HomeMy WebLinkAboutBLD9946 Addition - BLD Permit / Conditions - 8/13/1976 ,Cw4, /sh.
MASON COUNTY
P.O. Box 186 Shelton, Washington 98'S84
DATE ISSUED 3 l7
PERMIT NO.
NAME MAIL ADDRESS CITY d STATE J ZIP PHONE
OWNER1129M/I / I )WAS-pi. l O Ef/—
DIRECTIONS
TO JOB SITEI LCT //Z
LEGAL (O SEE ATTACHED SHEET
DESCR. �I AIL * S 1' / L o r 112
CONTRACTOR NA1wE MAIL ADDRESS CITY fs ATE NO. PHONE
3 2 AcIf�tC: -do L 3 RB:P6
USE OF � A1W `
BUILDING m�� Q OI-I �1
Class of work: ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe GG
LV,Stc.
o,��.. �avNo��ra� a �>o. �faa� •
Valuation of work: $ PLAN CHECK FEE PERMIT FEEAe
- SPECIAL ONS:
Now POMMOMMM"
TIO I ACCEPTED BYJ PLANS bHEdt BYPM
F ANCE Typ.at Oawparxsy DMWM 107 Corm. /t�0 00 Group
own
Sin of Bldg. No. of Max.
(Total)Sq. Ft.6760 Storl" / Doc. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.O.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 Approval' Required Reoahad Not Required
onformance therewith. ZONING
HEALTH DEPT.
Fir PUBLIC WORKS
ROAD DEPT.
By
Lic. No �GL 7 M 7- Date j L
OWNERS AFFIDAVIT
1 certify that 1 am exempt from the requirements of the N O T I C E
contract or registration law NCW 18.27,and.am aware SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County Or�llawoe 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 WTMgN 120 DAYS, OR IF CONSTRUCTION OR WORK W
SUSPENDED OR ABANDONED FOR A PERKS OF 120 DAYS AT ANY TIME AFTER
Owner Date. WORK IS COMMENCED:
P CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. M.O. CASH
#9946
Walsh, Francis s-13-76
rimberiakes 1 Lot 112
Addition
$9,520.00
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