HomeMy WebLinkAboutBLD2122 Temp Storage - BLD Application - 5/3/1978 BUILDING PIRMIT APPLICATION 0 '
MASON COUNTY
P.O. Box 186 Shelton, Washington 9W4
DATE ISSUED ' ' Lo
PERMIT NO.
OWNER �.AME ,MAIL DD ESS CITY&STATE. ZIP PHONE
DIRECTIONS _ ! �X&4
TO JOB SITE 1E. 1 ®� yy���S/S d! ��C�e- 1C �! �! o 1%r.) oC� d Gyro ws 4O ems
LEGAL T (❑SEE ATTACHED SHEET)
DESCR: (� "`Z3 1 / � 31
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF
BUILDING ` =r! eY Y
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR X MOVE ❑ REMOVE
Describe work: /,Z Y2- 0
- O rC ��� a C� ca , /M i -.1
f / /
IJI"OL /-9 Pe. Cv� t-3. /'1 A, / .: 7n ' e a S'r e-m C �.
Valuation of wor PLAN CHECK FEE PERMIT FEI
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SPECIAL CO DITIONS:
af
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Type of �� Occupancy Divlslon
BY D. < Conat. Group
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 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 v es d,e' � PUBLIC WORKS
By ROAD DEPT.
Lic. No. Z 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 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 Date. WORK IS COMMENCED.
/AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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