HomeMy WebLinkAboutBLD8530 Cabin - BLD Application - 9/29/1975 r �
BUILDING PERMIT APPLICATION,
MASON COUNTY
P. O. Box 400 Shelton, Washinqton 98584
DATE ISSUED
PERMIT NO.
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OWNER MAIL ADDR[83i� PHONE
1 , Z,)/ k s 7/Hade, �X e J, C4 r
DIRECTIONS /
TO 106 SITE 0
MAIL ADORES. j ZIP (XS[E ATTACHED SHEET)
P/C
7J
MAIL ADDRESS PHONE
CONTRACTOR l?T s' i3� 3 2 '/3/-em
_ � 3 22-�7� .
USE OF / MAIL ADDRESS PHONE LICENSE NO.
BUILDING 0 G/—le l-S 221 3 Yl/
Class of work: NEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑MOVE ❑ REMOVE
Describe work: I
Valuation of work:$ ��$. � PLAN CHECK FEE /0 PERMIT FEE g y
SPECIAL CONDITIONS: C V
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY
Type of Occupancy
Const. Group Division
ze of Bldg. No.of Max.
(Total)Sq. Ft.'J;"4 Stories Occ.Load
CONTRACTOR AFFIDAVIT Special Approvals Required Reaived of Required
I Certify that I am a currently registered contractor in the State
of Washington and the County of Mason and I am aware of the HEALTH DEFT. #�
ordinance requirements regulating the walk for which the permit s
is issued and all work done wi;l be in conformance therewith. ROAD 505-ir.
Firm �3C./ /h ! j?
By C 3/ 0 Y /h -f
Lic. No a 2 3"U/ / y;;7( Date Z �
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
Counly ordinance requirements for which this permit is issued —
and that all work done will be in conformance therewith. N 0 T I C E
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING. VENTILATING OR AIR CONDITIONING.
Owner Date 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.
)tAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. M.D. CASH
SHELTON PRINTING CO.