HomeMy WebLinkAboutBLD75-8112 - BLD Permit / Conditions - 7/8/1975 #8112
Khaw, Bernard 7-8-75
Parkwood, Lot #19
Install insulation,
sheetrock, ceiling tiles and
two doors in basement (family room)
$592.00
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BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Box 400 Shelton, Washinqton 98584
DATE_—!1_�[ o
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Applicant to complete numbered spaces only. PERMIT NO, a
JOB ADDR ESSLEGAL
In
1DESCR. L 1 / 6j PA-IQKWC_D A-PDI-lPcN (0SEE ATTACHED SHEET)
OWNER MAIL ADDRESS
2 6��./ N A , Z PHONE
lh. �Jf ��--t F��� P-:T t o ac-x 61 I s �To
r� `8 �F z,6 - 9s a 9
CONTRACTOR MAIL ADDRESS P NE LICENSE NO.
3
ARCHITECT OR DESIGNER MAIL ADDRESS P NE LICENSE NO.
4
5 ENGINEER MAIL ADDRESS PHONE
LICENSE NO.
LENDER MAIL ADDRESS
6 BRANCH
USE OF BUILDING
7
8 Class of work: ❑NEW ❑ADDITION ❑ALTERATION X REPAIR ❑MOVE ❑ REMOVE
9 Describework: /N5"jALL /1\JS0LAT1cN_, SHECTfQ6C< k GEIC(NG --/LDS 4-rj" >
10 'Change of use from I?MG_[ G'N I
Change of use to F-A-M I Ly P'C 6
11 Valuation of work: $ 4:9 ;� C'c 06,
PLAN CHECK FEE 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: AP ROVED FQR ISSUANCE BY: Zone Zone Required ❑yes []No
No.of OFFSTREET PARKING SPACES:
�41 t-4 {'"! Dwelling Units Covered Uncovered
N 0 T I C E Special Approvals Required Received Not Required
ZONINC,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING, VENTILATING OR AIR CONDITIONING. HEALTH DEPT.
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 OTHER (Specify)
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 CONTRACTOR OR AUTHORIZED AGENT (DATE)
SIGNATURE OF OWNER IF OWN R BUILDER �* (DATE)
I
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. M.O. cASH
SHELTON PRINTING CO.