HomeMy WebLinkAboutBLD4088 Garage and Shop - BLD Permit / Conditions - 12/6/1976 Palmer, William #4088
12-6-76
Sam B. Theler's Garden Tracts
E 200' W 400' S1/2 Tr, `19
Garage & Shop
$4,992.00
D,3
BUILDING PERMIT APPLICATION
MASON COUNTY /Z332 M OIEZ
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED (° !/.
PERMIT NO. "Pe
MAIL
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
C — Z
DIRECTIONS
TO JOB SITE R
LEGAL (11 SEE ATTACHED SHEET)
DESCR. l , 7`d D / _57
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING S
Class of work: )(NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
A ICATION A EPT BY PLANS CHECK BY APPR D FOR I LANCE Type of Occupancy Division
BY Const. / 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 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
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIREDFOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conformance in ewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
/u / / / / SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner li t✓d 1�J1 Z' / Date. 6 �i WORK IS COMMENCED.
P4AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION [CK. N M.O. CASH