HomeMy WebLinkAboutBLD9593 Pole Barn - BLD Application - 6/21/1976 BUILDING PERMIT APPLICATION
MASON COUNTY 22.31f
P.O. Box 186 Shelton, Washington 985'2',,4
DATE ISSUED S2
PERMIT NO. 9�1-
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
DIRECTIONS I Air
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. -,Z) (-4)7
CONTRACTOR
NAME ?,!. E AIL ADDRESS CITY&STATE LICEN NO. PHONE
_
-
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
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Valuation of work: $ PLAN CHECK, FEE ;'ERMIT FEE
SPECIAL CONDITIONS:
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' APPLICATION ACCEPTED BY. PLANS CHECK BY APPI;OVE0 FOR ISSUANCE t Type of Occupancy Division
BY � Con;t. Group
....,.ate.,.o...,. .._, ..._._...< . ...........,,.. .... ��...e. Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVi i
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am cv,are Of the MOBILE HOME
ordinance requirements regilating the work for which
Ih-
permit is issued and all work done will be in Special Approvals Required Received Not Required
•nfortnance therewith. ZONING
HEALTH DEPT.
'-_rm - ----_—_-_— _ PUBLIC WORKS
ROAD DEPT.
ic. N : ...... _...-----.--Date -
-
OWNERS A,=r'IDAVIT
t ;erlif ;at I am exempt from the roquirements of the N 0 T I C E
:ontr,.a c;r roglsUation law RCW 18.27, and am aware SEPARATE PERMITS ARE REQUIRED FOR '_LECTRICAL, PLUMBING, HEATING,
of ihcr Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
NI,.,,t ;! , . permit is issued and that all work done will
be -n rf.nformance therewith, Tw8 PFRMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
;S N07 COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
�� / SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
O wner_ i',ate WORK IS COMMENCED
`41 VALIDATIC- , C M. CASH PERMIT VALIDATION CK. M.O. CASH i
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