HomeMy WebLinkAboutBLD7659 Bldg 3 Foundation for 4-Plex - BLD Permit / Conditions - 10/5/1977 dw BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED �� ' ,7
PERMIT NO.
OWNER /NAME MAIL A;ZSS CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITE
LEGAL Z
SEE ATTACHED SHEET)
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR �r
USE OF
BUILDING ,
Class of work: W ❑ ADDITIOV ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
F�P�ICATION ACCEPTED BY PLANS CHECK BY I AT D FOR I DANCE Type of Occupancy Division
al_ t.r. ,
� I BY _ 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 there Ah i 7 ZONING
�/✓ HEALTH DEPT. .
PUBLIC WORKS
By
� ROAD DEPT.
-� ate -22
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 conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
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
Own -0ate. /« WORK IS COMMENCED.
,mot
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
Hideaway Townhouse Trust #7659
10-5-77
Port. G. L. 3 & 4 31-23-1 Bldg. 3
Contractor
Foundation for 4-Plex Fab Tech
$3,180.00