HomeMy WebLinkAboutBLD75-8321 - BLD Permit / Conditions - 8/14/1975 k, BUILDING PERMIT A PLICAT i N
MASON COUN
P. 0. Box 400 Shelton, Wash' ton 98584
DATE ISSUE® - 11 -
---- '//:1 ErQl FL Tt?/9 -- PERMIT N 0.
MAIL ADDRESS ZIP PHONE
OWNERi J.
DIRECTIONS # ,/
TO JOB SITE Lochs' _ O i f.JcL .3_ �> ��*. ��
MAIADDR E39 ZIP
LEGAL _ SHEET)
CJ 'SEE ATTACHED
DESCR. �oCc7mj WhSA-')J 2 ' �>" �~ ' �i/ �tl' -lY L c� 1114
--_"— - MAIL ADDRESS PHO
CONTRACTOR At!- A L ow l ' V y" PF'o P0r-T.s ,,r.�c 'r 6 > z •2 3 c^ -� 2 c
USE OF PAT
MAIL ADDRESS PHO LICENSE N .
BUILDING to )?o F
Class of work: 'NEW ❑ADDITION ❑ALTERATION ❑ REPAIR MOVE ❑ REMOVE
_ Describe work:
?`hoc 1;i s 7-#9 Z A 7-1,6Al o _el , ;� .��-.� �1 Z_
Tic o,d -5�z d L/ 7
Valuation of work:$ PLAN CHECK FE PERMIT FEE
SPECIAL CONDITIONS: /
APPLICATION ACCEPTED BY PLANS CHECKED BY J!ED FOR ISSUANCE BY
Type of Occupancy
Const. Group Division
Size of Bldg. No.of Max.
(Total)Sq.Ft. Stories Occ.Load
CONTRACTOR AFFIDAVIT Special Approval Required Receiv Not Require
I Certify that I am a currently registered contractor in the State ZONING
of Washington and the County of Mason and I am aware of the 11CAL-FI-11 Cff
ordinance requirements regulating the wc►k for which the permit 11000012 W51 KO
is issued and all work done will be in conformance therewith. 502T.
FirMA A!'rViv, UgeI2 &Vpc"c7s J""<-
ot
By k
Lic. No. - z 3 _ 62- :�Ea 7 f Date - S - '7
OWNERS AFF DAVIT
I certify that I am exempt from the requirements of the contract
or registration law RCW 18.27, and am aware of the Mason N 0 T I C E
County ordinance requirements for which this permit is issued
and that all work done will be in conformance therewith. SEPARATE I, RMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING. VENTILATING OR AIR CONDITIONING.
THIS PERM11 BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC-
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
Owner i• ate —! —�J 120 DAYS AlANY TIME AFTER WORK IS COMMENCED.
4�
LAN CHECK VALIDATION CK. M.O. CASH PERMIT V IILIDATION CK. M.O. CASH
SHELTON PRINTING Co.