HomeMy WebLinkAboutBLD8926 Shop - BLD Permit / Conditions - 7/28/1976 M & 0 Logging #9826
7-28-76
H. St. Island Lake NX. 13-20-4
Shop
$5,040.00
Why ,,,4NG PERMIT APPLICATION
MASON COUNTY qoot � qZ W
P.O. Box 186 Shelton, Washington A584
DATEISSUED 9� 7
PERMIT NO. ;/ 0
OWNER N AME MAIL ADDRESS CITY&STATE r ZIP PHONE'
O
DIRECTIONS vt
TO JOB SITE
LEGAL (❑SEE ATTACHED SHEET)
DESCR. SCC. f reeGy,Vs'�i;%I �O iIPe
CONTRACTOR
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
�r
2 2 3 - U - Z -2?1 t
USE OF
BUILDING ��O
Class of work: NEW ❑ !'ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE �❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL�CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Type of • Occupancy Division
Const. Group
Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVI i
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am 2r,are of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. / ZONING
Firm
/ •` /� / G HEALTH DEPT
PUBLIC WORKS
BY ROAD DEPT.
� �/'
Lic. No. — Date �.__�
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIREDFOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner __Date . WORK IS COMMENCED.
PLAN HECK VALIDATION CK M.O. CASH PERMIT VALIDATION CK. M.O. CASH