HomeMy WebLinkAboutBLD9484 Install Plastic Display - BLD Application - 6/8/1976 4' C--'a e-de'�7 -16; 1'-f'7
BUILDING PERMIT APPLICA TIQ
MASON COUNTY
P.O. Box 186 Shelton, Washington 44,1584
DATE ISSUED
G PERMIT NO. 9
OWNER NA/ME MAIL ADDRESS CITY R STATE ZIP PHONE DIRECTIONS
TO JOB SITEey�
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
CONTRACTOR
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
r
i N'cU�,s �1r tJ'T�..f�-�. t�nl-�I S No..�N���14K-►W_il4•}Uwr 12�-o i '76�� So q 218 317
USE OF
BUILDING
Class of work: NEW ❑ ADOITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
lr
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECK BY APPF�QVED FO 1S ANCEt Typo of Occupancy Division
IY/i 1 - Const. Group
Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories Occ. Load
CONTRACTOR AFF;DAVI
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am avlare 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
` c' �j 1 � *3 1iEALTH DEPT.
irm kN Tn.Ac. 1�� 0 PUBLIC WORKS
,;y — az��Tf��y ROAD DEPT.
-
i_ic. No. _��"�1—7(05'�s Date Z.6_
OWNERS AFFIDAVIT
I certify tF at 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 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
D SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner_C-ev -E Yz'r_ _ N_ _.Date 6 J- 7 6 WORK IS COMMENCED.
Pt AN ':HEC:( VALIDATION CK M.O. CASH PERMIT VALIDATION I . M.O. CASH