HomeMy WebLinkAboutBLD5539 Add Family Room - BLD Permit / Conditions - 7/12/1977 ` BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED
PERMIT NO.
Of
NA E MAIL ADDRESS CITY&STATE' IP >PHO E
OWNER5.fL, G-
DIRECTIONS /��
TO JOB SITE 2
LEGAL CLP CI + (❑ SEE ATTACHED SHEET)
DESCR.
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF / /<
BUILDING
Class of work: ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $
PLAN CHECK FEE PERMIT FEE l�
` � .
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS ECK BY APPRgVED FOR 1 U NCE Type of Occupancy Division
BY /v//� - Const. �_ Group A 3
.
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
ROAD DEPT.
By
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 SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be In conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
-5t'/.L SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner �We Date, WORK IS COMMENCED.
P A,CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. ASH"
McKinstry, E. #5539
7-12-77
NEB, SW4f 32-22-1, Lot 3
9
Add family room 16 x 20 and
extend deck
$4,300.00
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