HomeMy WebLinkAboutBLD1739 Cabin - BLD Permit / Conditions - 4/21/1975 Needham, Chuck #1739
4-21-75
Nickelson Rd. )
Assessorts Tract 2 of SE, NE, 34-21-3
Construct Cabin
$12,288.00
.. _ ��7
Ar Fp Dr1,09 Al Cyr.
` BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Box 400 Shelton, Washinqton 98584
DATE__ - 7S
PERMIT
Applicant to complete numbered spaces only. N
JOB ADDR E55dz
LEGAL / �/fS7 ( SEE ATTACHED SHEET)
1 DESCR.
OWNER MAIL ADDRESS 21P PHONE
z C'i/vc N,�,Eo f�i9M Q,r ;z 3s Ci'E'��w�s/ 9 758'1 75
CONTRACTOR MAIL ADDRESS PHONE LICENSE NO.
/G G s- i�s/�ir✓. Tis/ •O IYo,r 70o S1YfLr y � -.ZG/�
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.
4 5 U 1jc?X /-6,0 5fWA-"/ -yz 6-a C/
ENGINEER MAIL ADDRESS PHONE LICENSE NO.
5
LENDER MAIL ADDRESS BRANCH
6 ,B'-" 69a/w
USE OF BUILDING
8 Class of work: RNNEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
9 Describe work: 7-0 'eWS-C-7T '4 '?_ yX .3 av ��oD�-L Ov"sue
i
2
10 Change of use from
Change of use to
11 Valuation of work: $ /� � �� PLAN CHECK FEE _7 5 PERMIT FEE G ��
SPECIAL CONDITIONS: Type of Occupancy
Const. Group Division
Size of Bldg. No.of Max.
(Total) Sq. Ft. Stories Occ. Load
Fire Use Fire Sprinklers
APPLICATION ACCEPTED BY. PLANS CHECKED BY APPROVED FOR ISSUANCE BY. Zone Zone Required Oyes [:]No
No. of OFFSTREET PARKING SPACES:
welling Units Covered Uncovered
N O T I C E Special Approvals Required Received Not Required
ZONING
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING, VENTILATING OR AIR CONDITIONING, HEALTH DEPT. �J
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION FIRE DEPT.
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC- OTHER (Soxify)
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
hereby certify that I have read and examined this application and
know the same to be true and correct. All provisions of laws and
ordinances governing this type of work will be complied with whether
Spec
ified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any other state or
local law regulating construction or the performance of construction.
• S'1 GRA URE OF ZOR AUTHORIZED AGENT (DATE)
SIGNATURE OF OWNER Ir OWNER BUILDER (DATE)
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
v
SHCLT C?N PnINTI\G CO '