HomeMy WebLinkAboutBLD7661 Bldg 5 Foundation for 4-Plex - BLD Permit / Conditions - 10/5/1977 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED / ( A-, ,
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITE 2W ",
LEGAL ^Lj (❑ SEE ATTACHED SHEET)
r /
NAME MAIL DRESS CITY&STATE LICENSE NO. PHONE��}4 _
CONTRACTOR — �l
USE OF
BUILDINGAe*ik ��
Class of work: NEW ❑ ACbblTION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ _t, PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY1 PLANS CHECK BY APPRV.ED FOR ISSUANCE Type of Occupancy Division
BYI�'(t< e c.[1 Const. 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
c HEALTH DEPT. J
Fir —� PUBLIC WORKS
By '
ROAD DEPT.
ic.
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
e In conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
J� 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
QW , ate WORK IS COMMENCED.
r
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
Hideaway Townhouse Trust #7661
10-5-77
Port G. L. 3 & 4 31-23-1 Bldg. 5
Contractor
Foundation for 4-Plex Fab Tech
$3,180.00