HomeMy WebLinkAboutBLD9747 Reroof - BLD Permit / Conditions - 4/11/1978 Fire District #11 #9747
Island Lake 4-11-78
Tr. of land N 660' NW 1/4 NE 1/4 12-20-4
Re-roof - Contractor
Vernon Morris
$1,800.00
BUILDING PERMIT APPLICATION
�j MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATEISSUED _
4 �. Oat PERMIT NO.
OWNER ,l- NAME t MAIL ADD ESS CI STATE ZIP PHONE
/' G . J
DIRECTIONS
TO JOB SITE 7 � ) /� J—�A
LEGAL 1-� �L ((❑ SEE IATTACHED SHEET)
DESCR.
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR _
USE OF �Y
BUILDING
Class of work: ❑ NEW DDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ / Z7 CG• PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSMSize
of Occupancy Division
BY st. Group
r0
of Bldg. No. o1 Max.
(Total) Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT — -
'-"^•'•' E-D.NUMBER
certify that I am a currently registered cor Circulation List
the State of Washington and I am awar
ordinance requirements regulating the work DEPARTMENT Date
the permit is issued and all work done i Date A —
conformance therewith. in out yeess n nood Remarks
Firm . �,��Gf�/,� /��C.�!.< < Planning
Health
Fire Marshal /y-
OWNERS AFFIDAVIT
Public Works
I certify that I am exempt from the requiren 2111C
contract or registration law RCW 18.27, an Building
of the Mason County ordinance requir
which this permit is issued and that all we
be in conformance therewith. Note: To be / -
circulated to following department within 7 days.
Owner Dat Notification of Approval
Disapproval' Date
PLAN CHECK VALIDATION CK. M.O. r � �—