HomeMy WebLinkAboutBLD75-1853 - BLD Permit / Conditions - 5/16/1975 #1853
Bensen` Gary E• 5-16-75
Parkwood, Lot #9
Convert garage to family room
$1 ,600.00
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41 BUILDING PERMIT A PLICAT►ON
MASON COU TY
P. O. Box 400 Shelton, Wash nqton 98584 r
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DATE -
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PERMIT NO. S 5 p
Applicant to complete numbered spaces only.
JOB ADDRESS
LEGAL 1 DESCR. V`-�G 0 T �/ (aSEE ATTACHED SHEET)
OW R MAIL ADDRESS ZI Q/ I PHONE l /°T
I s� �L
2 rep r _ ' s _n , /0 x3 4 %
CONTRACTOR C�� M 1 bRE55 n P NE '1 .'ram /ry LICENSE NO.
3 �`11 v �� OC V� 7
RCHI T E C T OR DESIGNER MAIL ADDRIESS P HE LICENSE NO.
4
ENGINEER MAIL ADDRESS PF HE LICENSE NO.
5
LENDER MAIL ADDRESS BRANCH
6 —�—
USE
OF BUILDING
'G �Y? ( ��► fyl
8 Class of work: ❑NEW ❑ADDITION ALTERATION ❑ REPAIR ❑MOVE ❑ REMOVE
9 Describe work:—Y,17SG( 14 _71c �� /.z F �/"ta� . � / _ G!
eFt /
,12
D l-i 4 41 / 0 r4?OF 0,e_-
10 'Change of use 4orn 61a r G? le
Change of use to
11 Valuation of work: $
(�* Li f•+ PLAN CHECK F E PERMIT FEE
SPECIAL CONDITIONS: Type of Occupancy
Const. Group Division
Size of Bldg. No.of Max.
(Total)Sq. Ft. Stories Occ. Load
Fire Use Fire Sprinklers
APPLICATION ACCEPTED BY: PLANS CHECKED BY: APPROVED FOR ISSUANCE BY. Zone Zone Required ❑Yes []No
C `f� No.of OFFSTREET PARKING SPACES:
Dwelling Units Covered Uncovered
N 0 T I C E Special Approvals Required Received Not Required
ZONING.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEALTH DEPT.
HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION FIRE DEPT.
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC-
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
I hereby certify that I have read and examined this application and
know the same to be true and correct. All provisions of laws and
ordinances governing this type of work will be complied with whether
specified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any other state or
local law regulating construction or the performance of construction.
SIGNATURE OF CONTRA/TOR OR AUTHORIZED AGENT (DATE)
SIGN AT R OF O NE IF OWNER BUILDER (DATE)
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. A_C__SH
V SHELTON PRINTING CO.