HomeMy WebLinkAboutBLD76-8889 - BLD Application - 2/23/1976 BUILDING kk'MIT All PLICATION
MASON COUNET
P. 0. Box 400 Shelton. Washiz ton 98584
DATE ISSUED
PERMIT NO.
AIL ADDRESS Z7 - PHONE
OWNER; e f FZ
DIRECTIONS tJ `1f/;�/
TO 10B SITE1 __--- -� j— "Ls` f Lo
LEGAL MAIL ADDRESS - - P - ( SEE ATTACHED SHEET) _-
DESCR.
I - MALL ADDRESS
CONTRACTOR Z_ 5 .0/
USE OF MAIL ADDR ES� PH• E L SE O.
BUILDING E�W
Ic?—►„
Class of work: ❑ Co ADDITION '/ALTERATION 'Cl REPAIR MOVE ❑ REMOV
Describe work: >
Valuation of work:$ v PLAN CHECK FEE ,, PERMIT FEE C�
SPECIAL CONDITIONS:
APPLICATION A PTE Y PLANS CHECKED BY APPROVED FOR ISS ANCE BYEotal)
Ili
r Occupancy
y� / Group Division
y I/`
dg. No.of Max.
. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT Special Approval'1 Required Received Not Require
I Certify that I am a currently registered contractor in the State ONINd
of Washington and the County of Mason and I am aware cf the ~E'a`LrH c
ordinance requirEments regulatin the work which the permit PUNUC W 51 Ke
Is issued and all work done wi. b I nformarice therewith. A CREPT.! ',
Fi
y
LI . No. Date
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 N O T I C
County ordinance requirements for which this permit is issued
and that all work done will be in conformance therewith. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING. VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED'!+S NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC-
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
D�rner Date 120 DAYS A !ANY TIME AFTER WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT V ILIDATION CK. M.O. CASH
SHEL.TON PRINTING CO.