HomeMy WebLinkAboutBLD9169 Final Gas Tank - BLD Permit / Conditions - 5/27/2007 Nelson, Maynard J . #9169
4-19-76
Tract 6A of Tract 6 of J . 0. Ecler's D. L.C.
36-21-3 Contractor:
Otto Field
4,000 gal . gas tank
$1 ,200.00
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MJ. 1Ve- /,SviU
• BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 1186 Shelton, Washington 98584
/ 4� DATE ISSUED
PERMIT NO. j/6!2
OWNER NAME M IL ADDRESS CITY 3 STATE ZIP PH NE
O 0 4-2
DIRECTIOAS
TO JOB SITE e- Q h L— n al a —
LEGAL ( EE ATTACHED HEET) � —��—
DESCR. �'G 4 ✓-ti. 'Q •4,Wa"LA L) L . .
NAME MAIL ADDRESS CITY 6 STATE LICENSE WO.
PHONE
CONTRACTOR
USE OF r—
BUILDING
Class of work: IY.NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY, PLANS CHECK BY APPROVED FOR I U NCE 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
ROAD DEPT.
By
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 Count ordinance requirements for SEPARATE PERMITS ARE REQUIRED
NG. FOR ELECTRICAL, PLUMBING, HEATING,
y q VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
-� IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
/{ SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner Date WORK IS COMMENCED.
y r
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH