HomeMy WebLinkAboutBLD9521 Visual Final SFR - BLD Permit / Conditions - 6/24/1976 /
BultDING PERMIT APPLICATION " "
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED
PERMIT NO.
ZIP PHONE
NAME MAIL ADDRESS
CI'Tlf d STATE .., �.r
IONS
! SITE /� �� O —— (O SEE ATTACHED SHEET)
LICENSE NO. PHONE
e-7 DRESS CITY&STATE
NAME MAIL ADDR
'RACTOR " ` -- [L� le-
OF
_DING (,/� /� ���
as of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE [I REMOVE
ascribe work: l45/
/V� /f >1
PERMIT FEE rti
PLAN CHECK FEE gS ems' 2
Valuation of work: $ 119 ;01G<rvo�
SPECIAL CONDITIONS:
Occupancy Division
PLANS CHECK BY APPROVED FOP ISSUANCE Type of Group
APP ATION ACCEPTED BV BY i Const.
of Max.
Size of Bldg. No Stories 1 a Occ. Load /C
(Total)Sq. Ft. �;O CONTRACTOR AFFIDAVIT E.D.NUMBER
PERMANENT SEASONAL
.�
RESIDENCE
I certify that I am a currently registered contractor in MOBILE HOME
the State of Washington and I am aware of the Received
Required
ordinance requirements regulating the work for which Special APPrOvals Required
the permit is issued and all work done will be in ZONING ,5
conformance therewith. HEALTH DEPT.
c PUBLIC WORKS
Firm �� ROAD DEPT.
i
BY - /d -2
Lic. No.
,moo-� r� Date
OWNERS AFFIDAVIT N O T I C E
I certify that I am exempt from the requirements of the
contract or registration law RCW 18.27, and am aware SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
the Mason County N AUTHORIZE
ordinance requirements for VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTIO
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be in conformance therewith. IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 12o DAYS AT ANY TIME AFTER
Date, WORK IS COMMENCED.
Owner —
> RMIT VALIDATION CK. M.O. CASH
M.O. CASH
PLAN CHECK VALIDATION CK.
Gbsset, Robert #9521
6-24-76
Haven Lake Lots 101 & 102 of Wooten Lake Tracts
Vacation Home Contractor
Lumbermen's
$19,200.00
DUPLICATE CARD
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