HomeMy WebLinkAboutBLD9227 Carport - BLD Application - 4/26/1976 BUILDING 1 APPLICATION 9 ' 6 'D NG PERMIT A PPL IC N�
MASON COUNTY
r c)` P.O. Box1186 Shelton, Washingtcn 98584
"J �e�C00 0) DATE ISSUED
I
Ly / E
� PERMIT NO. �a��
OWlsql AME MAIL ADDRESS ZIP PHONE
DIRECTIONS
/�, � /`�
TO JOB SITE �f►'K .� /`0 —� !.—&—VL
LEGAL is -0 IF 1 (0 SEE ATTACHED SHEET)
DESCR.
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING �4-14
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION C REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
APP CATION ACCEPTED BY! PLANS CHECK BY APPROVED FOR ISSUANCE Type of Occupancy Division
BY �<<�� Const. Group
f
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
By
ROAD DEPT.
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 County ordinance requirements for SEPARATE PERMITS ARE REQUIREDFOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conforrijance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
/` IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
fi��lL SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner Date . WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION /CK. M.O. CASH