HomeMy WebLinkAboutBLD8487 Shell Construction - BLD Application - 9/15/1975 BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Box 400 Shelton, Washinqton 98584
DATE ISSUED
PERMIT NO.o6117
-�-- --- -----MAIL AD DR ES9 -- --_ZIP PHONE
OWNER
DIRECTIONS�
TO JOB SITE
MAIL AOOR E33 • ZIP
(❑SEE ATTACHED SHEET)
DESCR. 1 /` ----
-_�- 1-
MAIL ADDRESS PHONE
CONTRACTOR
___ l-U^f ,� Mr,�s of i,-ti�+.r�/ `'�f3o 7dd S�f�rcY.� a 3- n�- '?-rC
USE OF MAIL ADDRESS PHONE LICENSE NO.
BUILDING
Class of work: lil'NEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑MOVE ❑ REMOVE
Describe work: —�
Valuation of work: $ / OD `' • `
(e� PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECKED BY APP OVED FOR ISSUANCE BY
Type of Occupancy
Const. Group � Division
Size of Bldg. No.of Max.
(Total)Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT Special Approvals Required Received Not Require
I Certify that I am a currently registered contractor In the State NINO
of Washington and the County of Mason and I am aware cf the HEALTH DEPT.
ordinance requirements regulating the wclk fcr which the permit POOLIC WORKS
Is Issued and all work done wiA be in conformance therewith. DROr
Firm ��/► _< arc- M��sf/
BY S ,E"✓/� f/yL
Lic. No. ""O/f— 9hGC Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the contrect_
or registration law RCW 18.27, and am aware of the Mason N 0 T I C E
County ordinance requirements for which this permit is issued
and that all work done will be In Conformance therewith. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING. VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC-
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
Owner Date 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
/ PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
SHELTON PRINTING CO.