HomeMy WebLinkAboutBLD9066 Addition - BLD Permit / Conditions - 4/1/1976 t ahan, M. J
#9066
4-1-76
Vineyard Cove, Lot 3, Block 3
Addition to ,residence
2-story with decks, bedroom
and living room
$4,500.00
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BUILDING OERMIT APPLICAI�16
MASOb COUNTY
P. O. Box f `elton, Washinqton 98584
DATE ISSUED
PERMIT N0.
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A/� _ �/ �/-- MAGI AD�D✓RESSp—_------ - ZiP L PNON[ y
OWNER i ! /. � �_�//�/yd�S�/ s�'�-�'Z r/L5
DIRECTIONS I � — �7
TO JOB SITE V/N��/�/� L,-- -0 1/,-- _�_T/�'•ET C� ��L/9it/% — —
MAIL ADDRESS ZIP
LEGAL n �/ � (CJa E AYrncNED SHEET)
DESCR. �0T— 1��/� 3 L'//�� �C _ cr�11�_ ��I(/�
'MAIL ADDRESS PHONE
CONTRACTOR �� Gci��� Q0 �34 Lome- � �'� 3 n
USE OF MAIL ADDRESS PHONE LICENSE NO.
BUILDING Class of of work: D NEW 2YKl')DIT10N C1 ALTERATION 'D REPAIR ❑MOVE D REMOVE
Describe work: � •
a ,e 512217--la.t/ ta 17/1 A�/Y ROEP1 'o6.--1 4
AZO
Valuat PLAN CHECK FEE
ti aAYat ^+,s
SP'TCIAL
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY
Type of Occupancy
Const. Group � Division
Size of Bitle. NO.of Max.
(Total)Sq.Ft..2 Stories 7% Occ.Load el
CONTRACTOR AFFIDAVIT Special Approvals Required Received Not Required
I Certify that I am a currently registered contractor in the State ZONING
Of Washington and the County of Mason and I am aware of the lICALTM DKPT.
ordinance requirements regulating the work for which the permit PUNLIC.WMRS
Is issued and all work done will be in conformance therewith. DrfsT,
Firm jjT
By -
Lic. �2';?3 of,
Date
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 N 0 T I C E
County ordinance requirements for which this permit is issued
and that all work done will be in conformance therewith. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING. VENTILATING OR AIR CONDITIONING.
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.
Owner Date
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
SHELTON PRINTING CO.
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