HomeMy WebLinkAboutBLD9991 Deck - BLD Permit / Conditions - 8/23/1976 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED `
PER TNO. %9g�
OWNER NAME MAIL ADDRESS Cr TATE PHONE
DIRECTIO
TO JOB S TE
LEGAL (0 see ATTACHED SHEET)
DESCR. '10
CONTRACTORr
NAME MAIL ADDR)hS CITY 6 STATE LICENSE NO. PHONE
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: t
r�
f �r' � ! v
Valuation of work: $ PLAN CHECK FEE PERMIT FE
SPECIAL CONDITIONS:
s
APPLICATION ACCEPTED BYl PLANS CHECK BY rZDFORjSSUANCE Type of Occupancy Division
Const. Group
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 Rsosived Not Required
conformance therewith. ZONING
HEALTH DEPT.
Firm PUBLIC WORKS
By
ROAD DEPT.
Lic. No. Date
OWNERS AFFIDAVIT
I certify that 1 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 12D DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
flat IF Date. WORK IS COMMENCED.
AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION %ZKj. M.O. CASH