HomeMy WebLinkAboutBLD9485 Plastic Display - BLD Application - 6/8/1976 BUILDING PERMIT APPLICATION
MASON COUNTY go
P.O. Box •186 Shelton, Washington 98581
i
DATE ISSUED l �•�"�
i
PERMIT NO. �44F�
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
_!E�Pt741_,T7t"tSKr--T _ - ' N_
DIRECTIONS �y
TO JOB SITE C.-1-FFi(_ 0cPVTc'r_
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
NAME h;AIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR n
�v)�flE�c s C e�inAti P�1�cst�r z is 1J��.ZN,� r✓.-Ytwryif� l�r�• DL23-e 1 -7653 sa -: `F8 :3772
r----;USE OFILDING
Class of work: /1<NEW ❑ AO'?I?"ION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: ft i ti
�.i°csTt �• ,�•&'�ice'
Valuation of work: $ oe PLAN CHECK FEE PERMIT FEE
Soo
SPECIAL CONDITIONS:
APPLICATIQN ACCEPTED BYI LP.PNS CH7-7 BY --A �V1?D FO R,ISSLANCE Typo of Occupancy Division
� I BY 3 Const. Group
U1 .
I
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 av,are of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all wort: done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
e cz HEALTH DEPT.
Firm v` - L� `-c 7�G+; ' � fJ PUBLIC.WORKS
By - v� t=a,r,�-y,/tN�_ ROAD DEPT.
Lic. No. OI -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
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
_ SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner _�`� �� r''`i �N ' Date. WORK IS COMMENCED.
PLAN CHECK VALIDATION CK M.O. CASH PERMIT VALIDATION CK.) M.O. CASH