HomeMy WebLinkAboutBLD4108 Carport Storage - BLD Permit / Conditions - 12/13/1976 Schossow, Theodore E. #4108
12-13-76
Beards Cove, Div. 8 Lot 54
Carport & Storage Shed
$1 ,596.00
12331 s-l nm-
l
1,7 -176
A-0 SS 0 U-)
BUILDING PERMIT APPLICATION
MASON COUNTY , a/o!9/7�
P.O. Box 186 Shelton, Washington 98584 `
DATE ISSUED 1,-; 1, L7
I v 7 PERMIT NO. '//0 P
NAME - /MAIL ADDRESS ✓ CITY&STAT ZIP PHONE
OWNER T"
DIRECTIONS `' C
TO JOB SITE /(,VTJ'f� ,ZJ�✓fS/�.v g �E�/�/7�D.S1121T`!
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF � � P RT /
BUILDING , � 5 l%e*9,&& $h 6;C-L
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
o
Valuation of work: $ l� / PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS::
AP LICATION CE ED BY PLANS CHECK BY JAPP ED FOR fS ANCE Type of Occupancy Division
BY Const. Group
�-
Size of Bldg. —146 O No. of Max.
(Total) Sq. Ft. L Stories Occ. Load
CONTRACTOR AFFIDAVIT P
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
conformance therewith. ZONING
HEALTH DEPT.
Firm 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 SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
which thi it i issue all work done will
be I an th 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
Own ate, f WORK IS COMMENCED.
PLA'l CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
MASON REGIONAL PLANNING COUNCIL
• 5th and Birch Streets
P. O. Box 186
Shelton,Washington 98584 \
Phone 426-5593
l
MESSAE;E DATE 12 /13 /76 REPLY DATE Ir V17Z 21
TO f J QI/?— "Fe-
Theodore E. Schossow
P. 0. Box 385
Belfair, Washington 98528
Dear Dr. Schossow:
We received your check today. If Mr. M. J.
Whitchurch is to be listed as your contractor we
will need his contractors license number. Otherwise
we will process your application without listing 17212' In
him. Please notify us as soon as possible which
way to go.
SIGNED SIGNED
Redifprm9 4S 473 SEND PARTS 1 AND 3 WITH CARBON INTACT- PART 3 WILL BE RETURNED WITH REPLY.
Poly Pak(50 mft)0473