HomeMy WebLinkAboutBLD8567 Pier and Float - BLD Permit / Conditions - 10/17/1975 Phillips, J . W. & Molinero, D. P. #8567
10-17-75
Tract 4 of G. L. 1, 35-22-3
Pier and Float
$9,000.00
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BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Box 4W Shelton, Washinqton 98584
DATE ISSUED
E R M I T NO.
OWNER I MA L ADOR ZIP PHONE
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DIRECTION TO 106 SIT
LEGAL IL AD9RES$ ZIP
(D3[[ ATTACHED SHEET)
MAIL ADD ESS PHONE r)
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NTRACTOR � ,� ? �^�✓
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USE OF MAIL ADD E39 PHONE LICENSE NO.
BUILDING � (12
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Class of work: ❑NEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑MOVE ❑REMOVE
Describe work:
Valuation of work:$/`2 �i PLAN CHECK FEE PERMIT FEE
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SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY 1PLANSCHECKEDBY qPP VED fOR UANCE BY
" Type. Occupancy
/ Const Group Division
— zZ-✓` �� Size of Bldg. No.of Max.
(Total)Sq.Ft. Stories Occ.Load
CONTRACTOR AFFIDAVIT Special Approvals Required Received Not Required
I Certify that I am a currently registered contractor in the State N I N
of Washington and the County of Mason and I am aware of the HEALTH DEpT.
ordinance requirements regulating the work for which the permit RK®
Is Issued and all work done will be In conformance therewith. p�pT
Firm
By -
Lic. No. 3- O/ � Ur;?,C , Date 1,9 G � S
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
County ordinance requirements for which this permit is issued
and that all work done will be in conformance therewith. N 0 T I C E
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING. VENTILATING OR AIR CONDITIONING.
Owner Date 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
120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
LAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
ISHELTON PRINTING CO.
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