HomeMy WebLinkAboutBLD5011 Sign - COM Permit / Conditions - 9/28/1976 Severson, Mrs. Leah #5011
9-28-76
SW4 SEµ 29-23-1
Old Belfair Tavern
Sign
$850.00
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
AR/ 5 /1 - tnscz-rrt*Z-W'-.-qtZ W/f a 9 e3'0
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. 5-W �� O/ SL/�C - �i;cT'!0N �-`� 'r�u%�%�d1P �-3'�
NAME MAIL ADDRESS f CITY&STATE LICENSE NO. C. J�t}�,I(o PHONE
CONTRACTOR rsaS,�,J S/G�JCO goxG _jgdor�517pti 61�:-w;rri�UNu,t (N«v !�R-NS-� S' 3`73-60/S
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
I +a k-�n e, S i b Ai
Valuation of work: $ PLAN CHECK FEE PERMIT FEED t�
i
SPECIAL CONDITIONS: '
AP (CATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Type of Occupancy Division
(/� Const. Group
e IV-Ln
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
\ m J � HEALTH DEPT.
Firm - rJ PUBLIC WORKS
By 4 ROAD DEPT.
Lic. No. &-gS--0S "e ;Lqq Jae Date V -7
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 PERIy► ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OI CONDITIONING.
which this permit is issued and that all work done will
be in onformance there Ith. THIS PERMIT BECG5 ULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCe -HIN 120 DAYS!,-R IF CONSTRUCTION OR WORK
Owner �r y SUSPENDED OR ABA -D FOP A PERIOD 0f DAYS AT ANY TIME AF
Date. WORK IS COMMENCO.
LAN CHECK VA CK. M.O. CASH PERM. VALIDATION ,
1 2 3 4 5 6 7 8 9 .10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
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