HomeMy WebLinkAboutBLD75-8470 CARPORT - BLD Permit / Conditions - 9/12/1975 BUILDING PERMIT Af OPLICATI N
MASON COUNTY
P. O. Box 400 Shelton, Wash' gton 98584
DATE ISSUED
--- Z! V/ 0� ��5���//� �i is !"r� /f lJat it/ PERMIT NO.
-� MAIL ADDRESS � 1 // PHONE
OWNER i s C; t/ %E TER j,N 6 0 9 y SH¢L e
DIRECT OBISTE1I 2 t3 toLks of AIC5 4 WA-9 /o
I GAL MAIL ADC ESS ZIP -
� (❑SE[ATTACHED SN T) -
DESCR. Ti? yj, % IV. fit/ %y -,S¢c__/y 7o�w �i. ` 2,m 71 K r 0 Al
IL ADDRESS [
CONTRACTOR �� [vyvlrn d,t„ A0'& ,C-73 _[xC - sY-j3PN yc �io 4y6- 6 :�/
USE OF MAIL ADDRESS PH E LICENSE 1 O.
BUILDING CA R Po R T S.� u c .4 s 4a ko y r -> — C4 Z 7 -A-'2 7 a
Class of work: KNEW ❑ADDITION ❑ALTERATION ❑ REPAIR MOVE ❑REMOVE
Describe work: r
X 7- g/ /Y/a t/A Co Ala.104 �,r✓ r� Po �' C, ff
Q _ 3'rx ,3 !r
o u v Q c/ !rJ (Q t✓�Q k c! tr�L S'rX a 7—e b ttL.2 F
or a
Valuation of work:$ 2. Q C:. PLAN CHECK FE PERMIT FEE s �
SPECIAL CONDITIONS:
APP (CATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR 1 UANCE BY
Type of Occupancy
Const. Group IJ Division
Size of Bldg. No.of Max.
(Total)Sq.Ft. Stories Occ.Load
CONTRACTOR AFFIDAVIT Special Approval Required Received Not Required
I Certify that I am a currently registered contractor in the State ZONINCIll
of Washington and the County of Mason and I am aware cf the 99CALTH ca •
ordinance requirements regulating the work for which the permit P019LIC WOrg K8
Is issued and all work done wil be in conformance therewith.
Firm V .bP t-T3 1*^1Z.
By
Lic. No.2z3 Z- y'17 1- Date 'Aa /2 tll1
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.
r NOTICE
�N• `� SEPARATE P MITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
Q HEATING. VErlilLATING OR AIR CONDITIONING.
Owner Date /"I 7- THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC-
TION OR WOI K IS SUSPENDED OR ABANDONED FOR A PERIOD OF
120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
LAN CHECK VALIDATION CK. M.O. CASH PERMIT VA�IDATION CK. M.O. CASH
r�
SH ELTON PRINTING CO.