HomeMy WebLinkAboutBLD2922 - BLD Application - 8/24/1978Y
OWNER
DIRECTIONS
TO JOB SITE
LEGAL
DESCR.i //-/9-J
,CONTRACTORi
USE OF
BUILDING
Class of work:
Describe work:
NAME
Valuation of work: $
P.O. Box 186 Shelton, Washington 98584
426%5593
MAIL ADDRESS
G4/
MAIL ADDRESS
CITY & scars
CITY R STATE
DATE ISSUED
NEW ADDITION ALTERATION REPAIR MOVE REMOVE'
PLAN CHECK FEE
NDITIONS:
I)F:CKS
"IUrA1. SO. FT.
BASEMENT
IREPLACE
CONTRACTOR AFFIDAVIT
OLIACHf i)
I CerlIty that I am a currently registered contractor ,""
!hu Washington and I arc aware of thu
ordnance requirements regulating the work `c„ writ':tl
the permit is issued and all work done will be ;n
non '±u mance1. thereay.th
Firm ...,.
By
Lin. No.
Date
OWNERS AFFIDAVIT
I certify that I am exempt Irom 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.
c 1
PLAN CHECK VALIDATION CK. M.O
Date _i?'
AT TAClIEO SHEET)
NO
PHONE
PHONE
OTICE
SEPARATE PERMITS API RE.Q;IFrcc;Lr FOP PLIIMBINC3. HEATING, VENTILATING
OR A=P OONL',^N::G
HfS PERMIT BECOMES NULL AND VOID ;F WORK OR CONSTRUCTION AUTHORIZED
IS NEa COMMENCED WMTH% +as DAYS, OP it CONSTRUCTION OR WORK IS
SUSPENDED T'rF% ABANDONE&& OR A PER OD or Tar DAYS AT ANY TIME AFTER
i rut fiat Air+
'ZONING
PLANNING DEPT
HEALTH DEPT.
Pl0OLIC WORKS
FIRE. MARSHAL.
U
Al
e'NE!)
'ROAD ACCESS
OR VEHICLE PERMIT
APPL ICA ,ON ACCEPTED BY PLANS C-NEC,K B
ROVED FOR lySV„:A
CASH PERMIT VA-l.IOA.TION GK. M,0