HomeMy WebLinkAboutBLD5387 Gamble Roof Barn - BLD Application - 6/14/1977 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED fo�`Y/7 7
PERMIT NO. -5
OWNER NAME MAIL AD DR SS CITY&STATE ZIP PHONE
,S 6 2
DIRECTIONS
TO JOB SITE �i' ? d O o/,� 9,9 Ile
LEGAL I,/ / (❑ SEE ACHEDSHEEET)
DESCR. I r "l/ S QL��O '�C S v S�i �Z� A/
CONTRACTOR NAME MAIL ADDRESS CITY BTSTATE JV
/f} j��/ CE' /y��r�i ,S�,�" /PHONE
�ar r lt/L•'/r,7 S 2 / L,J
USE OF `J J-G y3 6 r
BUILDING oxm
Class of work: 9k1qEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
ats 6fV, 6/ Ae oo —
�'
Valuation of work:'�D PLAN CHECK FEE PERMIT FEE /
SPECIAL CONDITIONS:
r i
APPLICATION ACCEPTED BY PLANS CHECK BY A�01�ED�FORIUANCE Type of Occupancy DivisionBConst. Group
Size of Bldg. No. of Max,
(Total) Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am aware 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
co�anceh. ZONING
HEALTH DEPT.Firm ` d S PUBLIC WORKS
By
ROAD DEPT.
7-G 2
Lic. No. -A1 ate fl
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 MdSOn County ordinance requirements fOr SEPARATE PERMITS ARE REQUIRED FOR 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 CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. S