HomeMy WebLinkAboutBLD8378 Slab, 4 Wall, Metal Roof - BLD Application - 8/25/1975 BUILDING PERMIT APPLICATION
MASON COUNTY
P. 0. Box 400 Shelton, Washinqton 98584
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6 V LJ CJ,�o DATE ISSUED
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1 jj X tV 7 PERMIT NO. e,3 7,f
tw /+ MAIL DDR[55 t/./: c7 ZIP (� PHONE
OWNER i — G ' _ pr-- / JC 8 7 2 n 1
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DIRECTIONS I I
TO J0B SITE /t/1 1 C bjV h r �r�_r_[_G y P pcSOZ�T c^ C a6i5
LEGAL MAIL ADDRESS ZIP�, ��,!-IEEE ATTACHED SHEET)
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CONTRACTOR S I --�� /— ---- �! F G_tom �_ —`U—/ ,4 W,E y V[�
DRESS PHONE
S MAIL AD
-
USE OF MAIL ADDRESS PHONE LICENSE NO.
BUILDING 5 1_0 L_ /4
Class of work: NEW ❑ADD ION ❑ALTERATION ❑ REPAIR ❑MOVE ❑ REMOVE
Describe work:
Valuation of work: $ i PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR;SSUANCE BY
Type of Occupancy
Const. Group Division
Size of Bldg. No.of Max.
(Total)Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT Special Approvals Required Received Not Require
I Certify that 1 am a currently registered contractor in the State NINa _
of Washington and the County of Mason and I am aware cf the HEALTH DEPT.
ordinance requirements regulating the wcrk fcr which the permit POINLic V90AR9
Is issued and all work done wi;l be in conformance therewith. AMD DEPT.
Firm
By -
Lic. 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 E
County ordinance requirements for which this permit is issued
and that all work done wil' 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 IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC-
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
OwnerA Date U 2 ) / 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
/PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. M.O. CASH
I/ SHEI-TON PRINTING CO.