HomeMy WebLinkAboutBLD8953 Final Addition - BLD Permit / Conditions - 1/3/1980 BUILDING PERMIT APPLICATION
MASON COUNTY
P. 0. Box 400 Shelton, Washinqton 985,94
DATE ISSUED
PERMIT NO.
OWNER I MAIL aoaREssZIP PHONE------------
61REC—TiOnzi I �
TO JOB SITEL f2
DESCR.LEGAL "AIL ADDRESS zip — 0 3
(r-]SIEE ATTACHED SHEET)
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CONTRACTORT A.L AjjD�7E��------!
PNOkE
USE OF —MAIL CEN.E_N1.
BUILDINGPkONE
Class of work: DNEW CR ADDITION El ALTERATION El REPAIR —EMOVi EIREMOVE
Describe work:
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U BUILDING
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work:k
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USE
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SPECIALCONDITIO S: PLAN CHECK FEE PERMIT IF
SP E
'AL CONDITIONS:
ONS*
APPLICATION C7
C A C� ED BY PLANS CH
ACCEPTED BY PLANS CHECKED APPROVED FOR ISSUANCE BY
Occupancy
Type 0
Con't. Group
Division
Size Of Bldg. No.of Max.
CONTRACTOR AFFIDAVIT (Total)Sq.Ft Stories .% occ. Load
I Certify that I am a currently registered contractor In the State Special Approvals Required ReceivedNot Requln
Of Washington and the County of Mason and I am aware of the -REx—L--rHom -
ordinance requirEments regulating the week for which the permit Fw —
Is Issued and all work done wI;I be In conformance therewith. D Ke
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
County ordinance requirements for which this permit is issued
and that all work done will be in conformance therewith.
NOTICE
SEPARATE PERMITS ARE REQUIRED
HEATING. VENTILATING FOR ELECTRICAL, PLUMBING,
OR AIR CONDITIONING.
sr
Date THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC-
TION OR WORK IS SUS PENDED OR ABANDONED FOR A PERIOD OF
120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
I%N CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION
_Tllll�
SHELTON PRINTING Co. 7 r M.O. CASH
Noyes, Robert D. #8953
3-10-76
Sherwood Park #1 Lot 18, Allyn
1/2 mile up Shorewood Creek Road
Addition
DUPLICATE CARD
$1,800.00
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