
Valuation of work: $ V PLAN CHECK FEE PERMIT FEE t
SPECIAL CONDITIONS:
PPI-19ATION ACCEPTED BY1 PLANS CHECK BY AR 1 DANCE Type of Occupancy Division
Const. /-I H Group
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
y OWNERS AFFIDAVIT
Ice •that,l am empt'from the.requirements of the N O T I C E
cont4aot:oP`ragi I(ration law RCW 18.?7, and am aware SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of: the Mason .County ordinance requirements for
VENTILATING OR AIR CONDITIONING.
which This permit Is issued a that al work done will
�� O Qrma ce th THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
!— IS NOT COMMENCED WITHIN 12D DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
ate. WORK IS COMMENCED.
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VALIDATION CK. W.O. CASH PE � , VALIDATION CK. M.O. CASH