HomeMy WebLinkAboutBLD8437 Final Addition - BLD Permit / Conditions - 9/30/1975 Barnes, Helen L. #8437
9-4-75
Tract 8, 36-21-3
Addition of washroom
$360.00
BUILDING PERMIT APPLICATION
MASON COUNTY ll �qlmolo
P. O. Box 400 Shelton, Washinqton 98584 DATE ISSUED '/'71
PERMIT NO. J �Z 7
� ---- - -- MAIL ADDRESS ZIP --- PHONE -- -
OWNER
-- -I��J .4� --- L / Z4 �'
DIRECTIONS I '
TO JOB SITE — —_ -
LEGAL MAIL ADDRESS ZIP (CISEE ATTACHED SHEET)
DESCR. ._ /- .3
MAIL ADDRESS PHONE
CONTRACTOR
USE OF MAIL ADDRESS PHONE LICENSE NO.
BUILDING
Class of work: KNEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑MOVE ❑ REMOVE
-- Describe work:
^Valuation of work:$ 31�>� �'= PLAN CHECK FEE PERMIT FEE .'S '�—
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECKED BV APPROVED FOR ISSUANCE BY
/ Type of Occupancy
Const. Group Division
—•--- 'Size of Bldg. No.of Max.
(Total)Sq. Ft. /c�eI Stories Oee. Load
CONTRACTOR AFFIDAVIT Special Approvals Required Received Not Require
I Certify that I am a currently registered contractor In the State NIN-d
of Washington and the County of Mason and I am aware cf the HEALTH DEPT.
ordinance rEquirEments regulating the wcrk fcr which the permit PUINLic WORK6
Is issued and all work done wi,l be in conformance therewith. IqZ5Af5 t'EFaT,
Firm
By --
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the contract_ _
or registration law RCW 18.27, and am aware of the Mason
County ordinance requirements for which this permit is issued and that all work done will he in conformance therewith. N 0 T I C E
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING. VENTILATING OR AIR CONDITIONING.
Owner ate 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
120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
t' SHELTON PRINTING CO. y /